His gums duly numbed with painkiller, Michael reclined in the cushioned chair as the dentist loomed overhead with a whirring drill in her hand. Michael was about to start dental implant surgery to replace a broken tooth, a fairly standard procedure, except he was in a dental clinic in Bucharest, Romania. How did we end up there?
Dental implant cost: A mystery in the U.S.
Two years ago, we practically had to scrape Michael off the floor when he learned he needed a dental implant that would cost approximately $6,000. We’d gotten crowns and had root canals in the past, but never anything that rivaled the price of a decent used car. The high cost prompted us to explore less-expensive options. This endeavor proved to be more difficult than we expected.
It’s not easy to find published prices from most U.S. dentists. The U.S. practices we found advertising “discount” implants priced only the implant itself; they didn’t include the extensive prep work, including removal of the broken tooth and often the need for a bone graft, in the total cost.
We recalled that during a visit to Bucharest a few months earlier, we had noticed many billboards — in English — advertising dental services. Upon further investigation, we learned that Romania is a popular destination for European dental patients; the quality is top-notch, and the prices are very low. Would we actually consider dental work outside the U.S.?
According to Patients Beyond Borders, a guide and website for medical tourists, more than 150 million Americans lack dental insurance and are increasingly seeking dental work abroad. Currently, the majority of Americans traveling outside the country to see dentists venture to Mexico from the border states of Texas, Arizona, and California.
“Dental tourism has been going on for more than two decades,” said Amid Ismail, dean of Temple University’s Kornberg School of Dentistry.
Ismail had no statistical data — good or bad — regarding U.S. patients who had work done overseas. From our research, we learned it’s important to perform your own due diligence on any overseas provider.
“There is quality dental care everywhere, but the range is wider overseas, so you must be careful who you choose,” Ismail said. “Cheap care is most often not equivalent to good care.”
Affordable dental implants in Romania
Which left us still pondering the value — and risks — of using a dental clinic in Bucharest, Romania. We knew from our previous visit that English is commonly spoken in the capital city, so communication wouldn’t be an issue.
As part of our research, we contacted the U.S. office of Romania Tourism. The website addressed dental tourism and provided links to several dentists. Romanian law requires dental clinics to post their prices prominently — something we wish American practices would do.
We homed in on one dental clinic in Bucharest, Intelident, for several reasons. Its website was in English and provided detailed information about the education and work experience of the dentists. The clinic also posts prices online, which made our research easier. In addition, it is part of a network that provides dental services to U.S. employees of American companies (such as Citi and Oracle) that maintain offices in Bucharest.
Most importantly, we liked that Intelident used top-notch materials. We were determined to get a standard of care similar to that of the U.S. or Western Europe; there was no reason to consider dental tourism otherwise. We had heard anecdotes of people getting “cheap dental implants” in Eastern Europe, but details about the materials (and potentially the dental clinics) were sketchy. We wouldn’t seek out some back-alley practice back home; we sure as heck weren’t going to go that route in Romania.
We communicated extensively with the manager of the practice by email and clarified prices and approximate timelines. Unlike the U.S., where many dentists price the procedure in total, pricing in Romania is more of an a la carte model. Therefore, it’s important to understand exactly what is required for your complete procedure; a front implant cost may be different than a back tooth, for example, or you might need to factor in tooth extraction. (All cost comparisons here are as “apples to apples” as possible.)
The total cost to install Intelident’s most expensive titanium implant, made by highly regarded Swiss manufacturer Straumann, was approximately $1,500, including a replacement crown; 1/4 the cost of the same procedure in the U.S.
Now that we knew we could obtain affordable dental implants in Bucharest, was a saving of $4,500 enough for us to fly to Romania? Perhaps not. But what if we considered additional work?
We both had several metal-based crowns that were nearing the end of their useful lives; the replacement cost of a nonmetal zirconium crown in the U.S. was estimated at $1,400. The cost in Romania for a similiar crown would be only $350; root canals were similarly priced. If we got a significant amount of preventive work done, the trip would be worth it.
