Exploration on Dental Tourism Development as a Medical Tourism in Bali

1. Introduction

Social-economic factors have become the reason numerous patients want to get dental health care at a lower rate (Trohel et al. 2016). The factors comprise first is the dental care cost which is quite expensive for some patients. The second factor is access to dental care clinics considering mobility to get treatment right away. Third, is the factor of some people feel satisfied with the care given in other places. Fourth, the cost of dental care compared to economic flight is way more expensive. Fifth, the internet plays a role in increasing traveling for dental care and last is the reason of fees, regulations, medical choices, time, and quality for people to prefer dental tourism (Husain Akbar et al. 2020).

Dental tourism creates dental health care that can be conducted in recreational activities such as attending cultural shows. Increasing comfort for people to access dental care is a considered factor in achieving a healthy life for every citizen. It is stated that about 57% of foreign tourists come to Malaysia to get medical treatment, of which 332.437 are Indonesians. Some of the most sought medical cares are preventive medical services and dental care (Saub et al. 2019). This phenomenon can be an evaluation for Indonesia to develop medical treatment, such as dental treatment. Medical tourism should be the evaluation of healthcare quality in Indonesia so that Indonesians and more people trust to come to Indonesia to get treatment (Asa et al. 2024; Md Zain et al. 2022; Damayanti et al. 2021).

Tourism is one of the mainstay sectors supporting the Balinese economy (Artini et al. 2020). In addition to offering natural beauty, cultural richness, and the friendliness of its people, Bali continues to innovate to respond to the growing global trends in the tourism industry, one of which is dental tourism (Astuti et al. 2024). Dental tourism, or dental health tourism, refers to tourists traveling abroad to get dental health care while enjoying a vacation experience. This trend is increasingly in demand by tourists from developed countries such as Australia, the United States, and Europe, where dental health care costs are relatively expensive compared to developing countries such as Indonesia.

Bali has great potential to become a major destination for dental tourism. This advantage is supported by several factors, including more affordable treatment costs, continuously improving service quality by adopting international standards, and unmatched tourism appeal. Several dental clinics in Bali, especially in the Denpasar, Kuta, and Seminyak areas, have integrated dental health services with tourist needs, such as foreign language consultations, transportation arrangements, and service packages connected to recreational activities (Agung Putri Dwiastuti, Dewi Kumala Ratih, and Kristianto 2023).

This great potential is also driven by the role of the Bali Medical Tourism Association (BMTA), which has facilitated collaboration between the health and tourism sectors to create a more organized health tourism ecosystem. However, despite the great opportunities available, the development of dental tourism in Bali still faces various challenges, such as the lack of uniform regulations, the need for investment in health infrastructure, and less-than-optimal promotion in the international market.

This study aims to explore how the development of dental tourism can be a profitable business opportunity in Bali, as well as analyze strategies that can be applied to maximize this potential, with a focus on the integration of sustainable health and tourism services.

This research was conducted in Bali, focusing on areas that are centers of dental tourism activities, such as Denpasar, center for dental clinics with international standards, Badung, an area that is frequently visited by foreign tourists and has clinics that serve the medical needs of tourists, and Ubud, an area with world-class tourism infrastructure that has the potential to support health tourism.

2. Method

This research used a descriptive qualitative approach with primary and secondary data collection. The primary data was obtained through the Focus Group Discussion (FGD) method. This was conducted with related parties such as dentists and clinic management serving international tourists and representatives from the Bali Medical Tourism Association (BMTA). Meanwhile, the secondary data was obtained from Bali tourism reports and statistics, including data on foreign tourist visits, scientific articles, journals, and reports related to medical tourism and dental tourism in Indonesia and globally, publications from associations, such as BMTA, as well as market reports from international bodies related to health tourism.

The collected data was analyzed using descriptive qualitative analysis techniques that simplify relevant data from interviews, observations, and documents to focus on the main research issues.

The validity and reliability of the data were performed with the triangulation method, namely Source Triangulation which comparing data from interviews, observations, and secondary documents to ensure consistency of information and Triangulation, using different methods (interviews, observations, document analysis) to gain a comprehensive understanding.

This study produces an analysis of supporting factors for the development of dental tourism in Bali, potential business opportunities that can be utilized by local business actors, strategies to overcome the challenges, such as promotion, regulation, and service standardization.

This methodology is designed to provide a holistic picture of dental tourism development in Bali, while providing practical recommendations for business actors and policy makers to optimize opportunities in this sector.

3. Results

This study reveals several important findings related to the development opportunities of dental tourism in Bali as a promising business sector. First, Bali's great potential as a dental tourism destination. Bali has a unique combination of medical service excellence and tourist attractions, making it a potential destination for dental tourism. Some of the main potentials found in this study include first, competitive cost and high quality of service. The cost of dental treatment in Bali is much cheaper compared to countries such as Australia, the United States, and Europe. Besides, dental clinics in Bali, especially in Denpasar, Badung and Ubud, have adopted modern technology and international service standards. Beside the competitive cost, it is supporting tourism attractions. Bali is known as an international tourist destination with its natural beauty, rich culture, and friendly people. Tourists who come for dental treatment can also enjoy a memorable holiday experience, such as visiting beaches, spas, and cultural attractions. Besides that, an easy accessibility in which Bali has Ngurah Rai International Airport with good global connectivity, making it easy for tourists from various countries to access dental tourism services.

