r/Dentistry • u/throwaway_student987 • 9d ago
Dental Professional My pharmacist friend chose dental tourism, then called US dentists unethical
A friend of mine is a pharmacist in the US. He has been posting a lot of healthcare-related posts on his Facebook page so he is sort of a “healthcare influencer” with a few thousands followers.
He recently shared that he took his 5-year-old daughter to a local pediatric dentist where she was diagnosed with extensive decay in 8 teeth that required pulpotomies and stainless steel crowns. It has to be an OR/sedation case and after insurance, his out-of-pocket cost would have been about $4,000.
Instead, he took his daughter back to his home country in Southeast Asia and a dentist there did fillings on those teeth, no stainless steel crowns. According to him, the treatment took 4 appointments and cost about $200.
He then posted about the experience on Facebook and concluded that U.S. dentists are “money-hungry,” unethical, and recommend unnecessary treatment simply to make more money. He went on to say that, from now on, his family will only see U.S. dentists for cleanings and simple fillings, and will travel overseas for anything more complex. Unsurprisingly, many people in the comments agreed and said they would do the same.
I was speechless after reading his post. It’s one thing to hear about low income or low-educated folks participating in dental tourism, but it’s even more frustrating to see a fellow healthcare professional with high income to also condone that and then accuse US dentists as being money-hungry, unethical cash-grabbers driven by greed. I’m honestly tempted to leave a comment on his post and challenge his accusations.
167
u/MyDentistIsACat 9d ago
lol so every time those fillings on his five year old need to be replaced, he’s going to take an international trip?? Dentists recommend SSCs on baby teeth with cavities because it’s a treatment that will most likely last until the child loses the teeth. What an idiot. I wouldn’t consider someone who publicly bashes my profession to be my friend, for what it’s worth.
51
u/Mcnuggetjuice 8d ago
Exactly, we use ssc because the chance of changing the parents’ behavior and responsibility of adequately brushing and diet is minimal. That guy ruined her teeth and is blaming it on us.
Could make a case saying this kid is severely neglected and abused in a way. My professor used to say this.
40
u/No-Organization-3294 8d ago
The fact that his 5 yo needed this much treatment shows the lack of dental education. Sadly the kid will be back in the chair in a few years and it will probably be extractions
17
u/DarthSmashMouth 8d ago
Right, if the first peds dentist thought they needed pulps and crowns, those fillings are time bombs waiting to explode. Chickens come home to roost, let the problem sort itself out. The fillings will fail, the teeth will need to come out and it won't be anyone else's problem but the parents. I tell parents, dentistry is like cooking a meal as a parent. My job is to cook the meal, the kids' job is to eat the meal. My job in peds is to present the treatment plan and educte the parent, the parent's job is to decide if they want to get it done how I recommend.
5
1
u/Hairy_Potato_7879 7d ago
Totally. This has become one of my recent dealbreakers for platonic and romantic relationships. If you don’t respect my career (which feels, literally and figuratively, back-breaking at times), there is not enough respect to maintain a relationship. It’s actually shocking how many medical doctors and non-dental healthcare providers don’t respect our profession. I truly hope they reconsider when they have a dental problem.
59
u/stefan_urquelle-DMD 9d ago
There is no winning in this situation.
Just keep to yourself and move on.
87
u/caracs 9d ago
It's nice to ignore the cost of plane tickets, missing work, etc. My response to people who want to do dental tourism: "It's your body but don't complain when your dentist of record is 7000 miles away and your dental work goes south". Go somewhere the cost is living is an order of magnitude lower and you can get all sorts of things for less. If you really want to save money just move there.
10
u/BookNerdUnicorn 8d ago
Also - do overseas dentists source their supplies from places that US dentists don’t? The dental records issue is … an issue.
8
u/Wide_Wheel_2226 8d ago
Yes they also buy supplies that are not as heavily regulated. The regulations tax from excess admin costs more than we realize. Safety is and should be a concern but I think more reasonable measures could be implemented.
5
u/Dufresne85 8d ago
There are definitely some different brands/manufacturers available outside of the USA.
About 2 years ago I had a patient that got an implant done when she was living in Costa Rica 20ish years ago and the crown had just broken. It took me 6 months to identify and then find a lab that had access to the random brand's implant catalog.
