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Old 20.12.2020, 19:32
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Dental Implant Treatment Outside Switzerland

Dear All,
I have been reading the various posts regarding Dental Implants and found in a few cases there are suggestions to perform the Dental Implant outside Switzerland. It could be primarily because of the cost or for any other reason. Can anyone kindly share his / her experience of doing a Dental Implant outside Swiss? We all know there are reviews, scores and other data points. However, sharing your own experience will be highly appreciated!
Regards
Neel..
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Old 20.12.2020, 19:43
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Re: Dental Implant Treatment Outside Switzerland

There are good and bad dentists in every country. However, with the Covid situation going on, you can't really plan future travel to other countries. That might be a bit of a problem if you would have complications and suddenly have to go back to your dentist outside Switzerland.
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Old 20.12.2020, 19:57
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Re: Dental Implant Treatment Outside Switzerland

Having implants is a process, not a one-off thing. It took something like 6-9 months if I recall to have mine done, with 4-5 appointments in all. And that was all entirely straight-forward with no complications. If you factor in the travel and cost of staying, the risk that there could be some difficulties, I would suggest to do it locally and just accept the higher cost for the convenience.
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Old 20.12.2020, 22:34
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Re: Dental Implant Treatment Outside Switzerland

Hello Jaudi,
Thanks for sharing, appreciated! I had a cursory look into the cost figure and found that within Swiss ( In Zürich, per se ), per implant it's around 3500 ~ 4000 CHF whereas outside I am seeing somewhere around 400 - 450 Euro. Honestly, am not sure what causes such a massive price difference. Yes, for the implant, at least two sessions are absolutely minimal, that I agree.

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Having implants is a process, not a one-off thing. It took something like 6-9 months if I recall to have mine done, with 4-5 appointments in all. And that was all entirely straight-forward with no complications. If you factor in the travel and cost of staying, the risk that there could be some difficulties, I would suggest to do it locally and just accept the higher cost for the convenience.
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Old 20.12.2020, 23:21
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Re: Dental Implant Treatment Outside Switzerland

I had quite a bit of dental work (implants, some root canal) done in Budapest about 5 years ago. It was incredibly cheap -- about 500 euros rather than the 5,000 I was quoted in Switzerland -- but also very good quality. 5 years later, everything is holding up well. Budapest was also a great place to spend a week waiting between the two sessions. I'm not saying that therefore you should do the same but for me personally it was a great decision. I turned something unpleasant into an enjoyable mini-vacation.

Whether this is possible / advisable during the pandemic is another question.
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Old 20.12.2020, 23:47
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Re: Dental Implant Treatment Outside Switzerland

I needed implants after a fall that broke a bridge. I chose to do it in Switzerland, despite the cost, because the process involved many visits. So as you are thinking about going abroad, here is what implants involved in my case:

As best I can remember, it was 12 visits , maybe even one or two additional that I've blurred out.

(Not counting the visits to determine that implants were the best solution.)

Regular Dentist:
1. Extraction of the anchoring teeth
2. Check up to make sure the gums had healed.
3. Impression to make a temporary fixture (not strictly required, but be aware you will be without those teeth for 6+ months)

Implant dentist:
4. Consultation with 3D X-rays
5. Second set of x-rays due to concerns with thickness of the bone
6. Implanting material to bond to existing bone because the bone itself was too thin.
7. Consultation to check that the material had successfully bonded, x-rays
8. Implanting the screws
9. Consultation(s) to remove stitches, check healing, x-rays

Regular Dentist:
10. Consultation to do impressions, select material for teeth
11. Consultation to place teeth onto implanted screws
12. Final check-up, adjustments.

In the middle of all this, the pandemic lockdown happened, so add another couple months to the time it usually takes. All in all, it was about 11 months.

I found it onerous enough to have to travel into Zürich to do all this, I can't imagine trying to do it in another country.

Yes, implants in Switzerland are expensive. But I trust my regular dentist, have been with him for 20-some years. He has never steered me wrong.

I felt comfortable with the implant dentist because the guy I know and trust recommended him. I wouldn't want to go through that without a solid recommendation from a trusted professional.

YMMV.

Hope all goes well for you with the procedure.
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Old 21.12.2020, 00:03
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Re: Dental Implant Treatment Outside Switzerland

I'm not a fan of the tourist travelling.



It's also about hygiene - lower cost generally means higher turnover of patients, more pressure on hygiene systems...



