ARE CHEAP DENTAL TRANSPLANTS A REALITY FOR AUSSIES?
(Author Trevor Payne shares his teeth restoration experiences)
Author Trevor Payne is a former daily newspaper journalist who commenced his career in South Africa and Rhodesia (now Zimbabwe) and then travelled to the United Kingdom for a couple of years before settling in Australia in 1972.
Since retiring, he occasionally writes investigative feature stories, particularly when the subject matter is challenging to readers’ interests and has wide applicability to their lives.
This particular feature story concerns itself with the exorbitant cost of extensive tooth transplantation procedures within Australia and demonstrates the considerable financial relief that can be found overseas without compromising on the quality of the dental surgical standards that would be expected in Australia.
The story is not a recommendation for general dentistry needs, as it concentrates specifically on a procedure normally known as “all-on-4” transplants where a full arch of crowns (usually numbering 12 teeth equivalents or more) are arranged on a bridge supported by 4 implants into the upper or lower jaw bones, or both in the case of full-mouth restorations.
It is usually designated an “all-on-n” procedure where “n” is the number of implants in each jaw, usually a minimum of 4, but frequently 5 or 6 or more depending on the health of the jawbone tissue and what the jaw (and wallet) can accommodate.
The author provides a firsthand account of what was entailed in having 16 of his unworkable teeth replaced by 24 transplants (12 each top and bottom) that are now fully functional for eating once more and also look “nice” too.
He estimates that his cost savings of doing the procedure in Mumbai, India, as against in Australia, was a minimum $23,000 at the cheapest available prices in Australia (about $40,000), but, at the generally quoted prices of $54,000, the savings were a remarkable $37,000.
The Mumbai experience was made more expensive by the included costs of two return air flights totalling about $2200 and about 4 weeks’ hotel accommodation at nearly $4000 at a modest establishment next door to the dental clinic.
This story, though, is not entirely about the financial aspects of the experience; it opens the door to preparing the “patient” for what to expect during the process, and the precautions that are necessary to avoid some potentially disappointing discoveries when it is “too late to turn back” that possibly can trigger the onset of “buyer remorse”, as was aptly expressed to me by a fellow transplant recipient.
It should also serve to quell the commitment anxiety and indecision that inevitably plagues one’s thoughts to proceed with major dental surgery in a distant country where little is known about surgical standards and practices along with the nagging worries about the ramifications of making a poor or wrong decision!
The short answer to that last concern, at least for this author, is don’t worry!
Mumbai was the best possible solution that I could find for anybody that must have this procedure done.
It is appropriate to declare here that no benefits were sought from any entities that could gain financial returns from the publication of this story, which is offered free to all media outlets, including business and educational services, upon publication permission from the author. The intention of the story is to demystify the procedure for others who are facing the trepidation of the unknown regarding all-on-4 transplants in a foreign country.
Content copyright reserved wholly by Trevor Payne, 80 Chinderah Bay Drive, Chinderah, NSW 2487, Australia. Email: trevor.seaski@gmail.com, December, 2024.
Mumbai puts the bite on ‘all-on-4 dental surgery
(& big dollars in your pocket!)
Australia is readily recognised as providing one of the best free healthcare systems available worldwide, yet, paradoxically, it has one of the most prohibitively expensive dentistry industries to be encountered within the developed nations, leaving its citizens in a parlous financial position when it comes to managing their severe oral health options.
And oral health’s invasiveness is now considered to be one of the world’s most prevalent health issues that affects peoples’ lives, being more common than cardiovascular disease, stroke, cancer or diabetes and contributing to all of those conditions as well, to some extent.
It is so prevalent that 90% of Australian adults have suffered tooth decay at sometime in their lives and about a quarter of the population (some 7 million) have untreated decay.
Severe tooth loss afflicts 15% of Australians and the national government estimates that one million citizens aged above 15 years have no natural teeth at all.
Five years ago, some 30% of adults aged above 15 years suffered moderate to severe periodontitis, which is a contributor to heart disease, high blood pressure, stroke, cancer and is the leading cause of tooth loss in adults.
