An Indian dental clinic which markets cut-price services to Australians has been accused of using "fake" online reviews, price gouging and leaving one woman in pain after she travelled to the subcontinent for care.
Queensland retiree Christine Gwin went to the Dentzz dental clinic in Mumbai in September 2023, because she couldn't afford to get the major dental work done at home.
"I went to various dentists here and the cost started to become quite astronomical, way over 30 thousand [dollars]," Ms Gwin said.
After sending the Mumbai clinic x-rays taken in Australia, she was given a "preliminary treatment plan" and "ballpark" quote of between $4,330 and $4,560 for the reconstructive work, including a dental implant, five implant crowns and 22 crowns.
A dental implant is a metal screw that can be inserted into a patient's jawbone in place of the roots of a missing tooth. An artificial tooth is then fitted.
Crowns are caps or coverings used to strengthen and improve the appearance of damaged or broken teeth.
Cost tripled on the chair
Having seen glowing video testimonials and online reviews of happy patients from countries including Australia, New Zealand and the USA, the 74-year-old decided to accept the quote from Dentzz and travel to India.
"All these people on the website were saying how wonderful they were, they had no pain, they were really happy," she said.
"I was stressed, but I was just so hopeful that I would have a proper functioning mouth to eat when I came back."
But after she got to the clinic in Mumbai and had more scans and an examination, she said she was told the cost would more than triple, to $16,000.
"They just said that their x-rays had come up with something different to all the x-rays I'd sent before," Ms Gwin said.
The retired accountant and former business owner said the Dentzz waiting room was "full of Australians", and patients she spoke with said their quotes had also gone up once they arrived.
"Everyone was saying the same — another lady said hers went from 7 to 12 [thousand dollars] and someone else's had tripled."
'In pain from day one'
Despite the ballooning cost, Ms Gwin decided to proceed with the dental work.
"We were all saying it's still cheaper than Australia anyway … you've already paid for airfares and accommodation and you can't just change that without enormous cost."
She was able to increase her credit card limit to $12,000 and agreed to pay the clinic the rest of the fee on a planned second visit.
The 74-year-old spent more than two weeks having dental work, including the removal of old crowns, the fitting of new crowns and root canal treatment on two teeth.
She said she was "in pain from day one" of her treatment in India, and eleven months later constant pain, temperature sensitivity, a loss of taste and difficulty eating were persistent issues.
Ms Gwin said two Australian dentists and a university dental clinic have since reviewed her teeth.
"The prosthodontist I went to said that the crowns are not covering the teeth properly, they're too bulky and food's getting in so there's going to be constant issues all the time with these crowns and the work that's been done," she said.
She said the crowns were also poorly shaped, making it difficult to grind and eat food.
ABC News has seen documentation from a Brisbane-based prosthodontist — a specialist dentist skilled in reconstruction — who evaluated Ms Gwin's mouth reconstruction.
It said a treatment plan for the "assessment and likely replacement of the majority of the crowns placed overseas and the restoration of overseas placed implants" is estimated to cost "in excess of $50,000".
Ms Gwin said she had been left worse off after the treatment by Dentzz and is bringing forward plans to sell her house.
"It's just been too much," she said.
Several months after returning to Australia, Ms Gwin's credit card company clawed back approximately $11,500 from Dentzz, refunding the retiree.
"I sent them the [Australian prosthodontist's] report, I said the work I had done is not working, I did not get what they offered me, I did not get what they said they would give me," Ms Gwin said.
"And then after their own investigation they did a charge back on the whole lot."
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Dentzz declined an interview, but in a lengthy written response the clinic said Ms Gwin was diagnosed "with a severely deteriorated dental condition" after a thorough clinical evaluation and consented to the cost.
"Until an appropriate diagnosis is made, we cannot provide an accurate quote, and this is explained to every patient, including Christine," the statement said.
Dentzz said Ms Gwin "did not return to complete the treatment with us".
"We have had the privilege of serving tens of thousands of patients, many of whom describe their experience with us as truly life-changing," they said.
"This positive feedback is testament to the exceptional care we consistently provide."
Hundreds of 'fake' reviews removed
According to its website, Dentzz has dental clinics in Mumbai, Delhi and Dubai.
The site includes vision of modern-looking dental theatres and video testimonials from happy Mumbai patients, including former Australian international cricketer and renowned pace bowler Brett Lee.
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But there are question marks about the authenticity of some of the reviews on other platforms.
The international review website Trustpilot said its fraud detection technology had used "hundreds of data points" to identify "a significant number of fake reviews" on Dentzz's company profile page on its review site.
"To date we have removed more than 650 fake reviews out of a total of nearly 950 posted for the company," a spokesperson said in response to questions from the ABC.
There are more than 1,000 reviews on Google from patients of the Dentzz clinic in Mumbai — the vast majority of which are positive.
When asked about the Dentzz reviews, a Google spokesperson said the company's policies stated "reviews must be based on real experiences".
"We've looked into this case and are removing the policy-violating content," the spokesperson said.
Google did not clarify what "policy-violating content" it was referring to.
Dentzz said its Google reviews "include real patient images taken in our clinic, clearly substantiating the authenticity of these testimonials".
Dentzz rejected Trustpilot's findings.
"We firmly assert that we do not engage in posting fake reviews. We have observed that Trustpilot has removed several genuine reviews, which we believe indicates a bias," the clinic said in a statement.
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The risks of dental tourism
There are no official numbers on how many Australians travel overseas each year for dental care.
While many so-called dental tourists are happy with their experiences, the Australian Dental Association (ADA) said the risks include having unnecessary treatment and acquiring infections.
"You don't have the legal support that you'd have in Australia — the required regulatory standards that we have in Australia," said ADA president Scott Davis.
The Port Macquarie-based dentist said while some patients received good care overseas, he saw others return with major issues.
"There's often crowns that might not fit, might not be the right colour, may not have been cemented properly," Dr Davis said.
"So there's a lot of sensitivity, dead nerves, decay left behind, teeth extracted and half the roots left behind, all sorts of things.
"If the government funded dentistry properly in Australia so it targeted vulnerable Australians like seniors and those on low incomes, then many Australians who head overseas every year to get dental treatments done supposedly for less money would not need to."
'Deeply disappointing' government response to dental inquiry
In 2023, a Senate committee investigating the provision of and access to dental care in Australia made 35 recommendations to improve the state of oral health in the country.
Key recommendations included considering a Seniors Dental Benefit Scheme and a move toward universal access to dental care under Medicare or a similar scheme.
Neither of those recommendations were supported by the federal government, which instead noted them, along with 22 others, citing "competing budget priorities".
Dr Davis, who is a specialist prosthodontist, said the response showed the government did not take oral health seriously.
"It was a non-response. They noted the recommendations, which were very clear specific recommendations, which need to be done for the good of vulnerable Australians," Dr Davis said.
"They didn't dedicate a single dollar — it was deeply disappointing."
A spokesperson for the Health Minister Mark Butler said "a number" of the Senate committee's recommendations were being considered.
"The government has commenced work in partnership with all states and territories to develop a new National Oral Health Plan for 2025-34," the spokesperson said.
"The plan will include goals to improve the oral health status of Australians and reduce inequalities in oral health status."
At her home in Logan, Ms Gwin is continuing her volunteer work caring for rescue chickens and coping with her dental pain as best she can.
She doesn't believe all overseas dentists are bad.
"I think you just have to be really, really, really careful," she said.
"You've got to look at people who've already done it and talk to them personally — don't go on these reviews."
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