There's no cap on dentists' fees

India, Dec. 12 -- New technologies such as dental implants have flooded the market, but not only are these priced out of the common patient's reach, they are also not needed as often as dentists prescribe them. Priyanka Vora explores their pros, cons and other options Dadar resident Vinayak Athle's dentures come loose every time he eats or speaks. Athle, a retired businessman who takes tuitions to support his family, cannot afford dental implants and his medical insurance policy does not cover expensive dental procedures.

"Dentists gave me an estimate of more than Rs1 lakh for dental implants. I opted for dentures, which are cheaper," said Athle.

Fortunately, Athle's dentist got him free implants for his upper teeth four years ago by enlisting him in a dental workshop. "Since then, I have been trying to save money to get implants for my lower teeth as well," Athle added.

In cases of tooth decay, accidents and old age-related tooth loss, patients can either opt for implants or dentures (see box). In cases of partial tooth loss, doctors advise root canal treatment as the natural tooth can be saved.

Doctors say implants are among the newest forms of dental treatment, so they are more expensive than root canal and dentures. The cost of the procedure depends on the price of the implant, the artificial tooth and dentist's fees.

Dentists said the cost of a single tooth implant could cost anything between Rs3,000 and Rs18,000. The cost of a single tooth implant in private hospitals and plush clinics could range between Rs25,000 and Rs60,000.

The cost of the procedures also depends on the location of the clinic. "Dental procedures are implant and equipment driven. To set up a clinic in the suburbs, one needs between Rs6 to 10 lakh. These costs will obviously be passed on to the patient," said Dr Rakesh Narshan who runs a clinic in Malad.

Dr Sagar Shah, who runs a clinic in Girgaum, said dental procedures in India are probably the cheapest in the world. "Most equipment and material used in implants are expensive. The cost of the implant and equipment used is one-fifth the cost of the entire procedure," said Dr Shah.

Health experts said the biggest group to suffer is middle-class families, which pay large premiums for medical insurance policies, but end up paying for dental care themselves as expensive dental procedures are not covered under such health policies.

Dr Narshan suggested that patients who cannot afford private clinics approach dental treatment facilities run by a charity group where the services are reasonably priced.

Athle's dentist, Dr Dilip Deshpande, who runs a clinic in Mahim, helps poor patients by enrolling them in workshops where charity groups provide free medical procedures.

"Unable to afford good ones, poorer patients may opt for cheap implants and compromise on quality. Substandard work will not show up in a day, it will take at least a few years for the patient to know that his implants are not good quality ones," said Dr Deshpande.

Others pointed out that costlier treatment does not always mean better quality, and some even suggested that dentists sometimes try to swing bigger profits by using cheaper quality implants and making patients pay the price of expensive, better quality ones.

"Dental procedures are patient-specific. The dentist can reduce costs by customising treatments for individual patients," said Dr Milind Karmarkar, professor at Bhartiya Vidyapeeth University's dental

college.

Clinic chains: Cheaper but less reliable?

Priyanka Vora

Mumbai: Much like restaurant chains, dental clinics are opening up franchisees across the city. And these provide you with a menu too - by listing the different treatments they specialise in, along with their prices, special offers and bulk-order discounts.

At present there are at least four dental chain clinics operating in the city.

These clinics work on the principal of buying implants and other prostheses and material required in dental treatments in large quantities, therefore providing cheaper treatment. Chain clinics are brands in themselves, unlike private clinics where a well-known or established doctor commands a premium in fees.

"As we are a dental chain, we have a 10 to 15% cost advantage. We buy implants directly from the company, bypassing the distributor, dealer, and importer. Hence, we get the implants for cheaper and pass on the benefit to patients," said, Vikram Vora, CEO, Mydentist, a chain of dental 34 clinics in Mumbai and Pune.

Although many patients opt for these chains which claim to be 'affordable', dentists who run private clinics doubts the expertise at such clinics. "We have come across patients who opted for treatment at such chain clinics, but then came to us after complications arose from treatments done there," said Dr Gaurang Shah who runs a private clinic in Bandra.

"Newspapers carry advertisements for implant treatment and teeth makeovers every day. These treatments cannot be done in a day by any technology or doctor, but people go for them and are conned into paying enormous amounts," said a senior dentist from a private hospital, adding that dental clinic chains are akin to "furniture shops".

Another way in which dental clinics cut treatment costs is by hiring new dental graduates and paying them salaries.

"As a patient, you don't want to be attended to by a different doctor every time you visit the clinic. These clinics aim to standardise dental procedures, which is not possible," said Dr Sagar Shah, who runs a clinic in Girgaum.

Published by HT Syndication with permission from Hindustan Times.

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