Sir, we would like to bring your attention to the increasing burden of dental tourism on our hospital service.

A 53-year-old patient attended our oral surgery department with a history of recurrent infections. The patient had travelled abroad for dental treatment 13 years previously. On clinical examination, a mobile full-arch prosthesis was present in the maxilla; the surrounding gingiva was suppurating and inflamed. Radiographic examination revealed a subperiosteal implant spanning the entire edentulous maxilla with severe bone loss (Fig. 1). These implants are designed to rest on top of the alveolar bone, underneath the mucoperiosteum.1 The implant was surgically removed to resolve the infection but resulted in oral-antral communication (Fig. 2). Soft tissue closure was not possible due to the degree of bone loss and therefore an obturator was recommended. On discussion with our prosthodontics colleagues, we learned that our patient was not eligible for further treatment in secondary care.

Fig. 1
figure 1

Orthopantogram

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Fig. 2
figure 2

The subperiosteal implant following surgical removal

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Subperiosteal implants were first described in Sweden in 1942.2 They demonstrated good success rates in atrophic mandibles but are no longer used in the UK owing to the improved success rate of bone grafting to facilitate placement of endosseous implants in atrophic arches.3It is likely that if this patient had sought treatment in the UK, they would not have been restored with a subperiosteal implant. They would also have been able to access their clinician post-operatively to manage their complications earlier, and likely reduced their morbidity.

The Department of Health, in response to aesthetic surgery tourism, limited responsibility of the NHS to managing emergencies but not remedial work.4 We ask: can this reasonably be applied to dental tourism given that teeth are functional and not only aesthetic?