Dental Health – 31st March 2014 with Dr Larry Benge
10 Apr 2016
Speaker 1: And on nights with Steve Price, Dental Health with Dr. Larry Benge, thanks to Maylo Clinic, Sydney, the original home of and inventor of the All-on-4 dental implant system.
Steve: Dr. Larry joins us in the studio or on the phone each Monday night. Evening to you.
Dr. Larry: Steve, how are you?
Steve: I note in the, one of the papers this morning, a suggestion that the dental organization of Australia has been having strip tease artists at their conferences. Are you on the committee that organizes that?
Dr. Larry: No, I had nothing to do with that.
Steve: Are you sure?
Dr. Larry: I’m positive. I was at a conference on the Gold Coast on the weekend. They certainly weren’t with us.
Steve: No strippers then?
Dr. Larry: Not at all.
Steve: I couldn’t believe that story when it came out. I read it today and I thought of you immediately. A video clip of strip tease acts filmed at a major dentist conference as landed the body in strife.
Dr. Larry: No, that’s not me.
Steve: Must be a dentist overseas, mustn’t it?
Dr. Larry: Yeah, I’m sure. Absolutely.
Steve: New Zealand dentist.
Dr. Larry: Maybe Thailand.
Steve: We read last week again that the health insurance company NIB is encouraging people to have offshore medical procedures for a whole range of things, including breast enhancement, face lifts and dental work. They will cover with a one year insurance policy, any problems with the work that’s carried out offshore.
Dr. Larry: And not only that, they’ll organize your travel, and they’ll organize your hotel and your package and yet they’re not paying any rebates on it, so I’m not sure why a health fund is getting into the position of providing dental tourism out of Australia.
Steve: I find it entirely irresponsible, because you and I have talked before, as a professional you’ve seen the damage that can be done.
Dr. Larry: Well, the problem is, you know, dental implants is that in a year you’re not likely to see many of the complications. So them providing a year is really just silly. If he comes out and says I’m going to give you ten years warranty.
Steve: Or a lifetime guarantee.
Dr. Larry: Or a lifetime, then obviously, you’re going to look it more clearly. The things or the problems that present usually with dental implants are not going to happen, the percentage wise, under a year. It’s going to be four or five years. Then they say, we’re going to have some people in Australia that are going to fix it, well are they going to pay the full fee of them? There’s so many things they haven’t included in it, which is quite ridiculous I feel.
Steve: If you’ve been offshore and had dental work and you’ve had some problems with it, give us a call on 131873 and tell us your story. Likewise if you’ve been offshore and had dental work, and it worked, we’d be happy to hear from you, but a warning, you’re taking a big risk. Dr. Carmelo Bonanno was the vice president of the Australian Dental Association. Doctor, thank you for your time.
Dr. Bonanno: Yes, thank you, good evening.
Steve: Does this worry you?
Dr. Bonanno: Well, we’ve done some reading on this already. We’re very worried about it, on a number of fronts. I think Dr. Benge has covered a lot of the points quite succinctly, and in fact, just as you were saying Larry, what you were saying before about failure of implants, I think it’s a bit disingenuous to offer any sort of, only a twelve month guarantee. We know that in dentistry most problems with general treatment don’t occur for sometimes three, four, five years and with implants I think statistically, seven years seems to be the magic mark. So I think that’s bit of a false promise on their part.
Steve: Yeah, I agree and the fact is that they look at also they people they’re doing, if you look at the surgeries they want to send to, and you look at their qualifications, they’re not nearly what you would expect of the people that are doing it in Australia. We yet can’t look and see the quality of the sterility. It was also pointed out to me, are the implants that they put into people covered by the TGA? When you come back here, are the implants companies here going to supply other implants? Raises just an immense number of questions I feel.
Dr. Bonanno: Totally agree with everything you’ve said. We’ve put these scenarios and these issues to NIB, but they don’t seem to share the same concerns that we have.
Steve: First, let’s just simplify all of this, take all of the technical dental aspects out of it that you two are concerned about, I’m just concerned that somebody in Australia, running a health insurance company in Australia is encouraging people to go offshore for medical procedures. Why aren’t we encouraging people, if they want to have medical procedures here, to do it in Australia? Why would you be sending people offshore?
Dr. Bonanno: Well they are, sorry, if I can answer this one.
Steve: Yeah sure.
Dr. Bonanno: In terms of the main driver’s cost, in Australia we have a very tight regulatory framework. Probably one of the toughest internationally. So there are a lot of drivers that keep our prices where they are, and that includes the cost of running a small business, certainly the cost of labor and the cost of using these materials, which have to go through a fairly rigorous TGA approval process. If you look at what the overseas clinics are offering, their products are purchased for a fraction of the price that we pay. They don’t have the same sort of clinical standards and accreditation processes that we go through. And also the cost of labor there is significantly less than what it is here. Naturally that’s going to translate to cheaper treatment.
Steve: There is a thriving trade in this happening now, as you both know. Larry, you’ve told me before, you’ve seen some horrific end results.
Dr. Larry: Yeah, I’ve got cases that come through my clinic regularly, weekly in fact, overseas and number of people that have got into desperate problems in going overseas. They’ve been in there four, five years and as Carmelo said, seven years down the track, they’re the real problems, because people then, they might have got it cheap in the first place, but then they’re just in no position at all to fix it. So they’re often in pain, discomfort and they’re far worse than were before they started.
Steve: You reluctant to take those cases on?
Dr. Larry: Very reluctant, because there’s fees associated with it, and you just, and often I’ve had people come in and you just don’t know the type of implant that’s been put in.
Steve: And here’s the other problem, you get involved in it and something might go wrong with what you’ve done.
