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Travelling, Tourism, Holidays IELTS Speaking Test with Answers

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Updated On Jul 11, 2024

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IELTS Speaking consists of a short discussion between the examiner and the candidate. You will be asked a series of questions on common topics. You have to state your opinion or experiences. This article contains the Travelling, Tourism, and Holidays Speaking sample answers.

Given below are the actual IELTS Speaking Part 1 stuff based on Travel and holiday speaking topic questions and answers, followed by Speaking Part 2 and 3 on the same topics. When speaking, your tone will clarify and convey meaning.

Speaking Part 1

1 do you like travelling.

Yes. Travelling just changes your mind and refreshes you and makes you forget the busy work schedule. When you start enjoying yourself for some time, you get charged up.

2 Whom do you often spend the holiday with?

I often spend my holidays with my cousins at my grandma’s place in Hyderabad which is the capital of Telangana state. We enjoy each other’s company.

3 Have you done much travelling?

Yes. I have. Places which I visited have a very rich heritage and are colourful like Jaipur which is also known as the pink city, Hyderabad which is also a great metropolitan city, Nagpur famous for its oranges, Delhi famous for its shopping centres and food, Punjab famous for its lively atmosphere and etc.

4 What kind of places have you visited in your life?

I have visited almost every type of place where people enjoy their life, places where people have a lot of opportunities to express their creativity, places which are well known for their educational facilities etc.

5 When you visit new places, what do you like to do?

Whenever I visit a place the first thing I do is search about the history or past of that place ,then record the experiences I get there. I write about what I did , what I liked etc. I just jot down in my travel diary so that whenever I open and read it I can relive those memories.

6 Do you prefer travelling alone or in a group?

I prefer travelling in a group as it’s always safe and most affordable. Also when we go on a trip as a group we are bonded with different type of people and make a lot beautiful ,sour and sweet memories.

7 Do you often travel abroad?

I haven’t travelled abroad yet. First I want to tour all places within my country.

8 In which seasons do you prefer to travel?

I prefer travelling in winter because the weather and atmosphere remains cool and soothing and it feels good to travel when it’s cool and soul-satisfying.

9 What is the best season to travel in your country?

The best time to travel in India is in the span of November to February when it is mixed weather. In this period it’s cold and dry simultaneously.

10 Would you say your country is a good place for travellers to visit?

Yes , definitely. India is considered to be one of the best countries to travel to because of its rich and diverse culture. The way the people in India welcome others with such a warm heart is tremendous to be felt.

11 What would you recommend a foreigner to visit in your country?

Each and every place in my country is significant for a particular thing. I would rather suggest a foreigner to tour all over India because there is not even a corner here that isn’t unique.

12 What places would you like to visit in the future?

I would like to visit New York and also Switzerland. These are my most favourite and desired destinations because of their scenic beauty and also the people who are very generous and sweet.

13 How much time do you spend travelling on a normal day?

On normal days I don’t spend much time as you know I’m pursuing my studies and working simultaneously. So it is really difficult to travel on normal days.

14 What do you do while you are travelling?

When travelling in a car I just sit back and enjoy the scenery. When on the train I really prefer sleeping and if I’m travelling by flight I would prefer reading a novel with my music on.

15 Do you think your hometown is a good place for a holiday?

Yes , definitely. My hometown is the best place to visit on a holiday as it has the best scenic views and a lot of places to roam around. Also my hometown is kind of famous for its delicious food and shopping areas.

16 Are you planning any vacations at the moment?

Yes, I am actually planning a vacation at the moment. I’ve been considering taking a trip to South Korea, which is known for its unique food and beautiful landscapes. I believe it would be a great opportunity to unwind, explore a new culture, and take a break from my daily routine.

17 Can you easily find your way around new places?

I would say that I’m quite adept at finding my way around new places. I enjoy exploring unfamiliar destinations, and I usually start by researching the area before I arrive. I rely on maps and navigation apps on my phone, which are incredibly helpful. Additionally, I often ask for directions from locals, which not only helps me find my way but also allows me to interact with people and learn about the local culture.

18 Can you tell me about the kind of things that you usually do on holiday?

I spend most of my time with my family members because my holidays are the only time I am available to them. I also pay visits to my extended family members. We as a family love to talk a lot, play games, watch films and go shopping.

IELTS Speaking Part 2

Describe a tourist attraction you once visited..

You should say

• When you visited it
• Where is it situated
• Whom you went with
• and say what about it you like the most

Sample Answer 1

I love to visit places, but due to my busy schedule, I am unable to go out on a lot of trips on holidays. Before the global pandemic started, I visited Sikkim with my family. I don’t clearly remember the exact date ,but it was in the month of May, 2019. It was summer, but the weather was very soothing there. Sikkim is  one of the smallest states of India situated in the North eastern part. Since my childhood I was drawn towards mountains more than I was towards the sea. Mountains always used to be peaceful and calm and I think that is the most attractive part of it. We started our journey from Pelling which is a small town in the northeastern Indian state of Sikkim, at the foothills of Mount Khangchendzonga. The town is filled with monasteries and waterfalls. Pemayangtse Monastery is another equally important Buddhist shrine in Pelling. I visited the place the same day I visited Khecheopalri Lake,Rimbi fall, Kanchenjunga falls  and Singshore bridge. It is the second largest suspension bridge in Asia. The next day we visited Rabdentse Ruins and in the evening we were off to Ravangla. Unfortunately it started to rain so we were unable to visit anything but Temi tea garden on our way to ravangla. The next day we were off to Gangtok. We stayed there and went out on alternative days for sightseeing. We visited Tsomgo lake, Seven Sisters waterfall, Banjhakri falls, Rumtek monastery. The days we were not sightseeing, we used to spend quality time in the Gangtok “mail” which they used to call their shopping markets. We were unable to visit Nathula Pass as it started to snow heavily. We visited Yumthang-the valley of flowers and the flower shows of Gangtok. The beautiful snow capped mountains, the waterfalls, the monasteries, the lakes, the people and everything was so serene and beautiful. Sikkim increased my love for mountains ever since. I had a memorable trip which I will relive forever.

Vocabulary for Cue card

•  Suspension: hanging Eg: The suspension bridge is beautiful
• Sightseeing: visit places of that area Eg: She was going sightseeing before she left.
• Relive: to live again Eg: She was reliving her old memories.
• Monasteries: Buddhist Pilgrimage  Eg: The north east is full of monasteries.

Sample Answer 2

The Colosseum, one of the few intact Roman Empire constructions, stands today as a testament to ancient Rome’s architectural and engineering prowess. It is also a significant source of tourism.

I visited it with my family during a trip to Italy. I have always been very interested in the history of Rome, so I was excited about this visit. The Colosseum is a Roman amphitheatre open to the general public. It was built solely for the amusement of the Romans, and there were numerous games held there during the week in ancient times. It was famed for hosting exotic animals, chariot races and gladiatorial combat. We did the underground tour of the Colosseum. Our guide told us how the lower levels would be flooded with water to simulate naval battles during the shows. She also gave us great detail in terms of the architectural structure and cultural importance of the site. I learned a lot and was amazed by the sheer scale of witnessing it in real life as opposed to photos. I would definitely recommend checking it out if you have the opportunity.

Describe a beautiful place you once visited.

• when you went to this place
• where it was
• whom you went with
• and say why you liked it so much.

Sample Answer

I happened to have a trip to Darjeeling a few years back. I don’t exactly remember the perfect date, but it was soon after my class 10 board examination. It was a trip conducted by my school authorities which can be classified as an excursion. Darjeeling is one of the prettiest hill stations in India located in the northern part of West Bengal. It’s all about magnificent views of snow capped Kanchenjunga, streams flowing down the mountain slopes, lovely tea gardens, landscapes with firs, pines & ferns, and all that combined with friendly people and modern yet colonial charm. We took a train from kolkata to NJP station. From there we took a bus that was pre-booked by our tour guide manager. There were fifty students and 8 teachers,along with our tour guides. We were served our lunch packets on the bus. We visited the beautiful himalayan railways aka toy trains. It was so beautiful to get a city ride on a toy train by the side of the mountains, stopping at every beautiful spot. The majestic view of the mountain on one side and the busy lives of people in the city was something worthy of watching. We also visited Batasia loop, Tiger Hill,ropeway,Himalayan Mountaineering Institute , the zoo,Rock Garden and several other places. We stayed there for about a week. On the evening of the fifth day, we were given permission to buy things from the shopping area of Darjeeling. As it was an excursion, it’s needless to say about the amount of fun I had there with my friends. On the sixth day we were off to the NJP station recalling the very new memories and sadness of the ending of our much-awaited trip. We bid our goodbyes to the most beautiful place of our dream, but the art of heaven, named as Darjeeling, will remain cherishable in our heart and brain forever. 

• Majestic: having or showing impressive beauty or scale. Eg: The sight was majestic in its own way
• Excursion: a long trip held by the institution Eg: our school held an excursion to hyderabad.
• Relive: to live again Eg: She was reliving her moments with her grandmother.
• Art of heaven: very beautiful Eg: The sketches she makes are like art of heaven

Describe a short trip that you usually make (or, take) but dislike.

• where you travel from and to
•  how often you make this trip
•  why you make this trip
•  and explain why you dislike this trip

Since I study in Bhubaneswar and stay in Kolkata, the trip from home to college is often the trip I dislike to make. The journey from Kolkata to Kalinga is the most disliked journey I have to take every now and then. 

I return to Kolkata whenever I get a long holiday in my college and whenever I want to spend some quality time with my family. 

Being born and brought up in  a bengali family, you are bound to be home-sick. And I’m no exception. Just everytime I get a chance, I pack up and return home. So, I have to make the trip back to Bhubaneswar when the holidays are over.

Whenever I return home, my mother pampers me so much that I always feel reluctant to return to the college hostel and live on my own. Though good food is available in the hostel, it is no match to the home-cooked food. So, whenever It’s time to return to the hostel, the thought of doing everything on my own is the very reason why I dislike travelling. But there’s one more reason too. I have to travel alone most of the time and since this is long, I often get bored by the monotonous journey. I usually travel in 3 tier AC, and the people travelling are on a trip to Puri with their family, which makes me want to return. They are all to themselves, and being a grown up it seems awkward to reach out and start a conversation. Thus the dislike becomes stronger each time.

• home-sick: loving to stay at home. Eg: She was home-sick.
• homeland: a place where u grew up Eg: Nadia is my homeland .
• Pamper: give special care Eg: She often pampers her sisters.

Describe a trip that took longer than you expected.

• when it happened
• where you were travelling to
• whom you were travelling with
• and explain why it took longer than you expected.

A few years ago, we were on a  road trip to Digha. It was my elder sister’s Bachelorette party. There were ten of us, out of which five were her friends, and 5 were cousins. We booked a ten-seater van to travel. It was air-conditioned. If I can recall, it was in 2018. 

