After a few directions from locals, I found my destination. The dental clinic looked clean and modern. It overlookeda busy, dusty intersection. Amid the intersection was a chaotic dance of cars, scooters and pedestrians all trying to navigate the road.
The road was surrounded by faded signs and slanted poles that supported knottedpower lines, some just wilting into the dirt. It seemed like a developing area. Tempos drove alongside brand new four-wheel drives.
An older woman dressed in a sari passed a younger girl wearing skinny-jeans with a leopard- print bag. A young man stood near her, absorbed in his smartphone.
I am reassured by these signs of modernity
The traffic stirred the dust from the road, it rose up like smoke as I trudged over the bricks and rocks, I felt like I was wearing a veil of dirt as I made my way into the clinic.
My dental negligence, largely influenced by the huge cost of dental care in Australia, has resulted in the need for quite a bit of dental work. I can’t even remember the last time I visited a dentist. It’s not that I didn’t want to go, I just couldn’t afford it.
An inquiry by the Australian Dental Association last year found that the demand for public dental services currently far outweighs the resources and workforce needed to meet the needs of those who rely on the public sector for dentistry.
The problem with dentistry, it said, is that the majority of dental costs are borne by the individual, not the public, as is the case with medical care costs.
Because of the high cost of dentistry and the number of people choosing to go overseas for treatment, there is a rising number of Australian companies offering dental tourism holidays. These companies organise flights, accommodation and even sightseeing packages.
Dr Turner, an Associate Professor at the Centre for Bioethics and the School of Public Health from the University of Minnesota said some years ago that we can thank the internet for facilitating dental tourism. Dental tourists can now have a cyber-tour of their potential clinics, and dental clinics can also advertise easily to their international patients.
Dental and medical tourism has become so common now that Health Insurers have responded to the growing practice. Recently, the Australian Health Fund NIB introduced a 12month guarantee for medical tourists. The cover extends to cosmetic, as well as major dental work to clinics and practitioners that the Health Insurer has vetted.
Before my trip, I began to think about the prospect of getting some work done while I was in Nepal.
The Australian Dental Association stresses the importance for those considering overseas treatment to do their research.
Among their list of cautions, they advise prospective patients to find out where their dentist was trained, if it was a reputable university and what the health standards are for that country. After all, they warn – “it’s your health in their hands”.
The ADA says that one of the trademarks of dental tourism is compressing multiple treatments into a short time frame, and this can increase the chances of a complicated procedure.
The problem with getting treatment done in a short timeframe means that if something does go wrong, the symptoms of a botched procedure might not appear immediately. By that stage, the medical tourist is back at home, may not be able to pay for another trip, and is left with the additional cost of getting their procedure fixed by local dentists.
The ADA warns against compressing multiple treatments into a short time because the teeth and gums need time to settle after getting any work done. They ask any prospective dental tourist to ask themselves “does the cost truly weigh up against the risk to your oral health?”
With the ominous cautions of the ADA in my mind, I considered the risks, which were quickly overshadowed by the enticingly low cost of dental treatment in Nepal. I was willing to risk it.
As I sat in the reception room, filling out the pre-consultation questionnaire, I scan the walls looking for reassurance that I had come to a reliable clinic.
There were three other Nepalis waiting, one of them was reading a broadsheet newspaper. There was also another tourist in the waiting room, sifting through his backpack.
The receptionist’s desk sat between two walls, flanked by posters that outlined the dental clinic’s hygiene standards and procedures. Another wall, which led down into the dentists’ offices, was dotted with awards and qualifications.
The receptionist told me that the clinic gets a lot of international visitors. She says that they treat almost as many tourists as they do Nepalis.
“Lots of the tourists come from the US”, she says, “but they come from all over”.
I lay back in the dental chair while the dentist prods around in my mouth. The room is clean and modern and seems a world away from the chaos on the street outside.
As I tell the dentist the work I want done to achieve the perfect smile that has thus far eluded me, she tells me that “functionality is important too”, and says that I may not be able to have all the work done that I want to do in the short time that I am in Nepal.
Her cautious approach to my haste testifies to her professionalism, and reassures me that I have chosen a reliable dentist.
She has a patient and calm look about her. I felt same in her hands, which were now prodding small, sharp silver tools in my mouth, inspecting the damage.
My first consultation, which included a check-up and a clean costed me around AUD $35, had I done the same work at home, I would be looking at parting with an average of $125.
My dentist told me that I would need quite a few fillings before I should consider any kind of cosmetic work. The average cost of a filling at the clinic is around $20 to $40 per tooth. The average cost of a filling in Australia is anywhere between $150 to $300.
My sense of frugality surrendered to my vanity and I decided to get some bleaching, and also some tooth-reshaping done.
The receptionist changes one of the existing patient’s booking to fit me in, so that I can fit in all the work that I want done and still have enough time for my teeth and gums to settle beforethe next treatment.
I felt confident with the treatment and care that I was getting, but not everyone I met shared my faith in the Nepali Dental Industry. As I sat in the waiting room, before the bleaching, an international volunteer came and sat next to me.
After an accident, his embassy sent him to the clinic. My friend told me that he just got some temporary cement, because he was due back to his home country in a month. “I prefer to get it done at home”, he tells me.
He put his hand on my shoulder and leaned in. There was earthy-coloured sediment settled into the corners of his mouth, the smell of red wine lingered in the air as he spoke.
He confided in me that he had had a few glasses of wine before he came to the clinic. “I’m like a kid, I don’t like dentists, I was scared”, he said
The dentist beckoned me, “good luck”, he said, as I gathered my things and headed into the office.
The day after the bleaching, someone from the clinic called me and asked how I was feeling. I’m impressed by their service, and I wonder if I would receive the same kind care in Australia. The bleaching costed around NPR 1350, that’s around $150.
After a check-up, a clean, around four to five fillings, a bleach treatment and reshaping on three teeth, my total spend was NPR 30150. That’s equivalent to $334.67. Had I received all this treatment in Australia, I would have spent well over a thousand dollars.
I have now been back in Australia for three months. There are no signs of a botched treatment, and I am happy with the care I received in Nepal.
Getting good dental care in Nepal is not so much a matter of ‘good luck’, as my drunken friend in the waiting room told me. Rather, it is the result of heeding the sober advice offered by bodies like the Australian Dental Association, that stress that tourists thoroughly do their research before getting any work done overseas.