<A dental trip to Thailand>

I was very dissatisfied with my teeth generally, and I desperately wanted to get them fixed. I had let them go for a number of years, and my blackening front teeth affected my self confidence... a lot.

I suppose I had some bad experiences as a child, with some fillings here and there, and braces for a few years. I hated the braces the most, as not many kids had them when I was at school. I thought all my dental worries were over when I turned 18 and left home to start my apprenticeship. My first adult trip to the dentist was when I was well into my 30's. I didn't realise, but even then it was too late.

I was told I had some rotten back teeth, and I had to get my wisdom teeth removed. I also had to have some more fillings. I went to the oral surgeon, but I was seriously upset by the cost of everything. I had just got married, and we had bought our first house. Lisa was pregnant too. I just thought I should put it off until I had frank dental problems, or money... or both.

One night I woke up with a really bad tooth ache, and a bad taste in my mouth. My face was swollen, and strangely it seemed to be getting bigger every hour. I tried to ring my dentist, but no one was available, so I went to the hospital. I had to get admitted, and they put me on a drip, with antibiotics. Eventually I had an operation to get rid of the swelling and the rotten tooth that had caused it all... I was off for 4 weeks, and whilst the public hospital treatment was free, I couldn't work. I was by then a sole contractor, working in the building industry.

I went to the dentist, and he said I had to have even more teeth removed than when I saw him last time, and he said I would need partial dentures to help me eat. He also talked about implants, and a whole range of other treatment options, but all I heard was "dentures". The proposed bill was enormous, and I still couldn't afford to definitively fix everything. I knew I needed treatment, but I had just bought a new car for the wife and kids, and I already had clocked up a huge credit card bill. And of course we had booked a two week long holiday to Phuket.

I was telling a friend of mine about our problems, and he suggested that while I was in Thailand, that I go and get some cheap dental treatment. He said that if we were going there anyway, that I should try to hook up with a Thai dentist and get my work done for a tenth of the Australian price... The best thing was I could do it with my holiday. I thought the idea was terrific.

If you go on the internet, and type "Thailand dentist" into Google, a thousand clinics pop up, with all sorts of dental treatments and examples of foreign tourists like me seeking the "extreme dental makeover". It was all very impressive, very enticing, and frankly I couldn't wait to go. I picked a web site that I liked, and emailed them, and the Australian that set it up for me (after I pad a "booking fee") soon started a cross country exchange of treatment ideas... All made the easier because I could email the dentist in Thailand some mouth photos, and they emailed me back treatment plans and costs in both US dollars and Thai baht. The treatment they said would take a day.

From talking to them, they wanted to set up a specialist implant surgeon, who had been trained in the US, and it was he who would take out all my upper teeth and insert implants. Another Australian trained dentist was going to build up my teeth into a whole new set on the implants on the same day. I did quite a bit of internet research on implant reconstruction, and had seen what implants could do in countries like the US and Australia.

It was going to cost me $AUD12,500, plus the cost of removing my teeth, and the sedation, and of course the travel company insisted on where I stayed, and they charged me a booking fee. Overall though, this was going to be much less than what it was going to cost me in Australia... To be honest, I didn't really find out what that cost would be here, as I didn't want to let on to a dentist what I was intending to do... After all he wasn't going to treat me anyway, and I didn't want to waste his time.

On previous visits, my own dentist in Australia hadn't even suggested a full dental reconstruction of my upper jaw, and the examples that the Thai dentist was showing me were certainly impressive. At the time I was really attracted to the idea of having the surgery when I arrived, and then recovering for two weeks during my holiday. During my two week stay, they would check and make sure everything was going well, before I would come back home, with a new smile... And a life time free of dental bills.

Well we went to Phuket in Thailand; me Lisa, and two children, and booked into a nice hotel. The dental clinic was only a few blocks away, so a day after we arrived, I went into the clinic. It was actually extremely nice, and I saw other foreigners there, from all around the world; mostly Americans, a few Brits and another Australian. I met the dentist, and I suppose the alarm bells should have started ringing then, as he could not speak english (despite my being told he had been trained in the US).

I was given a needle in my arm, and from that point I honestly don't remember anything, except that I woke up in another room with the most incredible pain in my upper jaw, and a lot of blood coming from my nose, and running down the back of my throat. The funny thing was I felt I still had all of my teeth, and when I looked in the mirror, I had the most fantastic smile! In the hours that I had been there (it turned out to be 8 hours), they had removed all my upper teeth, had placed 6 implants (originally they said four), and had also put in a new set of teeth that clipped onto a bar in my mouth that was locked onto my implants. It all felt quite weird, I was in a lot of pain, but it did look good!

The bill was a little suprising. I paid the $AUD12,500 cost up front, but there were quite a few more costs, like dental models, and I had to pay extra for a technician bill. There was also a fancy x-ray machine, and they said I was treated by two doctors, who each had their own bill. I was in a foreign country, I couldn't speak Thai, and they couldn't speak English (well, not very good English). They also held my passport, so I had to pay the rest of the $AUD8,000 for two extra implants, and they said that I was in the clinic for longer than was expected. The holiday cost another $AUD6,500 once you added airfares for the kids, the hotel, and food.

The rest of the two week holiday was a nightmare. I sent Lisa and the boys out to shop or to the beach most days, and I would just stay in the hotel swallowing vicodin all day... Vicodin is like panadeine in Australia. I was vomiting a lot of blood, and felt generally nauseated, and the pain just wouldn't go away. I saw one of the clinic dentists a few times, who could speak a little English. He said everything should be fine before I got on the plane back home.

