Most of us age 50 and older grew up before the era of dental sealants — and we have mouths full of fillings to prove it. Those fillings are aging, and so are our teeth. 

“There’s an accumulation of a lifetime of wear and tear on teeth, and in spite of going to the dentist and getting things checked, teeth can deteriorate,” says Edmond R. Hewlett, DDS, consumer advisor for the American Dental Association and a professor at the UCLA School of Dentistry.

Getting our teeth back in solid shape as we age can be costly. Most people are surprised to find that Medicare doesn’t cover most dental care, dental procedures or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates or other dental devices. If you don’t have dental insurance, you can find a policy or get a quote online.

Crowns can cost $1,000 to $3,500 apiece. Dental implants can run $3,000 to $4,500 per tooth. Veneers, which are considered cosmetic and generally not covered by insurance, can be $250 to $2,500 each

It’s tempting to look for ways to lower these costs. And one way to do that is to travel outside of the United States for dental care. An estimated 800,000 people a year visit other countries to have their dental procedures performed. 

Julie Gavage is one of them. She manages This Is Luxury Travel and travels more than six months a year. She spends a lot of time in Bali and gets her dental work done there. “You can basically have a holiday to Bali and a dental procedure for cheaper than just the dental procedure at home,” she says. She’s done fillings for about $40, cleanings for about $30, and a root canal for $100.

While leaving the country works for some people, there are other factors to consider before going overseas for dental care.

And while it works for Gavage, those of us who live in the U.S. have other factors we should consider before going overseas for dental care. 

Mark Burhenne, DDS, of Sunnyvale, Calif., founder of Ask the Dentist, says, “Extensive dental work is frequently inexpensive in countries such as Mexico and Costa Rica, and can help some patients deal with the financial burden of treatment in the U.S. The major drawback to this is that care is often inconsistent in other countries.”

Here are 6 questions to ask before booking that trip:

1. Who is performing the treatment?

Many companies that provide overseas dental care vet the dentists, and there are often U.S.-trained dentists in these countries providing care. But do your research. 

“The U.S. is one of the world’s leaders in dental care based on technology available, education requirements, and safety,” says Charles Sutera, DMD, FAGD, a TMJ and reconstructive dentist with Aesthetic Smile Reconstruction in Waltham, Mass.

“To become a dentist in the U.S., it requires four years of college, four years of dental school training, and often advanced training,” Sutera says. “Many countries outside the U.S. may grant a degree after only half the amount of schooling.” 

2. What precautions are in place?

“Many countries outside the U.S. do not have regulatory bodies, so safety and quality of materials used can vary dramatically from provider to provider,” Sutera says. 

“Many countries do not have regulatory bodies, so safety and quality of materials used can vary dramatically from provider to provider.”
–Charles Sutera, DMD, FAGD

The U.S. has a robust system of safeguards. “I’m not saying it’s better in this country or that country, but it deserves some consideration by the consumer. In our system we take it for granted,” Hewlett says. 

He lists a few examples: licensure and licensure renewal regulations, infection control, radiation safety, and FDA oversight of the materials and instruments that are used. “There is a cost to that,” Hewlett says. “That’s part of the value of the standard of care we offer in the U.S.”

3. How are the procedures planned out?

“The more costly procedures tend to be more complex,” Hewlett says. Many of these procedures require careful front-end planning. For example, a 3D scan of the jaw helps your dentist precisely visualize and measure for implants. 

If you need multiple crowns and veneers, you’ll need your gums, bone, and bite evaluated. “It takes skill on the front end to plan something like that, and it takes the ability to adjust the plan midstream as needed and to address complications as they arise,” Hewlett says.

4. Where will you get follow-up care?

“With complex kinds of restorations, it’s never a matter of, ‘Okay, today we’re doing everything and now we’re all done. There are always going to be follow-up adjustments that need to be done,” Hewlett says. “It’s part of the process.”

He says it’s routine to check in a week after implants or extensive restorations to make sure the early stages of healing and adapting to a new bite are going smoothly. Then follow-up is as needed, usually a couple of times a year. 

Your dentist in the U.S. might want to do the work over to have control over the way things are done.

If you plan to have your dental work done overseas and your follow-up care done at home, you’ll want to make sure you have some understanding of that beforehand with your dentist. 

“That’s not going to be nearly as easy as it might sound,” Hewlett says. “Depending on complications or issues, the dentist has to consider, ‘If I start managing this patient’s situation, what’s my responsibility going forward if things continue to go wrong?’”

Your dentist in the U.S. might want to do the work over to have control over the way things are done. 

Burhenne, who has provided this type of follow-up care, agrees. “It’s a frustrating experience — the standards of dental care in the U.S. are among the highest in the developed world, and many developing countries have incredibly inconsistent standards. It can turn into a much larger expense in many cases, because follow-up care to correct poorly done dental work is not cheap,” he says.

5. What value do you place on familiarity and comfort?

Overseas dental care means you may be traveling to a provider you haven’t met, in a facility you have not evaluated, notes Sutera.

“Dentists develop very special relationships with patients,” Hewlett says. “A lot of patients find comfort in knowing someone knows them well. That person really feels very safe and very cared for. I don’t know what the dollar value of that is — that’s something I think each individual needs to think about and determine.”

6. What are your options for care at home?

Hewlett recommends talking about your plans with your dentist.

“If you’ve been going there, you must trust that individual. Perhaps they would be open to following up with you once you come back. Maybe you’ll find a way they can work with you on the financing that you might not have been aware of. Any patient who is a potential dental tourist owes it to themselves to talk to a dentist they trust and know,” he says. 

“I’m not here saying, nor is the ADA saying, don’t go overseas. But ask the right questions and be aware of some of these considerations before embarking on something like that,” Hewlett says.