Second main result is business opportunities in the dental tourism sector. This study identifies major opportunities for local and international business actors who want to develop businesses in the dental tourism sector, namely development of international standard clinics. Clinics that serve international tourists can develop premium services with tourist-friendly facilities, such as foreign-speaking consultants, comfortable waiting rooms, and advanced technology. Besides, is the integration of services with tour packages which comprises great opportunity to create health tourism packages that include dental care, accommodation, and tourist activities and collaboration between dental clinics and hotels, restaurants, and travel agents can increase the appeal of this service.

According to Zoltan and Maggie, (2010) from the model "Get there, stay there, Live there" what has been happening in Bali is shown in Figure 1.

Figure 1: Bali Tourism Model 

Figure 1 shows the first model, that the main point is the clinic, so that the tourist experience in the destination is only an accessory, organized by the hotel or at the request of the patient, as there is no integration with the destination, through the tourism business. It is also possible that the second model has an intermediary between the clinic and the patient by the travel agent, making the organization of the experience more efficient and consequently expanding the market. However, these two models do not include the tourist experience in the destination in the dental tourism market. Only the third model in which the travel agency plays a major role with direct access to the destination, namely packaging, organizing, offering the entire experience will provide space for the development of real dental tourism. The three models differ in terms of the intermediaries involved, the level of product integration, and the main point of the experience. This has been the concern of BMTA and is being designed in collaboration with the Bali Medical Tourism Board (BMTB) so that it can promote medical tourism in Bali more intensively and organized. It is expected that the tourist visit time will be longer, the destinations will be more numerous, so the country's foreign exchange will increase.

Another business opportunity in dental tourism is digital promotion and patient testimony. Global market can be reached through a strong digital promotion strategy, including social media, reviews on international health platforms, and testimonials from successful patients. Using the branding of "dental care and vacation combination", it can attract developed countries markets such as Australia, Europe, and the United States.

4. Discussion

Medical tourism is a method of getting medical treatment while travelling aboard. Another definition of medical tourism is a travel intended to receive health services. Travelling aboard to get medical services is driven by some factors including cost-effectiveness, access to services and health service unavailability. Medical tourism has become the positive trend and developed in to global industry. It is known that tourism as an industry has become one of largest sectors that demonstrate the growth of world globalization which connects between individuals and nations (Vovk, Beztelesna, and Pliashko 2021; Lovelock, Lovelock, and Lyons 2018; Zhong et al. 2021; Tahir, Hasan, and Dinar 2023).

Bali has great potential to develop dental tourism as a promising business opportunity. The combination of competitive treatment costs, increasing service quality, and international tourist attractions provide advantages that many other destinations do not have. However, the success of developing this sector depends on collaboration between the government, business actors, and local communities in overcoming existing obstacles. Because the success of medical tourism relies on the stakeholder involvement and collaboration at divergent level (Supriadi et al. 2024). In efforts to develop dental tourism in Bali in 2024, the role of dentists, the health office and the tourism office already exist. With the right strategy, dental tourism can become one of the main pillars in diversifying Bali's economy and strengthening its position as a global tourism destination.

According to the research findings, the following are recommendations to optimize the potential of dental tourism in Bali, such as strengthening regulations and service standards by local governments together with associations such as BMTA need to set quality standards for clinics serving medical tourists, and certification of clinics that are oriented towards international tourists can increase patient confidence. Besides, is integrated promotion by integrating dental tourism into Bali's overall tourism promotion strategy, for example through branding "Bali as a health tourism destination", digital campaigns with a focus on markets in countries with expensive dental care costs, such as Australia and the United States. Another recommendation is by multisector collaboration. This can be performed by encouraging collaboration between tourism actors and health service providers to create integrated tourism packages that combine medical services with recreational activities, and last recommendation is infrastructure development, such as investment in health facilities and training of medical personnel to improve service quality and improving connectivity between health services and major tourist centers in Bali.

Author Contributions: Conceptualization, S.A.P.D. and IADKR.; Methodology, S.A.P.D. ; Software, IADKR.; Validation, IADKR ; Formal Analysis, IADKR.; Investigation, S.A.P.D. ; Resources, S.A.P.D. ; Data Curation, S.A.P.D. ; Writing – Original Draft Preparation, S.A.P.D. ; Writing – Review & Editing, S.A.P.D. ; Visualization, IADKR; Supervision, S.A.P.D. ; Project Administration, S.A.P.D. ; Funding Acquisition, S.A.P.D.

Funding: This research was funded by Ministry of Health of Indonesia with scheme of Penelitian Dasar Unggulan Perguruan Tinggi (PDUPT), grant number HK.02.03/F.XXXII/949/2024.

Conflicts of Interest: The authors declare no conflict of interest.

Informed Consent Statement/Ethics approval: All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of Denpasar Polytechnic of Health Ministry Number DP.04.02/F.XXXII.25/0731/2024.