I have had one implant so far, and could have 3-4 more due to a genetic condition...


I have had one done so far:


1. Dental Hygiene visit to get teeth properly cleaned.
2. First consultation with dentist, full set of xrays. General checking of all teeth for any urgent repairs/treatment.

3. Second consultation to assess current situation, review x-rays and referral for an MRI scan to check sinuses/bone density.

4. MRI scan at another facility.

5. Third consultation with dentist to discuss options and make a treatment plan.
Dentist posted a cost estimate for the implant procedures.

6. Fourt appointment procedure to place bone graft to build jawbone as it was too thin to place implant.
follow up to check/assess and ensure no infection, remove stitches I think...


Then a long wait for the bone graft to develop (6+ months).


Further appointment to place the implant into the bone.


Another long wait for implant to fuse appropriately and heal (at this point, treatment can completely stop as the implant is under the gum and will fully heal over...



Preparation of the tooth.


PLacement of the screw and a temporary tooth to 'test' fitting.



Placement of the final implant.



Oh, and dental hygiene visits once a year over time.


The cost may seem big if you put it all onto one bill, and try to do it all at once. But for me it's also the balance of not taking any time off work for treatment, and doing it at the time when I am ready to do it.


It's not a walk in the park.... there is always recovery time, swelling and pain/discomfort, and the risk of infection.


It was absolutely not recommended by a friend who was a dental assistant in Switzerland for many years, to do too much dental work at once. The more you do at once, the higher risk of complications. It's not the dentist trying to make multiple visits, it's about spreading the risk and discomfort and not overwhelming the patient's healing system.



At least, that's my take on it.


The only person I know who went to Hungary or maybe Bulgaria to get substantial tooth work done , ended up with septic shock (blood infection) and managed to make her way by car, across the border to Switzerland and booked herself into the first hospital she found - emergency, 4 days intensive care and at least two further weeks off work... I am sure that cost far more than what she 'saved' by travelling outside Switzerland for treatment.


That said, I would also get my teeth treated in my home country (Australia) but it would actually not be cheaper. Dentistry with a high-quality specialist in Australia isn't substantially cheaper than Switzerland.
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Old 21.12.2020, 00:17
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Re: Dental Implant Treatment Outside Switzerland

Also have a dental implant, had it done in Zurich. Cost roughly 5000 chf over 11 visits. Cannot imagine how you would arrange 11 visits with a dentist far away. Am still very happy with the implant, 10 years later... I have a good (read : expensive) dentist who did everything (meaning he is also a surgeon) apart from making the implant. I had a infection of the jaw bone that rotted away part of the jaw (unnoticed by me). He had to re-grow bone before putting a screw in. As mentioned, 10+ years later all is well and I had no problems or issues.

My girlfriend had several implants done in Hungary, also all went fine (she has friends from university who live there and helped) ... but I would go the ZH route.
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Old 21.12.2020, 14:40
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Re: Dental Implant Treatment Outside Switzerland

Hi All, would also agree to “take the ZH route” in this case. If anything goes wrong after your visit to a foreign dentist (you get an infection, for example) you will have difficulties finding the dentist in Zurich willing to help - you will be asked to go back to the dentist who did the intervention in the first place. Had a colleague with a similar experience and he was simply asked to go back to Hungary as dentists in Zurich were “not sure about the history and what has been made”.

If all goes smooth, going abroad is fine, but in the unlikely case of something going wrong, it can become a nightmare.

Cheers.
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Old 21.12.2020, 21:52
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Re: Dental Implant Treatment Outside Switzerland

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Hello Jaudi,
Thanks for sharing, appreciated! I had a cursory look into the cost figure and found that within Swiss ( In Zürich, per se ), per implant it's around 3500 ~ 4000 CHF whereas outside I am seeing somewhere around 400 - 450 Euro. Honestly, am not sure what causes such a massive price difference. Yes, for the implant, at least two sessions are absolutely minimal, that I agree.
Rarely are two implantations the same. So the cost can vary depending on your circumstances. For example, if you need bone grafting than that will increase the cost compared to a base scenario (i.e. if this procedure is not needed).

We have been practicing dentistry in Switzerland since 2012; prior to that we practiced in Germany. From this experience, here are some thoughts I can share:

- there is much more risk of an adverse outcome after implantation than with most other dental procedures. So if you decide not to go local, then make sure you can return to the dentist quickly should things go wrong.

