Dr. Will Rymer:

The most stark statistic I can give regarding medical tourism and dental tourism is that since 2019, nine Irish people have died while receiving medical care abroad since 2019, with two cases specifically regarding dentistry. We have no reliable data on the number of patients looking for treatment abroad. This used to be primarily an economic decision for patients, but increasingly, as we were discussing, it is becoming an issue of access. If I have a patient who requires two or three crowns, say, they can go on to a waiting list for a couple of months. We may not have the ability to get them in quickly as this is quite a big piece of dental work. If I type "dental crown" into Google or Facebook I will be bombarded with a series of ads coming from eastern Europe and other areas offering discount rates for dental treatments, often for huge courses of treatment. They usually offer 16 crowns for several thousand euro cheaper than what they would cost here.

We usually recommend minimally invasive dentistry to patients. For the majority of our day we are counselling patients about cutting the tooth as little as possible. We want to preserve tooth structure as much as we can. Every time we intervene, we are potentially reducing the life expectancy of the tooth and then creating more problems further down the line. Take a scenario where patient goes away with a recommendation for a treatment plan from me and they come back for their routine checkup. I can see that they have had either two or three implants and 16 crowns on top of them, or they have had teeth which I would have regarded as being healthy, removed and replaced with implants and bridges. These are often hugely aggressive treatments, which are very difficult to maintain so they cannot maintain adequate hygiene. As a result, they start to collapse after a number of years. Patients are often initially very happy with treatments. The offer they have received online is that we get to combine this knockdown price with a holiday in the sun, so it is very tempting for patients. Unfortunately we have to deal with the consequences which can be devastating for the patient. In many cases, they may go from a reasonable standard dental health to a very poor standard of health. We talk of Romanian and Turkish dentistry being of a very high standard, but the issue I have is with commercial enterprises, aggressively advertising in the Irish domain through advertising on online.

A month ago we had a series of interviews on radio and in the press, where we highlighted this issue. Along with our colleagues in medicine who do bariatric surgery for treating obesity, we are seeing increasing numbers of people travelling abroad. The following week, in the same print media there were advertorial articles advertising the very problem we were trying to highlight. We have a huge problem with tourism and vulnerable patients are being lulled into these attractive offers. Unfortunately, there is a time lag between people getting the work done and them presenting with the problems. It might be three or four years before things start to go awry. If a person has had a piece of dental equipment welded into their mouth, which they then cannot clean, it is eventually going to disintegrate. It is just a question of how long that takes.