Max drills into dental tourism

Crrunncch! I momentarily freeze to process what just happened. My tongue reluctantly explores the craggy crater where my lower rear molar was a few seconds ago. I have bitten on something hard and my tooth has disintegrated. I hurriedly assemble the fragments in my mouth and spit them into my cupped hand. Bloody hell! Bits of tooth mixed with peanut muesli bar. A thought flashes across my mind – this repair is going to cost a bomb!

Now, I am lying on the dentist’s chair at Prime Plus Medical in Canggu, Bali, wondering whether my story will be yet another to add to the tales of woe about overseas dental work. I feel better when my mind switches to the positive feedback and reviews from previous patients. Dr Sharon is a young, petite lady originally from Java and trained in California. She explains the dental procedures I am to about to undergo. Today, she will take a plastic mould impression, which will be used to create a crown.

I look around the room. It is clean and has the equipment one would expect in a modern dental surgery – apart from the large TV showing a National Geographic animal chase. Is this an attempt at patient relaxation or a diversion technique? I’m thinking of an apt word to describe the situation – yep, the word that comes to mind is ‘tacky’, even though I’m drawn to the chase images shown on the screen.

Dr Sharon takes photos of my teeth with a ‘wand’ and projects the images onto a screen for me to view. She shows me a disc with incremental yellow to white coloured tags, then checks my teeth. Sadly, I’m down the wrong end of the scale. My love of coffee and red wine over the years has taken its toll, which is why I’m getting my teeth whitened as well. After the treatment I flash the pearly whites to Jenny. She is impressed and makes her own appointment to have the same teeth whitening treatment. Obviously, the teeth will stain over time, given the type of food and drink we consume. But for now, we are all smiles and very happy.

Why would anyone contemplate overseas dental work when there are so many things that could go wrong? It’s obvious that the attraction is the significantly lower comparative cost. The crown will cost A$450 and the whitening A$250. In Australia, a health fund will cap (pardon the pun) the rebate for a crown at about $600, so your out-of-pocket cost may be significant. There is no rebate for the cosmetic whitening. An alternative for whitening is a DIY take home kit, which will set you back up to A$600, and you will require extended treatment times because of the much lower concentration of active hydrogen peroxide.

The advice from my own dentist in Melbourne, a couple of days after the incident, was that I needed a crown, but it was not urgent.

“I’m going to Bali soon,” I said. “I might look at getting it done there.”

Her answer was a non-committal “Hmmm.” When I mentioned the prospect of getting veneers: “No, definitely not recommended,” she said.

“That process initially removes the enamel from your teeth. They would be forever compromised. But you could consider teeth whitening.”

Yes! A reluctant overall tacit approval.

So then it was time for a bit of online research. My search revealed that there is a plethora of dentists in Bali. The main online hit was an agency called Dental Departures, under which there is a long list, rated according to recommended dental surgeries. It’s here you look at reviews, procedures, prices, staff, qualifications and so on. This also allows you to compare whatever procedure/s you require. I selected Prime Plus because it was within walking distance of our villa, the prices were competitive, and the reviews were positive. So, what crown would I get? A full porcelain, a porcelain/metal fusion, or zirconium? Porcelain crowns are usually for front teeth and are softer. After some discussion, Dr Sharon suggested the harder zirconium type.

Now what about teeth whitening? Laser is very popular, as is UV light-induced whitening. But there’s also Opalescence and over the counter DIY band kits without the use of laser or light. My science background ensures I undertake a thorough review of the options before going to Bali. I delve into scientific papers about the pros and cons of laser and/or UV light enhancement. The overall findings are varied and non-conclusive. There is no conclusive evidence of the whitening benefit of using laser or UV light in combination with peroxide, other than an accelerated process resulting in a shorter treatment time. It seems though that there are some deleterious effects of using UV light, including radiation exposure to the gums. The one that I settle on is the Opalescence Boost process – no UV or laser and much cheaper. This is a ‘dentist only’ in-house kit and uses 40 per cent hydrogen peroxide gel (the maximum concentration of any of these processes). The gel is also pH neutral – not acidic like other gel types. It takes up to three 20-minute applications depending on how stained your teeth are.

It’s five days after the impression was made and I’m back in the chair for the crown fitting. There is no drilling. The doc uses a two-pack non-toxic resin to attach the crown onto the base. I’m all done and am very pleased that all has gone to plan.

So, the question remains – would I recommend overseas dental work, specifically in Bali? Yes, I would, albeit with some risk. But why pay exorbitant prices in Australia when you can get equally professional work done overseas for significantly less? I guess the proof of the pudding will be if and when I get the seal of approval from my local dentist.

The aftermath
It’s four months after the crown and I’m at my local dentist for a check-up. How’s the crown doc? Yeah, it’s okay (monotone voice and not overly enthusiastic). She’s found that it can’t be flossed to its base because of resin or crown overhang. Damn!

Now it’s five months after and I’m chewing on a sticky Minty. Yeah, you guessed it – the crown came off. So, it’s back to my dentist to face the music. I think she had an internal chuckle when I told her what happened – ‘told you so’.

Another $125 later and I’m done. Glued back in place, flossed okay and hopefully stuck there for many years to come!

I did say that there is some risk in overseas treatment, but would I go back and have work done in Bali? I would have to think very hard about it, but based on my recent outcome, probably not.

Would you go overseas for cheaper dental work? Or any other form of surgery or treatment?

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Written by MaxWilliams

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