One report places Australia’s teeth health as the world’s third worst after the Philippines and India in terms of the DMFT scale, which is a measure based on decayed (D), missing (M) and filled (F) teeth: (https://www.dentalproductsreport.com/view/5-countries-with-the-worst-oral-health).
This scale recognised that nearly 50% of Australian 6-year-old babies teeth are decayed and this can have serious consequences for the permanent teeth when they eventually replace the baby teeth. By comparison, India had 70% of the population under 15 years suffering dental caries and 95% of all adults with gum disease, only surpased by nearly 100% of Filipino children aged 3-5 years having cavities.
Clearly, there is an enormous number of Australians who require and need quality dental services, but they are confronted by the prohibitive cost of such services within our national borders and, for the less affluent, that means foregoing remedial procedures and coping as well as possible with the subsequent suffering.
At best they can seek free treatment at a dental school where dental students can gain industry experience under the guidance of properly certified dental teachers, however this may entail considerable patience while awaiting a surgery opportunity and is not widely available.
The only other prospect for defraying treament costs in Australia is taking out private insurance and this option provides limited financial relief because of the cost of the premiums, which, over the life of the insurance term, are probably little better than the full price of the treatment sought. Thus, if the patient cannot afford this treatment out of pocket, they probably cannot afford it through private insurance either.
Implant insurance usually only covers 50% of costs, and at best 70%, so a large amount remains to be found when the implant procedure is fixed at prices like the $54,000+ for full mouth restoration in Australia. Some practises even quote prices greater than $70,000.
This leaves patients in a situation where they must seek treatment from sources other than Australia, if they can, which was precisely the only financial option for this author 9 months ago (April, 2024). Many others who underwent transplants at the time of my visits were not only suffering poor oral circumstances, but had teeth conditions that were probably contributing to serious cardiovascular disease as was the case for one patient from Perth, who needed a triple bypass operation and another who had undergone a quadruple bypass and both were in their fifties.
I also saw two instances where the patients had almost perfect teeth but they suffered from severe and irreversible gum disease that could develop into heart disease, stroke, diabetes or even pneumonia, all potentially life-threatening, if the teeth were not removed.
In my case, where the 16 teeth available to me had only two opposing teeth that could be called functional for chewing purposes and which were becoming painful and were rapidly failing as well, my fairly dire oral situation could no longer be ignored.
Owing to my financial constraints, I had for five years closely investigated the best price options on the internet for the remedial work I needed doing (all-on-4 transplants) and I kept coming back to Mumbai as the city that purported to offer undeniable price competitiveness in combination with world best practises.
This CBCT (Cone Beam Computed Tomography) dental scan of the author’s remaining teeth assisted the surgeon in determining the optimum placement for the titanium implants. The 3-dimensional X-ray technique provides more comprehensive information for diagnosing dental conditions and planning complex treatments like dental implants.
Is Mumbai too good to be true?
In particular, one clinic seemed to have the maturity of sustained performance in the procedures most appropriate for me and it also displayed the aggressive promotional prowess to keep it highly ranked in the internet search engine algorithms that I factored in.
So my decision of choice finally went to a clinic called Dentzz in Linking Road, Khar, and was swayed by the endorsements on its website from a great many Australian and other western nationals who were very supportive of the care and surgical expertise they received at Dentzz.
At this time I was the recipient of a very small financial windfall that just covered the costs of the dental care quoted by Dentzz of about $7500 along with the travel and hotel costs (about $2700) that accompanied a single visit to Mumbai, so, with some trepidation of stepping into the unknown, I decided to accept the cost and make the commitment.
What follows gives some credence to the adage “if something is too good to be true, it probably is” as what transpired for me, and others I met in Mumbai, was not so much an issue of something being “too good to be true” (what I received was as good as stated and beyond personal expectations), but really a matter of how it was stated.
This might seem convoluted to the average Australian, but some things in India are convoluted, and in a city the size of Mumbai with a population the size of Australia in its entirety, there do seem to be some business precepts that are considered acceptable for their norms, but would not be so from the Australian perspective.
