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Purpose: During the past decade German patients developed an increasing tendency to dental health tourism in countries outside the European Union. The present investigation aimed at evaluating both clinical and economic outcome of dental care in these countries with regard to German directive standards., Methods: Based on physical examinations performed by the Medizinische Dienst der Krankenversicherung Rheinland-Pfalz in the context of reimbursement or regress requests after dental care in countries outside the European Union, an individual treatment concept was designed and its direct costs from the patient's perspective were estimated according to German standards. Furthermore, the clinical outcome was evaluated and treatment concepts for the correction of clinically relevant findings were simulated; the corresponding costs were estimated. A descriptive cost-cost analysis has been performed from the patient's perspective and a secondary one from the health service's perspective., Results: A total of 60 examinations (january 2001 to october 2002) were analysed. 29 of these 60 patients showed clinically relevant findings affording post treatment correction, among which 23 treatment concepts significantly disagreed with German directive standards. From the 60 patients' perspective median costs of 942 euro; for treatment outside the EU versus hypothetical costs of 750 euro; for treatment in Germany were observed. In addition, the 29 patients with clinically relevant findings affording corrective treatment implied median costs of 1,383 euro;. From the health service perspective, median costs of 761 euro; could be avoided due to treatments outside the EU, whereas median costs of 1,220 euro; were simulated due to necessary corrective treatments., Conclusion: From the patients' perspective dental care outside the EU has to be reconsidered both from a clinical and an economic point of view.