Dr. Larry: And then I own the problem.
Steve: You’ve got the problem sitting in your surgery. They can turn up and knock on your door. They’re not going to walk back into the front door of the joint in Bangkok.
Dr. Larry: Yeah, that’s true.
Steve: So Carmelo, is there anything the association can do, other than make a loud noise about it?
Dr. Bonanno: Well, we’ve made lots of noise about it, but ultimately NIB has developed a business model here. They don’t share our concerns, in fact they’ve been fairly dismissive of them. They think they have an answer to all the issues. We don’t agree with that. Like Larry’s mentioned, I think definitely a lot of dentists have seen a lot of issues. The trouble is that when the treatment is so costly and it’s complex, the failures are costly and complex as well. Usually the cost of remedial treatment is far greater. If you have problems with the quality of treatment in Australia, we’ve got a fairly tough regulatory regime, which I think more than adequately deals with these things.
Dr. Larry: Absolutely.
Dr. Bonanno: So I heard you say before Steve, that you’d like to hear from people who have had good experiences, and look, there are a lot of those, and I genuinely hope that people have had good experiences. The trouble is, it’s what’s, the facts are that a lot more people are reporting adverse outcomes and a lot of these will be hidden for some years. We won’t discover these adverse outcomes well into after the treatment and the holiday have been forgotten.
Dr. Larry: But I don’t understand what’s in it for NIB, if they’re not paying any premium. They’re not getting premiums from people, they’re organizing for other people.
Steve: They seem to be acting as a travel agent.
Dr. Larry: What are they actually getting out of it?
Dr. Larry: Yeah, publicity. Sending work away from Australians. There’s actually an oversupply of dentists in Australia. Dentists need work and they’re actually sending it out overseas. So I just don’t quite get where they’re coming from. Maybe their CEO’s got a good explanation, he wants to come on radio and talk to us.
Steve: Yeah, he could come and tell us. Camelo, thank you for your time tonight.
Dr. Bonanno: Okay, thanks very much.
Steve: Dr. Camelo Bonanno there. The other point about this too, Larry, is if there’s people listening to us who are in desperate need of dental work, and they’re thinking, well I can’t afford it in Australia, I can only afford to do it when I’m overseas. What’s your advice to them? What do they do?
Dr. Larry: Look that’s a real problem. What they can do, is come along and have a consultation and just find out and get a comparison, weigh up all the things. What we like to do in a consultation is give you all the options, basically from the cheapest to the most expensive. I always say, you’ve got to do your homework when you’re selecting some treatment. I often tell people, if they’re going to go overseas, ask them what type of implants they use. What’s the guarantee on the implants? How long is it, what type of materials are they using for the teeth? Because this really affects the longevity.
Steve: What happens if you get sick while you’re there?
Dr. Larry: Exactly. Have a look at the sterility that they’ve got and obviously as a lay person, you’re not expected to know how good that is. But you get a general idea of the cleanliness of the environment. So you’ve just got to weigh up what might happen four, five, six years, seven years down the track. What we’re seeing, is we’re seeing more problems than we’re seeing good results.
Steve: There is. And we should remind people, there are economical ways to solve your problems.
Dr. Larry: There are.
Steve: You don’t have to go and have the Rolls Royce that you deliver, you deliver the best.
Dr. Larry: Yeah, but we’re still look after people if they can’t afford it and there’s still payment plans and people are still trying to help people and do the right thing by them. What appears cheap in the beginning, may as we know, be expensive down the track. I think, and look, that’s only dentistry, what about breast implants, and face lifts and these sorts of things.
Steve: The question you’re going to ask these people is, would you go overseas to have a heart operation? Would you go overseas to have a brain tumor treated? Would you go overseas to have your kidney removed or you know?
Dr. Larry: It’s crazy. Look, I had a call from a few plastic surgeons during the week, saying I can’t believe they’re sort of doing this. They’ve named a few plastic surgeons that’ll be here, to actually fix it for them. Well, what if they go for a face lift and something goes wrong and is the plastic surgeon here going to charge his full fee or is NIB gonna pay that, within that period of time? What happens if it’s a month over the twelve months, you know, it’s thirteen months. Who’s going to pay for them? The fine print you’ve gotta look at, but I just think that, we’ve got the best medical, dental system, one of the best in the world here, as Dr. Carmelo said is, we’ve got our requirements are stringent, we have sterility, all our things we use in the body have to be approved.
So you’ve got comeback, so it’s not a matter of just having the treatment and then you’re hung out to dry. You’ve got some things that are going to support you. So I think that’s very important.
Steve: I should point out that we don’t say that every medical procedure done overseas is no good, but what we’re saying is, why take that risk?
Dr. Larry: Well, look, we understand it’s price related. That understandable, and it’s a shame that it’s got to that sort of point that people are doing it. In fact, there’s actually a company here setting up reverse tourism. They’re actually bringing patients in from Asia because there’s people that want to come here…
Steve: Because of the standard our work.
Dr. Larry: Because of the standard of the care, they want to come in. So there’s actually a reverse thing going on at the moment. So it’s very interesting anyway. I just don’t understand why the health fund would push it if they’ve got no vested interest in it at all. They’re just not getting premiums, they’re not paying out money, they’re acting as a travel agent, and I don’t know many health fund that want to be in the travel agency business.
Steve: We will invite the boss of NIB on to explain it all.
Dr. Larry: I’d love to sit and talk to him.
Steve: Larry, a pleasure to see you as usual. See you next week.
Dr. Larry: Steve. Thanks a lot.
Steve: Dr. Larry Bens.
Dr. Larry: Cheers, thank you , bye.