Dental costs: How not to drill a hole in your pocket while getting your teeth fixed
Every little girl dreams of getting crowned one day but sadly, for most grown-ups it's their teeth rather than their head that becomes the recipient in later life. As the old joke goes, it would be much more useful if we grew our second set of teeth at 60 rather than six.
This big girl is undergoing crown fitting and will be significantly lighter of pocket as a result and therein lies the first problem. There is little consistency about treatment prices. Although it is mandatory for dentists to display a price list, you can pay anything from €40-€100 for a filling. In my experience you can pay anything from €260 to €1,000 for a crown, with country dentists tending to be cheaper. Braces can send the bank manager off the rails.
City practices are far more expensive in the main; they'll argue that their premises have higher rents but the first tip in keeping your costs lower might be to travel to a country destination.
Going further afield for more complex treatments has become popular. Clinics abound north of the border, and in foreign destinations such as Budapest and Turkey. While many are top notch and offer a great service, others need to be approached with caution.
Cork-based dentist Anne Twomey, President of the Irish Dental Association, says that business is picking up, but "90pc" comes from bread-and-butter cleaning and fillings rather than cosmetics like veneers and tooth whitening.
"They're not coming in saying they want teeth like Simon Cowell, but people are re-kindling their relationship with their dentist," she says. "There is an established link between oral health and general health. We see other medical practitioners referring patients to their dentist and there is good science out there to link gum disease to other illnesses, such as diabetes."
With the State providing precious little free treatment, going for a 'check-up' can put people off if they feel there'll be further expense involved. Twomey describes the State's cutbacks as cynical. "They only kept the check-up for PRSI patients because they know we look for mouth cancer. 95pc of dental work is preventable so it would be much better to support everyday work than have people getting extractions."
Indeed, Mouth Cancer Awareness Day is next Wednesday, 16th September. There are more than 300 new mouth cancer cases diagnosed every year (see mouthcancerawareness.ie).
But it's easy to be tempted by prices in Eastern European clinics, especially if there's lots of work involved.
"Dentists have changed; we do price fairly. In Australia, you'd pay four times the price treatments cost here. Perhaps 20 years ago we didn't like to talk about money, but we've all grown up a bit now," says Twomey.
"I've seen very good work carried out abroad but also some appalling treatments. The problem is if something goes wrong, it's much more difficult to go back to the dentist. No treatment is forever; that's like saying you can get your car serviced only once - it's an ongoing need."
For parents, an unexpected bill can often accompany the shock of being told your child needs braces. 'Train tracks' might mean an ugly couple of years for an adolescent, but these days they can be clear, invisible or even come in county colours. What they are in every case, though, is costly - anything from €400 to €7,000 can batter any household budget.
When my son Andrew needed them I shopped around and decided to go to Newry, finding a huge difference in price. The clinic allowed stage payments, and the Sterling differential proved beneficial - it is not so now. The benefits were twofold: it worked out 40 pc cheaper, and tax relief (at 20pc) is still allowed on what you do pay, irrespective of where you get it done in the EU, as long as it's a 'qualified' practitioner.
Most people are nervous enough when it comes to seeking out a dentist.
Anne O'Donoghue of the Northumberland Institute has 25 years' experience as a periodontist and implant surgeon. She has tips for those seeking a dentist for treatment to avoid problems later on. She cites one patient who had 12 implants fitted by another dentist where unnecessary work was undertaken.
"This type of over-treatment is a regular occurrence; 25pc of our patients are those returning with complications from surgery elsewhere.
"One of my favourite patients is a 92-year-old lady who still has all her own teeth. Twice yearly check-ups, cleans and polishes have a huge role to play."
Home and away: Quality check-up
Sourcing an Irish dentist
* Don't go somewhere purely for a free consultation.
* Ask friends and family for referrals and recommendations.
* Make sure you get plenty of time in assessment.
* Ask for a written report and have a cooling-off period after consultation.
* Do not be afraid to grill your dentist - ask them what your treatment options are and what other choices do you have?
* Ask if s/he has examples of the suggested treatment, before and after images etc.
* What happens if treatment is unsuccessful or you are unhappy with the result?
* If there are complications and further treatment is needed, who pays?
* Is the practice/surgeon EU Regulation compliant? You can find out about health regulators and professional bodies in other countries on www.fedcar.eu.
* Will the same person I meet for a consultation in Ireland be the person who actually treats me/performs the surgery at the foreign clinic?
* What material and brand is going into my mouth? Look for internationally approved companies (e.g. Straumann, Nobel Biocare etc.)
* Is the material you are using for an implant crown plastic or porcelain? (There can only be ONE answer here!)
* If I need aftercare, where do I receive it? If I have to travel, who pays for it?
* Will I be given all my records after treatment in English?
Are you insured?
Most private health insurance companies offer some insurance on dental visits. Laya, for instance, has a money-back option on half of its policies and it includes routine procedures along with emergency treatments. It's usually capped at a percentage or specific claim amount per year, so do check. Anne Twomey says many of her clients avail of this while others were never aware it was an allowable claim.
Cash Back Insurer HSF offers non-hospital and dental policies. Their 'Scheme FDA', for example, costs €56.60 per month for the whole family, with 100pc money back on dental visits up to €500 per year, along with a range of medical procedures and doctor visits (www.hsf.ie).