Medical tourism – getting a dental implant in Bali

Medical tourism is booming as increasing numbers of people are electing to have procedures done overseas, usually because of the prohibitive cost of treatment in their home country. Although the data is unreliable, an estimated 750,000 people in America alone travel overseas for medical care each year.  I recently became a medical tourist …

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My missing front tooth

When the root supporting an old front crown cracked while I was in the UK on holiday, I had to have it extracted. I got a temporary false tooth on a plate made in the UK and was told my options were to have an implant or a bridge. I decided on an implant but had to wait at least four months for the site to heal. As I was gradually heading back to Perth in Australia where a front implant costs around AU$6,000, I researched getting a dental implant overseas.

Implants involve two main stages with a stay of a couple of weeks for each stage, so I decided on Bali because it is close to Perth and cheap to stay there. Dental implants are also about a quarter of the price of those in Australia. After doing a lot of research online and emailing some of the reputable dentists, I narrowed it down to two dental surgeries in Kuta – Dr Syamsiar Adam at Kuta Dental, and Bali 9-11.

I eventually chose Dr Adam as I had a recommendation from a friend who had recently had implants done by her … and she’d had a recommendation from a friend of hers. I’d also read an article on Weekend Notes about an Australian who’d had her abscessed teeth treated by Dr Adam and raved about her. Dr Adam is very experienced, having graduated in dentistry in 1992, and is the dentist of choice for expats living in Bali.

My first appointment with her was in August 2015. I stayed at Hotel Neo, a short walk from Kuta Dental on the same street (Jalan Patih Jelantik). When I arrived at the dingy looking building I felt a little apprehensive, but my friend had told me not to be put off by appearances. As soon as I met Dr Adam I felt confident. She had a calm, professional manner and spoke good English so was able to answer all my questions and explain what she would do on each of my visits.

Four days later I was back at the dental surgery for the implant operation. I was given an antibiotic tablet and a pain killer before the operation plus a jab and mouth numbing lotion before they started drilling. Once, when I winced, I was instantly given another jab. Throughout the procedure Dr Adam was very calm and hummed along to music, which I found very soothing, and her dental assistant was also very gentle, attentive and proficient.

Drilling the hole for the implant seemed to happen quickly (I was still waiting for the pain!) and then Dr Adam sewed the implant into place and fashioned a temporary tooth, as it was a front tooth I was missing. Altogether, I was in the chair for nearly two hours. When I left, I was given a course of antibiotics, anti-inflammatories and painkillers (for only $30), and a follow up appointment four days later to check the healing process.

On my next visit to Bali, four months later, the temporary tooth Dr Adam had glued in was still firmly in place. She removed it and opened up the implant so she could take an impression for the crown. I was in the chair for 1.5 hours this time. Instead of putting the temporary tooth back, she adjusted my plate (that I had been wearing before I started the procedure) so I could use that as there were only 13 days until my next appointment to fit the crown.

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My new implant

Fitting the crown went well and took only 45 minutes. The tooth was a perfect fit, although I felt the colour could have been a bit better matched. My gum had receded after having no tooth for a year so a small portion of the screw is exposed, but this is above my smile line so you don’t see it. I could have a skin graft to hide it if I felt the need.

All in all, I was happy with my implant experience overseas. We stayed in Bali for two weeks on each trip. The two holidays cost me and my partner a total of around AU$4,000 (including flights) and the implant cost AU$1,500 – so it was still cheaper to get my implant done in Bali than Australia.

If you are considering getting medical treatment done overseas, there are several sites that offer advice and information, such as this useful UK based one: http://www.treatmentabroad.com/ If you do your research, it’s possible to get high quality procedures done overseas for a fraction of the price of developed world prices.

When metered taxis are not a good idea in Bali

Sorry for the long time between posts. I was busy organising our fundraiser for the Rural Agency for Social and Technological Advancement (which incidentally was a great success and raised over $4,000), and then getting my Christmas cards and presents organised before heading off to Bali. That’s where we are now, or rather Lombok to be precise.

We spent our first night in Bali in Kuta before travelling east to Padangbai where boats to Lombok leave from.  2015-12-17 15.46.18Travelling around Bali, we tend to hire taxis as they are so reasonably priced and distances are short. Also, public transport is not well publicised. We asked taxi drivers outside our Kuta hotel how much they would charge to take us to Padangbai, a distance of 53km. They said $50.

I had a dental appointment before we left, and we chatted to a gay Indonesian couple in the waiting room. One was in the tourist industry and had a car. He said that his driver would charge about $30 but he recommended using Uber, which he uses all the time especially from the airport. The taxi drivers at the airport seem to have it all stitched up and all quote the same price (AU$15) – our new friend travels from the airport to Kuta for just $5 using Uber.

We’ve used Uber in Australia but hadn’t thought of using it overseas. When we got back to our hotel we booked an Uber ride to Padangbai, the quote was just $12.5. What a bargain! The driver arrived but when we told him where we wanted to go he said he couldn’t drive that far. He rang his boss to check, but no. He quoted us $60 to drive us privately for cash, but we decided we could do better than that, given our other quotes.

