Sunday Independent (Dublin)
October 10th 2004

Albert Smith saved more than €9,000 by making his dental appointment in Budapest and enjoying a week's holiday there.

MODERN anaesthetics and high-speed, hi-tech equipment have taken the physical pain out of most dental work. But the financial agony is worse than ever.

   If you need any treatment more complex than an extraction or a simple filling covered under
PRSI, prepare to remortgage the house.

   Unless, of course, you fancy a little holiday.

   My odyssey began because I was presented  a heart-stopping bill after I asked a Dublin
dentist what she would charge to install half a dozen crowns and a couple of bridges  to
restore six teeth with  worn fillings and replace a loose, intrusive partial denture.

   Thirteen-thousand-four-hundred euros, she said sweetly.

   The price, in other words, of a perfectly decent new car.

   I would rather, I vowed, have a smile like Shane McGowan's for the rest of my life than
part with that kind of dosh for a job which I knew would only require a few hours work on her
part.

   So I began, in this age of `health tourism' to look at some of the alternative routes to my
 fairly standard dental treatment. First there was the North, where cursory inquiries
indicated I could have cut between 25 and 30pc off that monstrous bill.

   However, cruising the web threw up a much more realistically-priced alternative: Take my
dental problems to Budapest , the Hungarian capital, to which canny Austrians have been rushing for dental treatment since the Iron Curtain fell and where price-conscious Britons and Dutch have been heading in increasing numbers over the last few years.

 I decided to try the highly recommended Kreativ dental clinic, set up by a retired British
dentist, Ian Domville, who filled it with the latest western technology and hired highly
trained Hungarian dentists. I e-mailed, described the work that I needed  and asked for a
quote. The six crowns, which my Irish dentist said would cost €1,000 each, would set me back just over a quarter of that (€265 per unit), I was told. The additional bridging work would
bring the total bill to €3,265 ... €10,135 less than my Irish dentist demanded.

       In the event, it turned out that getting the work done in Hungary was a lot less
hassle. One of the worst things about having crown and bridge work done here at home is that the dentist is invariably miles away from the technician who actually makes the metal and
porcelain units that go into your mouth. It usually takes weeks - and several visits - before
you leave the dentist with the job complete. During those intervening weeks you face the world and all who know you with  temporary dental wear which frequently looks and feels naff – often while your dentist and the technician blame each other for the delays.

   In the Kreativ clinic they do it differently. On Monday morning the dentist worked on me
for three-anbd-a-half  hours, completing the preparatory work and taking impressions, which he handed over to  technicians working in the clinic as part of the team.

   I was then free to enjoy  Hungary with temporary teeth for three days (the clinic even
provide a free seven-day travel pass for Budapest ) before returning on Thursday, when my
crowns and bridges were fitted in one  half-hour session. No adjustments were needed but, if
they were, the technician was working just feet away and would set to work immediately - no
delays, no "come back next week" ... or next month.

 On Saturday - just six days after I arrived - I flew home with the job done.

 The drawbacks? I found none. Yes, you do have to go away for a week, but Budapest is a
fascinating, highly-cultured city packed with museums, delightful architecture, bewitching
music and lots of things to do. I would have been delighted to spend a few days there anyway.

   The Danube flows through it and offers interesting possibilities for boat trips ... to
provincial towns or as far as Prague or Vienna . There are lots of wonderful baths to enjoy and
prices for food, drink and transport are far lower than those at home.

   Staying at the hotel attached to the clinic, which offered a 50pc discount to patients,
provided a number of readymade friends who were all in the same, surprisingly humorous, boat.

 Even allowing for the cost of flights in August (the dearest month), and of making the jaunt
into a really enjoyable six-day holiday in Budapest , I saved around €9,200.

 And, yes, you can claim the cost of the treatment against you tax bill,  just as if you had
it done in Ireland .  Ask the tax office for a form Med 1 and the clinic will fill it in for
you.

  As far as the problem of what you do if you have problems with the work done to your teeth
after you go home goes, the clinic couldn't have been fairer. They guarantee crowns for five
years and implants for 10 years. If you have a minor problem or need a small adjustment after
returning home, they will pay for you to attend a dentist in Ireland . If the problem is more
serious, they will fly you back to Budapest , at their expense, to put it right.

But they seldom shell out on such flights. The standard of work is extremely high - it is
worth remembering that before the Iron Curtain fell, Hungary was regarded as one of the most medically advanced nations in the world with an exceptionally good reputation for producing doctors and dentists of the highest calibre.

   It is a tradition they jealously guarded and maintained under communism. Not one of the
patients I met during my six days in Budapest was a `returnee' with a failed or unsatisfactory
treatment.

   There are direct flights from Dublin through Aer Lingus and Malev, the Hungarian national
carrier. But if you take a cheap flight to London then the low fare options such as Easyjet to
Budapest come into play and  you can realistically expect to fly Ireland-London-Budapest
return  for under €200.

 Once at the clinic, where the staff speak English, you should have no problems ... apart from
grinding your new teeth at the extortionists who quoted you monstrous bills at home.

   Overall, the scale of the rip-off we endure from Irish dentistry is nothing short of a
national disgrace. Ivan, my extremely competent Budapest dentist, spent a total of four hours
working on me. Admittedly, the time taken by the clinic's technicians to construct the crowns
and bridges would have been considerably greater. But even so, the €265 per crown seems a
perfectly adequate price.

   For an Irish dentist to demand €1,000 a crown as "the going rate" is nothing short of
obscene.

 It surely does not take an Irish dentist or technician, using the same equipment, three times
or even twice as long as his or her Hungarian counterpart to provide a dental treatment. And
if it does, you would have to question their competence - who wants to spend extra hours in
the dentist's chair?

   Quite simply, we are being royally screwed by a cartel whose members have banked for years on our fears - and, until recently, the difficulties and cost - of leaving the country for
treatment. Only when this grasping cabal find that their waiting rooms are empty because we
have  taken our dental problems elsewhere will they fess up and introduce a reasonable pricing policy.

   Unless, of course, the government decides to actually use that great-sounding competition
legislation brought in two years ago which empowers it to take civil actions against
individuals or professional bodies involved in price-fixing. But I wouldn't hold your breath
if I were you.