Check out the facts before you check in
With more and more people considering dental treatment abroad, UK dental regulator, the General Dental Council (GDC) has issued guidance and advice to dental patients with a checklist of questions to ask before travelling abroad for treatment.
The aim of the checklist, produced in association with the British Dental Health Foundation (BDHF), the UK’s leading oral health charity, is to help dental patients make informed decisions about their dental care, wherever they receive treatment.
Duncan Rudkin, Chief Executive and Registrar of the GDC, said: Our job is to protect UK dental patients by making sure all dental professionals practising in the UK are trained appropriately and registered with us. We think it’s important for dental patients – wherever they receive their treatment – to know the questions to ask to ensure they receive the best possible treatment and care, and where they can go if something goes wrong.
That’s why we want to encourage people considering travelling abroad for dental care to ask questions before making a decision about their treatment. Qualifications and standards are likely to differ from country to country, so it’s important that you collect as much information as you can before committing to anything.
Dr Nigel Carter, Chief Executive of the BDHF, said: The National Dental Survey 2008 found that 16% of people would be willing to travel abroad for dental treatment and the figure was even higher among the 18 to 30 age group – suggesting the trend will continue.
This document provides members of the public with a very useful starting point on the questions to ask before getting dental treatment abroad.
Styles and standards of dentistry can vary a great deal from one country to another and, if things do go wrong, patients could still be left facing some difficult and potentially expensive decisions.
However by researching their chosen practitioner and asking the right questions they can reduce the chances of encountering potentially avoidable problems further down the line.
A copy of the dental tourism checklist is available on their website, www.gdc-uk.org.
The International Dental Health Foundation, is dedicated to improving the oral health of the public by providing free and impartial dental advice, by running educational campaigns like National Smile Month and by informing and influencing the public, profession and government on issues such as mouth cancer awareness and water fluoridation.
For free and impartial expert advice contact the Dental Helpline on 0845 063 1188 Monday to Friday.
Val Reynolds Brown, Editor
This feature was first published in January 2010
Jennifer Worth, author of Call the Midwife – currently a hugely successful TV series – sadly died just before filming began in 2011.
Some seven years previously she had contacted me offering a feature about the severe eczema she had developed at the age of fifty five and her efforts to relieve it.
The first line was startling: Severe eczema doesn’t kill you; it just drives you insane.
Written in much the same style as her books the feature chronicles the development and relief of the eczema she experienced.
I developed eczema for the first time when I was fifty five. Within three short months two tiny patches of eczema on my legs had spread to cover my entire body. It is the itching that drives you mad. I would scratch the whole night long until I drew blood, then it would begin to hurt, but the pain was infinitely preferable to the itching.
Dermatologists could only offer steroids. These helped a little, but the itch came back worse than ever afterwards. I was in despair, until I happened to eat a Chinese meal, which gave me food poisoning and I did not eat for four days. During that time my eczema virtually cleared up. When I started eating again it came back. The cause was obvious – food allergy.
The dermatologists told me it was coincidence, as in their view there was no connection between food and eczema. But I was not convinced and searched every path for the offending foods – with no success. Let me say here that most people fail if they try to identify food allergies alone. It is too complex for the layman and you need an allergy specialist, a qualified nutritionist or at least a reputable book to follow.
I was fortunate in finding the right specialist, who guided me through a strict elimination diet. Once we had found the right diet, my skin cleared within three weeks. Then he led me through the challenge/reintroduction phase of the diet, which was very difficult and troubled by many pitfalls. After about six months, my skin was completely clear and I felt wonderful. Incidentally a side effect of an elimination diet is a surge of good health. Eliminating dairy products, gluten, yeast, sugars and chemical additives from your body can only be beneficial. We all eat the wrong things and suffer for it.
My specialist advised me to have a course of Enzyme Potentiated Desensitisation (EPD) because, he told me new allergies would develop. I have had EPD – see below – twice a year for nearly ten years and my skin remains perfect, for which I thank God every day of my life.
The charity Action Against Allergy asked me to write a book about my experiences detailing the elimination diet given me by my specialist. I was asked for this because there is so little information available on this subject. My book Eczema and Food Allergy was published in 1997 and featured in the Nursing Times, the Sunday Telegraph and the magazine Here’s Health. It sold out of two editions and last year they decided to republish online – see below.
This is a very controversial subject. Doctors, dieticians and even the National Eczema Society will state that eczema is not connected to food. But I have proved that it is.
In this article, I have deliberately refrained from giving any advice to eczema sufferers about diet. It would be rash and irresponsible for me to do so, because the subject is far too complex for a short article. But my book contains all the details necessary for a successful elimination diet and includes many addresses for specialist treatment. My heart goes out to anyone afflicted with severe eczema. I know the suffering involved and it is beyond description. If my experience can be of help to anyone, I am well pleased.
Many people have asked me what EPD is; how does it work, where can you get it, and what does it cost? It is a very subtle and complex medical process, and I give below a brief summary of what it is about.
