Published: 22/07/2004, Volume II4, No. 5915 Page 23

Is the idea of sending acute dental patients to India given the cost and waiting-time benefits? Abhijeet Kulkarni thinks not

The acute shortage of NHS dentists appears to be causing discomfort to many patients - some are beginning to explore how to get early treatments elsewhere. Some are reported to go as far as Hungary. There are several other locations to choose from, however - and with good reason.

Outsourcing of dental services abroad seems a smart option. It aims primarily to reduce the surplus of clinical work, and shortage of skilled manpower, rather than to reduce costs, or take away existing jobs. It is therefore wise to allow people to make an informed choice to take elective treatments at a much earlier stage, at a much lower cost, under the watchful eyes of the NHS, in a guided manner, in overseas locations, and with active support and collaboration of NHS dentists.

Dental healthcare facilities in countries like India are very much comparable to the NHS, except they are very cheap. The lower costs result not from lower quality but factors such as cheaper cost of running clinics, lower laboratory bills, technicians who charge much less, lower general cost of living, a less litigious culture and the ensuing lower cost of medical and dental indemnity insurance.

Moreover, since dentistry worldwide is highly mechanised, most dental equipment and material is imported from comparable and reputable sources, mostly in Europe, Japan and North America. The only probable difference is the level of paperwork required.

Another concern may be the level of sterilisation and infection control.

From personal experience in Mumbai, and observing the dental set-ups in the UK, I can see no basis for these concerns. Most dental clinics follow the required sterilisation norms and in Mumbai, for example, many clinics seek certification from 'standards' bodies such as the International Organisation for Standardisation to reassure increasingly informed overseas patients in a consumer-driven environment.

The cost benefits are obvious. Treatments like dental fillings can be done much earlier before they require costlier alternatives.

Composite fillings are available for less than£15, which is considerably lower than what it would cost in Britain. Single-sitting root canal treatments can be obtained for£50 or less. Dental implants are available for about£300 per implant, depending on the type of system and surgeons charges, but are considerably cheaper than the£2,000 it might cost in the UK. Fabrication of dental prostheses may require laboratory support, and therefore greater time commitments from the patient, but dentists in India work longer and at more convenient after-office hours.

Another benefit would be the reduction in the inflow of overseas dentists to Britain and the reduction in damage, if any, this immigration causes to the health systems of these countries.

NHS dental practices can benefit from the comparatively cheaper dental laboratory services in countries like India. Many laboratories receive orders from overseas dental practices. The overall cost to patients staying in the UK can be cut if laboratory bills are cut by outsourcing.

Dr Abhijeet Kulkarni is a general dental practitioner in Mumbai, currently in the UK to pursue postgraduate training.