Patient safety crux of House actions on dental tourism

San Antonio鈥擱ecognizing that dentists are concerned about the care their patients receive outside the U.S., the 2008 House of Delegates adopted Resolution 28H-2008.

Among its directives, the resolution calls on appropriate ADA agencies to keep abreast of developments affecting dental tourism and continue to provide all relevant information to ADA members. It encourages patients to seek information from their dentists, insurance companies and employers before seeking treatment outside the U.S. It also directs the ADA to collect information on patients who seek treatment outside the U.S.

In its report to the Board of Trustees, the Council on Dental Benefit Programs drew on findings it developed as the lead agency responding to Res. 34H-2007. By calling on the support and collaboration from the breadth of ADA divisions, the council amassed its data. ADA dialogue on dental tourism began at the 2006 House of Delegates with Res. 44H-2006.

Like the ADA Board of Trustees, CDBP believes cost-shifting to patients and the “flattening” of the world are among the top issues driving dental tourism, when patient safety is the most important consideration.

“Primarily most important in any given scenario are the establishment and preservation of optimal health and well-being of the patient,” observes Dr. Joseph Hagenbruch, CDBP chair.

Dr. Hagenbruch says that although patients should be extraordinarily particular when it comes to choosing health care providers, including when searching for sources outside the U.S., the public may not always be able to adequately discern what optimal dental care may be.

“From the perspective of patients, the assessment of the quality of a dental service performed may be based more on the patient’s experience of the visit itself, including applicable fees, than on the actual attributes of the treatment rendered,” says Dr. Hagenbruch. “This may be a contributing factor in the interest of some individuals to seek dental care outside the U.S.”

Dr. Hagenbruch says patients may not be aware that within the U.S. there exists a distinctively sophisticated network of checks and balances in terms of measurable parameters that ensure a superior level of probability relative to the quality of treatment.

Res. 28H-2008, adopted under the ADA’s Strategic Plan goal鈥擳o create and transfer knowledge鈥攚as assigned to the Council on Dental Benefit Programs, the Council on Dental Practice and the Health Policy Resource Center. It includes a more concise definition of dental tourism and resolves:

• that the following definition of dental tourism be adopted:
  • Dental tourism is the act of traveling to another country for the purpose of obtaining dental treatment.
• that the appropriate agencies of the ADA continue to promote the importance of a dental home while working for increased affordable access to dental care and freedom of choice so that every American who needs dental care can receive it,
• that the appropriate agencies of the ADA establish a repository of information relevant to dental tourism, that the information be collected in a manner that protects patient confidentiality and that the information is used in a lawful manner;
• that the appropriate agencies of the ADA increase efforts to provide patients, insurance companies and plan purchasers with credible information and resources about quality dental care, including follow-up, delivered by professionals with accredited education;
• that in keeping with the ADA position on freedom of choice, patients seeking dental care outside of the U.S. should do so voluntarily, and that prior to travel, be urged to arrange for local follow-up care to ensure continuity of care upon return to the U.S.;
• that patients who have insurance coverage for dental care performed outside the U.S. should confirm with their insurer and/or employer that follow-up treatment is covered upon return to the U.S.;
• that patients choosing to travel outside the U.S. for dental care should seek information about the potential risks of combining certain procedures with long flights and vacation activities;
• that the transfer of patient records to-and-from facilities outside the U.S. should be consistent with current U.S. privacy and security guidelines.聽