Enzyme Potentiated Desensitisation is a form of immunotherapy developed by Dr. L. M. McEwen in the 1960s and now used worldwide. It has the potential to desensitise anyone to the allergens to which they are allergic. This includes foods, dust, animals, birds, grasses, pollens, moulds, and many chemicals. An ultra-low dose of allergen is used – approximately 1/1000 part of a routine skin-prick test – combined with the natural enzyme beta-glucuronidase which enhances, or potentiates the desensitisation process (thus we get the rather curious name). It is particularly effective for the treatment of eczema, and will work quickly for children – the younger the child the quicker it will work. It takes about 2-5 years to be effective for an adult.
EPD is only available on the NHS at the Royal Homeopathic Hospital (60 Great Ormond Street, London W1N 3HR). Dr Michael Jenkins, Consultant Allergist will see patients via a referral from their GP. EPD has a ‘Specials’ licence. This means it is accessible only to suitably accredited doctors to supply on a ‘named’ patient basis. The doctor must be a qualified MD trained in allergies, and who is specially trained to hold a licence to administer EPD.
There are about twenty such doctors in the country, and their names and addresses can be obtained from the British Society of Allergy and Environmental Medicine, PO Box No. 7, Knighton LD7 1WT Phone: 01547 550378; Web site: www.bsaenm.org.uk. This is a charity which will give you the address of your nearest medical practitioner of both EPD and Neutralisation. An adult course of EPD, lasting about five years, will cost around £2000, but far less for a child. This may seem a lot, but, believe me, EPD is worth a second mortgage.
In my book ‘Eczema and Food Allergy’ I devote two chapters to EPD, which gives far more detail than I can give here.
Eczema and Food Allergy is available in print from Merton Books www.mertonbooks.co.uk
Jennifer Worth, born 25 September 1935 died 31 May 2011, was a nurse, midwife and ward sister from 1954-1973.
Her book Call the Midwife about her years as a district midwife in the slums of London’s East End is published by Orion Books There is an interview with Jennifer talking to Danuta Kean about writing her books on that web page.
Two more books Shadows of the Workhouse and Farewell to the East End make up a trilogy. All three books have sold almost a million copies and stimulated a publishing subgenre of nostalgic true life stories.
You can watch a short video interview where she talks about her nursing career and working with the nuns in the East End of London.
Val Reynolds Brown, Editor
Oh yes, this is dip in reading for at least a year! With 100 historical objects to read about, from the earliest surviving object made by human hands to the 100th object – a solar powered lamp and charger it would fascinate anyone interested in man’s history.
The BBC wanted a series of talks about historical objects that previous civilisations have left behind them, often accidentally, as prisms through which we can explore past worlds and the lives of the men and women who lived in them. They collaborated with the British Museum and the chosen range of objects is enormous. Those talks were broadcast on Radio 4 and are still available via the web where you will also find a list of the objects, access to the programmes and other related and relevant information. Each day shows a different object.
In the book Neil MacGregor shows us the significance of each object, how a stone pillar tells us about a great Indian emperor preaching tolerance to his people, how Spanish pieces of eight tell us about the beginning of a global currency, or how an early Victorian tea set tells us about the impact of empire.
Each immerses you the reader in a past civilisation accompanied by an exceptionally well informed guide.
This is truly a feast of information, well written, easy to assimilate and most memorable.
It is a family book too, not just for dad. I’m sure many a pupil will find the book a very good source of reference. It is a triumph of planning and dissemination.
Reviewed by Bob Beaney, social observer and guest contributor
Five years ago I decided to implement a plan that had been brewing in my mind for a long time – to take a group of In Balance readers on a city break and to experience Hungarian thermal spas.
We booked into Hotel Margitsziget on St Margaret’s Island which had its own thermal spa and a range of treatments – many only available with medical approval, although we had the choice of a range of massages and beauty treatments.
Only having three days to visit, we needed to get moving – and fast! For the group briefing we consulted our copies of the excellent Budapest City Guide, generously provided by Bradt travel guides. In constant use every day, the small size made it an ideal travelling companion in pocket or handbag. Update: It is now in its third edition. The maps fold out – great improvement with points of interest numbered and cross referenced. Physically it has doubled in size. Much improved and very, very informative.
One of the first things we learned is that the city is a misnomer. The reality is two cities – Buda and Pest, one each side of the river. With so much to see it was a smart move to arrange a coach tour with a guide. Driving around Buda, we were really very impressed: the historic city has been well restored and, at night, the main buildings are lit giving the city a fairytale backdrop. Great views and a real treat for the photographers.
Across the Danube, Pest was another story altogether. Flat and built up, many of its buildings have a stucco finish which was broken almost everywhere giving the city a tired and run down feel. Work on an extension to the Metro was causing traffic havoc.
Overall, the two cities had a melancholy beauty. Everywhere we saw cruelly pruned trees and piles of rubbish in the streets, awaiting collection.