Our first appointments entailed a general examination, including a review of new X-rays. The dentists then prepared a complete treatment plan for each of us. Michael focused on getting his new implant, and Larissa addressed replacing her old crowns, some of which required root canals. We were given specific pricing upfront. They even said we should defer some work they didn’t feel was necessary, so we never felt “up-sold.”
X-rays are taken in another office, about a mile away, saving the dentist the investment in equipment that is not often used. The excellent prices ($18 for a full set of digital X-ray bite wings, $6 for a single tooth) at the state-of-the-art imaging facility offset the slight inconvenience of an extra errand for the patient.
Throughout all our work, the Romanian dentists used sterilized equipment and sealed products that they opened in front of us.
For Michael’s implant, his dentist even shared the packaging materials to demonstrate their authenticity. Straumann implants come with a unique serial number, and Michael was able to verify his through the company’s website. Tomas Konrad, a Straumann representative, agreed that best practices include sharing the package with the patient.
A verification document with details about the implant also ensured that Michael could have follow-up work performed by any dentist around the world trained to use Straumann implants — which includes the dental clinic at Temple University.
“That’s a good [standardization] model,” Dr. Ismail said.
To date, there have been no complications with the dental work we had done. Three months later we were back in the US where Michael had the work reviewed by an American dentist, who was impressed with the high quality level.
In the end, we saved more than $18,000 by seeking work outside the U.S. Of course, travel expenses must be deducted from that amount, which is a different variable for everyone.
Visit Romania: Travel considerations
By European and American standards, Bucharest is an inexpensive city. We found a fully furnished apartment in the heart of downtown on Airbnb for $850/month. (For more information on places to stay, please see our detailed guide to lodging in Bucharest.) The dentist’s office was within walking distance, so there was no need for a car. There are no direct flights from the U.S. to Bucharest, but Delta’s SkyTeam alliance offers several connections through European gateways. We flew from New York to Bucharest via Amsterdam.
Dental Tourism considerations: Do Your Research
Dental tourism is not right for everyone, but with the increasing costs of dental procedures in the U.S., it’s an option worth considering if you are facing extensive work. The ideal candidate is someone without comprehensive dental insurance who has an open mind and time to travel abroad.
If you choose to explore this option, it’s essential to do your research. Consider the following:
- Education: Where did the dentist study? How good is the school? Has he or she done specialty training abroad?
- Experience: On how many patients has he or she performed this procedure? What’s the success rate? According to the Journal of Dental Research, success rates for most implant procedures are 90 percent to 95 percent; be wary of dentists who say they have a 100 percent success rate.
- References: Ask for names of patients, and contact them about their experience.
- Pricing: Be sure to ask for all costs related to the procedure, including X-rays and any prep work.
Even with satisfactory answers to these questions, there are still risks involved. If there is a problem with the work, the burden of extra costs falls to you. We acknowledged that if there were any problems, we’d have to take care of them in the U.S.
“Health tourism in a global economy is a reality of life, but we prefer that patients stay in their home country for continuity and follow up care,” said Ismail.
Prospective patients also need to verify the timing of their procedure to determine how long they will be overseas. One or two weeks are usually needed for a crown; an implant might require two separate short visits. Michael had already had his tooth removed in the U.S., which allowed several months for the bone to grow back before having the implant procedure performed in Romania.
We planned a month for our work in Bucharest, which also gave us plenty of time to explore the city and surrounding area. Overall, our experience as dental tourists was pleasant, and we will consider having work done here again. Plus we miss the Romanian pastries!
If you’ve got further questions about dental tourism, please click the “contact” tab at the top of the page. We’re not dental care experts, but we’re happy to share more about our particular experiences.
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Larissa and Michael are your typical middle-aged couple from Philadelphia who’ve been traveling the world full-time since 2011, seeking off-beat, historic and tasty sights. To receive our free quarterly newsletter with updates and valuable travel tips subscribe here.