Dental tourism: How to manage follow-up care for patients treated abroad
Dental tourism is booming as difficulties in accessing affordable treatment in the UK push patients to seek deals abroad. People may be tempted by companies marketing the ‘quick fix’ or ‘perfect smile’ on social media, often as part of an all-inclusive holiday package.
Although many dental practices abroad offer high-quality treatments, unfortunately this is not always the case and follow-up care can be inadequate. Patients booking cheap deals may be unaware of the long-term costs for their oral health and finances.
Dentists across the UK are seeing a rise in patients with complications resulting from dental tourism. This raises questions regarding the ethics, practicalities, and dento-legal aspects of managing the care of these patients. What are the responsibilities of UK dentists in this situation?
Common complications of dental treatment abroad
Cheaper dental treatments and shorter waiting times are key driving factors for patients to travel abroad, but these may come at a price. In a British Dental Association (BDA) survey, 95% of responding UK dentists had seen patients who travelled abroad for treatment; 86% had treated patients who developed problems as a result.
Patients with crowns and implants fitted abroad were particularly likely to need follow-up care at home in the UK. The most reported problems were failing or failed treatment (86%), pain (76%) and poorly executed treatment (72%).
Why is dental treatment abroad risky?
Within the UK, patients undergoing dental treatment are protected by strict regulations. Patients going abroad may find that dental standards are less stringent. For example, there may be different qualification requirements, lower standards of product quality, and less robust infection control measures. Language difficulties and lack of regulation may mean that informed consent is lacking, and misleading advertising may be more common.
When treatment is done during a brief trip abroad, additional concerns are shortened recovery periods (especially for dental implant treatment), continuity of care, and the potential need for costly ongoing maintenance care. Patients may not understand the long-term implications.
If things do go wrong after travelling abroad, it can be difficult for patients to bring legal claims and seek redress for complications, especially if there is no regulatory body in the country. They may face difficulties in communication and additional travel for legal proceedings. Furthermore, the cost of remedial treatment, often exceeding £1000, can outweigh any savings on the initial treatment.
How to manage follow-up care in the UK
What should you do if a patient visits for follow-up care after treatment abroad? This is a potentially complicated situation requiring careful consideration of the dento-legal risks. Management options will depend on the urgency of the problem, the skills and experience of the dental team, the cost implications, and the specifics of the treatment performed abroad.
Given the huge variability in techniques and components used in dentistry, especially when implants are fitted, the patient’s treatment may be unfamiliar. You may need to contact the dentist abroad for more details if the patient agrees. However, obtaining and understanding dental records from outside the UK can be time-consuming and confounded by language difficulties, while replacement components may be unavailable in the UK.
As always, you should follow the GDC Standards and Guidance and ensure that you are appropriately indemnified for all procedures carried out.
Key steps and considerations include:
- Fully assess the patient and ask about the treatment they received abroad.
- Discuss your findings, the management options, and any cost implications with the patient. Ensure that they understand and provide consent for any procedures performed.
- If it is in the patient’s best interests and they give consent, contact the dentist who did the work abroad for more details.
- Treat acute pain or infection as a priority.
- Consider the risk of litigation before commencing any remedial work. Contact Dental Defence Society if you need advice.
- If the complications are beyond your skill set and out of your scope of practice, refer the patient to a specialist with the experience required.
- If the patient wishes to make a complaint about the care they received abroad, advise them to discuss that with the dental company that provided their treatment, their travel insurer, or the regulatory body in the country where the treatment was done.
- Document all assessments, discussions, contacts with the dental team abroad, decisions made, procedures carried out, and advice given regarding ongoing maintenance.
Advice for your patients before they travel
If your patient tells you that they are considering travelling for dental treatment abroad, talk to them about the important factors to be aware of before they book. You can also discuss the alternatives, including payment options that may make treatment in the UK more affordable for the patient.
The NHS provides a useful checklist for patients thinking of going abroad, and the GDC also provides advice about what to expect and what risks are involved. For information about health regulators and professional bodies in other countries, patients can visit www.healthregulation.org.
If you need professional advice about managing complications in patients returning from dental tourism, please contact us at Dental Defence Society.
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