Dental treatment abroad

Degenerate

I had extensive work done 2 years ago at Vital Europe in Budapest, and I cannot recommend them highly enough. The experience was far superior to any of my previous, UK-based dentists. Now the last remaining bit of British dental work has failed (a bodged root canal), so I shall be returning to them in November for another implant.

Toothsmith and co, I bet I have an answer for all your warnings, give me your best shot.

welshdent

Degenerate wrote: »

I had extensive work done 2 years ago at Vital Europe in Budapest, and I cannot recommend them highly enough. The experience was far superior to any of my previous, UK-based dentists. Now the last remaining bit of British dental work has failed (a bodged root canal), so I shall be returning to them in November for another implant.

Toothsmith and co, I bet I have an answer for all your warnings, give me your best shot.

You make it sound like a challenge?

All any of us here try to do is make people aware of the pitfalls and risks of seeking treatment abroad. We have nothing to gain from it. None of us here advertise our services. None of us posts with our own names. What we have that you do not is knowledge of what constitutes good and bad dentistry. With all due respect you probably do not have that knowledge.

What do you think makes for a good root filling for example?

Do you look at the comfort in which you were treated? Do you look at the chair side manner of the treating dentist? Do you look at lack of pain as a definitive indicator?

Me personally I am looking at a) was a rubber dam used b) wasa microscope used c) was sodium hypochlorite used d) did they activate it? e) did they remove the smear layer? f) what did they use to remove the smear layer. g) was the diagnosis correct? h) was the appropriate treatment plan given? Just because it CAN be done doesnt mean it SHOULD be done. i) what was used to determine the working length j) did they have good apical control k) did they perforate the tooth l) is the obturation to length and well condensed m) what was the access closed with o) what are the suggestions for a coronal restoration? Are they planning amalgam, composite or a lab made restoration covering the occlusal surface, what material are they using? p) in the event of a failure .. or indeed bodge ... why did it fail? Was it to do with a failure in the procedure carried out relating to the questions above or was it to do with a root fracture, coronal leakage around a filling, recurrent caries leading to bacterial ingress under the well placed crown (if indeed it was well placed), was it to do with a resistant strain of bacteria? Was it because your own immune system was not capable of meeting the challenge of the remaining (and there will always be remaining) bugs? Havew you seen how complex the anatomy of a root canal system is? I mean its impossible to fully clean every part out. Was it carried out on a tooth with irreversible pulpitis or a chronic apical abscess? Because one will have a better prognosis than the other no matter how well you do the work. Ultimately ALL work will fail unless you do first. What constitutes a bodge?

I could go on and on and on for many different treatment modalities. With the best will in the world it is unlikely you would be able to know the complete answer to most of those questions ... and even if you did would you be able to interpret the information? Probably not.

SO you see, we try and help out as much as we can by providing un biased information to people that to all intents and purposes are going in blind to a mine field. Answer away

Degenerate

welshdent wrote: »

You make it sound like a challenge?

Kinda. I've been reading the scare-mongering from British dentists here and felt like taking it on.

All any of us here try to do is make people aware of the pitfalls and risks of seeking treatment abroad. We have nothing to gain from it. None of us here advertise our services. None of us posts with our own names. What we have that you do not is knowledge of what constitutes good and bad dentistry. With all due respect you probably do not have that knowledge.

Indeed, obviously like most patients I'm not in a position to directly analyse the technical standards of a dentist's work. Can you explain how this would be any different for a British dentist?

What constitutes a bodge?

Now this bit's easy:

...Treating an entire quadrant of the mouth with multiple fillings and RCT on a molar in one 45 minute session...

...Because you are in such a rush, trying to get as far as possible down the curved canals of the molar using a rasp bit on your drill rather than manual files, pushing your luck and breaking the tip off in one of the canals...

...Chuckling, shrugging your shoulders and telling the patient "it should be the perfect seal" to placate them...

If the two root canals this monkey did hadn't been my first, I would have had a better idea of how long a proper job should take and realized just how many corners he was cutting.

I could go on and on and on for many different treatment modalities. With the best will in the world it is unlikely you would be able to know the complete answer to most of those questions ... and even if you did would you be able to interpret the information? Probably not.

You can try to blind me with science all you want, it says nothing about the relative merits of dental treatment in different countries.

SO you see, we try and help out as much as we can by providing un biased information

...Unbiased... :rotfl:

Toothsmith

Degenerate wrote: »

I had extensive work done 2 years ago at Vital Europe in Budapest, and I cannot recommend them highly enough. The experience was far superior to any of my previous, UK-based dentists. Now the last remaining bit of British dental work has failed (a bodged root canal), so I shall be returning to them in November for another implant.