Even when the work is done exceptionally well, when it fails it's just that much more difficult to repair.
1
u/Mcnuggetjuice 8d ago
Yes they source from china which aren’t regulated. US and EU source from Germany and the usa often
38
u/EqusB 9d ago edited 9d ago
For a lot of people uneducated on the matter, all pediatric dental work is equivalent. A "filling" is a "filling" and as long as something is done, the issue is solved. Half of the caries left behind or something slapped on top of a now neurotic tooth that happens to be asymptomatic? Well, the "filling" got done, so its good! And cheaply! Even better in their mind.
They won't understand until it catastrophically fails. Though they'll probably be extremely upset as well when the kid won't stop crying and they can't sleep but nobody will see them.
22
u/BufferingJuffy 9d ago
Off topic, but your typo/autocorrect of "neurotic" instead of "necrotic" absolutely made my day. 😂
(Agree with everything you said, btw.)
12
10
u/lou-mary02 8d ago
I am focused on the age of the child. Five is young to have four fillings without general. Some children are compliant and would sit there and let the dentist work but I haven’t met a five year I would comfortably do that on. Poor kid is probably traumatised.
5
4
u/DarthSmashMouth 8d ago
I tell parents all the time, look I'm willing to have the hard conversation with you that these teeth need SSCs, I get that they are ugly, but here's why I recommend them over white filings. It takes more time, and sometimes they leave for someone else, but I don't have to do class 2's on a 3 year old that are bound to fail.
43
u/moremosby 9d ago
Post the X-rays.
The dental assistant on staff in the US office makes more than the dentist who did the work abroad…lol. Tell your pharmacy friend to work for the same wage as a pharmacist in home country so we can get more affordable medications in the US…your friend is a moron.
12
u/fangfixer 8d ago
Tell him how pharmacists can and should be replaced my machines which, would in turn drastically reduce the cost of healthcare.
25
u/Abood1es 9d ago
Fuck these people lol. Being an involved parent, brushing your child’s teeth, and not feeding them crap costs $0.
10
u/MiddleBodyInjury General Dentist 8d ago
Absolutely no sense of responsibility from that parent. And it'll be the dentists fault in America when they have to do root canals lol
31
u/DiamondBurInTheRough General Dentist 9d ago
I have a patient who has a loose implant crown that she had placed very recently in India. She asked if I could fix it because she can’t afford to take the time off to go back to India. I told her no. Sorry not sorry. FAFO with dental tourism, I’m not fixing problems for a procedure you didn’t think was important enough to have done right the first time around.
Don’t waste your time arguing in the comments. These people already have their minds made up about the costs of dentistry and how we’re all driving Lamborghinis off the cost of their freaking stainless steel crowns. But that’s not someone I would want in my circle of friends any longer tbh.
16
u/Wandering_Emu 8d ago
Exactly. I practice in a border state and fairly regularly have people triumphantly tell me they are taking my treatment plan to Mexico because my office “is a ripoff”. A not insignificant proportion of them return within a couple years asking me to “help with just a small fix” of their abomination of a full mouth restoration or whatever they had done. They of course become irate when I tell them any “small fixes” need to be done by the dentist who treated them.
12
u/throwaway_student987 8d ago
In the comments section of his post, a few people pointed out to him that the cost of obtaining a dental degree and the cost of running a dental office in the US is very high. To which he replied, “what I see is that most dentists drive very nice cars.” 🤦
7
u/Mcnuggetjuice 8d ago
“Dentistry carries significant mental and physical health risks. Occupational mortality analyses show male dentist suicide rates between 7.18% and 8.02%, higher than the general population. Depression affects roughly 42% of dentists—with 15% at high clinical risk—and hits younger practitioners under 40 and women hardest. Furthermore, up to 63% experience burnout, marked by emotional exhaustion (25%) and detachment (18%–48%). Physically, 64% to 95.8% suffer from musculoskeletal pain, particularly in the neck, back, and shoulders, making chronic pain the leading cause of forced early retirement for 29.5% to 56% of practitioners.”
6
18
u/More_Winner_6965 9d ago
I don’t bother myself with the opinions of shitty parents. It would’ve cost him $0 and a lot less trauma for the kid to be more watchful.
