Global Economics

Lack of Insurance Drives Dental Tourism


With only half the U.S. population covered by dental insurance, Americans are flocking overseas for high-quality, low-cost dental care

The U.S. is facing a dental crisis. Only about 50% of the population has dental insurance, compared with the 85% who have medical benefits. Medicare doesn't cover dental procedures, despite the fact that aging teeth are just like aging bodies—vulnerable and brittle. That means more and more patients will be traveling abroad to take care of their pearly whites.

The problem in the U.S. is aggravated by the fact that even people with dental insurance aren't that well covered. The vast majority of policies have a $1,500 annual cap on payouts, a level that hasn't changed since the 1970s, though premiums have been rising. That $1,500 can easily be wiped out by one complicated root canal or a crown.

"Dentists have traditionally stayed away from getting involved with the insurance side," says Dr. Stewart Hirsch, associate dean of New York University College of Dentistry in Manhattan. "But insurance increases access, and people with no insurance tend to stay away from the dentist."

Big Savings

Or, they seek a cheaper option, and that explains why certain areas of Budapest, Prague, Tijuana, and Bangkok are lined with dental clinics advertising their services and prices in foreign languages. For years dental tourism has been a thriving subset of medical tourism, as American and European patients seek affordable care for decaying teeth. Some surveys estimate that as many as 30% of the population along the Texas side of the Rio Grande cross the border into Mexico for cheaper dental services. British dental patients have long traveled to Eastern Europe for care. And in a 2008 survey, the nonprofit Healthcare Tourism International found that dental services were the most common procedures sought out by medical travelers.

The savings those patients rack up can more than compensate for their travel costs. Teeth caps that range from $750 to $1,000 in the U.S. cost $150 in Mexico. In Hungary, a top-quality crown costs $780, compared with $1,200 to $2,000 in the U.S. London-based Hungarian Dental Travel has built a brisk business referring travelers to English-speaking dentists in Hungary, because "in Britain the average cost of an implant is $3,500, but in Hungary you can get it done for $1,000," says Managing Director Christopher Hall.

Dental tourists are seeking far more than cosmetic improvements. Dental problems can be painful, can prevent a person from eating nutritiously, and can affect one's ability to talk, smile, and even find a job—it's tough to make a good impression if you're missing teeth. Links have also been found between advanced gum disease and heart disease, stroke, and bacterial pneumonia.

Satisfied Dental Patients

How do the tourists feel about the quality of their care? Highly satisfied, according to Healthcare Tourism, since they usually patronize dental clinics set up to match the highest U.S. standards. "Every year we bring to NYU 110 dentists from 33 countries, train them in advanced procedures, and then they go home," says New York University's Hirsch. "There is no reason to assume the quality of care is any lower overseas."

Last February, Fox News Radio reporter Lori Lundin blogged about her husband's experience getting dental work in El Salvador. After being quoted $60,000 for a "full mouth reconstruction," her husband decided to travel to El Salvador, where he was quoted $19,000 for the same work. "The dental care my husband has received has exceeded our expectations," she wrote. "I would even say it's been superior to what we've had in the States. The level of hospitality, concern for his well-being, and the short time it's taken to get the work done has been nothing short of amazing."

The American Dental Assn. does not take an official position on dental tourism, says its consumer adviser, Dr. Edmond Hewlett, an associate professor at University of California at Los Angeles School of Dentistry. "We tell people it is possible to get high-quality dental care in places other than the U.S., but they should be aware there are no international standards." He also notes that there may be few legal protections if things go wrong. Nevertheless, Hewlett says, even he has offered advice to people seeking to go overseas for care. "You should find a dentist overseas the same way you find a dentist in the U.S.—through referrals," he says.

Arnst is a senior writer for BusinessWeek based in New York.

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