The first few days flew swiftly. Then, the west winds started. Bengalis call it Kalboishakhi. Storm, rain, and sea never go well together. Beaches were a prohibited place, and we were instructed not to leave the hotel. Thus, we were stuck inside the hotel room and were all to ourselves. The return trip was canceled, and our journey got delayed. But it was the best time of the year. We had parties and were gossiping, recollecting memories, and even were on movie marathons. 

We were supposed to return after a week. But we returned after 15 days. Even though the situation was challenging, we were having a good time. The weather was scary near the sea. No tourists were out. But I loved the journey even though it got longer than expected. 

So when we returned, we had a lot to plan and organise for my sister’s wedding. But keeping in mind the storm and the sea, we were buckled up for whatever work stress that was about to hit. 

• Bachelorette: a celebration one gets before they get married Eg: She went to a Bachelorette party with her brother. 
• Kalboishakhi: the Western storm from Bay of Bengal that hits West Bengal during Summer Eg: There’s a possibility of kalboishakhi in the next week
• Buckled up: gather up what you dropped; gather courage Eg: She buckled her up for the upcoming competition 
• Delay: got late Eg: The train got delayed because of the rain.
• Movie marathon: watching a series of movie in a single sitting Eg: The friends were having a movie marathon . 

Describe a trip that didn’t go as you had planned/expected.

• where were you travelling to
• who was travelling with you
• what didn’t happen according to plan
• what did you do there
• and explain how you felt.

Last year we were on a trip to Puri.

It was a trip with my family members. We hadn’t been anywhere for a long time, so we decided on taking a short trip to freshen our moods. My father always has this habit to pre-plan all the places according to the days.

One day, we went sightseeing in Chilka and several other places nearby. It was a long day planned till evening. It was all according to plan until my father decided to take the advice of our driver. He was a localite and knew every road and turn. He was well accustomed to the history of the temples and the places. He suggested we visit a few temples that were really beautiful. He also added that the history of those places was very intriguing. 

We returned 3 hours later than we had planned but the journey there was worth the time, we lost. We visited 3 temples, and the driver took us to a small village near Kalinga. We saw handloom works and several other things that will forever stay in our memories.

It was an unnoticed, not so famous village. The people were so humble. We wouldn’t have visited the place if he hadn’t suggested it to us. I had fun, and so did my parents. If I visit Puri next time, I will revisit the place.

• Sightseeing : places inside an area to visit Eg: She went sightseeing .
• Humble: good and polite Eg: She was a humble girl 
• Localite : local area person Eg: He was a localite.
• Intriguing:  arouse the interest, desire, or curiosity  Eg: The friends were having an intriguing conversation. 

A bicycle, motorbike or car trip you would like to go on in the future

• Where would you like to go
• How would you like to go there
• Whom would you like to go with
• And explain why you would like to go there by car, motorbike or bike

The thing that troubles me more often than not when living in the city is that majority of people are riding motorbikes rather than cars. As a result, most people don’t know how to drive a car, including me, which also annoys me, since I have always wanted to take a road trip across the country. A road trip by car from the south to the north of my country would be tough and adventurous because hundreds of marvelous destinations are waiting to be explored. However, it is worth taking risks and stepping out of your comfort zone to truly experience what life has to offer when your legs can still carry you rather than to regret later in your life.

“If you wanna go fast, go alone. If you wanna go far, go together.” It might be fun if you were a lone traveller and didn’t enjoy getting lagged behind your schedule. But, the adventure could be more colourful and unexpected, when you’ve got company, especially during a long journey like the one I prefer. Hence, my choice would be to pick up a close friend or two who share the same vision, the same eagerness to capture the beauty of nature. We would start from the south where we are living and move north. On the go, we could stop by our favorite beaches a little longer than other places because there isn’t anybody who doesn’t have time for juicy coconuts and white sand paradise. Traditional cuisine would also be our utmost priority whenever we reach a new place as the best way to live like a local is to eat like a local. A car is our best choice because it would give us room to comfortably converse with each other and shelter from inclement weather during our journey if any. It is not only about the destinations but also about the time I would love to spend with my dear friends as we would share the same space in a four-wheel vehicle along the road; and at the end of the day, it’s the people that matter.

• more often than not: usually Eg: More often than not, people get confused with this map.
• take risks: to do something that might be dangerous Eg: You have to take risks to win .
• have to offer: have something available to be used or appreciated Eg: She has to offer prayers to God .
• get lagged behind: get fallen behind Eg: The yellow car got lagged behind.
• cuisine: style of cooking Eg: She likes Chinese cuisine.
• utmost: greatest; most extreme Eg: Knowledge is of utmost importance .
• inclement: not pleasant; cold, wet, etc. Eg: The inclement  weather is not safe for flights.
• at the end of the day: in the end, finally Eg: At the end of the day your hard work pays off.
• shelter: protect or shield from something harmful, especially bad weather Eg: The birds are in search of a shelter.

Describe an unforgettable trip you have had.

• When and where you went
• Who you went with
• What you did there
• And explain why you think it was enjoyable

Well, it has been two years since I had my very first motorbike trip with my colleagues to one of the most ancient villages situated in the Northwestern part of our country. And I have to say that it was the most memorable trip that I’ve ever had.

Our group with 3 people made a decision to visit a village because we wanted to get away from the hustle and bustle of the city and get off the beaten track. Moreover, the village was fairly typical of the countryside in our country, so we wanted to get an insight into the lifestyle of local people there.

We set out for a day trip quite early. I’m always a night owl, not an early bird, so leaving the city at 5 a.m made me feel like I was deprived of sleep. However, I was over the moon shortly after embarking on the trip to the village. This was because on the way to get there, we had a chance to get the magnificent views of breathtaking landscapes which is totally different from the city we are currently living in.  After a long drive, we got to the picturesque village which made me feel deliriously happy. We rented some bikes to cycle around the village to feel the vibes of the village. After that, we visited some 400-year-old ancient house and had a look at communal houses where the local people gathered for festival celebrations or public meetings. Then we had lunch and the food was scrumptious .  In the afternoon, we joined a cooking class with the villagers who were extremely friendly and clever at making traditional cakes. The highlight of the trip to the village was going to the paddy fields to help the farmers harvest the crop. It was once-in-a-lifetime experience which we really enjoyed. My friend was like a dog with two tails while I was also on cloud nine. We relished everything in the village from the fresh air, cozy ambience to beautiful landscapes such as small houses or paddy fields. We hoped that we can have a longer trip to the countryside down the road if we had more spare time.

• made a decision: Making an agreement to something Eg: She made a decision.
• get away from the hustle and bustle of the city: go to somewhere peaceful Eg: She wants to get away from the hustle and bustle of the city
• get off the beaten track: get distracted Eg: She got off the beaten track
• fairly typical of: things of the same type Eg: It’s fairly typical of her.
• get an insight into: to gain some knowledge about  Eg: She got an insight into the matter
• set out: begin a journey Eg: She sets out for the journey
• night owl: stays up all night Eg: She is a night owl
• early bird: wakes up early Eg: He is an early bird
• deprived of: devoid of Eg: She is deprived of medicines. 
• over the moon: very happy and delighted Eg: She is over the moon  for her success
• embarking on: to begin a journey Eg: She embarked on a journey to Delhi.
• the magnificent views of breathtaking landscapes: very beautiful sight Eg: She is awestruck by the magnificent views of breathtaking landscapes.
• picturesque village: Beautiful village Eg: It’s an picturesque village
• deliriously happy: very happy Eg: She is deliriously happy.
• feel the vibes: sensing the energy Eg: I can feel the vibes of winning.
• Scrumptious: delicious Eg: The meal was scrumptious. 
• Once-in-a-lifetime: happening once in your entire lifetime Eg: One should visit NYC at least once-in-a-lifetime.
• like a dog with two tails: used to emphasize how delighted someone is. Eg: She is so happy that she is like a dog with two tails
• on cloud nine: very happy Eg: She is on cloud nine today.
• Ambience: Surrounding and atmosphere Eg: The ambience is very appealing.
• down the road: down the memory lane Eg: She went down the road and realised how innocent she had been.

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IELTS Speaking Part 3

1 do people in your country like to travel.

Yes, people in India like to travel. India is a colossal country to travel around. There are so many beautiful and adventurous places here. Hence people of India are athirst to travel from one place to another. Indians are always keen on discovering the daring and quixotic moments through travel. Nowadays, Indians mostly travel with friends wherever they get a vacation or a weekend

2 How has travelling changed, compared to several decades ago?

With the growing population and economic growth, India has changed especially in regards to travel. People now travel for uploading travel blogs, pictures or everyday travel videos on social media.The mode of transportation has improved a lot, as travel now is cheaper, comfortable and faster. Nowadays content creators go to places, find stuff and share in social media which is phenomenal. Now travel has become so easy that anyone can go for a long vacation.

3 When do people travel (as tourists), whom do they usually go with?

People usually travel with family friends or loved ones for a weekend to a neighbouring country or for a family vacation or for long travel. There is something within us that triggers us to pack our bags and visit a new place. Tourists mainly visit India, especially the southern part of India, during April – May and December for experiencing the crystal blue waters and soft white sand beaches. Tourists usually visit India with family and friends. Some people come with their loved ones to spend their most adventurous moments of life.

4 Do you think travel can (or, does) change people’s ways of thinking?

I think travel has made people better communicators. It has allowed people to be more patient. Through travelling, people can get to know a lot more about the world around them. Travel increases the desire to meet new people and pushes one to explore all kinds of amazing, admirable things. You become a well-rounded person just by experience. Travelling focuses on a greater sense of empathy and we also gain knowledge about diverse cultures. Interaction with people is another pathway to revitalize our minds. I think travelling really develops a personality. They become less judgemental, more stable, more open-minded, find themselves more optimistic, and don’t panic often.

5 What are the disadvantages of not travelling?

There are many disadvantages of not travelling to a new place. Many educational and health benefits will be missed. We will be unable to learn new cultures and languages. Memories for a lifetime will really pass over. You will not be able to deal with the stress, if you don’t take a break and travel. Also, you cannot sense and appreciate independence. You cannot boost confidence within yourself. You cannot realize your passion if you are not physically exploring places.

Travelling in cities

6 how do most people in your country travel to work.

Most of the people in India own a vehicle. It could either be a two-wheeler or four-wheeler. And the ones who don’t have a private vehicle travel through public transport like metro, buses, or by local trains. Sometimes they travel by subways too.

7 People in cities used to like living downtown but now they prefer to live in the suburbs. Can you explain why?

In suburbs there is a lot of free space available. Also in most suburbs, there is an element of peace and people lead a normal life. But in cities, the places have become more and more compact with population increase. One more advantage of suburbs is that the cost of living is low.

8 What is the impact of vehicles on people’s lives?

Owning a private vehicle is very common nowadays. It makes our life easy as we can travel at our convenience. People have started travelling from one city to another. Vehicles have made their life comfortable. People have also become a bit lazy as they tend to take vehicles even for shorter distances and also a lot of fuel is burnt in this process.