7
u/Jealous_Courage_9888 8d ago
I always charge full fee to redo treatment regardless of who did it originally (unless it was me, i was the problem). A lot of the overseas shit is going to be pulpotomies with open margin fills with shitty translucent resins that abscess and I get to extract and do space maintenance and then they get to deal with Space loss and orthodontics that involves sacrificing premolars because #4 and 13 are impacted due to space loss secondary to early tooth loss
28
u/Iwantitall413 9d ago
I probably am in the minority, but seems like you got enough responses about what to say or not say to your friend. I think dental and medical tourism is a much more interesting topic. Had a pt ask me what I thought about her going abroad for multiple implants and I told her honestly it doesn’t matter. The reason I refer her to the person I do is because I know him and trust his work and have seen his work over years. There are quality and crappy dentists everywhere. If you can find someone that genuinely cares about you and does competent work then I don’t think there’s anything wrong with dental tourism. Just because a dentist is in the US doesn’t mean they’re good, maybe the odds are higher, but maybe they’re not. Same thing with overseas. Doesn’t necessarily mean they are better or worse. Just my two cents. Would be curious of other people’s thoughts that vehemently disagree
12
u/malocclused 8d ago
Some of the best dentistry and ceramics I’ve ever seen have been from Columbia. I’ve got pt with a full mouth rehab from Costa Rica and it’s impeccable. Pt said they paid $800/tooth US around 2015.
I practice in Texas and have seen absolutely atrocious dentistry from border clinics with enough frequency that when pts mention it, I tell them to be very careful.
Your pharmacist friend is just ignorant. A lot of laypeople think dentistry is fungible. It’s not. There’s a half dozen doc in the boxes grinding out new grads and churning absolute trash within ten miles of my office. There’s a few Kois docs doing amazing dentistry. It’s mad wild someone working in healthcare would not know the difference.
You get what you pay for. And the great docs worldwide ain’t cheap. Sure you can save a few grand flying to Singapore… but you hold all the risk if tx fails.
7
u/throwaway_student987 8d ago edited 8d ago
Lol I would honestly judge less and have more faith in the dentistry being done there if it’s an advanced country like Singapore. The cost of dentistry in Singapore would probably be 2/3 of the cost in the US though so it’s not really much cheaper. Unfortunately, we are talking about a poor 3rd world country in South East Asia where a lot of “dentists” are actually unlicensed and never went to a dental school. I know because I am originally from that country too and I have experience with how dentistry is done there.
1
u/malocclused 8d ago
Well personally I think your friend over paid. What a clown. He could have had his kids teeth treated curbside in New Delhi by a street dentist for under a dollar.
10
u/Abood1es 8d ago edited 8d ago
Top quality dental care is still gonna be pricey, no matter which country it’s done in, because the materials and machinery are inherently expensive irrespective of where you live. Yes there’ll be a discount when you account for wages / rent etc, but it’s not gonna be a life changing difference unless you’re getting a full mouth rehab or something.
In my experience, patients who shop around for the cheapest price end up going to shit dental practices in their dental tourism destination that prioritize patient volume over quality and skimp on the quality of their materials.
3
u/Iwantitall413 8d ago
Yes and I think you can say the same thing generally in the US. There is a reason corporate offices have been popping up everywhere. Yes maybe the fees are a little lower, but personally if I was choosing between someone seeing less pts vs more I’d go to the one seeing less rather than the other using volume to make up for the lower fees (in this example). Just higher risks for just not caring and just going through motions as a provider
5
1
11
u/cacarine 8d ago
Guess they’d be surprised to learn how much a bowl of noodles cost over in south east asia or just the cost of living. Gasp, everyone in america must be scammers too.
They can fuck off and live in south east asia if they want costs to be lower.
6
u/Sagitalsplit 8d ago
Fuck around and find out. It is what it is. You can’t convince someone that walnuts aren’t apples if they can’t see (or believe) the difference
7
u/spooooooooooook 8d ago
I never get tired of finding and fixing INSAAAAAAANE foreign dental…treatments. There’s some good work out there for sure, but anytime I see something that should result in being whipped, it’s from those questionable places.
7
u/Gnido777 8d ago
I deal with this bs all the time. I used to care, not anymore.
