Holiday in Cambodia

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As Australian health funds look at medical tourism as a serious option, Cambodian companies are looking for Aussie patients. By Julie Masis

A root canal and a crown in Cambodia costs around $700—four times less than in Australia.
A root canal and a crown in Cambodia costs around $700—four times less than in Australia.

Kingdom & Crowns—Dental Holidays to Make You Smile.” This is the name of Cambodia’s first dental tourism company that was launched by an Australian businessman this (northern) summer to encourage Australians to fly to Cambodia for dental treatment.

On its website, Kingdom & Crowns compares the cost of dental procedures in Australia and Cambodia—and offers to arrange everything from flights and dental appointments to hotel stays and trips to the beach.

“Kingdom & Crowns Dental Holidays is an Australian owned and operated business that cares about its clients,” says the website that was created by entrepreneur Michael Howard, a 31-year-old from New South Wales who followed his girlfriend to Cambodia a year ago. “Come for the dental work, stay for the experience!”

Howard got the idea for the dental business thanks to a toothache. The toothache brought him to Cambodia’s most luxurious dental clinic—the 10-storey Roomchang Dental & Aesthetic Hospital that opened last year—where he had a root canal and was extremely satisfied with the treatment.

“I experienced it myself—how good they are,” he says. “It was probably an 80 per cent saving on what I would have paid in Australia.” A root canal and a crown in Cambodia costs around $700—four times less than in Australia, Howard says. An implant done by a Cambodian dentist is also more affordable: it costs $2000 compared with $6000.

Cambodia is not a country that is known for quality medical care. The nation is still recovering from the Khmer Rouge regime during which anyone with an education—including dentists—was targeted for execution. Even Cambodians themselves travel abroad for serious medical procedures, rather than risk being treated by local doctors.

So why would anyone feel differently about Cambodian dentists? According to Roomchang’s marketing manager Adam Fogarty, who wants to encourage Australians to chose Cambodia over Thailand for dental procedures, dentistry is inherently not as dangerous.

“With dental treatment, the potential for negligence is much lower because it’s just teeth,” Fogarty says. “I don’t know anyone who had a life-threatening experience with dental treatment.”

But Dr Karin Alexander, federal president of the Australian Dental Association, disagrees.“It can be something like having a reaction to one of the drugs used—like the local anesthetic or if they give you the wrong antibiotics. It can certainly result in death if the allergic reaction is severe,” she says, adding that picking up an infection is another danger.

There have also been cases where Australians who had dental work abroad had to have everything redone—or worse.

Associate Professor Arun Chandu, an oral and maxillofacial surgeon consultant at the Royal Melbourne Hospital, treated several patients who suffered serious complications after getting dental implants in South-East Asia. One of them was a diabetic man who almost died from an infection he picked up in Thailand. “He was in the ICU for four weeks. We had to drain the pus out of his face at least three times,” he says.

On another occasion, he extracted implants from the mouth of a woman who returned from the Philippines. “These implants had copper corrosion and they were actually green when we removed them,” A/Prof Chandu says.

But Howard says Australian dentists are discouraging dental tourism simply because it means a loss of business for them.

“Put simply, it is not in the interests of Australian dentists to advocate dental work overseas, therefore there is a certain amount of scare tactics used,” he wrote in an email.

According to Dr Callum Durward, a New Zealand dentist who helped to develop Cambodia’s national dental school, Cambodian dentists are not as highly skilled as Australians but this is starting to change.

“The education of dentists in Cambodia is far below what the education of western dentists is. In Cambodia, at the dental schools, there are almost no specialists teaching,” he says. “But there are some dentists in some clinics who can provide very good care in many areas at a quarter of the price you would pay in Australia.”

Improvements are on the horizon, he says.

A selection of Cambodian dentists are about to graduate from Thai universities with degrees in periodontics, crowns and bridges, and maxillofacial surgery. New dentistry programs are being established in Cambodia thanks to visiting volunteer professors from Australia, New Zealand and the United Kingdom, Durward says.

“Cambodia has reached the stage of development where a lot of dentists are interested in improving their skills,” he says.

Cambodia’s European Dental Clinic

Other than being treated by local dentists, visitors to Cambodia can go to the European Dental Clinic—which employs one French and one British dentist.

Australian hygienist Angela Clifford, who also works at the clinic, is about to launch her own dental tourism company, Dental Holidays Cambodia.

