BehindTheDentspeak: The inciDENTAL tourist

That was the witty headline as it appeared above the July 29 USA Today front page story by Mary Beth Marklein on the newest trend in dentistry: "tooth tourism."

Long story short: like medical tourism, its dental counterpart takes advantage of the fact that in many countries around the world dentists are trained at least as well as in the U.S., if not better, yet charge laughably low rates compared to U.S. prices.

Even after factoring in the cost of travel and lodging and all the rest you can still come out far ahead.

For example, look at the table that leads this post.

Here's the article.

The inciDENTAL tourist

The first day was, admittedly, not great.

Within hours of landing in Vienna, a jet-lagged Nancy Carothers was tilting backward in a dental chair, mouth wide open, a dentist poking at her molars.

It wasn't too painful, though.

It was also part of the plan.

And by the end of her 10 days in this small border town, Carothers had much to smile about.

She had visited Budapest and Vienna, sampled some of Hungary's most popular wines and enjoyed people-watching in neighborhood cafes.

When she returned home to suburban Washington, D.C., she brought gifts for friends and a few souvenirs of her own, including eight new crowns.

A trip to the dentist may not be everybody's idea of a vacation, but it paid off for Carothers.

Literally.

The tab for her dental work came to $2,900 — about a quarter of the $11,150 she estimates she would have paid had she gone to a preferred dentist in her employer's insurance plan.

In all, she spent just under $4,300 on dental care and travel, including a $45-a-night hotel room and last-minute airfare at a pricey $899.

On top of that, "I could see a country I'd never seen before," says Carothers, a Silver Spring, Md.-based health educator with the federal government.

Austrians, Germans and other Europeans for decades have been crossing the former Iron Curtain to get their teeth fixed, often at jaw-droppingly low prices.

Now, a small but growing number of Americans, prompted by soaring medical costs and dwindling insurance benefits at home, are following suit.

They're contributing to the rising popularity of "tooth tourism," a relatively young trend here, but part of a fast-growing global phenomenon in which travelers, typically from wealthier countries, visit less-developed nations for medical care mixed with vacation — all at cut-rate prices.

Cosmetic surgery, in particular, is reshaping the face of medical tourism.

Want a nose job?

Combine it with a safari in South Africa.

Face lift?

Go to Mexico and lollygag at the pool while you recover.

Or, get bigger breasts in Bangkok and tummy tucks in Argentina.

Although it's buyer beware, most Web-based medical tourism companies boast state-of-the-art facilities and highly trained medical staff.

In Hungary and other Eastern European countries, dental tourism is putting a twist into the trend.

Here in Mosonmagyarovar (moshon-mag-yah-RO-var), brass plaques and molar-shaped signs bearing easy-to-grasp names like "Eurodent" and "Happy Dent" line the streets along a central shopping district.

Some clinics take up a full block; smaller practices are tucked inside hotels, above gift shops or beside casinos.

"Ten years ago, there was no dentist tourism," says Eva Szalai of Tourinform Mosonmagyarovar, a tourism office that displays brochures for dentists.

Today, she estimates that about 150 dentists practice in Mosonmagyarovar, population 33,000.

The slightly larger Sopron (SHO-pron; population 58,000), another dental mecca about 60 miles away, has about the same number.

How can they keep costs down?

"One reason. The manpower is very cheap," says Frank Kannmann, Carothers' dentist, who moved his practice here five years ago from his native Germany.

There, Kannmann says, most of the cost goes to lab technicians and salaries.

Here, he says, he uses the same materials, pays his staff better-than-average wages and still makes a bigger profit.

Kannmann averages two to three U.S. patients a month; Germans and Austrians remain the core market here.

Many of them traditionally combined dental visits with shopping for other lower-priced goods such as cigarettes and cheese, says Sopron tour guide Istvan Vranich.

But as the gap in the cost of other goods has been closing, border-hopping has become less attractive, says Istvan Tama, a tourism marketer in Sopron.

"So if dentists want more patients," Tama says, "they'll have to get them from other markets, like the English or Americans."

That may explain why dentists are trying to drum up U.S. business.

Carothers found Kannmann, for instance, through Posh Journeys, a Reno-based travel agency that has been offering dental tours since 2001.

In May, Poland's Vita Medical Dental Institute in Krakow picked up nine appointments during a Chicago trade show sponsored by the Polish American Chamber of Commerce.

And Budapest-based Kreativ Dental opened a tourism office in New York five years ago.