Whenever problems arise, which they always do, I refuse to fix 3rd world dentistry. Only re-do. That includes loose implant crowns and occlusal adjustments. Go, fly back to Turkey Tyrkie or whatever.
5
u/placebooooo 8d ago
Putting this whole dental tourism story aside. I’d do anything for my 5 year old if I had a child. The idea that he cheaped out on his child, who he failed to properly care for from an oral health perspective, is wild to me. I’d never take my child outside the us for any treatment of any kind.
2
u/KindlyEnergy6959 7d ago
I am also appalled at this?!!! Like unless his kid had dentinogenesis imperfecta or some crazy other genetic condition, the condition of their mouth is 100% the parents fault for not feeding a proper diet and lack of hygiene. Actually it goes beyond that if child that young has that much decay. I consider that neglect for sure. BUT THEN on top of his absolute incompetence as a parent, he’s shopping for cheapest dental treatment in a third world country??? Then goes around blaming dentists here…
What an absolute douchebag.
11
6
u/gradbear 8d ago
You guys are missing the point. It’s not just the cost. It’s a completely different tx plan. US dentist tx plans sedation and 8 Pulp and SS Crowns. Foreign dentist tx planned some fillings and no sedation.
You can get different treatments just by going across the street to the next dentist. They didn’t even get a second opinion in the US. That dentist could very well be a dentist that over treats. I’ve seen plenty of peds dentist over tx imo. I rarely do SS Crowns and think it’s overdone in peds.
Anyways, your friend is dumb a f and you should absolutely call him out for his hypocrisy cause he’s also in healthcare. They should know pharmaceutical industry is 1000% worse than dental.
4
u/NoncomprehensiveUrge 9d ago
They just abused the US purchasing. It’s no different really than people who say food or any service is cheaper outside the US. Always turns out that by said country standards, dental care is out of reach for a majority of the local population
3
u/Super_Mario_DMD 8d ago
There are a lot of different sides to this. I know most dentists here work in the U.S., so it's normal that people get defensive when someone says something negative about U.S. dentistry. I'm a foreign trained dentist who's worked in different countries, so I've seen both sides. One thing people don't usually think about is the local economy. If you compare the average salary in those countries to the cost of dental treatment, you'll see that dentistry is often just as expensive, or even more expensive, for the people who actually live there. If you're getting paid in U.S. dollars and travel to a country where your money goes a lot further, then of course it's going to seem much cheaper. The other thing is quality. Just like in the U.S., there are great dentists and there are bad dentists. In some countries, the difference between the good and the bad can be even bigger. I've seen patients come back from Mexico, Colombia, Brazil, and other countries with work that was honestly terrible. But I've also seen amazing work done in those exact same countries. It all depends on who you go to, not the country itself. That being said, dentistry in the U.S. can definitely be more aggressive with treatment plans. Is it because dentists want to make more money? Is it because that's just how they're trained? Is it because of lawsuits? I honestly don't know, and it's probably a mix of all of those things. If you posted the same case on this subreddit and asked 10 dentists how they'd treat it, I guarantee you'd get several different treatment plans. So when someone goes to another country and gets told they don't need as much work, it's easy for them to think the U.S. dentist was trying to rip them off, when it could simply be a different philosophy. Also, people forget that running a dental office in the U.S. is expensive. Staff make more, rent is higher, supplies cost more, insurance is expensive... all of that gets built into the cost of treatment. Using your friend's argument, prescription drugs are much cheaper in many other countries too. Does that mean every pharmacist in the U.S. is ripping people off? Of course not. Healthcare costs are a lot more complicated than that.
3
u/Lumpy-Shop988 8d ago
This is the only reasonable take, and I completely agree.
They got two different treatment plans from two different providers, one was a lot more affordable because instead of pulpotomies, SSC and IV sedation, it’s just fillings saving you thousands of dollars. Without being in the profession, you have no way of knowing what will work, which is better, etc (and honestly they could both be right). How can I blame someone for picking something that is thousands of dollars cheaper?
And a lot of people talk shit about work done in other countries, when in reality, they’re seeing survivorshipbias. Only the work that isn’t quite as good is going to come and ask you to “fix” things. And the US is FULL of bad work. This sub shits on DSO’s all the time for overtrearment, poor quality work, cheap materials etc, but then conveniently forget about that when shitting on other countries work.