9 Do people in your country prefer to walk or take a car for short trips?

People in India mostly prefer taking a walk if it is a very short trip like walking to the nearby grocery shop. Walking is also essential for a person to maintain proper metabolism. Walking is preferred because firstly it is, of course, environmentally friendly and also it boosts up our immune system ,energy, and also keeps our heart healthy and fit

10 How can big cities deal with the problem of having many people crowded in the same place?

We can help people by providing them with valuable and good sources of information to plan a visit. E.g., Help schedule the time of travel. We can also improve the infrastructure in an area that can reduce overcrowding in the particular region. We can also encourage corporate companies to build technology parks in the suburbs and villages as well.

11 Are there any connections between transportation and the environment?

Yes, there is a direct linking between travelling and the environment. When the weather is perfect and soothing, we enjoy travelling. If the heat comes right above our head, we get irritated and will not enjoy our trip.

12 Does your hometown have problems connected to transportation??

The transportation in my hometown is not good. The public transport can’t be trusted because the buses don’t arrive on time. Also, the people aren’t educated and are unaware of the timings of public transport. The most important thing is that women are concerned about their safety in public transport.

13 How could these problems be solved?

These problems can be solved by making people aware of the timetable of the buses. They can also educate the drivers about being on time. The people can be trained to use metro options too

14 Is cycling very popular in your city?

Cycling is given a lot of importance in my hometown because it is good exercise. People are educated and know that it helps in increasing cardiovascular fitness, muscle flexibility, decreasing stress level and that it also makes our mind fresh and boosts up our energy level.

15 What are the differences between travelling by car and travelling by bicycle in a city?

Car is faster and effective than bicycles. A car can hold more stuff into it, but you can’t carry heavy items in a cycle. Also in a car, safety is guaranteed because of its compact and secured design. A car can house a group of people but a cycle cannot. Also it is way more comfortable than a cycle.

16 What are the advantages and disadvantages of cycling in the city?

Riding a bicycle helps in building mental and physical fitness. It helps in saving a lot of money too. It is rejuvenating to take a cool shower after cycling for an hour or two. As we have pros, there are cons too. We may be exposed to the day’s temperature, which can harm our body ( if it is not moderate). We can meet with accidents. Cycles are theft-prone too.

17 How could the government encourage more people to use bicycles in the city?

Government can create separate lanes for cycling. They can also introduce some schemes related to cycling. Marathons can be held in a regular interval of time. They can even distribute pamphlets regarding the importance of cycling to encourage people.

18 What are the benefits of having a good public transportation system in a city?

Having good transportation in a city makes life convenient and helps people reach their destination on time. It will be safe for girls to travel. Also, it helps in less consumption of fossil fuels like petrol or diesel. By this, we can help in reducing the pollution as we will use the buses rather than our own vehicle.

19 How will transportation in cities change in the future?

There are already many plans that our government is looking into, and one of them is the technology of the bullet trains, which can help people travel in less time at a very reasonable cost. In the coming days, people might develop a technology that can help them reach their destination within the city very fast and without pollution.

International travel

20 do people from your country like to travel abroad.

 Yes , many of my friends travel abroad when they get holidays. Also, many such people are there who go out of India to experience more about the culture, food , people ,climate , of foreign countries.

21 Can you suggest why some people (from your country) go abroad to work?

Some people go abroad to work to get more exposure and gain experience. Some people like to travel a lot. So they take up a job which will help them in travelling. They even travel to embrace a new lifestyle and also to learn a new language.

Traffic congestion in cities

22 what causes traffic problems in big cities.

Due to the increase of population and growth of the economy in big cities, people rush for work everyday which is the main cause of traffic problems. Due to an increase in the number of vehicles on the road such as at the peak hour, lack of vehicle regulation has increased the problems. Sometimes non recurring events like road accidents slows down road traffic and weather problems also result in immobility of vehicles.

23 What could be done to solve this problem?

The more the lanes, the higher the capacity a road has. So cars should be able to drive faster, but that’s a very narrow analysis of the problem. Some technical procedure is needed to control the traffic jams over roads. The use of public transport should be encouraged. Parking should be controlled via universal pay and park-in parking facilities. Proper signboards at each and every junction may also help to reduce traffic. Traffic control systems should be improved, traffic lights should be fully computerized and constantly serviced. Traffic lanes could be created for multiple-car occupancy.

24 What do you think are the benefits of having a good public transportation system in a city?

Travelling by public transport is very useful in saving money. You don’t need to spend much money on purchasing cars. Imagine that you are on a bus, taking a seat, and starting to relax by reading the newspaper or sleeping a little while. Yes, you can do this on a bus. You don’t have to concentrate on the road. This source of transportation is perfect for tourists. It is a good alternative for the older generation. Public transportation sometimes becomes adventurous, and we get to know many new people every day.

25 How do you imagine public transport might change in the future?

I think public transport might change in the future. The world is changing fast. Cities are growing, and the urban population is rising. The need to transport people and goods is increasing, but so is congestion, air pollution, road accidents, and climate change. In the present times, electric vehicles are used for public transport, and the transportation system is enabled through an integrated cloud platform, connecting vehicles, people, infrastructure, and logistic platforms. Bus platooning is improving efficiency and capacity in the city of public transportation. The future is the electric zero mission with low noise, giving the electric combat excavator access to the environmental city zone.

Long-distance travel

26 what are some of the reasons why people travel long distances.

There are many reasons like getting more of a personal perspective, giving yourself some time, grasping more adventure. Also, the most important thing is building a solid relationship with whomever you travel.People tend to travel to meet their family members who stay at a distant place. Travel bloggers travel for fun and pleasure.

27 Is it easier to travel long distances today than in the past? (Why?)

Yes, it has become much easier to travel now than in the past. Nowadays, it is much more feasible and affordable for a person or a group of people to travel even to far off places. In fact, nowadays people just travel because they are crazy to explore the latest technology

28 How does long-distance travel today differ from the past?

Nowadays it’s very convenient and affordable and also we have a lot of options as in to travel anywhere but this wasn’t the case in the old days . People used to travel mostly with bullock carts or either used to take walk for travelling which would take a lot of time but with the help of recent technology we can travel faster

29 What effects does long-distance travel have on people?

People who are old or babies usually get tired in the long-distance journey. If we are with a group of people and travelling, it becomes fun, but if we had to travel alone, we tend to get bored. And also most importantly, it can turn into travel fatigue which disturbs our daily lives.

30 Can long-distance travel ever create problems for people?

People who travel frequently tend to become lonely and may develop long-term health issues that can be very dangerous at times. Travelling long distances isn’t cheap either. Also it is very taxing. Even after reaching our destination we become lethargic and tend to sleep more rather than taking a tour of the place.

31 Does long-distance travel have any effect on the environment?

Travelling long distances by any means of transport will cost you a lot and is also not environmentally friendly. All types of transportation including air create a greenhouse effect in the topmost layer, which is way too hazardous.The most polluting vehicle is the flight. Then comes the car and train. Cars use fossil fuel and release toxic gases into the air.

32 How might long-distance travel change in the future?

With the advent of technology, it might become much easier and affordable to travel. We can reach long distances at the fullest comfort in no time. Recent research shows that electric flights might be coming up in the future to minimise pollution.

33 How would it be like to travel to space?

It would be fantastic. There are very few people who have been getting a chance to undertake such excellent travel. And if I am the chosen one I might be very proud of myself to step into the moon.

34 What are the problems people might experience when going on a trip and what could be done to avoid/solve these problems?

 There are a lot of problems which might occur during travel. We might suffer from health issues or run out of cash, or get delayed, which might affect our whole tour. The only solution for this is that we should plan adequately before we step out.We can also pool vehicles to avoid pollution. 

Preparing for a trip

35  is it important for travelers to carefully plan the trip.

Yes, planning a trip is really important for travellers. If everything happens in an organised way, we can switch to the travelling mindset with ease. Traveling to different places and staying there for a few days will help us to rejuvenate and relax if we arrange everything before the trip.

36 What are the differences between a well-planned trip and a trip that is not well-planned?

Well-planned trips are those which accommodate even the sudden changes that occur on the spot. Talk and discuss the trip with whom you are going. Make sure you have the travel plans. Let the problems be sided and let all the solutions get strained in one piece of sheet. Not planned trips will face budget problems and they will meet with unnecessary expenditures. They will not know more about where to visit how to go, and how to stay. They will not be aware of the culture and of the place they are travelling to and will always face problems.

37 In general, what factors should people consider when planning a trip?

We need to first focus on booking tickets or visas or passports. Internal currency planning, sightseeing, etc seem to be so daunting which is why people rely on travel agents and they don’t mind paying them. But making a plan under budget needs time. The factors that we should keep in mind while making the trip are the number of days needed to reach the destination, travel companions, and adventures.

38 What essential things do people need to take when they go on a trip?

I will now talk about some of the essential things people need to take when they go on a trip: a neck pillow for train or flight travel to relax the body. Eye masks are also crucial for good sleep, as we also need time to energize ourselves through sleep. We need to take our clothes accordingly by keeping in mind the weather of that particular place. You can take a camera with you to capture those beautiful moments, which would remain handy. Chargers and power banks are very crucial during travelling. Skincare products and other necessary makeup materials can make you look glamorous with a photoshoot.

39 Do you think there are any differences between men and women when they plan a trip?

Yes, I think there lies a difference between men and women when they plan a trip. Women start packing a month early. They make several lists, pack for themselves and their kids. They plan many activities for their kids, and they get busy with packing different varieties of clothes and makeup. Women stage things serially and in an organised way, but men remain leftover with last moment packing. Men drag 2 – 3 pairs of jeans, shirts and 3 pairs of socks and shorts, and they’re done. They remain excited and capture the beautiful natural beauty on a camera.

40 People with different personalities sometimes plan or prepare for a trip differently. Can you give some examples of this?

People with different personalities plan and prepare for trips differently as they want to explore and explore that destination from their inner core. Naturally, people travel for enjoyment with family and friends, but some people think differently. They remain enthusiastic about bringing out the dangerous unknown adventure. They generally make sudden plans.

41 How do people find information about places to travel to?

There are several factors which people must consider while preparing for a trip. They should not get so confused about stuffing all the things in one bag. Some usually keep everything for the last moment and get confused. These people must make a checklist and ensure that all the necessary documents, cards are adequately arranged. They should also double-check that necessary medicines and clothes are packed.

42 What factors would people consider when preparing for a trip?

Nowadays we can find information about travel on the internet . We can get information through vlogs, twitter, and different social media sites. We can easily get a detailed analysis and budget list of the particular destination. There are travel agencies that help us with information about unknown places . The encyclopedia and youtube travelogue channels, also make our travel easy.

Travelling differences

43 if you were travelling with friends, what qualities would you like them to have.

When we have to choose the travel companion we should think of a person who is compatible and has a good sense of humour, is sensible, generous and also shares the budget

44 Some people prefer to go on guided tours when they travel while others prefer to travel individually. Which do you think is better?

From my point of view taking up a guide is more preferable as these people have knowledge which may not be in books or any kind of brochure and they also will suggest the best and affordable places to stay, eat etc

45 What are the different means of transport that a person can choose when travelling?

There are different types of transport which one can use for travelling. For example, sea, rail, flight or car. Most suitable out of these is the flight as it makes our travel quick and convenient. Other means of travelling such as public transport or cabs etc also make life easy and enable us to enjoy a tour.

