The Truth About Dental Tourism

The Truth About Dental TourismDental tourism has become a common practice among many Americans as a way to save money on dental treatments.

Statistics on this trend are hard to come by, but it is estimated that each year over one million people from around the world travel outside their country for some form of dental treatment, with summer being the busiest season for dental tourism.

The highest number of dental tourists is believed to come from the U.S., while Europeans are the second largest group to travel abroad for cheap dental treatments.

There are around 600 – 800 private clinics for surgical medical tourism, of which 80% offer dentistry services.

In recent years, medical travel companies all over the U.S. have sprung up to guide Americans through the dental insurance and logistical hurdles of treatments at medical facilities abroad in places like Mexico. One popular destination for Americans to receive dental treatment is in the Mexicali area, where the dental hub of Los Algodones is located.

Mexicali’s city tourism director, Omar Dipp even meets traveling medical tourists in the lobbies of their hotels.

Dipp recently told the online publication Fontieras that Mexicali received $16 million from medical tourism in 2010. His office is trying to boost that number by 50%.

The top 4 dental treatments patients travel for are –

1. Dental implants.
2. Crowns and bridges.
3. Root canal procedures.
4. Smile makeovers.

Some experts feel the rise in this trend is due to lack of dental insurance among patients, while others feel it is due to the rising costs of what patients have to pay over what dental insurance is willing to pay.

The American Dental Association has acknowledged that dental tourism is an increasing phenomenon that confronts dentists in the United States.

The ADA recommends the following to dentists:

1. A patient’s freedom of choice is an overriding consideration in any situation and is one in which dentists must recognize (ADA Code, Section 1, Patient Autonomy).

2. The ethical dentist will treat the patient who has received dental treatment outside the United States in the same manner as he/she would treat a patient who has transferred their care from any other practice, irrespective of the fact that the treatment performed outside of the United States might or might not be substandard and, in some instances, a possible detriment to the patient’s health.

3. A dentist should consult applicable state law to determine the definition of “patient of record.” Failure to treat such a patient may raise ethical concerns under ADA Code Section 2.F, Patient Abandonment.

4. A dentist should clearly describe to the patient his/her oral health status (ADA Code, Section 4.C, Justifiable Criticism) and maintain carefully documented records of treatment provided. Records should detail the patient’s baseline condition so secondary dental care can be clearly differentiated from treatment performed by another dentist whether in or outside the United States.

5. Where there is an emergency situation that develops as a result of dental tourism and the patient is not—or is no longer—one of record, dentists are obliged, at the least, to make reasonable arrangements for emergency care (ADA Code Section 4.B Emergency Service).

6. Dentists, especially those practicing in border states where dental tourism occurs more frequently, should begin to educate their patients about optimal oral health and costs versus the perceived value of dental tourism and advise them of the potential difficulty in seeking redress if problems are encountered with dental treatment performed in a foreign country.

Dentists, have you dealt with patients receiving dental treatments outside of the U.S.?

Have you lost dental patients due to dental tourism?

Dentists and Dental Labs Subject of New Legislation

Proposed Laws Highlight Importance of Disclosure

Even though there have only yet been official reports of two dental crowns (from Chinese dental labs) tainted with lead, that’s more than enough to make a lot of people very worried. And the relationships between American dental patients, dentists and dental labs are receiving more public attention than ever before.

The National Association of Dental Labs (NADL) has been campaigning the FDA for years to improve its regulation of dental laboratories. Of course the FDA already has regulations for foreign dental labs that export to the United States. But critics point out that inspections are minimal.

In addition, dental prostheses are in an import class of their own. Unlike virtually everything else, the FDA does not regulate the final products themselves, only the materials used in their fabrication. There’s no data on this point, but many worry that unethical labs may not be using the high-quality materials they report using, instead replacing them with less expensive alternatives. And China is already under the microscope for doing just that with other products such as pet food, toothpaste and cough syrup.

One of the issues this current scandal has highlighted is how little American consumers know about what’s in their mouths. Your shirt has a tag telling you it was made in China. The same message is imprinted on your dishes, stamped on your furniture, written on your user’s guide. But your dental crown that was made in China? No one ever tells you that.

Canadian dental patients have to sign an informed consent form before their dentists can give them a dental prosthetic manufactured outside of Canada. American dentists, on the other hand, aren’t even required to tell their patients where their dental bridge or crown was manufactured.

Now, a wave of new legislation has been proposed to help close that gap.

One such bill was recently introduced before the New York State Assembly. “Consumer protection is very important to me,” said Assemblyman Rob Walker, author of the bill. “If the bill is passed and signed by the governor, dentists will have to notify consumers where the actual prosthetic was made.” Dental patients would also be told what materials were used to make it. (Read more)

A similar bill was also introduced in Alabama. The synopsis of The Alabama Consumer Dental Act of 2008 reads as follows:

This bill would require dentists to provide prior written disclosure to their patients if any fixed and/or removable dental prosthetic device or appliance, whether fabricated in part or completely, including, but not limited to, a complete or partial denture, veneer, inlay, onlay, crown, or bridge, is manufactured outside of the United States and to provide that failure to make such a disclosure would be grounds for disciplinary actions.

South Carolina first introduced dental lab legislation a year ago. It focuses not on doctor-to-patient disclosure, but rather lab-to-dentist disclosure. The bill, which is still in committee and has yet to be approved, would:

  • …require a dental laboratory that performs dental technological work outside of this state to employ a person who is registered by the state board of dentistry to authorize such work based on the prescription of a dentist licensed in this state,
  • …require the laboratory to provide information on where the work was performed, and
  • …require the laboratory to provide a list of the materials used in the work.

Similar legislation has been proposed in Florida in response to the lead scare. “This legislation is proactive and helps the state of Florida protect its citizens in light of recent documented cases of lead contamination in dental work coming into the U.S. from foreign countries.” The bill would:

  • …require dental laboratories that operate in Florida to disclose to dentists where a product was manufactured and what materials were used in each restoration, and provide certificates of authenticity if available. (Although, the bill does not address this information going to the patient, under existing patient rights, a patient may request a copy of this information for their records from their dentist.)
  • …require dental labs in Florida have a full-time technician who maintains 18 hours of approved continuing education in dental technology every two years.

Within the next month, we should hear the results of more tests, so we’ll have a better handle on the scope of this potential problem. But regardless of what the research reveals, you can bet that more states will be introducing similar legislation. (It’s already in the works in Michigan, Mississippi, Minnesota, Kansas, and California.)

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