As UK dental system decays, surging numbers seek treatment abroad

[December 11, 2023]  By Sachin Ravikumar and Ali Kucukgocmen

LONDON/ISTANBUL (Reuters) - Once Marion Parks found out she needed intensive dental work, the 55-year-old decided her best course of action was to leave her small English village to have implants — in Istanbul.

Parks is one of thousands of British people going abroad for dentistry. Where once they travelled for cosmetic work to achieve the perfect smile, now many are going for basic dental treatment that they say they cannot get in Britain.

"It's just a sign of the times," she told Reuters from her home in eastern England, prior to the trip. "It's a bit sad."

Famously the butt of jokes about bad teeth, Britain has a shortage of dentists, ranking third from bottom among 22 of the OECD's mostly rich nations in terms of access in 2021.

Problems with a government funding system have compounded the issue, meaning millions of people cannot access a low priced dentist in the state-run National Health Service (NHS).

With the cost of private dentistry prohibitive for many, the crisis has added to a sense of malaise in Britain, where a treasured national institution such as the NHS is in perma-crisis, with staff on strike, and the cost of living rocketing.

A parliamentary report in July said in extreme cases people were pulling out their own teeth - something it called "totally unacceptable in the 21st century". Charities warn that other ailments will be missed without regular dentistry access.

"I just feel sorry for the people who are in pain in the UK," Parks later told Reuters as she arrived in Istanbul to have one tooth removed and two implants fitted, paying a fifth of the cost she was quoted by a private British clinic.

There are no official statistics on dental tourism from Britain but interviews with six companies in the highly fragmented industry show UK dental tourism is either at record highs for those companies, or growing rapidly.

SURGING DEMAND

Parks' Tower Dental clinic in Istanbul has treated more than 500 British patients this year, up from 200 in 2022, and it expects that to continue to grow, helped in part by a weak lira.

Other dental companies operating across Turkey and in Hungary and Romania said they were seeing strong UK demand.

Medical Travel Market, a UK-based consultancy, received over 1,500 inquiries up to mid November this year, up more than 450% over 2022. Dental Implants Abroad says it has served a record number of British people in 2023, helping fly "hundreds" to Romania to get dental implants.

Dental Departures, which says it is the world's largest dental tourism company by revenue, is expecting bookings from Britain to jump 15% to a record high in 2023. And Dent Royal expects to have booked 600 UK patients to the Turkish seaside city of Izmir in 2023, up from 350 last year.

Eddie Crouch, the chair of the British Dental Association, told Reuters that the closure of British clinics during COVID lockdowns created a huge backlog and people were no longer just going abroad for cosmetic work.

Marion Parks, a 55-year-old British woman from a village near Ipswich, Suffolk, gets a dental X-ray taken at Tower Dental Clinic in Istanbul, Turkey December 4, 2023. REUTERS/Murad Sezer/ File photo

"Now, anecdotally I'm hearing that many patients are going abroad simply to access general dentistry," he said.

Vedat Etemoglu, who manages the Tower Dental clinic used by Parks, said there was a "staggering difference" in Turkish and UK dentistry bills, when an NHS dentist is not available.

In her case Parks has an NHS dentist but the service only provides implants in rare cases - such as when a patient has had mouth cancer - due to the cost. "Implants are usually only available privately and are expensive," the NHS website says.

She was quoted 5,000 pounds ($6,290) for two implants by a private clinic in Britain, as opposed to Turkey where she will pay 923 pounds ($1,160) for treatment including an extraction. The bill includes the cost of accommodation. The flight cost less than 200 pounds ($250).

NOT FIT FOR PURPOSE

The BDA industry body says the UK system no longer works due to a dental contract which the government introduced in 2006.

It says the payment structure does not distinguish between the complexity of treatments. As a result, many dental practices operate on a loss, and supplement NHS income with private work. Many do not accept new NHS customers. Some simply leave the service, reducing access for patients.

"We have a contract that isn't fit for purpose," BDA's Crouch said. "We have a workforce that is leaving in large numbers." He puts the number of those unable to access an NHS dentist at 12 million.

Parliament's health committee has said reform of the contract is essential. The government did not comment on the agreement but said it was making progress and would "shortly" set out measures to improve access to NHS dentistry.

A spokesperson said 1.7 million more adults and 800,000 more children were receiving NHS dental care compared with last year.

The spokesperson also pointed to plans, announced this year, to increase dental training places by 40%. Critics have said that hiring more dentists without reforming the dental contract will achieve nothing.

For Parks, she plans to return to Istanbul in April for further treatment. She said going abroad had been a "no brainer" and she had been really impressed with the service.

"It was outstanding," she said, walking through the streets of Istanbul two days after the procedure. "It has been a very worthwhile experience."

($1 = 0.7949 pounds)

(Additional reporting by Ceyda Caglayan in Istanbul and Ben Makori and Gerhard Mey in London; Editing by Kate Holton and Alison Williams)

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