46 In what ways does a person’s wealth affect the quality of that person’s travelling experience?

Wealth does affect the quality of travel we do. If we are rich, we can enjoy a trip to the fullest. The opposite of it is that if we have less money to spend, we may have to compromise our comforts.

47 Whom do you think learns more from travelling, old people or young people?

Young people learn more. The youth get inspired by travelling as they get to know more people and learn how to handle them. They also get excellent exposure, and come across new opportunities. They even get to know themselves and also will have a clear vision over what should be one’s goal.

48 Do you think it’s a good idea to use a credit card when travelling?

A credit card is considered the best friend of anyone travelling. It makes the payment easier and provides certain advantages such as cashback or a reward. People prefer this, as there is a considerable risk involved in carrying cash.

49 Some people like to take a lot of things with them when they travel and other people prefer to take as little as possible. Why do you think people have this difference?

It varies according to the individual. Person A would like to carry a lot so that he/she dont have to borrow anything from others. On the other hand, person B may not like to carry much luggage because he might prefer taking only basic things and buying the rest.

50 Do you think the tourism industry is very important?

Yes, the tourism industry is vital to the world’s economy. It not only takes part in the economy but also plays a vital role as the backbone of the country. It provides job opportunities to the people of the country. It also creates a special bond between the visitors and the localities. We get to know about the history of places, culture and almost everything.

51 What do you think has led to the growth in the tourism industry?

There are several factors that have led to the growth of the tourism industry. One of the most important factors is people’s hunger to learn and see. This “interest” is the reason why people have decided to consider this as a means of employment. Now, the most significant factor of the World’s economy comes from this industry.

52 What benefits does tourism bring to society?

Tourism brings several benefits to society. The tourism industry is the largest contributor to the world’s economy and facilitates foreign trade. For example, India is rich in spices, and our country holds the biggest spice trading business. Yes, if it hadn’t been for tourism, our minerals and resources would have been unknown to the world. The handloom industry is another branch, which has flourished only because of the tourism industry. In short, it has an impact on a lot of factors that are interconnected.

53 Are there any problems caused by tourism? How to address these problems?

Yes. Alongside the benefits, it brings in some problems too. All these trade and foreign business has resulted in exposing our wealth and riches to the other countries. This is one of the very reasons why the British empire wanted to settle in India and make it their colony. If the government is weak, it can easily be taken over and ruin the nation.

54 How to balance the economic benefits of tourism with the environmental damage that is done by tourism?

The economic benefit and the environmental damage can only be balanced by limiting the trading. One should stop forcing the environment to go beyond its limit just to produce a greater yield for exports . The greed for money has led to disaster. Tourists also tend to contaminate the ground by throwing plastics or wrappers. Some throw eateries on the road.

55 What effects do you think international travel has on the different countries involved?

International travel has an impact on the relationship between the tourists and localite. It builds a bond between the people of the two countries involved. This bond will eventually mature into foreign settlements which will be beneficial for both countries in the long run. It also helps better import and export systems.

56 How has international travel changed in the past 20 or 30 years?

With the passing ages, everything has changed. Places have changed their infrastructure. Villages have turned into metropolitan cities. I think currency is an important factor too. The value for money has changed too. What cost 1rs back then, might cost 10 rs now. So yes, that’s a factor too.

57 Can you suggest some things that people should and should not do when they travel to a foreign country as tourists?

People visiting foreign should not exploit their land and properties. One should not make fun of their culture and sentiments. Thus the person visiting a foreign land should respect it as how they want to be treated by their visitors/tourists.

58 Do you think that the media has many effects on tourism?

Media has a tremendous impact on tourism. In the modern world, people rely primarily on social media and news. An unknown place can turn into a popular holiday destination overnight. So yes, the media impacts a lot. Media has also captured attractive pictures and videos which have attracted many tourists too. So behind the popularity of a place, the media played a vital role.

59 Some think it’s not necessary to go to tourist places, now that we can see these places on the internet. Do you agree?

Some people think it’s not necessary to go to tourist places because we can see places on the internet. But it’s like watching a picture of your favourite food and filling up your appetite. Unless and until you are present in that area in person, you can never feel the true essence of the place

Changes in travelling

60 how do you think travelling today is different from what it was several decades ago.

In modern times, we have different modes of communication which were not in history. Earlier people used to walk and used animal drawn carts to travel from place to place. The discovery of petroleum was the light of revolution. Now, one can visit places conveniently.

61 In 20 or 30 years, how do you think travelling will be different from what it is today?

With every passing day, the level of crude oil is decreasing. Many vehicles are being idealised to  draw fuel in alternative ways. Tesla, is one such example. I am sure there will be inventions like this. So yes, there will be a huge difference between today and the future generation. Soon there will be a way to resolve the issue, and we might be able to run a vehicle via solar energy, or any other source for that matter. Even though there will be a lot to plan and implement, mankind will overcome every hurdle. 

Modern technology and travel

62 in what ways has modern technology changed people’s travelling experiences.

 In the earlier times, people used animal drawn carts or palanquins to travel from place to place. With the inventions of technologies, the vehicles have also become modernised. Modern technologies have reduced human effort and so of animals. It has saved a lot of time and it is much more convenient.

63 Do you think the internet has had an effect on people’s travelling behaviour today?

Yes, the internet has impacted indirectly on people’s travelling behaviour today. We can sit at home and book train tickets or flight tickets. One does not have to go to the station and search for trains or go to the airport to book tickets. The Internet has made online services like Ola,Uber or Rapido, which will help us to reach our destination in a shorter period of time.

64 If you were going on a trip, what essential modern technology would you carry, and why?

If i am travelling somewhere, i will carry my cell phone. It’s the modern technology I choose to carry because it will help us in several ways. Beginning with google maps, contacts, or helpline and emergency numbers. Among all the boons of mobile phones, the advantages overshadow them. One can capture the beautiful moments of the trip on their mobiles. They can also play music during the trip. So a mobile phone serves many purposes while you travel.

Vocabulary for Speaking Part 3

• Colossal: extremely large or great. Eg: In fact, this means a colossal amount of foreign travel.
• Athirst: Very eager to get something Eg: She was athirst to get her birthday gift
• Platooning: Use the strategy of alternating (a pair of players or one player with another) in a specified field position in successive games. Eg:   Marim designed a platoon for badminton along with her friends
• Immobility: The state of not moving; motionlessness. Eg: She was almost frozen into immobility by the fear that it would be something illegal.
• Petroleum: oil used to make petrol and diesel Eg: Petroleum is used for all purpose these days
• Crude oil: source of petroleum Eg: Crude oil is a source of energy which is found deep under the ocean
• Tesla:  a modern car working on electricity Eg: He is so rich that he can afford a Tesla
• Revolution: change Eg: Revolution is the only constant
• overshadow: to overcome something Eg: He overshadows his pain with a smile
• Impact: affect Eg: Good food has an impact on people. 
• Adequately: to a satisfactory or acceptable extent. Eg:  He was adequately prepared for the situation
• Hazardous: risky; dangerous. Eg: The situation in which we are working is really hazardous
• Facilitates: beneficial Eg: Befriending the captain facilitated better understanding of the team
• Exploits: destroys Eg: “ You should not exploit anyone’s innocence.”
• Appetite: Hunger Eg: She lost her appetite.

Sample Answers (Updating)

Suggested answers for part 1, do you like travelling.

Yes, definitely! I think getting to know the world, from great historical monuments to white sandy beaches, is what life is all about . It’s a very interesting way to learn about new cultures and explore new places.

Whom do you often spend the holiday with?

It depends on what kind of holiday it is. If it’s Christmas vacation, I prefer to hang out with my friends here and there and have a chit-chat. If it’s the New Year holiday, I just want to celebrate the holiday with my family and relatives in a cozy ambience.

Have you done much travelling?

Well, I’m an international student, so I travel a lot. I’ve been on a road trip to the USA, a vacation to Japan and Korea when I was younger. Thanks to my father. And most recently Australia – a splendid country.

What kind of places have you visited in your life?

I prefer to visit the places which elevate my mood and energize me. I have been to some of the beautiful beaches and lakes in my country. These places bring me closer to nature and rejuvenate me.

When you visit new places, what do you like to do?

It seems to me that there’s a lot of stuff to do when visiting a brand-new place. At first, I would love to take photographs to bookmark my travel experience as well as share it with my best mates. Culture vulture seems to be my other character when I feel like discovering the places of great aesthetic appeal everywhere I set foot in.

Do you prefer travelling alone or in a group?

Well, it depends on my current mood. A trip to the off-the-beaten-track destinations, mountainous or forested place, for instance, will be my initial choice if I feel devastated. On the contrary, I will congregate and sign up for guided tours as it’s a chance to be shown around and take photographs – one of my hobbies when feeling overjoyed.

In which seasons do you prefer to travel?

I guess it would be autumn. This season has little rain, clear skies, and temperature conditions. It’s really the best season as most places are at their best at that time.

What places would you like to visit in the future?

If I have the chance to visit one famous place, it will be Paris, a must-see place for me. I would love to visit the Eiffel Tower, to tuck into French delicacies in prestigious restaurants. In addition, it’d be great for me to visit the Louver Museum and discover history as well as La Sorbonne University – the oldest educational institution in modern France.

If the choice is in my hands, I’m yearning for travelling to Paris on Christmas vacation when the weather is neither too cold or too hot.

You can find some more questions about holidays at Holidays IELTS Speaking Part 1 Sample Answers.

You can also improve your Vocabulary for Cue Card about Traveling & Adventures which is a common topic in the IELTS Speaking test at IELTS Travel & Adventure Vocabulary for Cue Card.

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IELTS Speaking Tourism and Vacation Part 1-3 | Tourism Speaking

In the first part of the IELTS Speaking Test, the examiner asks you general questions from your own experience. Here are some examples of questions for speaking about tourism and traveling .

IELTS Speaking Tourism Part 1

1.do you enjoy traveling why or why not.

Sample Answer

Absolutely! I find traveling to be an enriching experience that exposes me to different cultures, landscapes, and ways of life. It broadens my perspective and provides a break from the routine, allowing me to create lasting memories.

2.Have you ever visited a foreign country? If so, which one(s)?

Well, I have travelled to Dubai with my family as a child. In fact, we stayed there for a couple of years since my dad got a job there on a contract. Dubai was a great place to visit and stay and we really enjoyed our time there.

3.What types of tourist destinations do you prefer, and why?

I prefer to visit beautiful hilly areas with natural beauty. That is why when I get a chance I prefer to go to northern side of my country with my family to see the snowfall, enjoy local cuisines and take some hiking trips in the quiet forests.

4.Do you have any near future plans for vacation?

