Sandra L Ross (United States)
Dear Dr Thomas, I am happy to have the opportunity to share my experience with others and support the wonderful care given by you and all of the staff at the clinic and hospital. Please also convey my good wishes to “Nurse Mary”…and all the others
R: Results or Opinions
C: Professional qualifications of Dr. Thomas
R: I reviewed the Smile Kerala website for initial information and after contacting the site manager asked many additional questions. He shared the following information: Dr. Thomas “has over 17 years of post fellowship experience in undertaking highly complex dental procedures and has a 100% success rate to date. Having fully qualified in the West 95% of his daily work is carried out on international clients from the united kingdom, Ireland, and USA.”
C: Testimonials from other patients, especially those from the United States who I could contact on my own.
R: The Smile Kerala website manager had obtained the same initial procedures as those I required and I questioned him at length. He also provided contact information for two other patients from the USA who had not initiated services through his website and I both called and emailed them. Both were extensive in their praise of their treatment, the professional quality of the services, their satisfaction with the results and the graciousness of the people in the State of Kerala. One patient shared his on-line photo gallery from his initial trip which was very comforting.
C: Special needs concerns
R: I have a needle phobia and can only cope with needles in one manner. It was absolutely crucial that I be assured beyond every shadow of doubt that the surgical procedures necessary in my case (removal of all teeth, double sinus lifts, implant of all supporting posts and synthetic bone, and final stitching of gums) be carried out only after a large amount of nitrous oxide under the auspices of either a CRNA or Anesthesiologist and only after I signal that my panic level was such that I knew I could cope with the one needle required for general sedation. For me, this issue was the most primary of all other concerns with these procedures. I had taken over two years in the USA to interview Implant Dentists and Oral Surgeons before I finally was able to find two that I felt I could trust (but then was unable to obtain the services from them due to the much higher cost in the US). I was quite clear with Dr. Thomas that should I arrive and find the surgical portion was not to be in the manner I required I would leave immediately and fly back home with nothing performed. Please see comments below regarding the actual surgical process.
C: Conditions in India for medical services
R: An RN specializing in Cardiology who was born and trained in Bulgaria resides in my home. He has been assisting on the establishment of medical tourism for his country and we spoke at length about this process. I had not heard of this previously and asked many questions and visited many other websites to assess what was available. I have traveled extensively in many countries for years but had not previously traveled to India and had concerns over the level of sanitation, experience and technical knowledge available. As I spoke to other healthcare professionals I was amazed to find that generally the opinion was that many professionals in India were of similar professional and technological standing as those in the US. Sanitation standards in the country as a whole are far different from those in the United States but this was not of concern to me due to the many countries in which I had already traveled, therefore, as long as the surgical portions of the services were performed under the strictest sanitation guidelines, the conditions in the country itself were of little concern as I was well aware of my responsibility to protect myself outside the hospital and clinic just as I would while traveling in any other country.
C: Adverse medical or health conditions of prospective patients
R: As I have been a smoker for over 50 years, am over 65 years of age, have had dental infections and problems for many years and have had serious bone loss and gum diseases, my prognosis for a successful implant process was greatly lessened. Many of the dental professionals in the US will not even accept a smoker as a patient due to the high probability of implant rejection and other adverse results. I had lost quite a bit of body weight due to the inability to eat many of the foods I loved; therefore, the only thing I could do to mitigate this and to prepare for a successful outcome was to take a small regimen of vitamins and other supplements to keep my body as strong as possible to promote healing. Dr. Thomas did not express concern over my various health drawbacks at the time, however, at the conclusion of all my procedures and the successful conclusion of the process, he did admit his amazement that all went so superbly and with only one minor area of concern around which he was able to work. Unforeseen issues and known potential problems can occur in any medical process in any country and with any health professional. It is my belief that one must be aware of their own medical condition and be willing to take responsibility for outcomes which might not be as they had hoped if they are honest and knowledgeable about the state of their own dental health and overall medical condition. These initial conditions are not the responsibility of the dental professional but of the patient themselves and, while Dr. Thomas is skilled enough to do all in his power and expertise to mitigate these types of issues, there are issues which can occur regardless of skill and knowledge. It is my opinion that these pre-surgical issues are the responsibility of the patient….not the dental professional.
C: Travel arrangements
R: Initially the manager of the Smile Kerala website suggested hotels and provided other information regarding the travel and stay in Kerala, however, I made most of my own arrangements. Dr. Thomas facilitated arranging a cab for pickup at the Cochin Airport and transportation to the initial hotel. Wonderful gentlemen named Matthew performed the pickups at the airport as well as the deliveries back to the airport for both trips. He is a very gracious and dependable person. His cab is very clean and as he is accustomed to those of us who are heavy packers, he can manage a heavy load of luggage. The first trip to India I traveled from the US and initially entered India in Mumbai. That is a very crowded airport and as it is necessary to clear customs there and drag your entire luggage from the International area to the Domestic area, I would strongly suggest that the flight be planned to arrive in India directly into Cochin. I was able the second trip to check my bags in my home state in the US and not worry with them again until I arrived in Cochin. A huge relief!
