Dental tourism: is treatment abroad really cheaper?

Dental treatment abroad is usually cheaper on the quote and less often cheaper in total. Clinics in popular destinations advertise implants, crowns and veneers at half or less of the home fee, and for a large plan such as a full arch the saving can survive the cost of getting there. For one crown or a couple of veneers it generally does not, and for anything that needs healing time between stages, the trip itself creates the risk that eats the saving. The honest comparison is the foreign quote plus everything around it against the home range for the same item, which for a single implant with crown is $4,500–6,500 in Australia, $4,500–7,500 in New Zealand, £1,900–3,500 in the UK, $3,000–6,000 in the US and $3,500–6,000 in Canada.

How much cheaper the headline prices are

Fees follow local wages, rent, regulation and laboratory costs, not the brand of implant or the grade of porcelain. Quotes from clinics in Southeast Asia, Turkey, Eastern Europe and Mexico commonly sit 40% to 70% below the home midpoint for implants, crowns, veneers and full-arch work.

The home ranges the quote has to beat, in local currency, are:

For a porcelain veneer the home range is $1,200–2,500 in Australia, £610–1,170 in the UK and $1,160–2,380 in the US per tooth; for a crown, $1,200–2,100, £480–1,150 and $800–2,500; and for a full arch on four to six implants, $20,000–35,000, £10,770–19,620 and $15,000–35,000 per arch. The Dental implant cost calculator and Veneers cost calculator give the figure for your own country and let you add the extras a real quote includes.

What is not in the price

A foreign quote is the fee for the dentistry. Everything else is yours to add.

• Travel. Return flights for you and, if you are being sedated, a companion. Long-haul flights immediately after surgery are uncomfortable and add a small clotting risk that Smartraveller and dental bodies both warn about.
• Accommodation and living costs for the stay, and for a second stay if the treatment needs one.
• Time off work. One to two weeks per visit, usually unpaid or taken from leave.
• Insurance. Ordinary travel insurance excludes planned procedures and their complications. A specialist medical-travel policy is a separate premium.
• Follow-up at home. Reviews, adjustments, X-rays and hygiene visits, which the home clinic would normally include in the fee and a clinic abroad cannot provide.
• Remedial work. In the British Dental Association's survey of a thousand UK dentists, 86% had treated complications from treatment abroad, crowns (87%) and implants (85%) were the items most likely to need remedial work, and more than half of dentists said the repair cost the patient over £1,000. Not every trip goes wrong, but a contingency belongs in the sum.
• Recourse. If the work fails, you are dealing with a clinic in another jurisdiction. The GDC in the UK, the ADA in Australia and their counterparts elsewhere regulate only their own registrants; complaints procedures, indemnity insurance and consumer protection at home do not reach abroad. A guarantee is only worth what it costs you to fly back and claim it.

Insurance at home will not help either. Extras, PPO and employer plans pay for treatment by registered providers in your own country, and no public scheme in the five countries funds elective treatment abroad.

Treatments that travel badly

Implants. A conventional implant is placed, left to integrate with the bone for three to six months, then uncovered and restored. That is two trips at minimum, and the integration period is when problems show. Clinics that load a crown on the day compress the timeline to make a single trip possible, which is a clinical compromise made for the traveller's convenience. If a fixture fails, the dentist at home may not stock that brand's components and may recommend removal and replacement at full fee.

Full-arch (All-on-4) treatment. It is the case where the headline saving is largest, at $20,000–35,000 per arch in Australia and $15,000–35,000 in the US, and also the case with the most stages: extractions, placement, a provisional bridge, healing, and a final bridge months later. Doing it across two or three trips, with no one at home responsible for the interim, is where the ADA's warning about treatment that is affordable to have but not to maintain applies most.

Orthodontics. Braces and aligners need reviews every six to ten weeks for a year or more. They cannot be done abroad unless you live there. Remote-monitored aligners are a different product and are not dental tourism.

Root canal treatment and gum surgery. Both need review, and both fail slowly.

Treatments that travel better

A single crown on a tooth already prepared or already root-filled. One visit for preparation and impressions, a few days for the laboratory, one visit to fit. The bite can be checked before you leave. The caveat is that a crown's life depends on the fit at the margin, which you cannot see and which your home dentist will only assess on an X-ray later.

Veneers, with caveats. A few veneers on healthy front teeth are a short course, and this is the most advertised package. The concerns are the number of teeth (ten or twenty units done in a week is a full-mouth reconstruction, not a cosmetic touch-up), how much tooth is removed (some packages are in fact crowns, which is irreversible), and the lack of a trial period to check the shape and the bite. Ask for a mock-up in temporary material first and for the material and preparation depth in writing.

Even for these, the sum works better the more units there are. One crown abroad rarely beats £480–1,150 in the UK or $1,000–1,700 in Canada once the flight is added; eight crowns might.

How to compare properly

1. Get a written home quote that names every component (for an implant: fixture, abutment, crown, scan, any graft) and includes the reviews.
2. Get the foreign quote in the same form, in your currency, with the brand of implant or the material of the veneer stated, and ask what is charged if a second trip is needed.
3. Add flights, accommodation, insurance, time off and a contingency of at least the cost of one unit of remedial work to the foreign figure.
4. Put both totals into the Dental treatment comparison calculator with an honest expected life for each. Work that fails at year five costs far more per year than work that lasts fifteen.

If the foreign total is still well under the low end of your home range, the saving is real. If it is inside the range, you are paying for the risk with nothing in return, and a second home quote is the better use of the airfare.

Questions to ask before you book

The GDC's patient guidance and the ADA's policy statement between them suggest these, and a clinic that will not answer in writing has answered.

• Who will do the treatment, what are their qualifications, and which body regulates them?
• What brand and grade of implant or material will be used, and will you give me the lot numbers and a full set of records, X-rays and scans to take home?
• What is the complete price, what happens if a second trip is needed, and who pays for it?
• What aftercare do you provide, how do I reach the clinician after I leave, and what is the guarantee worth if I cannot return?
• Will you take a full medical history and consult my home dentist before treatment?
• What is your complaints process, and is the clinic indemnified for adverse outcomes?

Speak to your own dentist first. They may decline to provide aftercare for work they did not plan, and knowing that before you fly changes the sum.

What to do next

1. Get a written, itemised home quote and compare it with the range for your country in the Dental implant cost calculator or Veneers cost calculator; a quote far above the range needs a second opinion, not a plane ticket.
2. Build the full foreign figure, with travel, insurance, time off and a remedial contingency, and run both totals through the Dental treatment comparison calculator.
3. If the saving still holds, get the answers to the questions above in writing, and agree with your home dentist what aftercare they will provide.