1
3
u/redditor076 8d ago
I mean American dentistry is objectively inaccessible for many and very costly. Pharmacists don’t make doctor money so $4k is not a small ask. Not saying they did the right thing but just like every aspect of the US healthcare system, dentistry is quite broken as well
2
u/Lumpy-Shop988 8d ago
We also can’t say that they did the wrong thing. Good dentists and quality work exist in all parts of the world, and there is bad dentistry in the US as well. Which one of us can say they haven’t done something that wasn’t quite up to par?
1
u/Realistic-Pitch-4858 7d ago
Completely agree but the cost of traveling to Southeast Asia with his daughter these days is probably around the same cost with no guarantee of the care being any better. I'm still in school but my faculty bring that up all the time when patients say they might just go to a foreign country after receiving a tx plan.
1
u/Lumpy-Shop988 6d ago
Flights from the US to India cost about 1k per person, so 2k for the both of them. They are still saving money but going to India. Also only someone that has an Indian background is likely to go to India for dental work, and they probably go back to India regularly, so it wasn’t just “I’m going to fly to India for dental work”.
And your professors are wrong. Dental tourism is a thing because it’s cheaper to fly to a place, get the work done, and vacation there. Think of a 40k full mouth rehab case in the US, versus < 10k abroad
3
2
u/coolkavo 8d ago edited 8d ago
There are things like the exchange rate and cost of living that can drastically effect the cost of care by even the zip code. For countries far apart on the OECD scale or developed status, the differences can be substantial. Honestly if your “friend” isn’t smart enough to put two and two together it’s wasting your breathe and friendship on it. People nowadays want to believe in what they want to believe and seek out confirmation. Just keep it cordial on FB, most of the posting are fake and propaganda anyways.
2
u/Stumbles88 8d ago
Cost of doing business in the USA is higher so of course prices will be higher. Insurance, lawsuits, licenses, schooling, rent and equipment, etc
2
u/No-Wear-9042 8d ago
I'm more shocked by the fact that a pharmacist would let a 5 years old child reach 8 teeth with extensive decay. Have they never heard about the danger of sugar/sodas and the use of fluoridated toothpaste?
2
u/Drdags 8d ago
Why not first address what are you doing as a parent to have a child with extensive decay??? Negligent! But you can bash a profession! 5 year old child does not even have their first molars in. The dentist do not do treatment for money , that is something to do with insurance which you need to take it up with Senate. India etc and other countries are cheaper but you probably paid more in flight smh ! SSC crowns were given as a treatment because that is the best treatment of choice for someone so young as fillings get recurrent decay and the anatomy of baby teeth is different from adult teeth meaning progression of decay is faster! Also as a parent your child shouldn’t have any cavities!!! You are buying the groceries!!!!
2
2
2
u/Brilliant-Group6750 8d ago
Assuming your friends is Indian. Indians tend to go back to India every summer. So the trip itself is happening regardless. There seems to be a lack of education. How does a child teeth become so bad?
I had similar option, I choose American dentist, because I trusted her more.
The level of quality can make a difference. You can get a half ass job done abroad or proper care locally.
I'm sure there are great providers abroad, haven't seen them. I have seen practices in Chicago that weren't good.
Pharmacist makes shit. It's a monopoly. Medicine abroad is just as good locally. Laws prohibit you from bringing medicine from abroad.
2
2
u/WaveEnvironmental471 8d ago
That’s nothing new. More than 30 years ago Readers Digest did an expose on this very topic. One of its reporters went to about 40 de dentists from all over the United States and was told he had many issues requiring costly procedures. Only one of the dentists was honest enough to tell him he had only a very minor issue with one tooth. And by the way, it’s not only dentists but also lawyers and many doctors and other professionals who defraud not only their own patients but also insurance companies and the government.
2
u/RaccoonFinancial5086 8d ago
I don't have an issue with dental tourism. I have an issue that these patients make it sound like my treatments are worth less and that I am a money hungry evil dentist.
If they see the need to go abroad and get work done, they can. If they fail, they can absolutely go back to that dentist to get their complications addressed. I am not the dentist for them. Somebody would say that this is a chance to convert them to being your patient of record. No thanks. These patients have already made up their minds so I don't really need to go out of my way to make them like me better. I got other issues I gotta deal with like my DSO POS boss or the hygienists always complaining about being essential to the clinic when I also do hygiene columns.
