If you're considering dental treatment abroad, do your research and be aware of the potential risks.
There are no official statistics on the number of people travelling abroad for dental treatment. But a 2007 survey by the consumer association Which? found dentistry is one of the most popular types of planned treatment for UK residents.
Damien Walmsley, professor of restorative dentistry at the University of Birmingham and scientific adviser to the British Dental Association (BDA), believes most of the work carried out abroad is advanced treatments such as crowns, bridges, veneers and larger reconstructions involving implants.
His impression, based on talking to other dentists and patients who have been abroad, is that most people seem happy with the treatment they have received, but a few encounter problems. The main difficulties are with communication and aftercare.
Walmsley says he has seen cases where there has been an exceptionally hard sell from an agency in the UK or a practice abroad telling potential clients every aspect of the treatment will be problem-free.
"Prospective patients then take a leap into the unknown and risk not having their expectations met," says Walmsley. "The communication difficulties are not just because of the language difference – there are also cultural differences. You may not get all the information or reassurance that you would from your dentist at home."
Aftercare can also be a problem. "When people seek follow-up care in the UK, sometimes several years after the surgery was carried out, it can be very difficult for dentists over here to treat them if they don't have full documentation about the way procedures were carried out. For example, more than 50 different systems can be used for dental implants."
Unfinished treatment abroad
To illustrate the type of problems faced by people who have treatment abroad, Walmsley gives the example of a woman who was referred to him after having dental surgery abroad.
Sue* lost all her teeth at a young age because of various dental problems. By the time she was 50 she was fed up with wearing dentures and wanted fixed teeth or dental implants instead.
Having found out she wouldn't be eligible for the treatment she wanted on the NHS, Sue contacted a private specialist near her home. The cost of the treatment was too much, however.
She then searched on the internet and found an agency in London that arranged for her to go abroad for treatment. "She soon got on a flight, without any cooling-off time to think about her options," says Walmsley.
Shortly after she arrived, Sue had the operation under local anaesthetic. During the procedure to place implants in her lower jaw, she felt very uncomfortable but didn't know how to communicate this, as the dentist's spoken English was poor.
Then, for some reason, the surgeons were unable to proceed with the implants in her upper jaw. There was a heated discussion between them that she couldn't understand and made her feel uneasy.
Sue was meant to stay on for further treatment, but the next day she felt very sore. She hadn't been warned this might be the case and became anxious.
"Because of the communication problems, she no longer trusted the overseas practice and decided to return to Britain without completing the treatment," says Walmsley.
Back in the UK, Sue saw her local dentist, who referred her to Walmsley. "As far as I could see, although she was very uncomfortable, it was all healing up," he says.
"I don't think there was anything wrong with the way the procedure itself was carried out, but things were not properly explained to her before, during or after the operation. She hadn't been told about the discomfort she might experience and as a result she got scared and lost confidence."
In the end, Sue went to the private specialist she had initially contacted in this country to have the rest of the reconstructive work done.
*Sue's name has been changed
How to minimise the chance of a problem
Do your homework
Anybody travelling outside the UK for treatment needs to do some research. Check the qualifications of the dentist who will treat you and make sure he or she is properly registered.
For more advice on how to do your research if you're considering treatment overseas, see Risks of treatment abroad and Questions to ask the surgeon or dentist.
Have a consultation with a qualified dentist
The General Dental Council (GDC) says you should always be assessed by a qualified dentist before being given a treatment plan and cost estimate.
Speak to your own dentist
The GDC also advises people to speak to their own dentist as they may be able to offer advice based on your dental history. Your dentist will also need to be aware of your plans in case of any complications.
Think of your aftercare
Ensure you have proper documentation in English about your procedure in case you need follow-up treatment in the UK.
Don't underestimate the communication difficulties
Consider how you would deal with a potential language barrier. There may also be cultural differences.
You could find your expectations of how a doctor or dentist should communicate with a patient are not met. You may also feel more vulnerable in an environment that is unfamiliar, especially if you can't easily ask questions.