This said, the cost and inconvenience caused by what could be judged a subterfuge on the part of Dentzz’s quoting system, is not especially an issue for those overseas patients who have spare finances and can afford an unexpected cost overrun of, say, 30-40%, but it is a problem for those who have scant funds to cover such an inconvenience and only find it out after arriving at their treatment destination.
Above all other considerations, this is an inconvenience that is easily averted if, either, Dentzz reviews its quoting system to transparently reveal the entire roadmap of treatment and the approximate costs for both “Phases”, or the prospective patient is forearmed with the knowledge to insist on getting specific costs at the time of quoting and before their departure.
If this is addressed properly, it will only benefit the service provider and give confidence to the potential customers to proceed with their necessary dental work. That said, the average Aussie/Kiwi patient I spoke to (more than 10 in total) about the cost factor “surprise” all said that even at a 100% cost blowout, the final cost remained exceptionally competitive to their home country asking price so they had no regrets about their decision to visit Mumbai.
What caused the cost surprise?
In order to understand what awaits them, intending patients need to know that this transplant procedure definitely entails two visits to Mumbai with a period in between each visit of about 5-6 months to allow the first surgery to heal and for the implants to integrate with the jawbone tissue before the final prosthetics can be constructed and fitted. In this period, the jaw shape is changing slightly as a consequence of the teeth extractions.
A mistake I made in calculating my final costs was not knowing that I needed to allow for two lots of airfares as well as a second lot of accommodation as my quote ambiguously spoke about the procedure technology being so advanced that it only required a single visit of no more than 10 days!
I saw other patients’ quotes in Mumbai that confirmed my quote as being of a standard format and some of them, like me, had been surprised by the additional costs, while a few others said they expected there to “be a catch” and were not too surprised.
The initial quote I received, which is presented in part elsewhere here, also failed to disclose that for purposes of the “all-on-n” procedure, Dentzz’s costs are apportioned separately for what is termed the Phase 1 process of surgically removing existing teeth, implanting the titanium posts, stitching and fitting temporary dentures before the 6-month intermission, to be followed by a second visit, Phase 2, as a separately and additionally invoiced treatment, for surgically exposing the implants again, fitting abutments to the implants, more stitching and then constructing and fitting the final fixed prostheses.
Unhappily, the additional costs of Phase 2 were an encumbrance on my original budget of $11,000 (calculated from my initial quote, or Phase 1 quote, and being the only quote that was issued) as it added a further $3600 for clinical costs and about $2700 in additional accommodation and airfare costs, altogether not an easy ask for a pensioner.
For some this could be considered unacceptable and I did have related to me a case where a New Zealand visitor was so furious that he cancelled his treatment in Mumbai forthwith and returned home, but, for my part, I was glad I could proceed with it because the outcomes have been above expectations as testified to by another person I shared this journey with who was so pleased with his results five months after the final transplants that he declared it “the best thing that has happened to me” and went on to describe his thorough pleasure at being able to chew on and savour the wing tips of roast chicken!
On balance, was Mumbai the best option?
To summarise the total experience: yes, there were discrepancies between what I validly understood would be my costs and what eventuated finally, however I would have no hesitation in commending the surgical practices and talents of the medical staff at the Mumbai clinic as well as the quality of the equipment and the skills of the practitioners, along with the friendliness and helpfulness of their front office.
The cleanliness of surgical rooms, scanning facilities and reception is testament to standards equal to and better, in some cases, than I have observed in Australia.
For other patients I met, who shared my procedure, the consensus about the “surprise costs” factor was a resounding acceptance of them and forgiveness for any inconvenience it caused.
I only encountered one patient who was less than pleased with the quality of his transplants, even after they were replaced just a day before his final departure.
Another matter of substantial concern for many embarking on this benchmark change in lifestyle, is whether there is significant pain associated with the procedure.
Pain can be a subjective matter for different people with various thresholds for enduring it, and I did hear from one person that she had felt pain during surgery whilst all others shared my experience of only briefly experiencing a twinge or two that lasted a few seconds.
Given that my surgery spanned about 6 hours in total and was all managed through local anesthetics, I found it quite remarkable that it was such a pain-free procedure, certainly a lot easier than previous tooth fillings, root canals and extractions done in earlier years in very much shorter durations.