The people were great though! In our hotel they were really helpful and friendly, although a little shy and slow to approach us at first. But we’d made a great choice for a relaxing base – for example, Lucia, one of the group, quickly forgot which day it was she was so chilled out! The thermal baths were excellent, clean and relaxing.
Interestingly Budapest had become a medical tourism centre, visited by many from the UK for the good value for money dental treatment. (You might like to read our later feature concerning dental treatment abroad). Around the hotel, we got chatting to several visitors from the UK with positive stories to tell about their experiences. Cosmetic surgery and laser eye treatment were popular.
Many of the old state run services, like health, still worked extremely well. Transport was very reliable and easy, with frequent trams, double coach buses, taxis, metro, bikes and river boats, a single ticket system linked all public transport. We found the ticketing regulations complex and struggled at times to travel legally!
Apart from our own hotel, we spent some time in Hotel Gellert – a general cry for coffee and cakes break!
The hotel’s own thermal spa is available to the public with its main bathing hall renovated and opulent. However the women’s changing area was awful – run down and smelly, with unlockable cubicles for your belongings. Bathing in the women’s pool was naked – an experience not to be missed. Or repeated depending on your view! The hot water gushes straight out of the rock and was absolutely wonderful to stand under it and have a good, natural massage on the shoulders, and other parts if you wished of course!
On aspect of nude bathing is that it is a natural leveller and also an educational experience. Never knew there were so many different shapes of parts of the body. Luckily the mixed pool insisted on swimwear. Thank goodness.
But our visit wasn’t all about healthy living! We ate in traditional restaurants and experienced the dated atmosphere, where music was provided generally by violinists and guitar players. Much of the food we found to be overcooked, but the exceptions were the freshly cooked dishes like trout with almonds and the baked salmon we found in a fish restaurant. We also enjoyed Hungarian dishes including hortobagh palatsinta – chicken minced with cream and paprika.
As luck would have it we visited during the Spring Festival, a time of music, dance and theatre. One of our stops was at an outdoor craft market with food stalls – a chance to try some more local snacks! And I was rather taken by a flute seller who played his heart out for us.
Organisational problems were few except when a couple somehow got separated from the main group, twice. So I quickly learnt how it important it was to always check mobile phones will work in the country you are visiting!
Well that was six years ago. It would be interesting to revisit and compare experiences. We would go later in the year, probably early April when it would be a good deal warmer, brighter and more conducive to joining in the city’s famous cafe society habit of people watching.
We stayed at the Danubuis Hotel Margitsziget on St Margaret’s Island www.danubiushotels.com
An informative website is www.gotohungary.co.uk
Val Reynolds Brown, Editor
For a long time in the alternative health and more recently in the popular health press, concern has been flagged up of the possibility of mercury leaking from tooth filling amalgam. A lot of money can be spent on having fillings removed and replaced by non-toxic amalgams, even going abroad to save money.
So it was interesting to read on the QuackWatch http://www.quackwatch.org/ of reviews that dispute the toxicity claims. I am reproducing it in full:
False dental amalgam toxicity claims slammed again
A study of 56 patients who claimed to have symptoms caused by mercury in their amalgam fillings has found that none of the patients had significant levels of mercury in their blood or urine levels. The researchers noted that 20 of the patients has previously been previously diagnosed with mercury toxicity by “commercial practitioners using unconventional testing panels.” [Eyeson J and others. Relationship between mercury levels in blood and urine and complaints of chronic mercury toxicity from amalgam restorations. British Dental Journal 208(4):E7, 2010]http://www.ncbi.nlm.nih.gov/pubmed/20186178 A recent review by the American Dental Association Council on Scientific Affairs concluded: “Studies continue to support the position that dental amalgam is a safe restorative option for both children and adults. When responding to safety concerns it is important to make the distinction between known and hypothetical risks.” [ADA Council on on Scientific Affairs. Literature review: dental amalgam fillings and health effects on amalgam fillings and health effects. Amalgam Safety Update, Sept 2010]http://www.ada.org/sections/professionalResources/pdfs/amalgam_literature_review_1009.pdf
During the past few weeks, unjustified scare headlines have been generated by an anti-amalgam campaign that involved testimony at an FDA hearing. In response, Robert S. Baratz, M.D., D.D.S., Ph.D. noted:
“The simple truth is that there is no significant risk because amalgam fillings are safe. . . . The promotion of anti-amalgamism is regularly linked with fringe practitioners, people with financial interests in promoting something else, and pseudoscience. Based on past practices, and rhetoric, I’m one of many who conclude that the anti-amalgamists resemble more a religious cult than a group of serious, objective scientists searching for the truth.” [Baratz RS. More notes on the anti-amalgam movement. Dental Watch, Dec 18, 2010] http://www.dentalwatch.org/hg/hearings/fda(2010).html
Earlier this year we wrote about a checklist of questions to ask before travelling abroad for treatment issued by the General Dental Council, reproduced in this Health section.