Tuesday, May 27, 2008

And then to crown it all . . .

Having totted up the dental costs in Ireland Kieran Fagan decided to look abroad for treatment.
Having totted up the dental costs in Ireland Kieran Fagan decided to look abroad for treatment.
Photograph: Matt Kavanagh

'Call me mad if you like but I made some significant saving by taking a trip to Poland.' KIERAN FAGAN tells his story.

MY NEAREST and dearest said I was mad. Going to Poland to get your gnashers fixed? Barking mad, they said. But that came later.

When the dentist in Dublin said I needed six top front teeth crowned, including bridging a missing one, which wobbled precariously on a plastic plate, my first thought was how much. The bridging work would be about €2,000-€3,000.

A specialist would do root canal treatment for two others. That I knew from experience would total €1,600, and I also needed an extraction of a tooth with a deformed root, for which I should have to attend another specialist. Totting rapidly up I was in for something around €5,000, plus about half-a-dozen visits to three dentists.

It is only money, I thought, promising to get back to her when I had thought it over. A family illness made that interval longer, and in the meantime I lost another filling. There was a nasty jagged edge in the corner of my mouth, rubbing against my tongue.

It was just over a week before Christmas, and I phoned the dentist in a panic. I was offered an appointment on January 7th. If I hadn't been mad before, now I was.

So much, I thought, for the Irish dentists' repeated warnings about travelling abroad for cheap treatment. "If anything goes wrong, and even in the best-regulated practices in the world [heavy pause inviting you to conjure up images of blood-stained forceps-wielders in Eastern Europe], things can go wrong, you are very far from help."

Fast forward to 2008. I was on an Aer Lingus flight to Berlin, where a mini coach met others and me and took us on a two-hour trip across the border to Stettin in western Poland. In the morning Dr Michal Wiklinski picked me up at my hotel and we drove to a medical facility to have a panoramic X-ray taken of my jaw.

Later at his surgery, on the ground floor of a nondescript apartment building in suburban Stettin, came the first surprise. He did not agree with the Irish diagnosis of root canal treatment for two back teeth. He identified another back tooth needing root canal treatment, confirming my long-held suspicions about it. I also needed a crown for the tooth which broke before Christmas.

He also thought that the tooth picked out for extraction could be saved. Over a desk in his office, he produced sketches of my mouth and invited me to choose what treatment best fitted my budget.

I suppose this was the first plus about the trip. I was not in the dentist's chair being told what is good for me, but on the other side of a desk, having a detailed negotiation, lasting 20-30 minutes about what I needed, and how much I was prepared to pay. We debated the merits of three unit bridges, one each side of the missing front tooth, and six unit bridges going from one canine to another and giving greater strength. I ruled out implants, as they require a return trip.

By about 11am on the first morning, I was in the dentist's chair; I looked around for differences between this and the surgery in Dublin and could see none. Both were equally boring sterile high-tech places. Michal took impressions of my teeth with some lethal tasting blue glop, and soon after set about removing the visible part of my top front teeth to make way for the crowns.

By 1.30pm, I was in a taxi on my way back to the hotel. Although I didn't realise it then, much of the "heavy lifting" was done. Six sites had been prepared for crowns, and temporary teeth were in place for five of them. Permanent teeth were now being prepared.

Next morning I had one root canal treatment, and some other bits and pieces, and was on my way back to the hotel within an hour. The final session on the fourth day involved putting the new crowns into place, and general tidying up. When I paid my bill, I got a receipt with the (Irish) Revenue Commissioners form Med 2 for reclaiming tax on exempt dental procedures duly signed.

I paid just under €2,700. Travel costs added less than €250, and with smarter prior booking could have been much less. My stay in a four-star hotel - neither the snow outside nor my sense of frailty lent themselves to much sightseeing - cost just over €50 per night, and dinner in a very nice Indian restaurant nearby cost a mere €20.

I reckon my overall saving amounted to more than €1,500. Another gain was getting it all done in four days under one roof, rather than making half-a-dozen visits to three Irish dental surgeries, losing half a day's work each time. I wouldn't travel abroad for a filling or an extraction, but a once-in-a-lifetime piece of cosmetic bridgework seems worth taking a chance on. It is early days, but I have had no problems.

Mad? I don't think so.

Ireland versus Poland: comparison of dental costs

Unit costs of individual items of treatment vary considerably between those quoted in Ireland and Poland. These are the prices I was quoted:

Six unit bridge porcelain fused to metal. Poland: €1,170

Six unit bridge porcelain fused to gold. Poland: €1,920

Six unit bridge quality unspecified. Dublin: About €2,500

Root canal treatment. Poland: €80-€200

Root canal treatment. Dublin: €800

Single back tooth crown. Poland: €390

Single back tooth crown. Dublin: No price quoted but estimates range between €500 and €1,000

I googled Poland dentistry and Dr Michal Wiklinski's Dental Team website came up among others. It showed how to book treatment, make travel arrangements and find a hotel in a very clear way. (An independent website, hosted in Ireland, which praised his work also came up on my Google search.)

I e-mailed details of what I required. He asked me to forward digital pictures of my mouth, and he then quoted a menu of prices.

Poland is just one Eastern European country offering dentistry at competitive prices. I chose Stettin because it is close to Berlin, a city I wished to visit. Stettin is a busy port on the Oder, and not a tourist destination. Hungary is also a popular venue for dental tourism. Italian clinics also offer substantial reductions on Irish and UK prices. Some websites offer local consultations in Ireland and the UK.

Aer Lingus and Ryanair have many competitively priced flights to European destinations, provided you book in advance.

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