C: Hotels, food and transportation in India
R: Initially I stayed in the Hotel Excellency. The room and bath facilities are adequate and are cleaned daily and the staff is very pleasant and considerate. The room service and restaurant menu is limited but even for those of us who are either “picky eaters” or are unable to eat certain items during the procedures there are plenty of foods available. I had been informed by other prior patients, however, about the Avenue Regent Hotel which is less than one block from the Excellency and I transferred to that hotel after a few days and on the second trip spent the entire time at that hotel. The Avenue Regent is much more similar to those in the US and has many more amenities and larger rooms but the cost is about twice that of the Excellency. Depending upon the desires of the patient themselves, I would recommend either as this is a personal choice. Even though I stayed at the Regent on the second trip, I still returned twice to the Excellency to eat and chat with their gracious staff in the restaurant. Initially, if needed, Dr. Thomas arranges to have his patients met at their hotel by one of his staff members and either walked from the hotel of their choice to the clinic or accompanied on the very short ride in a “three wheeler”. Once the patient has made one trip to the clinic (if staying at the Excellency or Regent) I believe walking to and from am the only sensible choice and is great exercise and gives one a chance to get to know the area. As a woman traveling alone, I had no fear at all walking or taking other transportation in Cochin. Having been in a few other parts of India, I would not suggest this but in Cochin this is not a concern. The Cochin folks are gracious, kind, interested in the travelers and were very helpful. Taking the three wheeled autos is very inexpensive and they are certainly abundant.
C: Hospital/Clinic conditions
R: During my initial procedures and due to my special needs for general anesthetic my procedures were begun in a small hospital quite close to the clinic. The nursing staff was wonderful and I simply cannot speak highly enough of them. They are tremendously attuned to your needs and on the second trip it was almost like returning “home”. The small hospital is meticulous in its hygiene and other than for a few short hours during both trips I was the only patient being served. Initially I was concerned that my fear of needles had not been communicated to them and thus I questioned everything the staff needed to do for fear a needle would be involved. They handled everything superbly and all took place in a manner even better than I had ever dreamed. On the initial trip, I brought a friend with me and she decided to have cosmetic surgery. She was booked into the Medical Trust Hospital and while the technical skills and knowledge of the professional staff is (in my opinion) of the highest, the conditions there are in no manner as clean and comforting as those in the hospital in which my procedures were performed.
C: Cost of procedures and travel
R: As I made most of my own travel arrangements, I was aware of the majority of these costs prior to the trip. Transportation within Cochin is extremely inexpensive as is the food. Dr. Thomas supplied the initial cost of the various components of the procedures; however, one should be aware that changes can occur in these costs depending upon unforeseen issues during the series of procedures. My costs were higher due to my requirement for an anesthesiologist and initial services in a hospital location rather than performing these procedures in the Clinic under local anesthesia. Additionally, other changes in costs may occur should more or less implant devices be required. Also, due to the fluctuating world economy, currency equivalents will play a part in the patient’s overall and final cost. There is little which may be done about these fluctuations unless one chooses to prepay for their whole services and, even then, changes can occur if additional procedures are found to be necessary.
C: Pain or discomfort
R: Even after the first set of procedures for the removal of all teeth, placement of 20 implants, bilateral sinus graft and all other services, I never had even one drop of pain! The initial surgical procedures were performed according to my wishes under general anesthesia and were completed in approximately 3 hours. While I felt completely well enough to be released within a few hours, following customary medical practice I was discharged the next morning. I have also spoken with other patients who chose to use local anesthetics within the clinic rather than using GA as I preferred and they also said they were very happy with their comfort level during the range of procedures. In my opinion, there is more discomfort in dealing with the temporary dentures necessary during the healing process between the two sets of procedures than during the procedures themselves.
C: Clinic and clinic staff
R: Dr. Thomas’ clinic is immaculate and his staff is extremely gracious. He has his own lab professional who is present at all times and thus any changes, modifications or fitting issues can be resolved immediately and to perfection. In my case, one implant post showed signs of weakness during the final fit of the lower implants. Dr. Thomas immediately (and with no urging by me at all) discarded the complete lower implant-supported bridge and rebuilt the whole lower set into three portions rather than the two portions initially felt to be required so pressure on this one location could be minimized. This change was more expensive for Dr. Thomas and necessitated more of his time and that of his staff but there was no additional charge to me and the results were outstanding. This would most likely not have been the case had I had this performed in the US? I did not initially understand the need for such a long stay (12 to 15 days) during the final set of procedures but now have personal knowledge of the potential for modifications which might occur and thus the need for additional time available should issues arise. On the daily trips to the clinic there were seldom other patients as appointments were scheduled to allow individual and undivided attention to the patient so usually there was no wait time as one would encounter in the US.
C: Ultimate results
R: The results of my procedures are a full mouth of “pearly whites” which are beautiful and stable and extremely natural looking. I have been able to eat everything I missed for so many months and years. There is a different feel of implants but one quickly gets accustomed to this and totally forgets that there is anything other than a set of beautiful teeth. The only things I have found that I can no longer do (which should not be done anyway) are to bite thread, chew off fingernails and other bad habits! With the return of the ability to eat everything and anything I love, I am finally regaining the weight I had lost prior to the initiation of the surgical procedures. Additionally, since there are no longer any dental infections with which I lived for so many years, my health now is getting better than I have experienced for years and years. I understand completely the comment made by another patient who completed his procedures prior to my beginning mine……his only regret was: “that he did not do this sooner”!! I agree with him totally!
Sandra L Ross
Kansas City, USA
By Sandra L Ross (United States)