The Times, 20 March 2006

Have teeth, will travel
Stefanie Marsh

There's a boom in tooth tourism as Britons seek cheaper dental care

James Goolnik is the kind of class-act dentist who inspires beauty editors to produce fervent copy about Hollywood smiles and turning back the clock. The girls at Harper’s, Tatler, even one style editor from the The Times, have fallen for Goolnik’s pioneering work as a whitener of smiles and fixer of snaggled teeth. His work may be cosmetic, but not, as once may have been the case, deemed inessential. Bad teeth, as anyone who became hooked on the Channel 4 series Ten Years Younger will know, give away your age twice as quickly as your wrinkly hands or thread veins. And that, as far as a growing minority is concerned, is unacceptable.
To have your teeth whitened at Goolnik’s City clinic costs £350 but £499 if you want them done in 45 minutes. That’s not including the initial consultation — “comprehensive new patient examination” in Goolnik’s phraseology — which costs £80. More serious work, such as a root canal, costs from £350. If you need a veneer, Goolnik is one of the best and his technicians will mix up an undetectable fake. A single veneer will set you back £850, the cost of a holiday for two in Kenya.

You could break the bank, but then again you could go to Budapest and have your veneer done for £150. Increasing numbers of people do, judging by the websites that are springing up catering to “dental tourism”. It isn’t that dentists such as Goolnik are ripping anyone off. His fees are about average for a top dentist and not so much higher than what you’d pay for something more run-of-the-mill. If you’re lucky enough to find an NHS dentist (and only 44 per cent of the population has) you’ll be sharing him with an average of 2,275 other patients. Anything remotely cosmetic you’ll have to pay for yourself. Big jobs, such as implants, are rarely available on the NHS and your private UK dentist will charge between £1,500 and £2,000 for the work. In Turkey an implant costs £566 and the consultation is free.

Ian Domville, a former dentist, now sends about 90 British and Irish patients a month to his dental practice, Kreativ Dental, in Budapest. People travel for all sorts of treatment but crowns, implant and bridge work are particularly popular because of the financial savings. And there’s the lure of spending a weekend in a beautiful city. As privatehealth.co.uk, a prominent internet site for medical tourism, soothingly puts it: “You can combine a relaxing break with a visit to one of the overseas cosmetic dentistry clinics which are now attracting patients from the UK. Popular destinations include France, Spain, Italy, Croatia, Cyprus, Greece, Hungary and Turkey.” India and Poland are soon to join the list.

Without budget airlines, medical treatment abroad would be unthinkable. But now SkyEurope flies from Stansted to Budapest from £17 each way, and Easyjet operates from Luton, Gatwick, Bristol and Newcastle to Budapest. Medical tourism is hardly new — the Germans and Austrians have been doing it for years to save money. In Austria going to Hungary for dentistry is so common that an estimated one in three seeks treatment there.

Domville says that in the past eight months he’s noticed an increase in the number of people seeking treatment abroad, and the number of providers. “Most people can’t get what they want — crowns, bridges, implants — on the NHS and so they go to a private dentist in the UK,” he says. “Then they almost drop out of the chair when told the price, go home, get on the internet and find me.” Indeed, type “dentist abroad” into Google and Kreativ Dental is there, top of the list, just above vitaleurope.co.uk and dentalpoland.com.

Despite the surge in demand, Domville says it is his mission to attract the “swing voters”, those who are unwilling to pay UK prices and yet feel anxious about receiving treatment abroad: either because they worry about standards of hygiene and treatment in countries they have never visited, or because they are intimidated by the language barrier. Domville can reassure all potential patients that all his dentists have a firm grasp of English and claims that the standards of treatment are as good as, if not better, than in Britain. “Why else would the NHS be recruiting all its doctors from the former East European states?” he asks.

Research published by Bath University in 2004 shows that on average the NHS has fewer than four dentists for every 10,000 people. This compares with five per 10,000 in Austria, Italy and Poland and six per 10,000 in the US. Compare these figures with Sopron, a small town in Hungary; the self-styled dental capital of the world has one dental practitioner per 80 inhabitants.Many patients also complain that the equipment NHS dentists use is not state-of-the-art (they have to pay for it themselves).

Next month the Government’s radical dentistry reforms come into effect: many dentists are sceptical about the changes, and predict that more will leave the NHS. So desperate is the need for dentists in parts of the UK that talent is bought in from overseas. Last month in Scotland, where the lack of dentists is acute, officials filled the gap with staff from Poland. A local paper reported: “The reception at the Scottish Parliament saw each dentist welcomed by the Deputy Health Minister. They were given a bag of goodies, including a woolly hat, a Saltire badge and a Scotland-branded pen.” There are 117 Polish dentists now working in the NHS.

“Which proves,” says Michael Sommers, chairman of The Patients Association, “that standards abroad are very high in most cases and it’s much less expensive. No wonder people are choosing to go abroad.”

Take crowns: if your UK dentist says that you need 12 crowns or units of bridgework at £450 a unit, that's a total of £5,400. At Kreativ Dental in Budapest the cost would be £2,400, plus 10 per cent to cover any extras (total £2,640), a saving of more than £2,700 — more than enough to cover the cost of your budget flights and accommodation (the recommended hotel in Budapest costs £28 a night).

Sommers says that large swaths of the population are forced to go without regular examinations, “which is dangerous as well as bad for your teeth and gums”, he says, because of the risk that oral cancers are not picked up. In many cases it’s not that people look to places such as Hungary because they want to save some pocket money, but because there is no alternative.

But Sommers worries about the lack of follow up and advises consumers to select an overseas dentist carefully — and to make sure that any problems are covered with a guarantee. “What happens if you see a dentist abroad and you need a course of treatment, or a follow-up X-ray?” To counter such fears, Domville says that his company will fly anyone back to Budapest and put them up for free if there are any resulting problems.

Keith Pollard, who runs treatmentabroad.net (a website that boasts that it is “helping you make the right choice” but is just a site on which doctors can advertise their services), believes that the quality abroad matches UK standards — at “ a third of the price”.

Does Pollard believe the standards of dentistry in Turkey, Hungary, Poland, Cyprus and Greece are exactly the same as those at a private dentist in the UK? “I can’t answer that,” he says. “We're like the Yellow Pages. If you found a plumber in the Yellow Pages and something went wrong you'd take it up with the plumber, not the directory.”

Or as the British Dental Association puts it: “Anyone thinking about dental treatment overseas must make sure that they are aware of the potential risks and the hidden costs. Difficulties may arise if there are problems with treatment when the patient returns home.”

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