A Dental Odyssey - A Malta Dental Holiday Experience

Taking a holiday in an idyllic foreign destination and having dental treatment there is a thriving proposition. Lack of NHS dentists and the cost of ‘going private’ is sending Britons abroad in their thousands.

This year I joined them taking the dental tourism trail to Gozo the diminutive off shore island from Malta. A 5 mile channel separates the two; a world of difference sets them apart. Tranquil Gozo’s population is little more than 28,000. While I was there I roamed its swathes of countryside and agreed with Edward Lear who called the coastal scenery pomskizillious and gromphibberous. There were no other worlds to describe such magnificence, he said.

The capital Rabat was renamed in honour of Queen Victoria’s Jubilee when the islands were still part of the British Empire. But the old quarter began to take shape more than 350 years ago. The ubiquitous Gozitan balconies gaze down on the narrow alleys, a maze of shadows and bright sunshine. Hardly the place you would imagine choosing to undergo extensive dental treatment; but that is what I did. It was in Victoria that I discovered dentist supreme Joseph Xuereb

My dental Odyssey began last Christmas. I wanted to escape the frantic shopping fest and plumped for Gozo. The experience was serenely beautiful, filled with pleasures such as the traditional visit to the Nativity cribs il presepju…. some take a year to create I basked in warm sunshine, sat in deserted village squares and discovered the mix of sacred and pagan in the island’s folk lore and myth: there is the legend of Calypso ensnaring Odysseus in her cave above the red sand of Ramla Bay while at Gharb they tell of the metamorphosis of an altarpiece of San Dimitri

But even here I couldn’t escape the nagging anxiety about my teeth. As I walked across the salt pans on Christmas Day I told myself I would not let another year pass without resolving it. I wasn’t sure how as I knew that I could never afford the verging on £20,000 my UK dentist was asking. The answer came out of the blue. One evening I opened the local Yellow Pages and looked up dentists. The following day I stood in a telephone box in Victoria making a call to the Savina Clinic. A few days later I flew home with all the literature.

Never one to make decisions swiftly, it took me almost a year to find the courage to go for it. In the meantime, the enormity of the problem and the lengths Brits go to solve it surprised me.
Facts and figures include:

70,000 Britons went outside the country for health care in 2007, a figure which is expected to rise to 200,000 by 2010.

Out of a sample of 650 UK health tourists, savings on treatment cost accounted for 92% of the reasons for having treatment done abroad. 97% of medical tourists said they would ‘definitely go abroad for medical treatment again’.

The ex-UK medical tourism market is currently worth £375 million. Dentistry is a particularly good example, due to the UK’s shortage of National Health dentists.

I’m a journalist who goes for research in a big way. In fact, some people tell me I delve far too deeply. The Google machine was both a blessing and a curse, taking up hours of my time as I ploughed through websites on dentistry abroad. The British Dental Association made gloomy reading as it only pointed out the pitfalls: number of visits required, qualifications and experience to check, and darkest of all, what does one do if things go wrong. Coincidentally I was contacted by a state of the art dental clinic in Bulgaria. I chatted to the pleasant call centre person and found myself accepting the offer of a press trip.

It proved to be hands on; any journalist who chose could have a consultation. On the first morning as I waited for mine I chatted to Terri Colley a youth hostel manager from South England who had begun treatment there in March. She said: ‘My dental problem undermined my confidence. I felt I couldn’t smile. But costs in the UK were prohibitive. I was quoted £15,000 – £20,000 Who can afford that?

In contrast, my first consultation here cost £10. We discussed the treatment I required and how many visits it would take. It took courage to have all my top teeth extracted and I’ve worn a temporary denture for six months. But I’ll soon return for implants and have a smile to be proud of. If that isn’t enough my dental bill will be around £4,500.’

I was suitably impressed. But when my turn came and I was ushered into a consultancy room, the extreme youth of the dentist unnerved me. I learned later that this is the practitioner’s first post after leaving dental college. The more cynical would add that it enabled low salaries and thus the inexpensive treatments.. I returned to a now crowded waiting room… most of the patients were German. This was the general lingua franca although some of the receptionists spoke English.

Within an hour I had a three page treatment plan which went into far more clinical detail than anyone would want to know about the procedures. Costs as predicted were reasonable.

On the second day we were received…..there is no other word for it… by the director: a slender Russian woman. She was dressed for the part in a snowy white frock coat and trousers, black high fashion pointed shoes. Her hair was short and bleached white blonde, her make up immaculate. All very James Bond! As we toured the place I began to find it quite spooky the computer operated machines churning out teeth, the apparently identical looking young staff making up prosthesis. It appeared a temple to implantology State of the art, certainly, but cold and clinical. I decided thank you but no thank you.

A month later saw me on Malta in the harbour side city of Sliema. I was combining a holiday with a trip to Gozo to see Dr Xuereb. It was incredibly hot and the long bus journeys coupled with ferry crossings were exhausting. But from the moment I stepped into the practice I felt I had come home. This was the person in whom I could put my trust. That consultation, the time Joseph (we agreed on Christian names as I couldn’t pronounce his surname) gave me to explain the x-ray and what he suggested might be done to restore my smile was miles away from the Bulgarian experience, . He took me through each step reassuring that while the treatment plan was important there was always the chance that other things would be discovered but solutions could be found for them. I’ve had a long standing phobia about having impressions taken since, on one occasion, it had gone frighteningly wrong. Joseph persuaded me to let him try with another material and hey presto it all went like clockwork. We agreed that we could work together on the smile.