While not painful, there can be some discomfit from holding the mouth wide open for such extended periods and some might having bruising around the cheeks and jaw from the surgeons’ manually restraining the jaw movement during the extractions.
My bruising, which was minimal, had no associated tenderness and was gone within a few days, but some women patients had quite obvious bruising.
Other than pain management, a large part of the procedure is focused on infection management and involves antibiotics, anti-inflammatory and painkiller drugs.
There is one aspect of the drug regimen that could be better managed and prior knowledge of the drugs involved should be mandatory for intending patients to know in advance to avoid potential problems during their Mumbai visit.
A problem I confronted, that should not have arisen, can be attributed to the failure of the drug dispensing staff to divulge that a small yellow tablet dispensed just before surgery was valium, despite me specifically asking what it was and only being told it was “something” administered to stop anxiety and to relax the patient.
Western society has a lot of valium users along with recovered valium addicts arising from its immense popularity in the late 1960s to 1982 and it should be a priority for the clinic to be fully transparent about this medication as it could trigger an addiction relapse if inappropriately administered. So, a useful guide to the drugs administered at Dentzz, and their possible consequences, is something that deserves proper prior knowledge for patients.
It should be a simple matter for the clinic to make this information available to their patients as part of their cost quotation before the client’s overseas departure.
Pointing the Finger of Blame
As with a lot of successful undertakings, it follows that there is usually a cohort of detractors who have reasons to denigrate a successful product and overseas’ dental clinics are no exception to this type of vilification.
Such overseas clinics are often the subject of warnings by Australian and New Zealand dental institutions that they are responsible for inferior work that then requires rectification by Australian dental surgeons.
Our Australian dental industry (and New Zealand’s) likes to infer that the overseas operators can afford to be much cheaper owing to lesser quality practices and not having to comply with stringent standards that are industry or government mandated at home, yet the clinic I attended was equally critical of Australian and New Zealand dental work that they say they have had to “fix” before they can proceed with their own contracted services and, often, at their own costs.
The head dentist at Dentzz, Dr Simran Kumar, otherwise known as Dr Sim, told me that the professionalism shown by their Australian counterparts when addressing issues arising from a common patient’s problems sometimes was quite discourteous and could involve elements of “blame” shifting.
Dental surgeon, Dr. Husain, attended to the author’s transplants in a spotlessly clean and modern environment.
She said the normal interaction between dental clinics would be to show professional courtesy to each other that would benefit their common patients through an open exchange of information relating to the patient’s history and treatment. Instead, she said, it was not uncommon for them to encounter reluctance by their Australian counterparts to work constructively in the best interests of the patient, and could entail blaming any perceived treatment problems on the Indian clinic when dental deficiencies could be traced back to work done in Australia.
This was confirmed for me first hand by two Dentzz patients visiting during my treatment period in India.
The first, from New Zealand, was a woman who had experienced two implant failures done by a New Zealand implantologist that, in her words, “fell out” within 6 months of being placed.
Sandra said her confidence in NZ dental mechanics suffered a similar fate, as she no longer could trust her oral health management to her domestic specialists.
The cost of the failed implants was not cheap, either, but I did not learn the amount involved.
The other person I met on my second visit, was a businessman from Kangaroo Point, Brisbane, who said he had a gold crown fitted to a tooth following root canal dentistry done in Brisbane.
The work was done about 10 years ago by a Queensland university training clinic supervised by professional dental teachers and the initial work entailed 4 visits for the procedure.
The patient, Jon, insistently told the practitioners the work was faulty because he was in constant pain.
He was told it could not be the case because the work had been properly supervised and conducted within strict protocols.
The Queensland dentists finally relented and re-examined the root canal work. They admitted that they had got it wrong, and over another 3 visits worked on the tooth all over again. They were able to relieve the pain, but it transpired that the work was still faulty due to an undetected abscess that had formed in the gum below the root canal.
The abscess had been draining into Jon’s bloodstream for years by the time Dentzz discovered the issue in February, 2024, and it accounted for why Jon often felt lethargic, but could never identify the cause for so many years.
