We've been talking again about dental tourism — specifically, how US dental insurance company Companion Dental is including an "international treatment option" in all its dental plans for patients who'd prefer to go to Costa Rica for lower-cost care.

So how big is this whole "dental tourism" business, anyway?

It's not really mainstream, but it is growing — and that's why we should all be keeping an eye on it.

Think tank Deloitte Center for Health Solutions predicts that about 648,000 patients will take medical and dental vacations overseas this year — 20% more than in 2008. (Read the article)

According to Deloitte, this 20% growth is actually a reduction in demand. (Deloitte once predicted medical tourism would double every year, reports one website.) As many as 750,000 American sought dental tourism in 2007. The recession seems to be to blame, with patients having less money to spend on discretionary treatment.

“Barring any tempering factors, such as supply constraints, resistance from health plans, increased domestic competition or government policies, we project that outbound medical tourism could reach upwards of 1.6 million patients by 2012,” said Paul Keckley, Ph.D. and executive director of Deloitte Center for Health Solutions.

In a 2008 article on dental tourism, The New York Times stated:

"Roughly half a million Americans sought medical care abroad in 2006, of which 40 percent were dental tourists, according to the National Coalition on Health Care, an alliance of more than 70 organizations. That’s up from an estimated 150,000 in 2004…"

So it would seem that about 200,000 Americans will take a dental vacation in 2009. That's nearly 1% of our adult population!

But there might be an upside… As the dollar slides, will foreigners start visiting the US for low-cost dental care? Maybe we'll be the ones offering discount dental implants, affordable sedation dentistry, and relatively cheap dentures…

Deloitte predicts that by 2017, up to 561,000 people from other countries will visit the US for dental and medical care.

Deloitte mentions a few other juicy tidbits:

• "West Virginia and Colorado have attempted to pass legislation that would either require or incentivize insurers to incorporate medical tourism within their health benefits plans. Although both bills did not pass, they demonstrate that state legislators are paying more attention to the value of medical tourism."

• "India’s medical tourism sector is expected to grow 30 percent annually from 2009 to 2015."

Make no mistake about it: Globalization will affect dentistry just as much as every other profession.

I've written before about the allure of dental tourism – the fact is, foreign dentists can have prices so low that even the most conservative dental patient can easily be tempted to leave the country. The risk, of course, is shoddy treatment.

Now one insurance company is offering UK residents "mishap insurance" should anything go wrong on their medical or dental vacation.

The managing director of the specialist travel insurer behind the Free Spirit Travel for Treatment program acknowledged, "It has taken me some time to persuade underwriters to do it. It looks pretty onerous." (AXA Insurance UK is underwriting it.)

"Free Spirit Travel for Treatment provides cover for complications occurring whilst abroad at least 48 hours and up to 31 days after treatment… It is available to UK nationals up to age 74."

Well, I can see why AXA wouldn't be eager to offer this sort of insurance, but the time limit should protect them reasonably well. It's emergency coverage only, really, and the policy says it doesn't cover any expenses incurred within patient's home country.

The long and short of it is — no one will truly insure you against the long-term risks of getting sub-par dental work in a foreign country.

The policy covers a variety of elective medical procedures, mostly cosmetic, including the following:

• Belly button surgery
• Calf implant
• Laser hair removal
• Liposuction
• Semi-permanent make-up
• Fertility treatment

In terms of dentistry, here's what the policy will cover:

• Cosmetic Dentistry
• Dental Bonding
• Dental Bridges
• Dental contouring
• Dental Crowns
• Dental Implants
• Dental laminates
• Dental recontouring
• Dental reshaping
• Dental slenderizing
• Dental stripping
• Dental Veneers
• Enameloplasty
• Gum lifts
• Invisalign®
• Odontoplasty
• Orthodontics
• Teeth Whitening

On a related note: our most recent survey asked dentists about their fee for a dental implant and crown. I thought it was a typo when one oral surgeon said he charges $500 for the dental implant and $500 for the crown, but no – just another example of low foreign prices. "I'm working in India, and hence even these charges are high for round here!" he explained.

Just a thought… at the rate the dollar is losing value against foreign currencies, I imagine the Brits and even third world patients in need will be coming to the US in droves for low-cost dental care by the end of 2010.

Visit the Free Spirit Travel for Treatment website