- as others said, implantation is a process that can take months; the length of time is dependent on what procedures are needed and the healing time.
Many places that cater to dental tourists compress the time by using various techniques (like immediate loading). This, of course, makes it appealing - who can resist the "New Teeth in 1 Day" promise; unfortunately, like with most things in life, there is a trade-off in that these techniques shorten the implantation time, but increase the failure risk significantly - the main reason why you don't see these techniques prevalent among dentists that don't cater to tourists and who provide a guarantee. Thus, if an implant fails and implantation needs to be redone, we do it at no additional cost to the patient.

- having such warranty is pretty important and we have seen cases where the patients informed us that the Hungarian practice they did the implantation has not honored it. It was not done explicitly, but by providing a long lead time for the follow-up and multiple reschedules, until the patient gives up and does it somewhere else.

- now onto the question of cost. There are three main components to the cost - the material cost of the implant (which includes the actual implant and the supra structure), the material cost of the crown and the cost of the dental labor.

1) The material cost of the implant varies greatly as implants come in different sizes (both in diameter and length) and are made of different materials. A cost for a standard Nobel Biocare implant (popular in the US) is about CHF 1300. Cost of Dentsply / Straumann (their premium lines, the gold standard around the world) is about CHF 900. You will not see these in a procedure that costs 500 euros in total. Instead, what you are going to get, is the smallest types of no-brand implants (mostly 2 mm diameter) even in situations that demand wide platform implants (i.e. need to be >4.5mm). These implants would have cost the dentist less than $50. They will, of course, break more easily and, due to the materials used, have much higher rejection risk. Again, it is a trade off between immediate up-front cost and overall life-cycle cost. As a dentist focused on local patients, we prefer something with low failure risk and long-term stability, as otherwise we have to re-do it at our own cost.

2) The material cost of the crown varies by country. Cost from a small lab in Switzerland is about CHF 900, done from a bite impression. Those of us that are 100% digital, use a scanner to take the bite impression, which opens up the possibility to work with larger labs (which have cost advantage as they can buy larger equipment and make many dozens of crowns at the same time) and, more importantly, opens up a wider geography for getting the crown done as the bite impression done digitally does not deteriorate with time as does a physical one. We have done work with labs in Turkey, Romania, Bulgaria, Hong Kong and Germany. A cost from a German lab is about CHF 500 for the implant crown; some of the other places are CHF 150 cheaper, but quality is less consistent and there are shipping delays. So the point here is that a dentist in Hungary will have similar ballpark cost for the crown as we do, unless he goes for thinner materials or lower quality. The same trade-off between cost / endurance / aesthetics here as with the cost of the implant.

These are just the material costs; quick math will tell you that a 500 euro per implant + crown cost is impossible, even in Hungary. We see on average 1-3 patients per month that come to us in emergency after the loss of the implant or with a broken implant (the worst outcome). Typically we hear they had paid 600-800 euros for the implantation alone (i.e. excluding the supra structure and crown).

There are other differences in techniques as well. We primarily do CT-guided implantations. It adds about CHF 350 to the implantation expense due to the addition of the surgical guide (produced by a dental lab), but it helps us achieve a level of precision in the outcome that is not possible with conventional freehand implantation. We have not heard of any CT-guided implantations done by the Hungarian clinics who focus on dental tourism.

In summary, you will pay in Switzerland between CHF 3500-4000 for a dental implant (full construction). It will involve about 6 visits over a period of 8-11 months. This will include everything, from the DVT to the crown placement. It comes with a warranty (you have to do your part to brush and maintain dental hygiene of course). Sure, some dentists here may charge more and some may not offer warranty, but both are easy for you to establish up-front before start of treatment simply by asking. Thus, your cost is certain and outcome can be relied upon. In Hungary your cost (full implant) will likely be around 1000 euros for the procedures, plus about that in travel. The implant won't be the same, and neither will the crown. It is not to say you won't get crap work in Switzerland as well, but it is easier to find out the bad local apples than it is to find the same in Hungary (more ppl you know would have local references). If the outcome is good and you are careful how you stress the implant, you will likely save some money. If the outcome turns sour, then it gets more expensive - even if you are lucky to get the work re-done at no cost, you still need to pay yourself the travel costs.

Not an easy decision due to the unknowns. Best of luck to you.
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Old 22.12.2020, 09:43
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Re: Dental Implant Treatment Outside Switzerland

Also made 1 visit to Budapest and came back with a bacterial infection, then stuck with the local clinics (Ireland/Switserland)
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