There is a saying in Maltese he told me ‘You don’t spoil the soup for a pinch of salt’ There are no hidden costs. If I find that there is something needing to be done that I haven’t calculated for then I will add it without any extra charge.’

This would be the tenure of my subsequent treatment with him .

So why when I returned to the UK did I continue to hesitate. It’s a question I ask myself in retrospect and have no answers. It had all to do with apprehension and my over fertile imagination. I read and reread the leaflet on Emdogain, a product that, in many cases, can help restore the ‘anchor’ teeth in the gum. Commitment to its success seemed huge: six weeks without brushing, using a special mouthwash and eating only soft, tepid foods.

I’d go to bed determined I was going to go through with it, wake struck with dread. The proof is the dossier of emails I posted to Dr Xeureb and his infinite patience in responding.

Anyway, to cut this long story short I finally inveigled my friend Andrew to take a week out and get his teeth fixed, too. The Practice sent us a series of appointments and Google sorted flights and a pleasant looking guest house in the seaside resort of Marsalforn. There was no turning back.

The journey went smoothly, the taxi flew through Malta to the ferry port. At Mgarr Harbour our host Joseph Saliba was waiting with a car to take us to the Lantern Hotel. But we went down to dinner with a sense of its being a last supper.

In fact, we had a gentle introduction. Monday morning’s appointments were spent discussing the treatment we would have in the ensuing days. Once again I was impressed by Joseph’s thoroughness, his intent that we understood exactly what and why we would be following these treatment plans. Feeling a bit of a fraud, we spent the lunch hour over sandwiches and beer at the Bellusa bar. The sun beamed down on us, you would have thought we were on holiday.

In the afternoon I sat in the waiting room reading while Andrew had an appointment with the hygienist. And so back on the last but one bus to Marsalforn for an aperitif before dinner.

Tuesday’s appointment firmed up my long term treatment plan. I was to have two teeth extracted, applications of Emdogain and, if all went well I’d be back in a month or so to begin on my implant programme. Once again, Joseph answered all my questions and I marvelled at the time he gave us both.
With an afternoon ‘off’ we caught an earlier bus back to Marlsaforn and did the salt pans walk again. The landscape is extraordinary, like walking over the moon’s craters.. We bumped into John, another of Joseph’s clients. Like me he’d been through the Emdogain phase and had now returned to begin on the implant procedure. I’d chatted to him in the clinic while waiting for Andrew

Lunch on the terrace of his delightful apartment next day was peppered with discussions about teeth. It was as if we all belonged to some esoteric society. We were back to reality on the Thursday when Andrew had several extractions,. He emerged completely numbed up and obviously feeling battered. We sat in the bar by the bus shelter until he had recovered and then onto the ubiquitous bus back to the hotel
Friday was the start of my sessions with deep gum treatment and application of Emdogain. Andrew was fitted with his temporary bridge which he complained felt like a load of plastic in his mouth…Temporary, I reminded him. What more can you expect if you can only spare a week away? We were finished by lunch time and decided to take the bus to lovely Xlendi Bay where we sat in the sunshine I felt peckish but because I was now on a soft food diet I had to make do with an ice cream.

In the early hours of Saturday morning Andrew flew back to the UK and faced the worst part of the treatment alone. On Monday I had a complicated extraction and went back to the hotel with a scarf covering my face. I felt weakened and dispirited and spent the afternoon in my room reading and dozing. I can’t even remember what I had for dinner.

During my years of trying to find a solution to my problem I have fought against the extraction of every tooth. Tuesday found me faced with the decision of having yet another one taken out Joseph said it was up to me. As always he was totally honest and gave me the odds. He had calculated the success rate of phase two, the placing of implants, and the prognosis for this tooth was not particularly good. It might jeopardise the overall success. Even if it reduced the success rate by 1per cent that was still an important percentage. I agreed.

It was that day I met Jo, bubbly TV producer, in Gozo to improve her smile. We chatted then went to a bar for a couple of hours of conversation although neither of us could drink anything more than a milk shake. Jo told me she had fallen in love with Gozo and would move heaven and earth to find a job and live here.
There is quite a considerable expat contingency on Gozo including the redoubtable group that works for the Society for the Protection and Care of Animals. I popped into their animal shelter in Victoria and shared experiences. Apart from being a writer I have run a feral cat project in Sicily for the past six years, On the Friday night I joined them for their weekly fish ‘n’ chips evening in a Marsalforn pub although I could not eat the chips, of course!

That morning as I had said good bye to Joseph I told him he’d changed my life. It is the truth. The confidence in knowing I am now on the road to correcting my teeth has over spilled into other areas. I have no qualms about returning to begin on the implant procedure. In fact I can’t wait.

Perhaps I wont have absolutely perfect teeth. There have been far too many years of my own and some UK dentists insouciance…..but I’ll be able to talk, laugh and eat with confidence. I have taken the step in time. It is a sad indictment on this country. I dipped into my savings and had the initiative to take myself to Gozo. What of those who can do neither and must suffer broken, painful and missing teeth for the rest of their lives?

A smile is so important. As Ronald E Goldstein wrote: “A charming smile can open doors and knock down barriers that stand between you and a fuller, richer life.” I’d had that smile once and now it is being restored.

As Christmas approaches once again I look back on that call I made from a Gozitan telephone box; it was one of the best things I’ve ever done.

© Jennifer Pulling 2009