Well, for my upcoming summer vacation, I am planning to visit “Sawat Valley” which is a beautiful destination. It is sitting at 3,220 feet above sea level and stands out with its cooler and wetter weather compared to the rest of Pakistan. The place is a hit among tourists, thanks to its lush forests, green alpine meadows, and snow-capped mountains, making it one of Pakistan’s top destinations.

5.What are the popular tourist attractions in your country that you would recommend to visitors?

Hey, if you’re thinking about cool places to check out in Pakistan, I’d totally recommend Swat Valley, Hunza Valley, and the Badshahi Mosque in Lahore. Swat’s got this amazing combo of lush greenery, alpine meadows, and snow-capped mountains – it’s like nature’s paradise. Over in Hunza, you’re in for a treat with stunning views, high peaks, and friendly locals. And Lahore, oh, the Badshahi Mosque is a masterpiece, showcasing our rich Mughal history. Trust me, these spots are top-notch for a memorable trip!

Part 2: Cue Card Questions Tourism IELTS Speaking

In the second part of the speaking test, the examiner gives you a cue card with question and cues written on it. You have one minute time to prepare your answer and 2-3 minutes to speak. Once your preparation time is over, the examiner will ask you to begin your answer. Here is an example of a cue card on the topic of vacation or trip.

Describe a vacation or trip you cannot forget…

• Where and when did you go?
• Who did you go with?
• What did you do during the trip?
• Why was it memorable?

Sure thing! One vacation that stands out vividly in my memory was a trip to Dubai in the United Arab Emirates. It was back in the summer of 2019, and I went with my family – parents and younger sister. We spent about a week exploring the city and its attractions.

During the trip, we visited iconic landmarks like the Burj Khalifa, the world’s tallest building, and the mesmerizing Dubai Mall. One highlight was our visit to the Dubai Desert Safari, where we experienced thrilling dune bashing, watched the sunset over the dunes, and enjoyed a traditional Arabian dinner under the stars.

The trip was particularly memorable because Dubai offered a perfect blend of modern luxury and cultural experiences. The city’s futuristic architecture, combined with the traditional charm of its markets and cuisine, left a lasting impression. Each day brought new adventures, making it an unforgettable vacation that we often reminisce about.

IELTS Speaking Q/Answers about Tourism Part 3

The third part of the IELTS speaking test is always a discussion part. The examiner will ask you various questions on the main topic, which in this case will be “Tourism”. Here are the kinds of questions.

1.What do you think are the reasons why people enjoy traveling to different countries?

People love traveling because it gives them a break from daily routine. They get a chance to experience new cultures, taste different foods, and see stunning landscapes. Whether it’s a relaxing beach getaway or an adventure in the mountains, travel breaks the routine and lets you learn and grow. It’s like a personal adventure that broadens your horizons and gives you a break from everyday life.

2.How has the tourism industry evolved over the years?

Well, back in the day, travel was a fancy thing, only for a lucky few. But now times changed! Thanks to planes, the internet, and cool tech, everyone can be a globetrotter now. You can pick your dream spot, find sweet deals online, and crash at someone’s place through apps. Plus, folks care more about keeping it green and respecting local vibes. After this whole COVID situation, safety’s a big deal too. So yeah, the travel scene has totally shaken up – more accessible, more choices, and a whole lot cooler!

3.What are the potential problems related to tourism?

Tourism has its share of serious challenges. For example over tourism; It’s when places get too packed, causing environmental damage and littering and making it hard for locals to go about their business.

Now, food … tourists might not have a taste for local foods so it can be challenging for them to find suitable places to find food in a foreign destination.

Jobs for locals can be tricky too, often limited to seasonal work, tied to tourist seasons. Imagine trying to make a living with that uncertainty. Once the season is over, the locals are out of jobs.

Security is a big thing too. Tourists should feel safe, but unfortunately, incidents can happen, impacting the overall trust in a destination.

So, while tourism brings benefits, addressing these serious issues is vital for a sustainable and positive impact on both locals and visitors.

4.Are there any measures that your government is taking to reduce the hazards of tourism on the environment?

Absolutely! Our government is stepping up to tackle the environmental downsides of tourism. They’re focusing on things like managing waste better to keep our spots clean and green. There are rules in place to make sure businesses go eco-friendly, and they’re looking into ways to control the crowds at popular places. It’s all about making sure our beautiful spots stay that way for future generations.

5.Do you think tourism can help improve the economy of a region or country?

Oh, totally! Tourism can be a game-changer for the economy. It brings in cash from visitors spending on hotels, food, and cool souvenirs. Plus, it creates jobs, not just in hotels but also in local shops and restaurants. So yeah, tourism can give a nice boost to the wallet of a region or a whole country!

6.In your opinion, what qualities should a good tourist destination have?

A good tourist spot should have cool things to see and do, like landmarks or nature spots. Easy peasy transportation is a must, so folks can get around hassle-free. Plus, friendly locals make a place feel like home. Oh, and a dash of safety – that’s key. So, a mix of attractions, convenience, friendliness, and safety makes a top-notch tourist destination!

7. Can tourism contribute to the preservation of cultural heritage? How?

Absolutely! Tourism can play a vital role for the preservation of cultural heritage. When people visit historical sites and museums, they bring in money for their upkeep. That cash helps with restoration and conservation, keeping these cool places alive for future generations. So, tourism becomes a guardian for our cultural treasures!

8.Do you think it’s essential for tourists to learn about the customs and culture of the places they visit? Why or why not

In my point of view, it might not be essential to learn about the customs and culture of a place but it can be useful to get some knowledge about basic culture of a place beforehand. By which I mean the tourists, with the pre-trip information, will know what to expect in a foreign place from people. It will also help them make connections with people in that particular area.It will also give them more confidence interacting with people. Learning about the customs of a place will make their trip more enriching than just visiting somewhere unprepared and ending up only sightseeing.

The speaking test of IELTS lasts for 12-15 minutes depending on the ability of the candidate to answer the questions. It is important to have prior knowledge of various topics and frequently asked questions in IELTS in order to perform well in the speaking test.

Find more IELTS Speaking Test topics with answers following the link below:

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IELTS Topics: Travel and Tourism

Posted by David S. Wills | Oct 12, 2020 | IELTS Tips | 0

One of the common IELTS topics that appears in the exam is that of travel and tourism. In today’s lesson, I will help you learn about this topic so that you can do well in your next test.

First we will look at a little vocabulary about travel and tourism , then we will explore some IELTS speaking and writing questions to give you an idea of what to expect.

Vocabulary about Travel and Tourism for IELTS

When you prepare for IELTS, you never need to know any specialist vocabulary, so for questions about travel and tourism you may find that you can give a brilliant answer with just simple language, as long as it is used with grammatical accuracy. Knowing the difference between “I went to London” and “I was going to London” is very important, for example.

Of course, there are other things to know. It helps to know modes of transport and related vocabulary. [You can learn about transport here .] Another interesting aspect is knowing things you might encounter while travelling, such as accommodation.

I made this PPT about travel accommodation many years ago, but I have just uploaded it today. 🙃 I hope you find it useful.

You should also know the necessary language to talk about types of travel or reasons for taking a trip. Sometimes, new words enter the language, such as “staycation,” which is a very recent portmanteau .

You might also find this list of synonyms for “trip” quite useful:

Travel and Tourism Questions [IELTS Speaking]

The topic of travel and tourism is really common in IELTS speaking. It could easily occur in any of the three parts of this test, so you should be prepared to answer a wide range of questions. [You can find some examples here .]

These questions will be pretty general and simple. It is entirely possible that the same basic question could be asked in a number of different ways.

Perhaps the most common question would be “do you like travelling?” This is very similar to “have you done much travelling?” Of course, the focus has changed slightly but the overall meaning is similar: it’s about you and travel .

I’ll give two sample answers to these questions so that you can understand better:

Q: Do you like travelling?

A: Yeah, I absolutely love travelling. I have visited many countries over the past few years, but of course this all stopped recently because of the virus.

Q: Have you done much travelling?

A: I have done quite a lot of travelling in my life. Altogether, I’ve visited about 50 countries and I try to spend a few weeks each year seeing new places.

Note: It is unlikely that these questions would be asked together because they are very similar. Also, I pretty much answered the second one in the middle of the first answer. I just included them to show how a “do you like travelling” IELTS answer example.

Vaguely Related: Space Travel

I definitely consider space to be a separate topic from travel, but there is some small degree of overlap here. For example, there is a reported IELTS speaking question that goes something like this:

• Do you want to travel in outer space?
• Would you want to travel in outer space?

You might also see this incorrectly reported as “do you want to travel in the outer space?” but this is not correct. We cannot say “the” before “outer space.” It is not a single, definite place. [Read about definite articles here .]

There are numerous possibilities for IELTS cue cards about travel. Here are two of them:

• Describe a place you have visited.
• Describe a place you would like to visit.

Of course, these would require basically the same sort of vocabulary to answer them, but the key difference would be the grammar. In the first instance, you are talking about the past, but in the second you are talking about a possible future.

Here is another one:

• Describe a memorable holiday.

This is pretty similar to the first cue card above, but the word “memorable” must guide our approach. You can see my answer in this video:

In part three of the IELTS speaking test, the questions will become more difficult. These will include abstract topics like age, gender, ethics, and so on. You might encounter questions like this:

Q: Do you think men and women enjoy different types of holiday?

A: I suppose that in general they probably do have different preferences, but of course we should acknowledge the fact that everyone is different and so there are women who enjoy stereotypically male holidays and men that enjoy stereotypically female ones. To give an example, it could be argued that men prefer more active, robust holidays that involve uncertainty, adventure, and even danger. However, I know some women who love this type of thing and so it is not really smart to make assumptions about people.

Q: Do you think that travelling abroad always changes people’s perspective on life?

A: No, not at all. While it certainly is possible that travelling can change people’s perspectives, it is by no means guaranteed. In fact, when you travel to places like Thailand, you see that most tourists have no understanding of the local culture and just hold on to their own original views. The experience may change some people, but I think most people live in a little bubble when they go abroad, and this prevents them from really learning anything.

Notes: I described the sort of travel that men like in interesting terms: “men prefer more active, robust holidays that involve uncertainty, adventure, and even danger.” This is good, descriptive language!

Travel and Tourism Essays for IELTS Writing

Now we shall move on from speaking and instead look at the IELTS writing test. In this section, I will show you some questions about travel and tourism, then show you my sample band 9 answer.

Here is a question that features data about people travelling. I thought that this travel and tourism essay was really interesting, so I have included it here alongside my sample answer.

The line graph displays the numbers of tourists that visited an unnamed Caribbean island between 2010 and 2017. The tourists are divided into two groups – those staying on cruise ships and those staying on the island itself – and these had a loosely inverse correlation. The total number of visitors, however, rose more or less continuously throughout the eight-year period.

In the first year recorded, which was 2010, there were about twice as many tourists staying on the island as those staying on cruise ships. A year later, the number staying on cruise ships doubled to a half million, but this dropped back to around a quarter million in 2012. When the figures for tourists on cruise ships dropped, the number staying on the island rose quickly and over the coming few years, as this sudden increased levelled off, the number of people who stayed on board their ship continued to grow again.