Toothsmith and co, I bet I have an answer for all your warnings, give me your best shot.

What do you differently now in your own day to day care of your new mouth?

How often do you intend to get this complex engineering checked out, and by whom?

My objection to people going abroad is nothing to do with relative skll levels of operators - there are a spectrum of abilities in all countries.

My objection is in the way 'quick fix' dentistry is sold in any country - be in dental holidays, or even programs like '10 Years Younger'.

If you have been well educated in how to look after your new dental bling, and have a place to go where it can be well maintained and checked regularly, and the dentist doing it was good - then you and it should be very happy for a very long time.

If you feel that this work was a 'fit and forget' item that you can now simply ignore and get on with your life just like you did before, then two years is way to short a timespan to be crowing about how wonderful it all is.

Come back in another 5-10 years and tell us how wonderful it is to be on a liquid diet because the implants have failed and there's no jawbone left to do anything else with.

Paul-B_4

Wow, a lot to take in.

Firstly, I am not looking for a "quick fix", but I am looking for somewhere where I can get the treatment I need at a price I can afford. My generation is used to being treated by NHS dentists/dental surgeons/orthodontists (whatever the current terminology is) funded by the NHS and since all that seems to have gone by the board, with what I can only perceive to be greedy dentists jumping off the NHS onto the private patient bandwagon and charging huge sums of money for something which used to be provided under a state "subsidy", for which we all paid out of our taxation, I am exploring the alternatives. A few years ago I read about treatment in the Indian subcontinent by dentists who have been trained to the same level as UK registered dentists, many of them studying in the UK, so I can't really see how such people are likely to give me any different service to the equivalent dentists who trained in and now work in the UK.

It may well be that all the horror stories quoted here are indeed a true reflection of dentistry outwith the UK, but equally I have heard, and seen reported, some equally horrific stories of treatment given to people back here in the UK. If good treatment initially is available abroad at a reasonable price I would have thought that getting the initial treatment, which is going to be probably the biggest expenditure lump sum, and then transferring the follow-on treatment to a local dentist might well be the most cost-effective way to go.

There's a lot to be thinking about and a whole lot of research to be done, which was why I posed the question on this forum. I don't know why my teeth are so weak, ever since I was a lad I've brushed rehularly twice a day and I've never smoked, but that's the way it's been. I had a lot of work done in the UK back in 1984 prior to going to work in Saudi Arabia, but it doesn't seem to have changed very much, and I honstly cannot afford to spend upwards of £12,000 here for something I may be able to get at a much lower cost abroad.

Degenerate

Toothsmith wrote: »

What do you differently now in your own day to day care of your new mouth?

Without going into the minutiae of my daily care regime, a massive change in diet is the biggest thing in my particular case. Actually, I find it highly patronizing the way you guys bring up the maintenance issue as if people are so stupid as to think nothing needs to change.

How often do you intend to get this complex engineering checked out, and by whom?

At least six monthly, by the guy who fitted it, or if for some reason he is unavailable, one of his colleagues.

Come back in another 5-10 years and tell us how wonderful it is to be on a liquid diet because the implants have failed and there's no jawbone left to do anything else with.

More scaremongering.

brook2jack

Please be aware that no British dentist will take on the maintainance of eg implants placed abroad .

This is because once they take on responsibility for care of the implants , if something goes wrong with the implant the British dentist becomes partially liable and when push comes to shove a lawyer is going to find it much easier to pursue a British dentist, in British courts with British indemnity than trying to recover money in a foreign legal system.

I would advise no one in any country to travel abroad for complex dental treatment.I have seen excellent work by excellent dentists fail or cause problems, due to no ones fault,and it is hard to see how easy it would be to sort out these unforeseen problems quickly when extensive travel is necessary.

What you should prize is dental care not dental treatment.... i.e.look at how you are going to look after your dental health for the years to come. From your brief description I would say your most important treatment will not be from the dentist but from the hygienist to tackle your gum disease ,cleaning and decay problems. This is unglamourous, time consuming work that should take place over weeks or months and should be done before you even think of restoring the rest of your mouth to give the chance of work lasting for years.

I have some patients who insist on travelling great distances to see me. I always try to encourage them to see a dentist close to home , since if they have an emergency the last thing they want to do is travel hours in the car to get emergency treatment.

The best dental treatment you will ever get is with a dentist you trust and with whom you can build up a longterm relationship so they know you and your mouth. The worst is all in one treatment treating many years of problems in a short space of time without looking and treating what caused the problems in the first place.