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Ian later discovered that Uber had charged him a penalty for cancelling an Uber ride! He emailed them to explain that it was the Uber driver who could not fulfil his side of the bargain. We are waiting to hear the outcome. It’s not the money we’re bothered about, as the penalty is only about $1, but the principle.

Meanwhile, back on the pavement outside our Kuta hotel, the next taxi who stopped and asked if we needed his services was metered. We’d been advised to use metered taxis when travelling around Bali as they usually work out cheaper. So we decided to take it.

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The traffic getting out of Kuta was very slow. The meter kept ticking over.  It soon became obvious that this was not a good idea. We were up to $30 and still only a third of the way to Padangbai. I was getting worried about how much it would cost, but our only option was to carry on or to get out, pay this taxi driver off and they try and negotiate a price for the rest of the journey with another taxi. We decided to stick with it.  The meter kept ticking over. I checked it periodically … we were soon past $50 and still a long way from Padangbai.

I told the driver this ride was proving to be a lot more expensive than other quotes we’d had. His reply was that metered taxis are not a good option for long rides. I said he should have told us before we set off, but he claimed he had no idea what it would cost as he rarely drove to Padangbai

The ride ended up costing us $73. Luckily the driver waived the 30% extra charge he could have added for a long one-way journey. Later, while walking around Padangbai, we saw taxis to Kuta advertised for $30.

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We had been ripped off, but it was our own fault. As Ian philosophically says, it’s not a matter of if you will get ripped off in these countries but by how much.

The moral of this story is that the best way to travel around Bali by car on short trips is to use Uber. On long trips, try to get an idea of what a journey should cost by asking hotel staff or taxi drivers. Then agree with the driver on a price you are happy with before you set off. That way there will be no nasty surprises!

Nyepi – the Day of Silence

We are currently in Bali and have just visited Ubud. The last time we were in Ubud (in 2013) coincided with the Balinese New Year, known as Nyepi. This celebration occurs on the first new moon after mid-March.

Before Nyepi, Balinese villagers are busy making ogoh-ogoh. These are demonic statues that symbolise malevolent spirits. Made from bamboo and papier mache, many sport bulging eyes, wild hair and claw-like finger nails.P1050110

On the day before Nyepi (called Tawur Agung Kesanga) the ogoh-ogoh are taken to the village square or sports ground for a ceremony. Here’s a short video of ogoh-ogoh arriving at the Ubud soccer field: http://youtu.be/kIzlk_8IV2w

P1050103The ogoh-ogoh were indeed fearsome. Our favourite was an effigy of an old hag who dripped bodily fluids from her fangs and (disturbingly, given that children are involved in the creation of ogoh-ogoh) from her wild pubic hair.

In the evening the ogoh-ogoh are paraded around the village on bamboo poles in a raucous ‘ngrupuk’ P1050091procession. This parade involves gamelan orchestras and much singing and shouting to frighten away evil spirits. Afterwards, following prayers and speeches the ogoh-ogoh are burnt, symbolising freeing the island of evil spirits.

P1050115Nyepi is observed for 24 hours from 6am the next morning with a day of silence and self-reflection. Everyone stays in their homes, there are no fires, lights are out or dimmed, and no working, travelling, entertainment or pleasurable activities are allowed. Bali’s streets are empty, everything is closed – even the airport, there is no noise and few signs of activity. Pecalang (village security men) patrol the streets to make sure that no one is out.

Although Nyepi is primarily a Hindu celebration, non-Hindu residents and visitors also have to comply. Visitors are free to do what they want in their hotel or guest house but are not allowed to leave it. Only emergency services are exempt from the restrictions. The idea of having a day of inactivity following Tawur Agung Kesanga is that the evil spirits will decide that Bali is uninhabited and leave the island alone for another year.

The day after Nyepi, known as Ngembak Geni, is celebrated as New Year’s Day. It is a social day where families and friends get together to ask forgiveness from one another, and perform religious rituals.

P1040998We were staying at a small guest house in a traditional compound. There were only four guest rooms and no pool. We initially thought that visitors were allowed to go out and had planned to take advantage of the empty streets and explore on our pushbikes. By the time we discovered that visitors were confined to their guest house it was too late to move to a bigger place with a pool.

We spent Nyepi in our room. Although this was very comfortable with air con, TV and DVD player and ensuite, the time dragged interminably. We had bought a few DVDs so watched those, we chatted, read, slept and lazed around. Every couple of hours we checked the time. We like P1050131chilling out on holidays, but not for 24 hours at a time. The guest house provided us with lunch and dinner as well as breakfast as there was no other option, and dinner was served by candlelight.

Afterwards we discovered that other travellers who stayed in larger compounds with pools had spent Nyepi in and around the pool, chatting to other guests and having a great time. My advice, unless you really want to spend a whole day on your own in self-reflection, is to avoid Nyepi or stay in a bigger place with a pool. Also, make sure you don’t need to travel on that day.