Happy to help ... Dr Sunisa in Bangkok, now a leading centre for medical tourism. Photo: Ross DuncanBangkok is a city of many faces - some seedy, some tacky, occasionally some dirty. It's also a city with charm, grace and style. But I'm looking for none of these things in the land of smiles.
I'm here for my teeth. I've never really paid much attention to them, apart from cleaning them a couple of times a day and annual check-ups. Then mild toothache joins my wife and me on a four-week European holiday. I decide to ignore the ache; something to deal with when we get home. One of those toothpastes for sensitive teeth will be enough.
Then, suddenly, I'm in agony in Seville. The left side of my jaw is swollen, as though I've swallowed a mango seed. In debilitating pain, I agree with my wife that I need to visit a dentist, right now.
Ten o'clock on a sleepy Saturday morning is not the time to go looking for a dentist - certainly not in a Spanish city of night-owls. And I don't hold much hope of stumbling across an emergency dental clinic.
As luck would have it, the concierge at our small hotel manages to find a clinic that agrees to open, and will even arrange for an interpreter to be present.
Several hours of poking, prodding, X-rays, drilling and filing reveal that I need root-canal surgery in two adjacent teeth. That requires another session the following day. I'm lucky that the clinic agrees to open again on the Sunday and to arrange for an interpreter.
After more than four hours of treatment on day two, I start to worry about the cost: two days, two specialists, a nurse and an interpreter.
The dentist finishes her magic and explains the treatment is temporary; I'll need to return home and see a dentist to finish the surgery.
I peer over my wife's shoulder as she is presented with the bill. In my drugged state, I think I see €2200 ($2900), which is about what I'd imagined. In fact, the bill is €220 - a minor miracle.
Fast forward a week and a suburban dentist in Sydney quotes about $6000 for two root-canal treatments. I explain that more than half the work has been done, but that makes no difference to the quote.
I book the first appointment reluctantly and mull over the cost. Phoning around, I discover $6000 is a standard quote for two root-canal treatments. Mulling further, I remember a video on medical tourism I once saw on a flight to south-east Asia. Kuala Lumpur, Bangkok and Singapore seem to have a choice of clinics, with websites of varying degrees of professionalism. I settle on Bangkok, chiefly because I can get a return airfare there with my frequent-flyer points.
I set about getting online quotes from several clinics. The one I choose quotes between 4500 baht and 10,000 baht a tooth ($143-$318), depending on which teeth are involved (front, pre-molar or molar).
The clinic also suggests a hotel around the corner, four stars for 1750 baht a night in the central business district of Sukhumvit.
I book both.
Three weeks after my Spanish incident I arrive in Bangkok. The clinic is a surprise. I had expected a gleaming white mini-hospital. What I find is an ageing, five-storey building, sandwiched between a convenience store and an optometrist. The ground-floor reception is shared with a beauty parlour. The waiting-room decor would be familiar to anyone who has lived through the 1970s: fake plants, mauve furniture, old magazines.
But the staff are open, warm, professional and patient, and they listen attentively to my expectations and understand I have only eight days in the city. I can stick with the original quote but after a long consultation I decide on the works: two root canals, whitening, cleaning, and changing my old fillings. I'm presented with a suggested schedule over eight days and a breakdown of the cost, which has risen to $2400.
A steady stream of clients comes through the doors each day. They include a Canadian businessman, an expat Australian, a British backpacker and dozens of locals making bookings and checking prices.
So how much did it cost and how much did it hurt?
I spend about 16 hours in the chair over eight days and the pain management is first class. I find it more uncomfortable than painful; the hours spent lying on my back with a drill and a tube in my mouth is worse than the pain of drilling.
Despite spending a few hours every day at the clinic, I'm only a short walk from the skytrain and the subway in Sukhumvit. So, despite some discomfort, I also join a food tour of Chinatown, a visit to the Grand Palace, the Museum of Siam and the contemporary art gallery.
The cost? Slightly more than the quoted $2400. I'm advised that years of tooth-grinding caused the cracked molars (which, in turn, caused the infected root canals), so I add a $75 night guard to the bill.
I had travel insurance covering my trip to Europe and claimed the cost of the emergency dental work in Seville. But I knew that the cost of dental care in Bangkok would not be covered by travel insurance or my Australian private health insurance.
The decision to become a medical tourist in south-east Asia is highly personal. On the positive side are cost, quality of treatment, no waiting lists and the chance to combine necessity and travel. On the negative side: language barriers, unfamiliar surrounding and potentially unfamiliar techniques.
Thailand has become the Land of Smiles - or as my clinic proudly claims on its business card, "Great Smile Start Here" - but medical tourists are not coming for dental treatment alone. People travel here for cosmetic and plastic surgery, breast implants, dermatological treatment, tattoo removal, elbow and knee reconstructions and, of course, sex changes.
Despite the threat of SARS, volcanic-ash clouds, long-running civil unrest and, most recently, serious flooding in the capital, medical tourists continue to arrive in Thailand in droves. A brochure in the clinic says from 2002 to 2011, the estimated number of medical tourists visiting Thailand has risen from 600,000 to 1.6 million.
According to a report by the Singapore-based travel supplier Abacus International, Asia's medical-tourism industry is expected to generate more than $4.4 billion by 2012. Thailand is one of the world's most popular destinations for dental work. The Australian Dental Association acknowledges that dental tourism is popular but warns there are risks: the more complex the dental work, the more likely it is that something will go wrong. Many travel insurers will not cover medical tourism, either.
But in my case, I've returned with a smile.
FAST FACTS
The writer was treated at Bangkok Smile Dental Clinic, a group with three Bangkok branches and specialists in nine disciplines, including gum, root canal, paediatric, orthodontics, oral surgery, implants and prosthodontics. Many of the staff have international qualifications from universities in Sydney, New York, London, Tokyo, Florida and Germany. See bangkoksmiledental.com/index.html.
Around the corner is the 138-room, four-star Citadines Sukhumvit 23. Rooms cost from 1662 baht ($52) a night; see citadines.com/thailand.
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