If you speak the language, spend a regular amount of time abroad so you continue with regular maintainance and use the dentist for your regular care you can get really excellent treatment .The problem is if you haven't recieved good treatment you probably won't know straight away and if you don't recieve regular care it may not be picked up until too late. Only this week I've seen a patient who has had an implant in this country who is delighted with it. Xrays revealed it is failing, so I've emailed the dentist who placed it who is getting the patient in to see what can be done. If this patient had not kept regular check ups the first he would have known was in a couple of years time when the implant became loose or fell out.

brook2jack

Degenerate wrote: »

Without going into the minutiae of my daily care regime, a massive change in diet is the biggest thing in my particular case. Actually, I find it highly patronizing the way you guys bring up the maintenance issue as if people are so stupid as to think nothing needs to change.


At least six monthly, by the guy who fitted it, or if for some reason he is unavailable, one of his colleagues.


More scaremongering.

As Welshdent has said none of us use our real names and as far as I know neither toothsmith,welshdent nor myself do implants. Indeed welshdent is a purely NHS dentist. So we have no direct interest in this thread except all of us have seen real people who have had ill advised major dental work and spent alot of money only to have it fail catastrophically. They are then left in the position where they cannot afford to go back to get it sorted and they cannot afford to get it properly sorted out in this country.

Many people read this forum and many people do not realise that crowns,implants etc are not a fit and forget item and need even more meticulous care than their own teeth. They may not factor in the costs of regular maintainance and hygienists visits into their costs.They may not realise that implant "guarantees" are only applicable if you return to the original dentist for 3 or 6 monthly checks and maintainance.

In this last year I've seen people who've had extensive implant work in India costing £12,000 fail and need extracting within 2 months , with the result they have so little bone it will be difficult to stabilise their full dentures. I've seen people who have had extensive treatment in Hungary ,Poland and Turkey and are delighted with it devasted and disbelieving when Xrays reveal a whole host of problems that will cause failure soon.

I've also seen migrant workers who go home regularly and invest in good quality dental care in their own countries taking up what must be a significant proportion of their income and making what they consider to be an investment in quality care. They have some of the best dentistry I have seen.

It is difficult for some people to believe that dentists can show any compassion for folks without having a direct financial interest, but having seen the very real distress caused by ill thought out treatment first hand I'm sure all of us who post on here would be grateful if even one person was spared the pain etc by reading these threads.

Degenerate

brook2jack wrote: »

Please be aware that no British dentist will take on the maintainance of eg implants placed abroad .

This is because once they take on responsibility for care of the implants , if something goes wrong with the implant the British dentist becomes partially liable and when push comes to shove a lawyer is going to find it much easier to pursue a British dentist, in British courts with British indemnity than trying to recover money in a foreign legal system.

So what if the Hungarian dentist in question also operates in the UK?

I would advise no one in any country to travel abroad for complex dental treatment.I have seen excellent work by excellent dentists fail or cause problems, due to no ones fault,and it is hard to see how easy it would be to sort out these unforeseen problems quickly when extensive travel is necessary.

So what if extensive travel isn't necessary for aftercare?

I have some patients who insist on travelling great distances to see me. I always try to encourage them to see a dentist close to home , since if they have an emergency the last thing they want to do is travel hours in the car to get emergency treatment.

Having had a couple of experiences of trying to get emergency treatment from local dentists, I could have flown to Hungary to get treatment quicker. (although this would not be necessary with my Hungarian dentist anyway.)

The best dental treatment you will ever get is with a dentist you trust and with whom you can build up a longterm relationship so they know you and your mouth.

I would agree with that. Where you are mistaken is in thinking this is not possible with Hungarian dentists.

If you speak the language,

Why would you need to speak the local language, when everyone at the clinic speaks excellent English?

spend a regular amount of time abroad so you continue with regular maintainance and use the dentist for your regular care you can get really excellent treatment.

Why would you need to go abroad regularly, when the clinic in question fly their dentists over here on a regular rota to do consultations and aftercare?

Toothsmith

Degenerate wrote: »

Without going into the minutiae of my daily care regime, a massive change in diet is the biggest thing in my particular case. Actually, I find it highly patronizing the way you guys bring up the maintenance issue as if people are so stupid as to think nothing needs to change.


At least six monthly, by the guy who fitted it, or if for some reason he is unavailable, one of his colleagues.

If that's the case, you'll be fine, and so the last warning wouldn't apply to you anyway.

But it's by no means typical of the sort of patient who goes for dental tourism.