As acute scarcity of dentists seems to have plunged the UK's NHS, more and more dentists from abroad are filling in the gap. But local doctors complain that overseas doctors are undercutting them.
For instance in Wales, a few years ago dentists accepting NHS patients were in such short supply that hundreds queued whenever a new dentist appeared.
AdvertisementNorth Wales suffered acutely, but now at least three large practices in the region are run entirely by dental surgeons from overseas.
Prestatyn Dental Centre has six dentists, from Poland, Hungary and Romania.
The Mostyn House practice in Llandudno has three from Poland and one from Denmark.
And White Cross dental practice at Wrexham Technology Park - offering NHS care for 10,000 people - has three dentists from Poland and one from Lithuania.
The chance to work in Britain does not appeal only to young people. Some of the dentists who have come to Wales brought a wealth of experience.
Dr Grazyna Pawlak, at Prestatyn Dental Centre, has a granddaughter aged two-and-a-half, but two years ago she chose to work in Wales because she liked travelling, had never visited Britain and was divorced.
"I met new people and new technology," said Dr Pawlak, who has been a dentist for 30 years.
"Everything was different for me, and I like changes."
But the British Dental Association is unhappy over the trend.
Stuart Geddes, director of the BDA in Wales, said competitive tendering by local health boards (LHBs) had seen established local practices undercut by large companies, which recruited some dentists from overseas.
That left newly qualified dentists who had trained in Wales with no jobs locally, he claimed.
"Recruiting from abroad means that they can pay less to the dentists.
"What the LHBs are effectively doing is robbing Peter to pay Paul. Existing practices aren't able to expand and the new ones take the money.
"It costs an awful lot of money to train a dentist. If we're going to have a policy of just recruiting from abroad we don't need to train dentists, but a decision has been made that we are going to train them.
"We train them and don't have jobs for them.
"We have people who maybe come from North Wales and have been given bursaries by their LHBs to go back there to train and provide services, but then the LHBs don't give them contracts to work.
"That's throwing public money away."
Many dentists would, if possible, stay in the place where they trained.
"If they like the training practice and there's capacity, the chances are they will stay there. You've then got succession for the practice built in," said Dr Geddes. "We have evidence that some of the Polish dentists are already going back home because the economy of those eastern countries is improving so dramatically.
"A lot of them have said they want to stay in Britain. Whether they intend to stay in Wales is another issue."
Tony Benton, dental contract co-ordinator at Conwy and Denbighshire LHB, said contractors, rather than LHBs, recruited dentists. But his LHB was aware that eastern European dentists might return to their original countries.
"Ultimately, it's the LHB's responsibility that we've got adequate dental provision for the residents of the area," he said.
"We have a succession plan in place. We're aware of where individuals are retiring. We've made assumptions of the turnover of dentists. Whether or not we see a higher turnover rate in certain practices, hopefully we have accommodated that in the succession plan.
"We would like to see people who have trained in the area having the opportunities to stay in the area."
There were vacancies for dentists in his area, he maintained, writes Rhodri Clark, Western Mail.
In her two years as a dentist in Denbighshire, Dr Grazyna Pawlak has found Welsh children's teeth to be just as good as those of children in her native Poland, where fluoride is added to tap water and table salt.
But she adds: "One thing here that's very bad is that when I refer patients to orthodontic treatment, they wait almost two years. It's too long.
"In Poland, children get appointments straight away, after about two weeks. Here they're waiting two years."
In that time the child's situation could change, and some parents pay for quicker treatment outside the NHS, says Dr Pawlak, 56, of Prestatyn Dental Centre.
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