“Dentzz did a full assessment upon arrival, and were honest and up-front in revealing the problem, which they explained in detail with their X-rays,” said Jon.
Their solution was for an extraction, thorough disinfection of the site and implant replacement and Jon’s health was immediately affected for the better, he said.
During the period of my transplant experiences, the clinic was also the subject of two adverse media focused stories that were critical of their product.
The first involved a couple from Auckland, New Zealand, which was reported in the NZ Herald and told how the husband’s front crowns had chipped as a consequence of biting on a harder food than he was used to and the incident was cited by the local dentistry industry as indicative of inferior overseas workmanship and a “warning to others” seeking cheap dentistry in India.
There was some angst generated between the parties by the story along with the original choice decision of the materials used for the crowns, but the final outcome was that Dentzz honoured its guarantee to repair the damage and met the expenses of flying the patient back to Mumbai for the repair work.
I was invited to meet the couple as we were concurrently in Mumbai, but I saw no need to because Dentzz described him as completely happy with the remedy (as I know I would have been!).
The other instance of media exposure followed a complaint to Australia’s ABC television service that was aired in Brisbane in August (2024) from a Dentzz patient who lived in the vicinity of Brisbane and who was displeased with her treatment. She cited problems with large blowouts to the quoted costs (of about $4500), painful surgery and displeasure with work done.
She said she suffered constant pain 11 months after her treatment, temperature sensitivity, loss of taste and difficulty eating. She did not return for a second visit to complete her procedure, but the clinic did refund all her costs for the entire procedure that she had paid for which was an amount of $16,000 approximately, a cost to which she consented to.
Dentzz said the much higher costs were a consequence of much greater and unexpected rectification work that was necessary for the patient, which appears to be confirmed by earlier quotes she had from various Australian dentists that she described as being way over $30,000. Subsequent to her return to Australia, she had an assessment done by a prosthodontist to replace the work done overseas and received an estimated cost greater than $50,000.
Footnote: Dr. Simran disclosed that Dentzz Clinic received a request prior to the ABC program for a payment of $45,000 from a dissatisfied Australian patient to withhold a news story from a major Australian television network critical of the clinic’s treatment of this patient and this request was refused by Dentzz.
What to expect when you get to the clinic?
This article relates to the process employed by one Mumbai clinic in India, but is likely to have close parallels to other overseas surgical clinics that do “all-on-4” procedures, and will most likely involve the following:
First the potential patient contacts the clinic of choice and establishes what treatment is being sought and is introduced to an “International Client Manager”, or co-ordinator, who will then handle all the preliminaries and manage all appointments for the patient. The parties will exchange relevant information about the procedure and photos and x-rays of the problem can assist this process.
A quote is formalised and helps spell out the options available and what the patient’s individual costs will be (NOTE: This can be contentious or confusing and advice is given in this article on how to navigate this issue).
A travel time is agreed to and then the patient makes their own travel arrangements and accommodation bookings, with recommendations available from the co-ordinator.
First Visit (Phase 1)
Depending on time of day of arrival in Mumbai, an appointment is made for day 1 or 2 for scans of the jaws and for blood testing and interview by the clinic’s senior management at which time the materials of choice for the implants and prostheses are decided and final quote firmed up.
On day 2 or 3, extractions of existing teeth can commence and usually involve 1.5 to 2 hours per jaw with each jaw done a day apart. Anitbiotic and anti-inflammatory/painkiller tablets are supplied to patients as well as an injection administered for infection control (NOTE: Further important information follows on the drug therapy you can expect). Also, expect to pay half the total cost before the surgery commences.
Several days are allowed for stitches to heal and seal the gums (as much as 5 or more days) so tourism pursuits are a possibility for those inclined. Note that Saturdays are a full working day in Mumbai whereas the clinic closes on public holidays and Sundays.
At the end of week 1 or beginning of week 2, stitches are removed and casts made of the gums for modelling of the temporary prosthetics.
At least two more visits are made to the clinic in the last week for fitting of the dentures and any final comfort adjustments and the final payment is made for the Phase 1 treatment at the beginning of the second week.
