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Statement on Dental Tourism — Ethical Obligations of Dentists

Dental tourism is defined by the American Dental Association (Resolution 28H-2008) as the act of traveling to another county for the purpose of obtaining dental treatment. The global market presents greater opportunities for the growth of dental tourism. Patients seeking care in foreign countries are becoming an increasing phenomenon that confronts dentists in the United States. 

The Council on Ethics, Bylaws and Judicial Affairs recognizes that there are very capable dentists, many of whom are ADA affiliate members, who provide quality care outside the United States. By issuing this statement, CEBJA’s ultimate goal is to advance the welfare of patients who choose to obtain dental treatment through dental tourism and assist dentists in resolving any consequent ethical dilemmas. 

A patient’s freedom of choice is an overriding consideration in any situation and is one in which dentists must recognize (ADA Code, Section 1, Patient Autonomy). The ethical dentist will treat the patient who has received dental treatment outside the United States in the same manner as he/she would treat a patient who has transferred their care from any other practice, irrespective of the fact that the treatment performed outside of the United States might or might not be substandard and, in some instances, a possible detriment to the patient’s health. A dentist should consult applicable state law to determine the definition of “patient of record.” Failure to treat such a patient may raise ethical concerns under ADA Code Section 2.F, Patient Abandonment. 

As in the case of all patients, the dentist should clearly describe to the patient his/her oral health status (ADA Code, Section 4.C, Justifiable Criticism) and maintain carefully documented records of treatment provided. Records should detail the patient’s baseline condition so secondary dental care can be clearly differentiated from treatment performed by another dentist whether in or outside the United States. 

Where there is an emergency situation that develops as a result of dental tourism and the patient is not—or is no longer—one of record, dentists are obliged, at the least, to make reasonable arrangements for emergency care (ADA Code Section 4.B Emergency Service). 

Dentists, especially those practicing in border states where dental tourism occurs more frequently, should begin to educate their patients about optimal oral health and costs versus the perceived value of dental tourism and advise them of the potential difficulty in seeking redress if problems are encountered with dental treatment performed in a foreign country. 

Aug. 2009; rev. Nov. 2009