Between 2012 and 2017, there were more and more visitors staying on cruise ships. From just a quarter million, this rose to two million, while the figures for those on the island levelled off at just one and a half million and then dropped slightly in the penultimate year, before finishing at one and a half. This meant that, for the final two years, more tourists stayed on cruise ships than on the island.

Notes on the Answer

In the introduction, I said “an unnamed Caribbean island.” It can sometimes be difficult to introduce something whose name you don’t know, and this is a really convenient way to do it. I strongly recommend you say “an unnamed ___” when this situation arises.

I have also used very few numbers in this essay. Instead of writing 250,000 or 2,000,000, I have said things like “a quarter million” and “two million.” This is much easier. [You can read more about IELTS and numbers here .]

Here is another travel and tourism essay question:

In future, more people will choose to go on holidays in their own country and not travel abroad on holiday.

Do you agree or disagree?

Sample Band 9 Answer

In recent years, people have coined the word “staycation” to describe the phenomenon of taking a holiday closer to home. This essay will argue that such holidays will become more common in the future.

First of all, it may seem as though international travel will become increasingly common, but in fact it is quite clear that it is an unsustainable trend. The carbon cost of flying to another country is enormous, and so many people have begun to ask whether it is ethical to continue doing this. Beyond just the personal level, it is clear that pretty soon governments will have to impose restrictions to limit the number of flights; otherwise, the world will suffer immensely from the burden of so many journeys.

In many parts of the world, people are probably ready to embrace this situation. Humans have had a terrible impact upon the world and many feel that it is time to undo the damage done. This involves some measure of personal sacrifice, which in this case could be forgoing the sort of international trips that used to be quite common. However, this is not all bad. Although foreign countries and exotic locations are exciting, there are treasures almost everywhere. Countries like the UK have poor weather, which is why so many people travel to warmer climates, but the natural beauty of the landscape and the extraordinary historical and cultural sites present myriad options for curious travellers. There will likely be a resurgence of interest in such trips.

In conclusion, it is quite possible that in the future people will realise how much damage humans have done to the world. Many of them may endeavour to make the sort of sacrifices necessary to counteract this ecological destruction, and one small step is embracing local travel.

Notes on the Essay

First of all, you can see that I incorporated the word “staycation” right at the beginning. When you use modern language like this, please don’t just jam it carelessly into your essay. Often, it is very informal, so you can only use it when properly introduced. In this case, I clearly explained its meaning and commented upon it from a sociological perspective.

Here is some more travel and tourism vocabulary from my essay:

• unsustainable trend
• carbon cost
• impose restrictions
• international trips
• exotic locations
• warmer climates
• myriad options
• ecological destruction

You can see that a lot of my language related to the environment, and of course that is often tied to the topic of travel and tourism because of the negative impacts these have on our planet.

I hope that you enjoyed my IELTS essays on travel and tourism, as well as the sample speaking answers I provided. Please remember that your own answers should be unique to you . Don’t try to copy others too much. Your vocabulary will depend upon your life experiences and the places you would or wouldn’t like to visit.

About The Author

David S. Wills

David S. Wills is the author of Scientologist! William S. Burroughs and the 'Weird Cult' and the founder/editor of Beatdom literary journal. He lives and works in rural Cambodia and loves to travel. He has worked as an IELTS tutor since 2010, has completed both TEFL and CELTA courses, and has a certificate from Cambridge for Teaching Writing. David has worked in many different countries, and for several years designed a writing course for the University of Worcester. In 2018, he wrote the popular IELTS handbook, Grammar for IELTS Writing and he has since written two other books about IELTS. His other IELTS website is called IELTS Teaching.

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IELTS Speaking practice: Travel & Holidays

Travel & Holidays Friends Technology Sport Food Education Weather Environment Music Books & Films Health

On this page you can find full IELTS Speaking sample with questions related to Holidays topic .

See IELTS Speaking vocabulary for Travel & Holidays topic >

This IELTS Speaking sample has 3 parts with questions related to Holidays topic. Remember that on the real test you will get a mix of questions from different topics , but for educational reasons we used thematic questions about holidays in this IELTS Speaking sample. It is very beneficial to read IELTS Speaking samples with answers and rememeber IELTS Speaking vocabulary by topics.

Our special formatting styles:

Useful linking phrases are in blue IELTS speaking vocabulary is in bold (put your mouse over such text to see explanations).

Do you like travelling?

Yes, definitely! I think seeing the world, from great historical monuments to white sandy beaches, is what life is all about Something that brings sence to life. . It's a very interesting way to learn about new cultures and explore new places.

What is your favourite type of holiday?

I really like going to the countryside, getting away from it all Escaping in order to rest from a daily routine. . Nothing relaxes me as much as wilderness... I am tired of tourist traps Places with many tourists. and usually go off the beaten track To visit a place where a few people go. ...

What do you do on holidays?

I prefer visiting various museums and places of interest Memorable and honorable places. . For instance , on my last vacation I was to Rome and I visited 12 museums. It was fantastic! Of course, sometimes I go shopping with my friends or relatives too... But I don't find it near as exciting...

Are there many tourists visiting your country?

Probably yes ... My country has different tourist attractions Places which tourists tend to visit. in many cities, especially the capital... For example , my country has old-time religious traditions... That's why we have a lot of ancient cathedrals and churches that are interesting for both tourists and local citizens...

Now, have a look at the card and prepare a monologue.

• When you visited it
• Where is it situated
• Who you went with

and say what about it you like the most

A couple of years ago I went on a holiday to Paris with my parents… it is a very popular tourist destination Tourist attraction. , since it has various places of interest Memorable and honorable places. , such as ancient museums and monuments… That's why there are always hordes of tourists Crowds of tourists. ... So we decided to go out of season To go not within the main holiday period. in the autumn… Fortunately , the weather was great, and we did not waste any days watching TV at the hotel... it was a memorable holiday … we enjoyed breathtaking views Amazing views. from the top of the Eiffel tower and dined in cozy little restaurants. I would certainly recommend visiting Paris, it is a picturesque Beautiful. city.

Why do you think tourism is so developed now?

Well, because it is a lot easier to travel nowadays… you can choose charter flights Cheap regular flights. and find various youth hostels A cheap hotel. all around the world, so you don’t need to spend much money on the travelling. Moreover, you can book a trip Arrange a trip. via the Internet, so you don't even have to leave home.

How people choose their destination?

There are a lot of ways. For instance, you can surf the internet for all the necessary information… Or you can visit different travel agencies An organisation that specializes in booking holidays. for more advice.

What kind of transport do you prefer on holidays? Why?

It depends… I usually reach my holiday destination A place where you go for a holiday. by plane because it is the fastest and the least dangerous way to travel. However , flying can be a bit uncomfortable... So I also travel by train from time to time … But I never drive car on a vacation, because I do it every day when I work... I would have a busman's holiday When you spend your free time similarly to the time when you work. This expression comes from the idea that a bus driver would spend his holiday traveling somewhere on a bus. otherwise.

Do you prefer travelling alone or in tour groups? Why?

I definitely prefer travelling alone because I like to plan the trip by myself... When choosing a guided tour A tour in which a group of people is guided by an expert. , you should always conform to a set schedule… So if you are in India and, say , you want to spend an extra hour at Taj Mahal, you simply cannot do that with a group tour... I like independent travel. That way I get to see and do exactly what I want and spend as much time as I want at various stops.

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Sample Answers for Travel and Transport in Speaking Part 1

Below are sample answers for the the topics of travel and transport for part 1 of the IELTS speaking test.

Q. Do you often travel abroad?

A. Not much, to be honest. I don’t get many days off in a year but when I do have time off, I mainly spend that time with my family in my hometown .

Q. When is the best season to travel in your country?

A. I guess it would be spring. That’s when the weather starts warming up and all the flowers start blossoming. It’s a really beautiful season and most places are at their best at that time. Unfortunately, it’s a busy time for tourists as well but that still doesn’t diminish the beauty of the countryside.

Q. Where would you recommend a foreign to visit in your country?

A . Without doubt, London. Not only is it our capital, but it also has some of the most iconic buildings in our country. I don’t think any visit to England is complete without seeing the Tower of London, London Bridge or Big Ben and the Houses of Parliament. They really are very impressive pieces of architectural work and can’t be missed.

Q. How did you get here today?

A . I came by bike because the roads are pretty congested at this time and a bike is quicker. It only took me about 15 minutes to get here.

Q . Do you often use public transport?

A. Yes, I do. I use the bus almost everyday. It’s the cheapest way to get around even though it’s really overcrowded and not particularly punctual.

Q. How could the transportation system be improved in your country?

A. Well, I think the first step to improvement would be to widen the roads and build to overpasses and underpasses to help traffic flow more freely which would reduce the congestion in the city center. Also, it would help if the bus service was improved to make it run more frequently which would help with the overcrowding in rush hour. I think those are the two main changes that need to happen.

Recommended

Speaking Part 1 Topic of Sleep with a Sample Answer and Vocabulary

Hello Liz. I take my speaking test tomorrow….I’m nervous much, but going through your Speaking tips is helping a whole lot. Wish me luck!

🤗🤗🇳🇬🇳🇬 you are the best!!

Tnank you so much for the tips…am doing my test in 2hrs time!!

Good luck!!

Good article , thanks and we wish extra! Added to FeedBurner as well

Hi Miss Liz you are an amazing of English teacher. Could please also give us samples of speaking part 3 questions. It would be greatly appreciated if you could do please. thank you very much.

See this page: https://ieltsliz.com/ielts-speaking-free-lessons-essential-tips/

How do you travel? Can you give me a answer of this question

This is a question from the topic if travel in speaking part 1. The question is “how do you usually travel?”. This means what kinds of transportation do you usually use in your everyday life.

Liz madam..my speaking is very weak and confidence is low. Give me suggestion how can i improve my speaking. tell me about sentence formation.

All my speaking tips are on this page; https://ieltsliz.com/ielts-speaking-free-lessons-essential-tips/

hi mam any links for speaking question with answers i need 9 band thanks

You can find plenty of model answers on my main speaking page: https://ieltsliz.com/ielts-speaking-free-lessons-essential-tips/

means of transport in the future

Thank you mam ….

hello, Liz my speaking exam held on next Monday and i am very afraid mam. can you advise me mam ,please. I need 6 band in speaking.

See my main speaking page: https://ieltsliz.com/ielts-speaking-free-lessons-essential-tips/ . Good luck!

Mam i want to ask a question. Do you feel that traveling and tourism promotes a uniform culture in the world?

Due to travel and tourism as well as international business and the development of technology, cultures around the world are becoming more similar.

Give me some more questions regarding the topic travel and turisom

Try some writing task 2 questions https://ieltsliz.com/100-ielts-essay-questions/tourism/ and https://ieltsliz.com/100-ielts-essay-questions/transport/

why you don’t but the listen record in this lesson , i think its better to record the lessons with any student you teach even with your self .. and thanks you a lot liz for this useful lessons .