Second Visit (Phase 2)
On day 1 or 2 of arrival expect an early appointment followed a few hours later by a 2-hour surgical session to expose the implants to permit new bone growth to be trimmed for proper access to the implants so the abutments can be placed and tightened to finger pressure before new stitches are inserted to close the wounds.
Again an injection is administered for infection and a further bout of antibiotic and anti-inflammatory drugs issued to be taken for 5 days.
Another meeting will be scheduled with the clinic’s senior manager for a final decision on the choice of prosthesis composition and a final price agreed on.
Within a day, a meeting follows with the prosthodontist for the measurements of the implants for production of the prostheses and may be followed by one of more further appointments for more measurements and tooth colour selection. The payment invoice for Phase 2 can be expected around this time.
A preliminary fitting of the final prostheses is performed in the last week of the Phase 2 visit or slightly earlier.
About 3-4 days before the patient’s departure, the final fitting takes place and the prostheses are locked onto the implants.
An appointment is made for the last day or two before departure for a final inspection and photographs taken of the finished product.
The author’s x-rays show the various stages of the procedure with (left) his original remaining 16 teeth which were extracted at only $20 each followed by the insertion of the implants (centre) which was completed in the first phase visit. The jaw and implants are then allowed 5-6 months for the grafts and bone to fuse with the implants before the final arches and crowns are securely fastened to the implants to complete the final visit.
Does the Right Hand know what the
Left Hand is doing?
Dentzz utilises a fairly novel way of client (patient) management by allocating an “International Client Manager” to each patient and it is a process that commences right from the outset of the first contact by the client.
It is designed to assist the client with an introduction to the clinic’s team and to determine what dental services will be performed and the respective costs of these along with assistance in obtaining things such as telephone simm cards and more.
These managers are effectively co-ordinators, or minders, who handhold the patients through the process and keep them informed of appointment times and can advise on a variety of issues about forthcoming procedures and choices of accommodation and even air flights and visitors’ visas as well as passenger pickups and departures.
The usual communication channels are through mobile telephones, but can also accommodate laptop email services.
These international patient co-ordinators, in the words of Dentzz management “while not dental professionals, have received comprehensive training to assist patients with scheduling and organizing their trips. All dental and technical questions are directed to our team of doctors, who provide responses through the coordinators.”
Looking more like a Star Wars commander, the author undergoes a 360 degree jaw scan. The equipment employed at Dentzz is world class technology and the latest available.
The concept is a good one, but seems to have some flaws in its actual operation that can be frustrating for the visitor if some issues are not anticipated, or allowances made for them.
Unfortunately, this can reflect poorly on what is otherwise a very professional operation in terms of the prosthetic and surgical experiences and the quality of them.
My own co-ordinator was on top of her game and operated out of Dentzz’s Dubai clinic with a high degree of reliability.
However, it was not unusual to hear other visitors complain about the inattentiveness of their minders, or to hear comments such as “the right hand does not seem to know what the left hand is doing”.
This, of course, can cause inconvenience when a patient is given an appointment time but, on arrival at the clinic, is told they are either far too early or were booked in for an hour or two earlier; either way it results in some long waiting room sojourns and is indicative of poor communication between the clinic’s staff.
My travelling companion, Jono, on my Phase 2 visit was not as fortunate with his co-ordinator as I was with mine; in fact, his manager was badly out of touch on at least two occasions.
The first was when he was scheduled to be picked up from his hotel at 9 pm for a 1 am flight out of Mumbai, but when it was apparent that no courtesy vehicle was going to be arriving, the hotel had to book a taxi for him.
We both had a similar experience on arrival in Mumbai for our Phase 2 visit when my co-ordinator arranged for our pickup, but on our arrival (about 11 p.m.) We were greeted by a Dentzz vehicle waiting for a patient with a woman’s name; obviously not one of ours.
We had to find a taxi operator who then did his utmost to double the fare price.
On Jono’s second occasion, his co-ordinator was well informed by Jono that my co-ordinator was arranging for our departure pickup from our hotel as we were leaving on the same flight. We were not too surprised, though, when we arrived in Singapore some eight hours after leaving our hotel to receive a message from him asking when Jono would like to be picked up from his hotel.
