Dental tourism (also called dental vacations or commonly known as dental holidays in Europe) is a subset of the sector known as medical tourism. It involves individuals seeking dental care outside of their local healthcare systems and may be accompanied by a vacation. Dental tourism is growing worldwide: as the world becomes ever more interdependent and competitive, technique, material, and technological advances spread rapidly, enabling providers in "developing countries" to provide dental care at significant cost savings when compared with their peers in the developed world.
Reasons for travel
While dental tourists may travel for a variety of reasons, their choices are usually driven by price considerations. Wide variations in the economics of countries with shared borders have been the historical mainstay of the sector. Examples include travel from Austria to Hungary, Slovakia, Slovenia and Romania, from the US and Canada to Mexico, Costa Rica, Ecuador and Peru, from the Republic of Ireland to Northern Ireland, Hungary, Poland, Turkey and Ukraine, and from Australia to Thailand and other countries of South-East Asia. While medical tourism is often generalized to travel from high-income countries to low-cost developing economies, other factors can influence a decision to travel, including differences between the funding of public healthcare or general access to healthcare.
Mobility of labour
For countries within the European Union, dental qualifications are required to reach a minimum approved by each country’s government. Thus a dentist qualified in one country can apply to any other EU country to practice in that country, allowing for greater mobility of labour for dentists (Directives typically apply not only to the EU but to the wider designation of the European Economic Area - EEA). The Association for Dental Education in Europe (ADEE) has standardization efforts to harmonize European standards. Proposals from the ADEE's Quality Assurance and Benchmarking taskforce cover the introduction of accreditation procedures for EU dentistry universities as well as programmes to facilitate dental students completing part of their education in foreign dentistry schools. Standardization of qualification in a region reciprocally removes one of the perceptual barriers for the development of patient mobility within that region.
Pricing and quality
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Dental tourists travel chiefly to take advantage of lower prices. Reasons for lower prices are many: dentists outside the "developed world" are able to take advantage of much lower fixed costs, lower labor costs, less government intervention, lower education fees and expenses, and lower insurance costs. Much of the bureaucratic red-tape that engulfs businesses in the developed world is eliminated abroad, and dentists are free to focus on their trade, dentistry. The flip-side of this is less legal recourse for patients when something goes wrong, but the result is that procedures, such as dental implants and porcelain veneers, which are simply financially out of reach for many people in the developed world, are made affordable overseas.
Much of the debate about dental tourism and medical tourism in general centers on the question of whether or not price differentials imply quality differentials. Another concern is whether or not large scale dental procedures can be safely completed abroad in a relatively short, "holiday-sized" time period. Another issue affecting this debate is the lack of an independent inspections committee for dental similar to the Joint Commission International for medical.
An instructive case study an analysis of patient outflows from the United Kingdom and Ireland, two large sources of dental tourists. Both countries were the subject of a report from the Irish Competition Authority to determine whether consumers were receiving value for money from their dentists. Both countries’ professions were criticised for a lack of pricing transparency. A response to this is that dentistry is unsuitable for transparent pricing: each treatment will vary, an accurate quote is impossible until an examination has occurred. Thus price lists are no guarantee of final costs. Though they may encourage a level of competition between dentists, this will only happen in a competitive environment where supply and demand are closely matched.
The 2007 Competition Authority report in the Irish Republic criticised the profession on its approach to increasing numbers of dentists and the training of dental specialties – orthodontics was a particular area for concern with training being irregular and limited in number of places. Supply is further limited as new dental specialties develop and dentists react to consumer demand for new dental products, further diluting the pool of dentists available for any given procedure.
Aside from the above issues, it is possible to compare the prices of treatment in different countries. With the international nature of some products and brands it is possible to make a valid comparison. For instance, the same porcelain veneer made in a lab in Sweden can be as much as 2500 AUD in Australia, but only 1200 AUD in India. The price difference here is not explainable by reference to the material cost.
Clearly, undergoing extensive dental procedures abroad, even when allowing for travel expenses, can be significantly cheaper than the same procedures at home. Pricing and qualifications of the dentists may be researched through websites or by contacting the dentists.
Another important consideration is location: if one travels far for a dental procedure and something goes wrong, it is a long way to return to fix it as well.
Many Americans choose to go somewhere relatively accessible from the US, such as San Salvador, Tijuana, Los Algodones, Tecate, Agua Prieta or Lima. Due to the ongoing narco-violence in towns such as Tijuana and Ciudad Juarez, clinics in safer towns 1,000 miles south of the border - Cabo San Lucas, San Jose del Cabo, Puerto Vallarta, Cancun, Playa del Carmen and Cozumel Mazatlan etc. have recently started offering large and small dental treatments. (See info below.) More than 70 percent of Mexico’s US patients travel from the border states of California, Texas, or Arizona
Since procedures often require multiple steps, or subsequent checkups, the patient may have to return to the same doctor for those reasons. Typically, a patient takes two trips to have implants. The first trip is to set the base and the provisional crown. The second trip is typically 4–6 months later after the implant has stabilized in the bone. One Day Implants are not recommended for dental tourists due to the higher failure rate of the system.
When combined with a holiday, as the name implies, dental tourism can be an opportunity to receive low-cost, quality dental care. Dental tourism is expected to continue growing, as consumers continue to seek out lower-cost options.
- http://www.deloitte.com/assets/Dcom-unitedStates/Local%20Assets/Documents/us_chs_MedicalTourismStudy%283%29.pdf[dead link]
- "Cross-border care in the south: Slovenia, Macedonia, Austria and Italy" WHO Report on patient mobility (retrieved 19 October 2007)
- "Catherine McNerney and Desmond Gillmor" Experiences and perceptions of rural women in the Republic of Ireland: studies in the Border Region (retrieved 19 October 2007)
- EC Dental Directives (78/686 and 78/687 EEC) (retrieved October 19, 2007)
- "EU Manual of Dental Practice" Includes comparative study of member countries dental systems: 3rd edition currently in preparation (retrieved 19 October 2007)
- ADEE Taskfore document on quality assurance and benchmarking (retrieved October 25, 2007)
- Irish Competition Authority Report (retrieved 19 October 2007)
- "More Fun Than Root Canals? It’s the Dental Vacation", New York Times, 2008-02-07
- Patients Beyond Borders