We did eventually fly back, and the trip home was also a nightmare, mostly because every time we took off or landed, the changes in air cabin pressure played havoc with my sinuses, which constantly seemed blocked. When I finally got home, my wife insisted that I go and see our own dentist, and to ask him to have a look at my new teeth to make sure he thought that everything was okay.

I suppose in retrospect I was a little naive in thinking that my Australian dentist could help me look after something that another dentist had performed in another country. He was happy to see me, but he warned me that if anything would go wrong, he had very little experience of Thai dentistry to be able to tell me what was going wrong, or worse, even how to fix it! He took an x-ray, and sort of didn't say anything, so I assumed everything was okay, and I let it go at that. Eventually all the pain went away, and it wasn't for about three months before I was brave enough to bite into an apple.

Everything was really good for about a 18 months after Thailand. There was no pain, and my Thai dentist had given me a water jet to clean around my implants, and this I used every day. He emailed me a few times to see how everything was going, and I really had no problems. We stopped communicating after 6 months.

One night though I woke with some swelling in my face. It wasn't painful, but the thing I noticed most was a really foul taste in my mouth. It seemed to be coming from my nose, like I was swallowing it. I looked in the mirror and was amazed that my whole left eye was swollen, to the point that I could barely see out of it.

Luckily my dentist saw me first thing that morning. He took an x-ray in his rooms, and then sent me straight to the Oral Surgeon. The surgeon seemed really concerned as well, and sent me for a CT scan, and then saw me immediately after before he sent me straight into hospital for an IV antibiotic drip. From the time that I fist saw my dentist at 8am, to when I got admitted was about 3 hours. Everything seemed to be quick, and very efficient for me, but I was only to find out a little later why everything was so hurried... My dentist and oral surgeon had a serious concern that I had an infection behind my eye ball, and that my sight was threatened.

That evening, the surgeon saw me in hospital, and told me that I had to have an operation there and then to drain some of the pus that had been collecting in my sinus, and in my left cheek. When I woke from the surgery, the swelling had come down quite a lot, but the surgeon had some bad news about the implants... He said they had to come out!

I explained about my trip to Thailand, and he was sympathetic, especially when I explained the amount of trouble and expense I had already gone through. He explained that three of the implants were not even in jaw bone, and that there were signs that the all of the implants were infected. He said two were causing my sinus infection, as well as a wider infection of the surrounding bone. He showed me how the metal bar in my mouth onto which my denture clipped should be rock solid. I was suprised by how much movement there was.

About three weeks later, my upper jaw and the swelling was a lot better. The infection had gone, and my dentist had made me a full denture. It was hard to eat with, and especially it was hard to speak with, but I was pain free. I emailed the Thai dental clinic, but I never got a reply. I got a friend of mine who was holidaying in Phuket to have a look in there, but he said he couldn't find the place, and the building that I sent him to was a Thai massage centre.

I tried emailing and ringing the guy who set up the clinic here in Australia, but eh said he took no resposnibility for what was in essence a pure relationship between myself and the guy in Thailand, He was sympathetic, and offered the name of another Thai dentist that I could go and see!

The most bizarre thing was,the oral surgeon actually showed me the implants and the dental/denture appliance that had been in my mouth. The metal parts were actually green! Apparently most of it was made in a metal that contained a lot of copper, and the surgeon doubted that any or all of it was titanium... Titanium was the usual material that most dental implants around the world are made of. The surgeon suggested that a lot of the cheapness that comes from Thai dentistry is usually because of the cheaper materials that they use.

These are some of the bogus web sites that offer or support dental trips to Asian countries, for unsuspecting Australians.

Some important points of why dentistry costs can vary from a first world country to a third world country...

Australian and New Zealand standards and laws, makes materiel selection and medical appliance manufacturing costs very expensive. In medicine, as well as dentistry, higher compliance standards are very protective for the Australian medical (or dental) consumer. Visit the Therapeutic Goods Administration web site to find out more.
Part of the costs of local Western medical treatment involve costs of training, medical indemnity insurance, ongoing training and professional registration costs, equipment purchasing, licencing compliance costs, maintenance and practice access costs, as well as ability to access production and medical materiel warranties.
Professionals in overseas nations are usually poorly regulated, and have levels of professional training that fall well below Australasian, EEC and North American standards. Even if professional standards are high within an individual, material use in third world nations is often not regulated.
Dental implants distributed throughout Asia (Singapore is an exception) are usually design copies of patented originals, utilising materials that are far from biologically compatible, and are usually metals or materials entirely different to what may be claimed.
If an overseas professional claims to have been trained professionally in Australia or the US, it is usually no more than a day long course, or possibly a conference that they have attended. Formal specialist training programmes are usually restricted to that nations citizens, and who have primary degrees obtained in that country (be it North America, the EEC, or Australasia).
If you are having complex surgery, complications rates are usually high. No one expects a complication, and Western trained specialists practicing in the EEC, North America or Australasia are trained extensively to both reduce complication rates as well as manage complications when they occur. If you are having complex surgery, always choose a local specialist, who is available to identify and treat complications before they become serious problems.
You cannot expect (even from the most altruistic and compassionate) your local specialist to know or even understand how work performed upon you in another country has gone. It is impossible for the surgeon or dentist to anticipate or offset any complications that such treatment may have introduced.
You unfortunately get what you pay for. If you have been quoted $10,000 for a gold Rolex in Macquarie Street Sydney, but only $2,000 for the same watch in Phuket... Chances are your new Phuket Rolex won't be serviced by Rolex Sydney when it breaks down, and starts to turn green.

If you are an Australian citizen (or permanent resident), the cheapest dentistry in the world exists right here in Australia... All provided by the worlds best dentists, and the worlds top dental and surgical specialists... And in the city or town you live in.

Don't go overseas for your dentistry needs because you believe you can get dentistry cheaper.