Even though most mistakes by co-ordinators (and there seem to be a lot of them) only result in time-related inconvenience, there are instances when it can be costly.
Jon (not Jono), from Brisbane, fully understood from his surgery staff that his second visit to Mumbai would require only a few days to complete the small amount of surgery that was scheduled and this would all be done in one day with a further 3 days recommended for post surgery checkups. Yet his co-ordinator had other ideas and was adamant that it had to be a two-week visit.
“I did ask to talk directly with one of the dental professionals, so I could confirm that I only needed 3-5 days, but access was always denied, as I had to work through the co-ordinator.
“Her word was final, although she obviously didn’t understand my case, and it seems apparent that she didn’t ask anyone, (she) just mandated the obligatory 2 weeks for my procedure.”
After a few terse exchanges between them, Jon relented and booked flights and accommodation accordingly.
As it transpired, Jon was right and his surgery and check ups were completed within the few days originally allocated, but an (unnecessary) extra 9 days of hotel costs were added to his bill for the Mumbai visit and, as a small business operator, he lost nearly two weeks of work-related income.
Jon, rather philosophically, used the time for tourism pursuits.
Misleading Quoting System created Confusion
All on 4 procedure (Using Nobel Biocare Implants): AUD 3500 (onwards per arch) X 2 = AUD 7000 (onwards full mouth)
Extractions: AUD 20 onwards per tooth.
Time Frame:
1) With the help of all the technology that we use, your treatment can be completed in a single visit of 10 days.
2) Some cases may require a traditional method which involves two visits. The two visits need a minimum interval of 3 months.
During this phase we will give you beautiful temporary teeth, so you can enjoy the benefits of eating and smiling well immediately.
Each visit would be approximately 7 days
Above is part of the author’s quote he received before committing to the procedure. It shows how deceptive the quote can be as it infers there is only one visit for All-on-4 and in no part does it declare that this quote is only for Phase 1 and that a necessary second visit will cost extra.
Beware the ‘Drug Scene’ in Mumbai!
This final observation on the process that constitutes the “all-on-n” procedure could be vitally important to some patients and really deserves thorough attention as it may negatively impact the patient’s entire visit and even their life style for many months after the completion of the procedure.
Having never experienced bad after effects from major surgery, the author did not take the drug treatment for his dental surgery at all seriously and paid a heavy price in discomfit for his negligence.
VALIUM (DIAZEPAM):
This sedative is administered just before each session of surgery at the Dentzz clinic.
According to the Mayo Clinic, this medicine may cause some people, especially older persons, who are the largest proportion of those attending the Dentzz Clinic, to become drowsy, dizzy, lightheaded, clumsy, unsteady, or less alert than they are normally.
The physiological effects of taking valium may last 4-6 hours, but a 5mg dosage can have a half-life of 50 hours (2 days) and small amounts can remain in the body for up to 3 months. In retrospect, Dentzz say they do not use this strength sedative.
When drinking alcohol after taking valium, the risk of debilitating consequences can become quite severe.
A hives attack (urticaria) endured by the author was attributed to the antibiotics he received and caused many painful sleepless nights.
Dentzz’s literature does warn not to drink alcohol following their surgery, but persons with my experience of beer consumption (after undergoing general anesthesia accompanied by antibiotic treatment in prior surgical operations in Australia), have most likely experienced no debilitating or adverse outcomes from mixing the two.
Therefore, we are less discouraged from enjoying a “few beers” to help with the mental adjustment of no longer having the familiarity of one’s life-long teeth!
However, alcohol used in combination with valium, and at a less forgiving age, can have consequences that are better avoided!
The American Addiction Centers’ website (https://americanaddictioncenters.org/valium-treatment/dangers) cites that some of the complications arising from mixing valium with alcohol or other drugs can lead to: Confusion, disorientation, accidents, sedation, stumbling, dizziness, nausea and loss of consciousness (as well as death when that is the intention of the consumer).
My own experience on my first visit (termed Phase 1 by Dentzz) was that I twice lost awareness of my activities within a day of taking the valium tablets (and the other antibiotic and anti-inflammatory tablets issued by the clinic), albeit in combination with me consuming beer at my usual rate.
