Considering going overseas for dental care? Read this first

Janelle Jeal was days away from a fourth trip to India for dental treatment when she woke up with an unbearably painful and swollen right eye.

After recording an eye pressure reading of more than double the upper limit, an optometrist sent the 61-year-old for urgent specialist care to stop her losing her vision.

Physical and mental stress after failed dental procedures in India had likely contributed to the episode of shingles in her eye.

"I could not fly back," the Sunshine Coast retiree said.

Instead, Mrs Jeal went to a local maxillofacial surgeon who uncovered failures with the dental implants and prosthesis provided by Dentzz, a company that runs dental clinics in Mumbai, Delhi and Dubai.

It was the turning point in a saga that began in early 2024 when she and her husband Brent Jeal started looking overseas for affordable dental care.

Mrs Jeal needed her "very poor" top teeth replaced, and Mr Jeal decided to have a full mouth reconstruction, involving dental implants and prosthetic teeth.

The retired café owners, who are vegans, had what they described as a "spiritual" and "cultural" affinity with India, having travelled there many times on holiday, so were not daunted by going again for dental procedures.

"It was going to be cheaper to go to India, even covering the flights," Mrs Jeal said.

During their first trip to Dentzz, the pair had teeth removed and implants, or small metal screws that act like the root of a tooth, placed in their jaws.

On the second trip, they had rows of prosthetic teeth, or dental bridges, fixed to the implants.

"The instant that they locked Janelle's off she said to them 'it feels like it's digging into the roof of my mouth, it's causing me trouble', and they assured her it would settle," Mr Jeal said.

But the pain and discomfort did not settle — even after an unexpected third trip to India for adjustments.

Queensland-based maxillofacial surgeon Trent Lincoln has completed more than a decade of training as both a medical doctor and dentist and, with her permission, told ABC News Mrs Jeal's overseas treatment was a "failure".

"Incorrect implant placement, bone graft not working and incorrect prosthesis was supplied, so there's failures at multiple levels," Dr Lincoln said.

In May, the specialist operated on Mrs Jeal to replace what was done at Dentzz.

The problems she had were quickly resolved, ending years of discomfort.

"It's affected me greatly, I've spent a lot of time in tears, I've isolated myself … luckily I have a supportive family, husband, friends, but it's been a lot," she said while choking up with emotion.

Mr Jeal has also been examined and is concerned about the potential for future problems with his new teeth.

"It's almost certain because the design of the prosthesis sets him up to fail, but also the implant placement isn't in the right part of the bone," Dr Lincoln said.

The Jeals' experience with Dentzz has been a financial burden too, with their treatment costing about double what was expected, at around $34,000, not including flights and accommodation.

"I haven't met anybody yet that was given a ballpark price [from Dentzz] and was close to that, they've all at least doubled, if not more," Mr Jeal said.

In response, Dentzz said Janelle's "situation" was "largely due to factors beyond our control" such as her history of smoking and existing oral health condition.

"Smoking is a well documented risk factor for the successful outcome of implant cases in medical literature worldwide," a spokesperson said.

However Dr Lincoln said while smoking "may have contributed", he believed inadequate bone reduction, prosthetic design and planning led to the failures.

Dentzz said its implant success rate is "on par" with other "quality" clinics.

"While we seek 100 [per cent] satisfaction, no dental practice in Australia or elsewhere, can guarantee that every patient will be fully satisfied in every case."

The company said it had received an "explicit and unreasonable" compensation demand from the 61-year-old.

Mrs Jeal asked for $77,000 in compensation from Dentzz. That included the cost of her treatment there, travel expenses, procedures in Australia and suffering.

Almost two dozen people have contacted ABC News about issues with Dentzz since concerns were first published in 2024 about the company's care of another woman and some online reviews deemed to be fake.

There are no official numbers on how many Australians embark on so-called dental tourism, but Dr Lincoln said he regularly sees patients with complications after visiting a range of overseas clinics.

"Last month it was four patients, off the top of my head, so three from India and one from Vietnam, but it's typically three to five," Dr Lincoln said.

Other patients may have silent complications.

"If they don't have symptoms and they're not seeing a dentist, they don't know there's an issue," he said.

But the specialist did not want to disparage overseas dentists, most of whom have strong skills and qualifications, saying he also gets patients with complications after treatment by dentists in Australia.

"The difference for an Australian patient having treatment in Australia is the avenues available to them,"

he said.

"There's regulations in terms of national boards, dentistry, medical boards and Ahpra [the Australian Health Practitioner Regulation Agency]."

He said there are also structural challenges with having major dental work done quickly when away from home.

"The fundamental issue is one of timing. These treatments are very complex, particularly full arch treatment, and they require often several steps and they require time."