What i have to do when a cue card handed over to me? How i remind in speaking all answers in mind,,,can i write ? Or hints are also valueable,,,

https://ieltsliz.com/liz-notice-2015-2016/

You are dedicated teacher.. I have ever seen…

Good day! I would like to thank you for sharing your tips and guide for us IELTS takers. I believed that your site made me felt confident that my score in IELTS improved. Your guide and tips are easy to follow, clear and clever. I am still waiting for 2 days more fir my IELTS GT results. By the way, I took my IELTS here in Pampanga, Philippines.

Hi Liz I’m a new student on your site and i have really enjoyed your lessons. I’m planing to take transfer from Russia to UK but before then, i need to take IELTS exames. How can you help me because am not all that good in the language. Please add me to your skype contact; godfred.ameyaw46. Thank you

All my lessons and tips are found on this blog or you can find advanced writing lessons on this page: http://subscriptions.viddler.com/IELTSLizStore , Unfortunately, I don’t work with skype. All the best Liz

Hi your teaching style is very helpfull I want to do test in a next month but I can’t understand where I can start ? Please guide me

Please watch my IELTS preparation video on the home page. Liz

I had my speaking test yesterday!

Part 1: 1. please tell me your full name please 2. are you a student or do you work? 3. What do you do at your work? 4. how important are social media sites? 5. which is good hand writing or typing? 6. why good hand writings are important? 7. in what situations people write by hands? 8. do you think in future, people will stop writing by hands? there were a couple of more questions which I don’t remember

Task 2. A country where I haven’t been and I wish to visit.

Task 3. Importance of tourism, what developments your government is doing to promote tourism, what are the advantages and disadvantages of tourism? There was one more question about tourusm, which I don’t remeber,

overall I think, my speaking was good. But I think my examiner was in hurry and she didn’t let me finish my answers in task 3, which was suppose to be long answers with descriptions and examples. also for task 2, she had to stop me because it was already 2 minutes and i was still speaking.

Liz, do you think this will affect my score?

My writing is on 26th.

Thank you! Palak

Thanks for sharing 🙂 In part 2, it examiner MUST stop you when 2 mins is reached. No students can have more than 2 mins. So, this is a normal part of the test and it won’t affect your score. It’s usually a good sign that you were still talking. For part 3, the examiner should give you a chance to explain your ideas for each question. But sometimes the examiner is happy with the language you are producing in an answer before you have finished. In that case, they will interrupt you and move quickly to another question which tests a different language point. I certainly shouldn’t worry. Let us know your results when they arrive. Good luck with your writing, listening and reading! All the best Liz

your site is very helpful. I’m having my ielts speaking test on friday and i’m continously practising for it from your site. Can you please tell, things I must not say and do while answering the examiner? this is my second time I scored 6 before but this time I need to score 6.5 or more.

The examiner is not interested in your ideas, only in your level of English. Add more to each answer. Speaking naturally as though to a friend. Add past tense, future forms, conditionals etc. Explain what you mean, give examples (particularly in part 2 and 3). Never answer with just a couple of words. Look carefully at my model answers for speaking test 1. Good luck! Liz

Hi Liz I have question Since I never been to my own country & I born & live in Bahrain so how could I talk about my own country? Can I talk about the country were I’m living , I mean considering Bahrain as my own country or hometown ? Thanks

You can talk about any place you want as your hometown. The examiner is not interested if you tell the truth or not. The examiner only wants to hear your English language. So, decide which place you want to be your hometown and use that in your answers. Don’t worry, this is a language test only. All the best Liz

There isn’t any tips or vocabulary about this topic

Not yet. I haven’t put up vocabulary on transport or travel but I will at some point. Liz

I have a question about IELTS Speaking Can we use words like “wanna”, “gonna”, “kinda” in the speaking? Will our scores reduce if we use that words?

Your score will go up. It is a form of pronunciation linking which is good for your pronunciation band score. Liz

Hi Liz, Can I have a certain time to prepare for my answers before speaking face to face with the examiner in speaking part 1?

There is no preparation time for answers in speaking, except in speaking part 2. You should answer the questions in part 1 and part 3 directly. If you need to time to think for one or two questions, you can ask the examiner to repeat the questions. It won’t affect your score and it will give you time to think. All the best Liz

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• Do you like travelling?

→ I must admit I’m a travel lover (1) and travelling to a new country is always on top of my todo list every year. Travelling helps me broaden my horizons ( 2) and blow off some steam (3) after strenuous (4) working days.

• (1) A travel lover /ˈtræv.əl ˈlʌv.ər/ Example: Travel-lovers need to keep living fully
• ( 2) To broaden my horizons /ˈbrɔː.dən maɪ həˈraɪ.zən/ Example: When I went to university I wanted to broaden my horizons.
• (3) To blow off some steam /bləʊ ɒf sʌm stiːm/ Example: To blow off some steam, they took archery lessons together.
• (4) To be strenuous /ˈstren.ju.əs/ Example: His doctor advised him not to do any strenuous exercise
• How many cities have you travelled to?

→ Probably 6. Last year, during my winter break, I had a chance to travel with a group of my best friends and visited the Northern region of my country. We are also planning to travel overseas next month.

• What kind of cities do you like to travel to?

→ Since HCMC is usually hot and humid all year round(5) , I would love to visit cities that have cool weather like Da Lat or Sa Pa. Additionally, I also want to get away from the hustle and bustle(6) of the city life, so anywhere which gives me a sense of tranquility (7) would be my kind of city to visit.

• 5)All year round /ɔːl jɪər raʊnd/ Example: The venue shows movies all year round.
• (6) To get away from the hustle and bustle Example: We both have busy lives and it’s good to get away from the hustle and bustle.
• (7) A sense of tranquility Example: I love the sense of tranquility in my hometown.
• What is the place that left you the deepest impression when travelling?

→ Honestly speaking, it is Sapa. The city has its unique charm and picturesque scenery(8) that takes my breath away (9) just by looking at the photos I took during the trip. This place is definitely worth visiting (10) and words alone are not enough to describe its beauty.

• (8) Picturesque scenery ˈsiˈ.nˈr.i/ Example: The countryside in this region is very picturesque scenery.
• (9) To take my breath away (idiom) Example: The beauty of the Taj Mahal took my breath away
• (10) To be worth visiting Example: Two other sites are eminently worth visiting.

Collocations & idioms: Topic Travelling

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What is Dental Tourism

In this article

What is Dental Tourism?

Dental tourism refers to traveling abroad to get dental treatment. Many people have left, or plan to leave, their country of residence for a “dental vacation.” They may seek higher-quality care, a more attractive price, or both.

Defining the Phenomenon

Visiting another country for dental care is an increasingly common form of medical tourism. Medical tourism, including dental tourism, can be divided into three basic categories:

• Going from a less developed country to a more developed country to access a higher standard of care — This is more common, as some procedures used to be available only in certain parts of the world. 
• Going from a developed country to a country where equivalent dental care is less expensive — This trend is rising as many countries offer more advanced medical treatment. 
• People living abroad who return home for dental care — This is also increasingly common due to global migration.  

This article focuses on the second type of dental tourism. For well-established dental treatments such as dental implants, going to a less expensive country is an attractive option for many people.

Calculate your dental savings now with a DentalPlans plan. Visit DentalPlans.

Benefits and Risks of Dental Tourism

As dental tourism becomes an increasingly compelling option for many people, it’s worth considering the benefits and potential risks. While the advantages of traveling for dental care may seem obvious, the drawbacks may not be as obvious.

Advantages of Seeking Dental Treatment Abroad

There are several potential advantages to dental tourism as an alternative to treatment at home, including:

• Cost-effectiveness — Dental tourist destinations may offer the same quality of care at home but at a fraction of the price. Many clinics cater specifically to foreigners and cultivate a reputation for affordability and expertise.
• The travel experience — Besides getting affordable dental care, tourism’s usual benefits include seeing new places, meeting new people, and having experiences that wouldn’t be possible at home.
• High-quality procedures — Travel may be necessary to access the treatment you seek. This depends on your country of origin, as some countries still have an advantage over others regarding the most advanced procedures.

Concerns and Potential Pitfalls

There are also some potential disadvantages to traveling abroad for dental treatment. These include:

• Risk of low-quality care — The price these dental offices offer may be attractive, but there’s a risk of providing poor care and/ or using low-quality materials
• Little to no recourse — If you receive low-quality treatment in a foreign country, you may not have any legal or financial recourse as a non-citizen
• Long travel times — Air travel may impact recovery, increasing the risk of complications such as post-operative bleeding
• Leisure versus recovery — Drinking, dancing, or eating certain foods may compromise the results of your treatment
• Local diseases — Contracting a disease you aren’t immune to is another potential pitfall that could harm your ability to recover

Which Countries are Best for Dental Tourism?

Some of the most popular destinations for dental tourism include:

• Costa Rica — Offers state-of-the-art dental care at about a third of the cost of the US; many doctors, like those at Cavallini International Dental Clinic , have trained at US or Europe dental schools
• Mexico — Has many quality dental offices that treat Americans and other foreigners; the border city of Los Algodones, nicknamed “Molar City,” is home to hundreds of dentists
• Thailand — An increasingly popular dental tourism destination for Australians and New Zealanders; they can save half or more on dental work at offices like Bangkok International Dental Center
• Hungary — The top destination for Brits, Germans, and other Europeans seeking dental care abroad; clinics like Medicover in Budapest offer dental implants and other procedures at half or even a quarter of the cost at home

Other increasingly popular countries for foreigners seeking dental care include Spain, Poland, Romania, the Dominican Republic, Turkey, and the Philippines.

The best country for you to visit will depend on your preferences, current location, available funds, and any cultural association you might have with the country in question. You should choose a reputable dentist with a proven track record wherever you decide to go.

Why is Dental Tourism Thriving?

The trend of people visiting dental clinics abroad (that cater to foreigners) has grown significantly during this century.

This type of dental tourism is on the rise for several reasons:

• A good deal for the patient — Many people from countries like the United States are affluent by global standards but find it difficult to afford certain dental procedures at home. This makes them ideal customers for high-quality dental clinics in less affluent countries.
• A good deal for the dentist — The clinic can charge a price higher than average within their country but still favorable for the foreign patient.
• An opportunity for travel — Dental tourists can enjoy the other perks of vacationing abroad. They can bring family and friends, visit attractions, etc.
• Favorable location — The above benefits can be found in nearby countries for dental tourists. North American dental tourists can go to Latin American countries, Australians can go to Thailand, and Germans and Austrians can go to Hungary or Romania.

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Cost of Dental Tourism

The total cost of a dental vacation takes into account the cost of treatment, travel, and accommodation. Keep this in mind and weigh these factors against potential risks.

Other costs you’ll want to take into account may include:

• Travel expenses — Getting to your destination country and back, plus what you’ll need to get around once you’ve arrived (taxi and bus fares, etc.)
• Accommodations — The cost of a hotel, hostel, Airbnb, or on-site guest house
• Food and leisure — Enough to live day-to-day while abroad, plus any excursions you want to take, souvenirs you plan to buy, etc.

