Jens* went to Kosovo for jaw treatment and estimates that he saved between 40,000 and 60,000 euros as a result. The 64-year-old “dental tourist” from southern Germany doesn’t have a guilty conscience.
FOCUS online: You recently went to Kosovo for dental treatment. How did that happen?
Jens*: Our drinks supplier has Kosovar roots and a dental problem similar to mine. Last year he told me that he was planning to have dental treatment in his home country. A few months ago he came back from the first part of the treatment.
With shining teeth?
Jens: Not yet, at that point he had a temporary solution in place. So no TV smiles. But he raved highly: Everything went great, he wasn’t in any pain, and the whole thing was more than affordable. He basically asked me if that wouldn’t be something for me too.
How did he know about your problems?
Jens: God knows that wasn’t hard to figure out. Everyone could see that I was missing a few teeth.
A couple?
Jens: Yes, the teeth and me, that is a vexing topic. From the age of 15 to my mid-30s, I went to the dentist a lot. There was drilling, filling, stuffing – probably not always professionally. The last 20 years have been a total horror show in terms of dental technology.
What does that mean?
Jens: I constantly had a toothache. Finally, I more or less avoided going to the dentist and the remaining treatment that was left.
What does “residual treatment” mean?
Jens: Well, there just weren’t many teeth left. Half if it comes up. Somehow you come to terms with it. With the fact that you can no longer bite peanuts or apples and also with the fact that every now and then a few nerve endings are dead again because the next tooth is out. Actually, that wasn’t the worst thing. At least the pain became less. However, being pain-free is only one thing. Not being able to bite anymore is of course not a long-term solution. My wife has been urging me to do something for a long time.
What was holding you back?
Jens: Unconsciously, I’m also afraid of the dentist. And last but not least, the crucial point: the costs.
What amount are we talking about?
Jens: I can only estimate here, because there was neither a cost estimate for the implants nor anything like a diagnosis. My estimate is a mixture of internet research and the result of numerous conversations – after all, almost everyone my age has some kind of dentures. We were talking about between 2,500 and over 5,000 euros per tooth, depending on the denture. Depending on the type of health insurance, depending on the tariff or whether you had additional insurance or not, you sometimes had to cover a larger or smaller part of these costs yourself. Usually it was the larger part. Let’s put it this way: I didn’t necessarily want to invest in a medium-sized house for the rest of my life…
How did you get that?
Jens: I assume 50,000 to 70,000 euros for the treatment here in Germany. You can imagine that I listened carefully as the drinks dealer reported. He couldn’t give a concrete statement about the expected costs, but he was sure: the treatment would cost a fraction in his home country. When he then said that he would regularly fly home for 25 euros…
… you were there.
Jens: Yes, I was. Everything went very smoothly. When he called the clinic for me, they said I could come in three days. In fact, we left a few weeks later. The friend had booked a holiday apartment for both of us during our stay. It was a good feeling to have someone who spoke German at my side. But it would have worked even without that. The young oral surgeon – estimated at most 30 – spoke English fluently. And surprisingly good German, almost without an accent. Even though he was never in Germany. As a child, he said, he watched a lot of German series on television.
Sounds like you felt comfortable straight away?
Jens: Yes, and not just because the communication was so good. The clinic was also a surprise. A positive one.
Tell.
Jens: Admittedly, I had imagined the rooms would be larger. But not so modern. The practice is on the first floor of a brand new commercial building. Everything is super chic. People in Germany are simply not used to that anymore. The health sector is generally in decline.
How did the treatment go?
Jens: I was put in front of a 3D scanner wearing a lead apron. A strange moment: you see yourself, without skin and “accessories”, just the bones and the teeth. From all sides. The doctor looked at everything carefully and measured everything. He seemed a bit surprised and said I was one of his more ambitious cases…
Were you worried that the planned treatment wouldn’t work?
Jens: Not really, but it quickly became clear that it wouldn’t be enough if I only came for the first treatment once. They said I had to introduce myself a second time after a few days. That seemed a little difficult for a brief moment because there had been a death in the doctor’s circle and he had to go to the funeral. He thought for a moment and then said: “Then just come on Sunday.” That’s exactly how it went. The entire staff came especially for me that day and the clinic was only opened for that reason. That’s what I call customer friendly.
Can you understand why people go abroad for dental treatment because of the cost?