But 9/11 and, more recently, the fall of the dollar have slowed momentum, says Akos Szilagy, Kreativ Dental's U.S. rep.

The company has served fewer than 100 U.S. patients, he says, "but we are working on it."

Meanwhile, in Mosonmagyarovar, businesses are boosting service for long-distance dental patients.

In the past two years, entrepreneur Florian Scheuer has built a business arranging lodging and airport transport for small dental practices, including Kannmann's.

In February, 8-year-old Diamant-Dent, one of the biggest outfits in town, opened its second clinic, an upscale complex, featuring Italian tile and Spanish furniture, along with an on-site hotel.

Guests who register for its "dental week" package are picked up at the airport and get a free massage.

There are, of course, potential downsides to a dental tour here.



Though locals may know some English, German is a more dominant second language.

Dining, too, can present a challenge for sensitive teeth — Carothers nibbled mostly on tuna salad or spaghetti.

Also, many businesses, including some dentists and hotels, don't accept credit cards.

But, Carothers says, most inconveniences are minor — and part of the adventure.

As for caliber of care, the American Dental Association consumer adviser Matt Messina offers caution.

"My concerns are not for the quality of dentistry received... but for the patient when it comes to long-term follow-up and possible complications," says Messina, who practices in Fairview Park, Ohio.

"The term 'buyer beware' is very much in play here, as you may have fewer options after treatment if you feel it has not gone well."

On that count, Carothers, who doesn't have a regular dentist, acknowledges she took a leap of faith — though she had confidence in Kannmann based on the recommendation of Posh Journey's owners, who had been treated by Kannmann.

"I knew if I walked in the office and it didn't look right, I could leave," she says.

Today, more than two months later, she still has no regrets.

Those concerns aside, dentistry and tourism seem an ideal match.

Carothers was delighted, for example, to get all of her work done in one fell swoop.

And once the major part was out of the way, stopping back for brief fittings left ample time for sightseeing.

Mosonmagyarovar and Sopron are tucked into the Western Transdanubian region, home to thermal spas, wellness retreats and castles along with biking, fishing and kayaking.

It's also the former stomping grounds of composers Franz Lizst and Joseph Haydn.

Sopron is the more attractive of the two, with its cobblestone main square and preserved baroque architecture.

Mosonmagyarovar, too, has its charms, including a castle-turned-university and a quaint downtown.

But perhaps its biggest asset is its location, as Darioush Dadian, 48, a restaurant owner in suburban Philadelphia whose visit to Kannmann overlapped with Carothers', discovered.

After his first appointment, he took off for an eight-day visit to Germany.

After a second appointment, he visited Vienna, just an hour's drive away, and even-closer Bratislava, Slovakia's capital.

Back in Mosonmagyarovar, he happened to meet a local man who invited him horseback riding.

"The highlight of this trip is the people you meet here," Dadian says.

Well, that, plus the cost. Dadian, who found Kannmann on the Internet, had work done on 26 teeth, including crowns, bridges and two extractions.

A dentist back home estimated $43,000 for similar work, Dadian says.

He paid Kannmann $6,000.

"It was grueling that first day," he says.

But "I look better. I feel better. It's money well spent."

***************

If you go...

Getting there: To reach Mosonmagyaróvár or Sopron, it's best to fly into Vienna or Bratislava, Slovakia.

In Mosonmagyarovar: Among the 150 or so dentists practicing here, those with English-language services include Dr. Frank Kannmann (011-36-96-217-979 or happy-dent.net) and Diamant-Dent (011-36-96-579-067 or diamantdent.com), which has its own hotel (doubles, $83 a night) and provides airport pickup from Vienna.

Posh Journeys (775-852-5105 or poshjourneys.com) is a Reno-based company that has been offering dental tours using Kannmann's services since 2001. Their dental packages include accommodations, rental car or airport pickup, a complimentary initial exam and tourism information. They offer a 10% discount on dental services.

Also, dental-offer.com (0036-70-586-9600) provides links to several dentists and helps coordinate accommodations, airport pickup and related matters. General information: infosite.hu.

In Sopron: The most established dental office in town is inside the family-owned Best Western Pannonia Med Hotel (011-36-99-312180 or pannoniahotel.com). (Its office website, dentalpannonia.com, is in Hungarian and German only, but some dentists and staffers speak English.)

In Budapest: Kreativ Dental (888-573-2848 or kreativdental.com) offers dental services and arranges flights, lodging and tours. Patients are booked into the Hotel Amadeus, where doubles run about $40 a night.