Michael Batson

Please note that since this article was written the Chhuon Meng Thmey Dental Clinic, and the dentist referred to, Dr Sok Chenh Chhean, are no longer recommended by the writer.

I don’t much like going to the dentist, let’s face it who does? They cause you grief and cost you money, and if you need major work doing, then they can cost you a lot of money.

Hence the reason many people are venturing into the field of dental tourism and why not? For the price of a treatment plan in New Zealand you can go overseas to some tropical destination, have a holiday while you get your crowns done and come home with change on what the same work would have cost you back home.

Traditional destinations for such work have been the Philippines and Thailand, but increasingly Cambodia is appearing on the dental highway for foreigners. Once an add-on to a trip to Thailand or Vietnam, Cambodia is now increasingly a destination in its own right.

When I first worked in Cambodia in 2006, I had a crown done by a local dentist. At the time I worked at an international school and several of the teachers recommended local dentists confident in the work being done. A couple of colleagues recommended Dr Hong Someth.

When it came down to it, going to see Dr Hong Someth was much like going to the dentist back home. He had been trained as part of an aid programme at the University of Otago’s faculty of dentistry and had spent several cold winters in the south of New Zealand. His wife was the receptionist, spoke excellent English, and after school their children would come and play in the waiting room, which resembled the family living room. In fact, it all had a family feel about it.

There was a television in the examination room where you could watch the work being done if you were so inclined. At the time Dr Hong Someth was head of the Cambodian Dental Association. On the wall there was a picture of him with the former King of Cambodia, Norodom Sihanouk. His practice contained several students, and he spent time passing on his expertise to the next generation of Khmer dentists.

The only major difference with seeing a Cambodian dentist and one back home, apart from the price, is the requirement to change your footwear, and replace your shoes with white jandals available in a cupboard near the door. I was quoted US$150 for a porcelain crown and twice that for a gold crown, I opted for the latter and touch wood, I’ve not had a problem with it since.

I’m of a generation, that when at primary school, we were routinely frog- marched off to the rigours of the school dental nurse. I can recall many an unpleasant hour sat in the chair staring at the ceiling while Nurse Cruel, yes, unbelievably, that was her name, back-filled all my molars. The small out-building that housed the dental nurse quickly acquired the name “The Murder House”.

The raison d’être for this was prevention was better than the cure. If your teeth were filled in that would prevent decay at a later date. So in other words, there was nothing wrong with my teeth, but they were to be filled with amalgam so they wouldn’t need to be later on. It was slow, painful and in most instances, totally unnecessary.

Much to my displeasure, dentists today now refer to the amount of work done on my teeth as requiring further work, implying that in some way the fillings occurred through my lack of care. The result is that the teeth, they say, are weakened and will required capping, or having crowns.

Before leaving New Zealand I saw dentist for an appraisal of any work required; and was told I needed two fillings, one crown and that I should seriously consider some whitening process after years of coffee, age and other beverages had done their darnedest.

The quote, all prepared and presented in a glossy brochure, was $1380 for the crown, $510 for two fillings, and up to $900 for teeth whitening depending on which process I opted for.

To be fair dentists in New Zealand face an uphill battle. Tuition fees and associated course costs at New Zealand universities outstrip even those of medicine. Once qualified, there are the costs of setting up at practice; hiring staff, purchasing modern equipment, and then there’s the cost and time involved in keeping up with the latest techniques and the ongoing dental training to ensure best practice. All of this unsubsidised for any patient over the age of 16, and with no co-payments from the Ministry of Health, as there are for medical patients.

Hardly surprising that for many people, a visit to the dentist is down on the list of essentials, and usually only undertaken on a needs be basis. Or, has many people are discovering a trip to Asia, for a holiday can now also include having your dental work done, while you recover around the pool or on some tropical beach.

There are many dentists in Phnom Penh. I don’t know how many but if you walk around the streets of Cambodia’s capital, you will see surgeries everywhere. The signs are distinctive and blatant, usually some stylised dental symbol, or bright smiles of perfect teeth, usually on the faces of smiling European models.

Based on the recommendation of an English acquaintance who had once had a crown done I went to the Chhuon Meng Thmey Dental Clinic which has two practices located beside the Kandal Market and Chas Market in central Phnom Penh.

The dentist was running late, so rather than keep me waiting the receptionist suggested going down the road to their other premises, so she took me on her motorbike.

My dentist was Dr Sok Chenh Chhean, a slightly built Khmer, who had received his training at the Faculty of Dentistry at the University of Hong Kong. The practice I attended is on the corner of Streets 13 and 130, however, plans are afoot to build a single new premises.

A number of dentists work at the practice and the walls are covered with framed degree certificates of achievement and attendance at various dental conferences, and certificates in English proficiency, and of scientific report writing. After a change of shoes I settled down to review the obligatory magazine rack, which rather than the usual gossip trivia contained books on famous speeches and a book on Barack Obama. A young boy browsed the free internet provided.

The rooms are windowless and colour coded but it seems entirely random which room you are allocated. For the fillings and assessment, I was in the yellow room but then later moved to the blue room for fitting of the crown and bleaching. While doing the cavity work Dr Chhean received visits from a number of his colleagues, who while appearing to receive his counsel, also cast a glance at the foreigner in the chair.

When I arrived for the next appointment at 8am to have the preliminary work for the crown done, I found Dr Chhean sitting in the waiting room dressed in sandals, a t-shirt and jeans. “Have you had breakfast?” he asked. I said that I had. “Then let’s go,” he said breaking into a broad grin.

The young dental assistant working with Dr Chhean broke into a broad smile everytime she looked at me, a feature not hidden by the surgical mask, as he eyes gave her away. Dr Chhean clearly explained the procedure in clear English and then broke into Khmer when talking to his staff. At some times there were two other assistants in the room, and I don’t think I’ve ever been at a dentist where there was so much mirth between the staff.

Dr Chhean explained that he used to see the odd foreigner, but that now they made up the bulk of his client base, many of them New Zealanders. In fact, rather than have tourist walk-ins or business from local expatriates, he explained that some now book appointments with him before leaving home. “I’ve got some people coming from New Zealand next month who already have their appointments with me.”

Cambodia dentists are cheaper than in New Zealand but not cheap, and prices now compare with those found in the Philippines and Thailand. A top quality crown will cost US$350, and are guaranteed for seven years. Fillings are cheap coming in at around US$20-25.  X-rays cost a few dollars, and a scale and polish about US$15. Top of the line teeth whitening will set you back about the same price as a crown.

My crown was fitted on a Sunday afternoon. Dr Chhean explained that he was unavailable to complete the work on Saturday, as he was teaching and supervising students for most of that day.

So all-in-all, I got all my dental work done for about one-third the cost of having the same work done in New Zealand.

But it’s buyer beware. Four years ago a friend of mine had a wide range of dental work done by another local dentist in Phnom Penh, including crowns, bridges and root canals. All up he paid about US$1000 for all the work which by some estimates would have cost about NZ$15,000 in New Zealand.

After an examination with Dr Chhean on the state of the work, he was told that some of the work would have to be replaced. A problem in Cambodia explained Dr Chhean, is that many of our colleagues learn dentistry in part passed down from their parents, and consequently have also learned outdated habits, and have not kept up with the latest developments.

It’s customary practice in Cambodia to pay half the cost of the dental work up front once the work has commenced, and the balance upon completion of the work. All payments and prices are given in US dollars.