Bianca Göpner-Fleige, executive officer for patient advice: If you only look at the financial side and want treatment that goes beyond standard care, I can partly understand that. Dentures in Eastern Europe, such as Poland or Hungary, including Turkey, are usually cheaper than in Germany. However, this has less to do with the costs of the dental treatment itself than with the laboratory costs, which in Germany make up around two thirds of the total costs and are usually higher than what foreign laboratories charge. German laboratories simply have to calculate differently because, among other things, we have very high non-wage labor costs here.
We spoke to a gentleman who assumes that his treatment in Germany would have cost at least five times as much as it would have in Kosovo. Are there dental treatments that only people with deep pockets can afford – or is basic care guaranteed for everyone?
Göpner-Fleige: The basic supply, in Germany we speak of standard supply, is guaranteed. It is generally financed by statutory health insurance, depending on the use of regular check-ups. However, over the last few years, patients’ demands have increased: Today, many want to go beyond standard care, for example to close a gap in their teeth with an implant and a crown. This is an artificial tooth root that is screwed into the jawbone and fitted with an implant crown. This is complex and therefore expensive. Patients have to finance the additional costs out of their own pockets. The most important thing: Whether such a treatment is successful can only be seen in the long term. Talk to the Lord again in three to four years.
In your opinion, what could potentially speak against treatment abroad?
Göpner-Fleige: In Germany there is a statutory two-year warranty on fillings and dentures. There can also be claims of this kind for treatments abroad. However, if complications arise, you have to go there again. German dentists are not obliged to eliminate complications caused by the dentures provided by other dentists, including domestic dentists. Treatment would be limited exclusively to acute pain. Another problem can arise from the fact that patient information abroad is only provided in the respective national language. Especially with more complex therapies, it is important to understand both the overall planning and possible risks in order to get a correct picture in advance.
Back to treatment. What happened next?
Jens: I was given a local anesthetic, three or four injections. Then I had a few teeth pulled. At the first appointment it was the lower jaw, at the second it was the upper jaw. While treating the lower jaw, the oral surgeon discovered that the bone probably wasn’t that great. That’s why he inserted a titanium plate in one place for safety. I was scheduled to have a bone scan done at a nearby polyclinic that same day.
Surely that was associated with unexpected costs?
Jens: No, the total costs result from the calculation of the 3D scan. Binding. 8500 euros. For the polyclinic, between 70 and 100 euros were added. In addition to the bone scan, a blood count was taken, I was vaccinated against tetanus and given a vitamin D preparation to build bones.
“Between 70 and 100 euros”… that’s a bit inaccurate.
Jens: If you take 100 euros, then the painkillers are also included. In Germany you would have spent that much just on the required ibuprofen.
How much did the titanium plate cost?
Jens: Nothing. It wasn’t calculated.
Why not?
Jens: The oral surgeon took it upon himself. As I said, you only pay for what was calculated as part of the 3D scan.
That sounds fair.
Jens: I think so too. All in all, I’ll end up with somewhere between 9,000 and 10,000 euros. Depending on how expensive the flight and accommodation are next time.
Are you already halfway through the procedure?
Jens: More. Part two of the clinic visit should be much less spectacular. Everything is already prepared for the implants in both the lower and upper jaw. The – as I call it in layman’s terms – counter threads or “dowels” are inside. Now all that’s left is the ceramic, screwing on the tooth parts, so to speak. At the moment I’m pretty toothless…
Wasn’t it possible to do everything in one go?
Jens: I was advised against this. The doctor said that before anything can be unscrewed, everything should grow in well and fuse well with the bone. Apparently doing everything at once is quite stressful on the jaw. I know you always hear about people who go abroad for dental treatment and come back after three or four weeks with a great smile. I rely on the opinion of the local surgeon. I have a really good feeling about him and the whole clinic.
And when will the radiant smile come?
Jens: At the beginning of June, then four months are over. It will definitely be very unusual to see myself in the mirror…
What does your conscience say about dental tourism?
Jens: My conscience is clear. As long as we have a two- to four-class society here in the German health system, I have no problem with it. Ultimately, what I do is born out of necessity – we can talk about cosmetic surgery abroad separately. Once again, my point of view is clear: not every average elderly person who wants to be able to chew food at 80 can invest in half a house. *Editor’s name known