The consequences of these awareness lapses was that I twice found myself sitting on my hotel toilet seat with no recollection of how I got there and without any need for me to be visiting the toilet! In both cases I had been watching television after dinner and drinking beer at a normal rate.
On my final visit five months later (Phase 2), I had another more serious experience after taking the valium tablet (still not knowing its identity at that stage), where I had been drinking alcohol with a friend, and woke up in the night to go to the toilet, but lost all stability and fell against the wall of my room and then onto the floor backwards with a jarring blow to the back of the head.
I was fully lucid and recognised the severity of the situation so remained in situ until I judged I could crawl on hands and knees to the toilet and back to bed, but I was highly unstable when trying to stand upright.
My experience was validated by another Dentzz patient, whom I shared my return flight with after my first visit (which was his second and final visit), when he recounted that he was dining alone in his hotel restaurant after his surgery and drinking wine when he “awoke” on the floor with staff and another Australian standing above him.
They assisted Jeff back to his room, but, like me, he was a healthy individual, but 61- years-old compared to my 77 years, and not readily and immediately aware of the contributing cause of his blackout.
The takeaway, obviously, is to be very cautious about mixing valium and alcohol, no matter what country or surgical practice you are visiting.
Had I been told by the clinic that I was being administered a valium tablet, I would have refused it, absolutely, as I had no anxiety at all about the procedure I was about to endure.
ANTIBIOTICS
While seemingly of low concern to healthy people, antibiotics can have an explosively transforming effect on the microbiome of the human gut where 70-80% of the body’s immunity cells are located.
A BBC story from August, 2023, delves into the issue of how antibiotics can be equally damaging to our essential gut bacteria as they are to the pathogenic bacteria that they are hunting: (https://www.bbc.com/future/article/20230825-do-antibiotics-really-wipe-out-your-gut-bacteria).
It is not unusual for the effects of antibiotics on beneficial gut bacteria to appear up to 6 weeks after completing the dosage.
One consequence of taking Cephalexin 500 mg, the antibiotic administered by Dentzz to be taken twice a day for 5 days following surgery, is it can cause serious antibiotic-induced diarrhoea.
This follows the destruction of the useful microorganisms in the gut by the antibiotic which may then allow Clostridiodes difficile, or C. diff, to proliferate with some very unpleasant consequences.
Some symptoms common for C. difficile, are frequent bowel movements of foul smelling and watery diarrhoea containing blood and mucous accompanied by fever, pain or tenderness in the stomach, nausea and reduced appetite: https://www.mayoclinic.org/diseases-conditions/pseudomembranous-colitis/symptoms-causes/syc-20351434.
Cephalexin can have interactions with other drugs such as anticoagulants or blood thinners, diuretics, drugs for diabetes and medications used to treat gout, all of which are frequently prescribed for the age group that makes up dental implant clients.
If swallowed by a person allergic to cephalexin, reactions may also manifest in the form of skin disorders (rash, hives, itching, blisters, peeling), angioedema, or trouble breathing.
The frequency of antibiotic-associated diarrhoea in its milder form is about 1 in 5 people and might have been a source of problems for two guests in my hotel as they were both avoiding drinking local water, but still suffered severe gastro disturbances, as did I at a lesser level, but which persisted for several months after my return to Australia, growing ever worse for nearly 3 months, until it effectively kept me house-bound.
I also found out later that a severe bout of hives I experienced in my second visit was almost certainly a consequence of taking Cephalexin as it is known to cause urticaria as a side effect.
ANTI-INFLAMMATORY
An anti-inflammatory and painkiller administered by Dentzz is Enzoflam, a combination drug containing paracetamol, diclofenac sodium and serratiopeptidase (taken twice a day for 5 days after surgery). Some common side effects of Enzoflam can be nausea, vomiting, dizziness, indigestion, stomach pain, constipation, diarrhoea, flatulence, bloating and rash, but they are usually mild and self resolving if it is the only drug present.
Footnote: Patients on the drug regimen administered during their surgery period would be sensible to check with their GP before leaving home whether any existing drugs they are taking can interact with the new medications and to be cautious about any consumption of alcohol with valium.