Clifford says she moved to Cambodia despite a lower salary to experience a different culture.

“In Cambodia my hours are more flexible, the cost of living is lower and I have the spare time to think about doing something different, like starting a small dental holiday business,” she says.

She explains that treatment costs less in Cambodia—even if it is done by European dentists—because overhead costs, such as nurses, secretaries, and security guards are less expensive. Cambodian dentists also don’t need to worry about licenses for X-ray machines, litigation insurance, or registrations with the dental board.

Australian patient Barbara Cockroft, 61, has been setting up her appointments at Phnom Penh’s European Dental Clinic for six years. She’s had three crowns and two implants, and saved thousands of dollars, she says.

3 COMMENTS

  1. This is the main problem with overseas dental work: “Cambodian dentists also don’t need to worry about licenses for X-ray machines, litigation insurance, or registrations with the dental board.”

    In Thailand and Cambodia legislation and regulation is not in place to protect patients against negligence or malpractice. Private entities seeking to benefit from the cost differential focus on how Australian dentists are trying to protect their businesses with scare tactics yet conveniently ignore the fact that there are no legal remedies available if anything goes wrong.

    In complex rehab patients the chances of treatment failure and associated complications are much higher hence the extra cost and specialist training required to treat these patients.

    Suggesting a Cambodian practice with no legal sanctions or regulatory bodies and lesser trained dentists can offer a comparable standard of care for a reduced cost is irresponsible.

    Notice how dental tourism companies focus on “Luxurious 10 storey” and “Brand new facilities” etc… the main focus is on the facade and costs, not on a long term relationship which is required if you have complex dental need to maintain oral health.

    A statement like this “With dental treatment, the potential for negligence is much lower because it’s just teeth,” shows the speaker knows very little about dentistry.

    Implants, flap surgery, treatment of odontogenic infections can be complex and may specialist referral depending on the complexity of the case and the medical status of the patient, i.e. current medications, conditions, immunosupppression etc…

    Without a regulatory framework and legislation what Thai or Cambodian dentist would utilize a proper triage process and refer when they can have a crack at it themselves and see what happens. As complications may take time to manifest it is likely the patient would have left the country before they realized the treatment was compromised by poor procedure and training.

    What you get in Australia (or should get) is a realistic assessment of the options available to you, their relative risks and costs/benefits. If you don’t get this you should talk to your dentist as they should provide you with a couple of treatment options as part of informed consent, and the difference between here and the third world is there are legal implications for practitioners who fail to provide informed consent to their patients. Australian practitioners should also provide you with follow up care and oral hygiene instructions to increase the longevity of restorative and prosthodontic work.

    Don’t make the mistake of getting expert advice from a private company on the risks involved in dental tourism. To suggest Australian dentists are using scare tactics and are purely motivated by money is pretty hypocritical coming from the likes of a dental tour company or NIB created exclusively for profit.

    Until these countries develop a government supported regulatory framework there is no way they can compare to Australia as any company suggesting they can “Self regulate” their industry has a financial conflict of interest suggesting otherwise.

  2. There are many, many reasons why I feel medical/dental tourism can be bad – for the patient/consumer. Aside from the differences between the way dentistry is practiced, infection control standards and the regulatory aspects of dentistry, the many safeguards we have here in Australia are either non-existent overseas or highly limited, especially for a transient group such as tourists! Continuity of care can be very challenging (fancy a flight for your 6-month checkup or for that sudden onset of toothache?) and more importantly, who addresses post-treatment complications given that tourism is short-termed and your problems are likely to occur when you are back on home soil? Is it fair or even appropriate that the rest of the taxpayers and our already overburdened public healthcare system pick up the slack to treat your medical/dental tourism (mis)adventure just because you wanted to save a few dollars? It’s your health. Allegations of professional protectionism is utterly irrelevant because many dental schools have opened up in recent times and there is a growing oversupply of dentists.

  3. So let me just clarify some points (I live in cambodia for ten years) First of all I did my last dental implant ceramic crown in Paris for 800 euros (so really 30% from the prices on Phnom Penh) and when it come to dentists here especially Roomcheng, I would be very cautious. You can find good clinics in PP but most of the dentists habe no clue of what they do. Even if they dit in brand new 10 storey buidings; Doesn’t help much.

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