Dental Holidays: What Could Go Wrong?
So what are the risks or concerns with heading overseas to have your crown, implant or cosmetic make-over completed?
Lack of Diagnosis and Treatment Planning
Firstly, and most importantly, is the lack of appropriate diagnosis and treatment planning. The treatment plan is in most cases, being planned and quickly undertaken to suit the holiday timetable, and not what suits the ideal treatment needs for the patient. Many of our aesthetic treatments and especially dental implant treatments require multiple procedures over an extended period of time.
Aesthetic treatment plans may include such things as crown lengthening procedures or gum re-contouring, pre-treatment tooth whitening, dental hygiene therapy, or for implant treatments; bone grafting prior to implant placement or connective tissue grafting to minimise tissue shrinkage and the appearance of ‘long’ teeth. All of these treatments are utilised to achieve ideal aesthetics and function – and without this, a compromised treatment result can be expected. Biology of the teeth, gums, and bone of the mouth must be respected.
Poor Level of Treatment Quality
The second issue after compromised treatment planning is the poor quality of the treatment itself. Dental treatment, both dental implants and cosmetic dentistry, can be extremely invasive, and I am often amazed at the ‘lackadaisical’ attitude of many patients when deciding in whom to entrust their care.
Teeth are extremely critical for eating, speaking and aesthetics, and are in use 24/7, 365 days a year – what could be more important? Are those patients heading overseas investigating the qualifications held by their treating clinicians? Are they concerned with the materials used – and are they monitored for quality and compliance? Australia has strict rules and regulations as to the types of materials that can be used in medical procedures and these must be TGA approved –unfortunately many other countries do not share this diligence and protective regulation.
Don’t let having a dental crown completed in Thailand be the time you discover you have a severe allergy to potentially poisonous poor quality metal alloys. We pride ourselves on using accredited laboratories, where they follow strict rules of compliance and use only the highest quality materials and technologies.
In considering dental implant treatment, it is also important that the implants used are of the most up to date technology and not an old, redundant implant design/s. In the future – needing maintenance, it may be that the required materials and componentry is not available – and thus you are stuck in ‘limbo’. It has also been reported that some clinicians in these countries use ‘out of date’ implants – where the sterility and prognosis for success is compromised. Here at The Macquarie Street Centre, we use implants from the world’s leading implant manufacturers, including Nobel Biocare™ and Astra Tech™.
No Post-Treatment Follow-Up or Service
Thirdly, is the lack of post-treatment follow-up. Generally, treatment is completed, and immediately the patient returns to Australia. For surgical cases, healing can be a lengthy process, and many changes can occur in the body’s natural biological healing. Complications may only become evident a number of weeks or even months down the track – at which point the patient is unable to return to their treating clinician overseas.
The dentist charged with taking over the treatment, rightly, has to be fairly compensated for this. However, if the treatment was completed at his clinic, postoperative follow-up may have been included in the treatment cost.
In the case of restorative treatment, such as crowns, veneers or fillings, occlusal or ‘bite’ changes, after these are completed, can cause pain or discomfort – and again, patients seek the assistance of a domestic clinician to adjust and correct this.
There would generally, further, be no ‘warranty’ provided for this overseas care – as after the patient returns home, the clinician who carried out the treatment, no longer has anything to do with their ongoing care or maintenance. Hence, there is no recourse for treatment to be rectified by the original treating clinician.
So in clear terms, what are some of the issues that you can face when choosing to have potentially poor quality overseas dental treatment?
Incorrect Dental Implant Placement Leading To:
- Perforation of the sinus, nasal floor, nerve canals
- Damage to the inferior alveolar nerve meaning permanent paresthesia (loss of sensation or numbness) to the lower lip/chin/tongue.
- Fracture of the lower jaw bone.
- Peri-implantitis (infection of the implant – leading to loss of the implant).
- Loss of bone on the outside surface of the implant, leading to recession and gum issues
Poor Quality Material Selection Which Means:
- Possible allergic/poisonous reaction to metals used in crowns.
- Fracture and failure of crowns or veneers.
- Poor aesthetic result.
- Use of unknown and rare ‘copy’ implant systems complicating future treatment needs or requiring removal of the implant.
Lack of Skill in Undertaking Treatment:
- Poor crown margins, leading to the incorrect fit of the crown. This traps plaque/bacteria leading to gum inflammation and subsequent loss of the supporting bone around the tooth.
- Heavily cut back teeth (preparations) leading to degeneration of the nerve – necessitating root canal treatment.
- Poor contacts between crowns/teeth, leading to food impaction/trapping. This can be frustrating and also quite painful and uncomfortable.
- Poor or damaging bite relationships.
- Poor quality endodontic (root canal treatment) leading to endodontic failure resulting in the need for either expensive specialist endodontic treatment, or removal of the tooth.
- Incorrect implant positioning compromises the fit and appearance of the replacement tooth/teeth.
- Poor aesthetic result, with patients then unhappy with their appearance and with a concomitant loss of self-esteem and confidence.