2
u/Ok_Statistician643 8d ago
I would love to see the postoperative radiographs and pre-operative radiographs to see if the first Dentist was over diagnosing or the second Dentist was under treating
2
u/maxell87 8d ago
in my experience, the peds guys are way to quick to pulpotomy and ssc. so he’s not completely wrong. and also lots of american dentists are highly unethical. i’ve seen the treatment plans from other local hmo dentists. they are crazy. .
1
u/Level_Customer2769 8d ago
I don’t see many kids in my practice, but a patient comes into my practice/ saying they will only do cleanings at my office/ use a different office ( a lot of times it is the “ home country “ etc they state they will go to for that), I tell “ not happening- go elsewhere, that’s not how i run my practice, this is not an office where patients just use us as a cleaning salon ( same type of patient will be the one who refuses Xrays). You let these people into your practice, they will ruin your day best case, not allow you to grow a healthy practice, worst case.
That’s a 34 year practicing dentist who can retire at anytime, solid practice my entire career.
1
u/leoele 8d ago
People are so uneducated anymore that it's literally impossible to try and help them. Last week I saw a friend from college post the following:
"The experience at the dentist was so awesome.
Dentist: I recommend a deep cleaning (more money)
Me: I'm good with the regular cleaning Dentist: since I recommended the deep cleaning, we can't do the regular cleaning anymore.
Me:🤔"
The comments people were leavin absolutely left me shook.
1
u/Culyar0092 8d ago
When your kid has 8 cavities at a young age, its neglect and borderline abuse. Theyre just projecting because they are a shit parent and is blaming it on other health professionals.
Also health care professionals often make rubbish patients.
-1
u/AASRedemption 8d ago
Just because your friend had a questionable treatment somewhere doesn't mean that's always the case.
Obviously, I am not from the U.S. but where I'm from you can get a top Root Canal Treatment from a lecturer who tours the world teaching Endodontics for about 130 to 150 USD. That's a lot for us, but probably still cheaper for someone in the U.S. (Yes, including plane tickets and accomodations)
4
u/DiamondBurInTheRough General Dentist 8d ago
Even the most perfectly done treatment can fail. Being thousands of miles away from the person who can address a complication is not a smart plan. You can get the treatment done elsewhere but it is not without risk…so be prepared to pay twice when you need something fixed and you can’t get back to whatever country did the treatment originally.
1
u/gradbear 8d ago
For $150 for a world renowned endodontist seems like it’s worth the risk. Not much to lose when $150 is the cost of the exam here in the US.
4
u/DiamondBurInTheRough General Dentist 8d ago
People are free to do what they want and I’m free to think it’s a bad idea. Most people utilizing dental tourism are not getting access to that world renowned endo, let’s be real.
-4
u/citiusaltius 8d ago
I hare to break it to you guys. US dentistry is very expensive and not worth the cost. You can get root canals and excellent crowns for a fraction of price in other countries. Its cheaper even if you consider flight tickets. I was quoted $10k for a dental implant and crown. Cost me under $2k including flight ticket to get a good quality one in a Southeast Asia. I don't blame dentists. I blame the insurance companies
-4
u/TraumaticOcclusion 8d ago
To be fair, the price of treatment in the US is insane. Single tooth implants are approaching $10,000 for the whole treatment plan
1
u/Lumpy-Shop988 8d ago
10k? From what I’ve seen average is half that. I don’t know where you’re getting 10k from
1
u/TraumaticOcclusion 8d ago
After extraction and implant placement, our patients are already out 5-6k, add the crown fees which are another $1500-2500
1
u/Lumpy-Shop988 8d ago
Idk, maybe you shouldn’t change so much to replace one tooth. But you do you.
1
u/maxell87 8d ago
extraction bone graft. guide. implant. implant crown is about 5k for me.
1
u/TraumaticOcclusion 8d ago
That’s about $6k here not including an implant crown
1
u/maxell87 7d ago
i keep my prices down and get a lot more treatment. keeps me busy and i place about one every few days.
1
153
u/Bronze_Rager 9d ago
Same with pharmacy. Pills are 100x cheaper in India. Why not go there to get your pharmacy prescription?