'They've got you over a barrel'

At home in Lismore, in the Northern Rivers region of New South Wales, Paul Giles grapples with a crossword puzzle.

He has a bright white new set of teeth after having a full mouth reconstruction at Dentzz early last year.

He is happy with the dental work, but outraged the bill went up when he got to Mumbai.

"They've got you over a barrel when you're there, halfway around the world, staying in a hotel room," the retired handyman said.

Records show Dentzz had given him a quote ranging from $2,375 to $5,800 for the treatment, depending on what materials he chose.

But he said the price skyrocketed to $9,700. He argued and Dentzz agreed to drop the final bill to $8,000.

The 71-year-old said having to pay extra was a common experience among the dental tourists in the clinic's busy waiting room.

"I didn't speak to one person that had a price that they [Dentzz] stuck with."

Dentzz said it does not present quotes "as a final binding figure" in any correspondence with prospective patients.

"All written communications from Dentzz state explicitly that final treatment costs are confirmed only following an in-person clinical evaluation," the company said.

Mr Giles also cannot find a local dental clinic in Australia to do six monthly cleans and checks of his implants and prostheses.

"As soon as I said I had it done overseas, [one clinic said] 'oh no, no, no, we don't want to know about it'," he said.

President of the Australian Dental Association (ADA), Chris Sanzaro, said the ongoing cost of maintaining complex dental work is not always factored in.

"One of the things we find is people travel overseas for dentistry that they wouldn't be able to afford in Australia, get it done overseas and then they can't afford to maintain it," Dr Sanzaro said.

Social media advertising targets Australians

In a happy snap taken at a Dentzz afternoon tea in Mumbai last February, the Jeals can be seen grinning widely, standing shoulder to shoulder with Australian cricket legend Brett Lee.

The former fast bowler, who has lived and worked in India, has been spruiking the company in videos posted on social media since around 2019.

In one clip from last year, he described Dentzz dentists as "the best" in Mumbai.

"You're getting hundreds of people coming out from Australia — they wouldn't be doing that if they didn't do a good job. So, I can vouch and I can hand on heart say they are number one," Mr Lee said in the ad.

Neither Mr Lee nor Dentzz responded to questions about the partnership.

Dentzz has posted hundreds of positive video testimonials from patients, many of them Australians, to social media.

Mr Jeal did one of the videos himself, explaining they are usually done as soon as a patient's treatment is finished.

"While you're there, you're treated like royalty," he said.

"You feel like they love you to bits … the instant you come home, it's a different story."

The Jeals and Mr Giles say they did their own research and did not rely on social media when deciding to go overseas for treatment, but that the videos added to a positive impression of the company they chose.

In Australia, health practitioners registered with Ahpra, including dentists, are banned from advertising that includes: "patient stories, endorsements or comments that refer to treatment, diagnoses, outcomes or the practitioner's clinical skills."

In a statement, an Ahpra spokesperson said that is because such advertising can create "unrealistic expectations of treatment benefit, encourage unnecessary use of health services or be misleading through selective presentation or editing".

The agency does not regulate advertising for health services provided overseas.

Dr Sanzaro said ADA members had reported "an increased prevalence" in ads from international clinics, some of which were making "quite ridiculous claims".

Federal budget a 'huge disappointment' on dental

The cost of dental care in Australia's mostly private oral health system is the main factor driving people overseas for treatment.

Adults generally only qualify for free public dental care in state-run clinics if they hold concession cards and those who are eligible can wait years for treatment.

Dr Sanzaro said not only was the recent federal budget a "missed opportunity" to boost access to dental care, but it also meant a funding reduction "in real terms" because money for state services was not "indexed or inflation adjusted over time".

"That's a huge disappointment," he said.

The Launceston-based dentist said a new national oral health plan was overdue and there had been no progress on long-running calls for a scheme to fund care for vulnerable groups, including seniors.

"We think starting with a senior dental benefits scheme is the right way to go, it's been mentioned in two Senate inquiries," Dr Sanzaro said.

"It makes a lot of sense to target that section of the population that have got a high disease burden."

A spokesperson for the Department of Health said the government "acknowledges the importance of accessing affordable dental services".

They said a national group, comprised of federal, state and territory representatives, had been set up to develop "options for sustainable and longer-term dental funding arrangements that better meet community needs, particularly those of older Australians and First Nations people".

"The National Dental Reform Oversight Group's advice will be considered at a future meeting of all health ministers," the spokesperson said.

Mr Giles is not confident there will be meaningful change anytime soon.

"I'd like them to make it so people could look after their teeth at a reasonable price here, stop everyone having to go overseas, but I can't ever see it happening particularly," he said.