It’s possible that when everything is accounted for, the total cost of your trip will still be significantly less expensive than getting treatment at home. This is the bargain dental tourists are typically hoping to achieve.

On the other hand, the total cost may be more expensive than just getting treatment at home. You should rethink your plans or decide if the trip is still worth the expense.

Does Insurance Cover Dental Tourism?

Dental insurance may cover out-of-country treatment. Many travel insurance policies also cover dental treatment (however, this is typically only for emergencies).

If you’re living or working abroad long-term, you may want to consider an international health insurance policy with a global network of care providers. Dental coverage can often be included in this kind of policy.

If you have dental insurance, do the following to ensure you’re covered before traveling:

• Check with your insurer
• Find out any requirements your insurer places on out-of-country treatment (it may be handled differently than treatment at home)
• Make sure your dental clinic files any necessary documentation
• Be ready to pay out of pocket at the clinic (your insurance may require this, reimbursing you after the fact)

Even without insurance, dental tourism may get you a better deal than getting treatment at home. But only you can determine this.

Thoroughly research your options, and consider getting dental insurance (and travel insurance) if you don’t already have it. Remember that there may be a waiting period between starting your policy and getting full coverage.

Tips for a Safe Dental Tourism Experience

You’ll need to plan beforehand to ensure a safe and successful trip. Before committing to going abroad as a dental tourist, here are some steps you’ll want to take:

Research Thoroughly

Do your research to ensure quality treatment with a reputable dentist. Before traveling, you’ll want to:

• Choose a dentist — Pick a dental clinic with verified experience with foreign patients, using their website and any available reviews to vet them and make an informed decision.
• Make a plan — Contact your clinic of choice to establish a treatment plan and schedule and settle any logistical or financial questions.
• Know where you’ll be staying — Know how close your hotel, hostel, or Airbnb will be to the dental office, and plan for transportation back and forth. Some clinics that cater to foreign patients offer on-site guest rooms.

Before embarking on your trip, you should eliminate as many uncertainties as possible about the reputation of your dentist and the quality of treatment you can expect.

Consider Your Treatment

The specific dental procedure you’re getting may dictate your travel schedule. Be ready to plan multiple trips or a longer stay if necessary.

For example, many people going abroad for dental care seek dental implants. Implant surgery generally requires at least two visits:

• One to place the implants and temporary crowns
• A second visit several months later, after you’ve healed, to place permanent crowns

Consider having your dentist at home handle the permanent crowns, but getting the information they need from the original dentist may be difficult. You’ll likely need to plan two multi-day stays several months apart for successful treatment.

This is just one example of how your specific treatment needs may affect your travel plans. Know beforehand what you plan to have done and how you’ll account for follow-up visits or changes.

Travel Preparations and Considerations

Before traveling abroad, it’s best to be as prepared as possible to be a guest in another country. At a minimum, you’ll want to ensure you have a valid passport and the funds needed to cover travel expenses.

After that, consider the following:

• Location and logistics — Knowing where you’ll be staying and how you plan to get around is best. You’ll also want to ensure any other activities you want to do on your trip will be compatible with your treatment schedule.
• Travel advisories and safety concerns — Stay updated on recent travel advisories for your host country. Consult other travelers online to avoid scams that may target tourists.
• Health risks — Different parts of the world have different disease profiles. If there are illnesses common in your host country that you wouldn’t encounter at home, consider getting vaccinated before traveling.

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Dental tourism is a growing industry, as many people from countries like the United States can find quality dental services at a lower price by going abroad.

This is especially the case for procedures like dental implant surgery. These procedures require a high degree of skill and expertise but can vary greatly in cost from one location to another.

If you’re interested in getting dental work done in another country, do your research. Get advice from others who have done it before. Look for a reputable dental clinic with good patient feedback, and make sure you’re financially and logistically prepared to travel.

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• Jaapar et al. “ Dental tourism: Examining tourist profiles, motivation and satisfaction. ” Tourism Management, 2017.
• Mohammed, F., and Arishiya, T.F. “ Dental Tourism: Global Competition in Health Care. ” Medical Equipment & Automation, 2012.
• Dhama et al. “ Global Tourist Guide to Oral Care – A Systematic Review. ” Journal of Clinical and Diagnostic Research, 2016.
• Kopmaz et al. “ Dental Websites as New Media Tools for Patients in Dental Health Tourism. ” Acta Informatica Medica, 2019.
• Turner, L. “ Cross-border dental care: ‘dental tourism’ and patient mobility. ” British Dental Journal, 2008.
• Adams et al. “ A critical examination of empowerment discourse in medical tourism: the case of the dental tourism industry in Los Algodones, Mexico. ” Globalization and Health, 2018.
• Lwin et al. “ The level and determinants of international patient satisfaction with dental tourism in Bangkok, Thailand. ” Cogent Business & Management, 2021.
• Gergely, A.M. “ The Phenomenon of Dental Tourism: The Case Study of Hungary. ” Modul University Vienna, 2020.
• Oltean et al. “ Aspects of Marketing in Dental Tourism—Factor of Sustainable Development in Romania. ” Sustainability, 2020.
• “ Cost of a dental implant in selected countries as of 2019. ” Statista, 2019.

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Language Testing for the Tourism Industry

Language proficiency can create opportunities for new experiences, especially in the tourism industry. Tourism brings people from different countries, cultures, and backgrounds to the same location, potentially leading to language barriers. Language Testing International ® provides proficiency testing from ACTFL that can help improve communication between employees and tourists.

Understanding Language Proficiency Requirements in the Tourism Industry

Before your employees begin the language proficiency testing process, understand the requirements, role, and importance of language and communication in the tourism industry. 

Unpacking the Role of Language in the Tourism Industry

Communicating effectively with customers can enhance their experience. It can feel frustrating and isolating to be unable to communicate effectively when traveling — from asking for the location of the bathroom to getting an extra towel or needed supplies at the front desk.

If a guest is from another country, they may not be well-versed in the native language of their destination — having the employees of their resort, hotel, or surrounding shops meet them where they are in their native language can offer comforting and efficient communication while they are away from home.

The Importance of Language Certification for Hospitality Employees

A hospitality employee's role is to ensure guests feel at home, and speaking their language is an excellent way to achieve that goal. Feeling comfortable at a certain destination — especially if they are there to relax — can directly impact customer satisfaction and their chances of spreading positive accolades of your business to their friends. They may even book another trip after a stellar experience.

An Introduction to Language Proficiency Testing

Show language proficiency and feel confident in your company's ability to make guests feel at ease through language certification. Language Testing International offers proficiency testing through ACTFL to enhance hospitality employees' and businesses' communication skill sets. Specifically, these tests can help build your staff's proficiency in the four language skills — speaking, listening, reading, and writing.

Learning how to speak a different language effectively and correctly is the step most people consider. However, speaking is only one step in understanding and becoming proficient in the language, encompassing your team's ability to communicate with others when answering questions or explaining information in person or over the phone.

To be able to respond to a customer, you must first listen and comprehend what they are saying or asking. Someone's listening skills may even develop through immersion before they can speak the language proficiently.

Another form of using language is through reading, which professionals in the tourism industry rely on to read emails or letters in another language. In response to reading something, you may choose to write back. With language testing, your employees can use their newfound proficiency to understand verb and noun structures and craft comprehensible sentences.

Leveraging Language Testing International Services for the Tourism Industry

Language Testing International provides the certifications and assessments your hospitality business needs to succeed in the tourism industry. Here's an inside look at how these credentials and services can help your tourism business succeed.

About Language Testing International

Language Testing International has been a leader in the language proficiency sector since 1992, helping individuals across 60 countries become certified in over 120 languages. Accreditation through ACTFL equips LTI ® to provide assessments that major companies, government agencies, and educational facilities widely recognize.

The tests available cover a wide range, from Afrikaans to Zulu. Some of the most popular languages for proficiency testing include Arabic, English, French, German, Italian, Korean, Mandarin, Pashto, Persian Farsi, Portuguese, Russian, and Spanish.

Language Testing International's Language Skills Assessment for the Tourism Industry

Language skills assessments from ACTFL are designed to determine how proficient individuals are, outlined by the four language skills previously described. These proficiency tests include:

• Listening proficiency: The listening proficiency test will assess an individual's knowledge of a language through a series of audio recordings, after which the test-taker will answer multiple-choice questions based on what they heard.
• Oral proficiency: The oral proficiency test can be taken online or over the phone. Online tests are done through a virtual avatar, while over-the-phone tests will be with a real person, mimicking a real-time conversation.
• Reading proficiency: This internet-based test provides passages for the test-taker to read and answer questions about, all in the chosen language.
• Writing proficiency: The writing proficiency portion requires the test-taker to respond to open-ended prompts so an ACTFL proctor can review and grade their answers.

Candidate results of all testing assessments are then measured through one of three scales:

• The ACTFL scale
• The Common European Framework of Reference for Languages (CEFR) scale
• The Interagency Language Roundtable (ILR) scale

Get Your Tourism Company's Language Proficiency Testing With Language Testing International

Communication is important in the tourism industry, and LTI can help your employees improve their efforts through language proficiency testing. LTI makes it easy to request company-wide language testing with our sales form :

• Fill out your organization's name, email or phone number, and location.
• Select what your company is most interested in.
• Estimate the number of tests you will need.
• Add any additional information about testing purchases from LTI.
• Submit the form.

After submitting, an LTI team member will get in contact with you to further discuss your company's language testing options.

Frequently Asked Questions

LTI can help answer the most common questions related to language testing in the tourism industry. Check out some of the most frequently asked questions below.

Can You Help My Staff Learn to Interact and Speak With Non-Native-Speaking People?

Absolutely! LTI is the exclusive licensee offering ACTFL resources to businesses and individuals looking to advance their language proficiency. Your company can also benefit from receiving language audits and task analyses to better understand where your staff is in their speaking, listening, reading, and writing skills.

My Boss Is Proficient in a Non-Native Language — Can They Proctor Me?

Language proficiency is a complex assessment to ensure all boxes are checked for certification. It's best for a professional to ensure the test runs smoothly and avoid legal issues.

How Much Does Language Efficiency Cost?

Each test can vary in cost depending on the language and assessment type, as well as the scale of testing your organization requires. Explore the languages you can receive certification in and choose a test to learn more about prices.

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Tourism: Question Loop Speaking Activity

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You can do this fun interactive integrated speaking, reading and listening activity at any time. It suits the beginning of a new topic like ’Tourism’ to introduce new material, or the end of a topic to revise material already learned.

Tourism - Question Loop Speaking Activity

• British English
• Business / ESP
• Intermediate
• Lesson Plan / Teacher's Notes
• Pre-Intermediate
• Printable Worksheet
• Up to 30 mins
• Whole Class

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All the Adventure, a Fraction of the Cost: The D.I.Y. Orient Express

The luxury version of this classic train journey costs almost $50,000, but for $1,000 or less, you can book the rail trip from Paris to Istanbul yourself.

Rail fans can stitch together their own version of the Orient Express, which includes the Dacia train between Vienna and Bucharest. Credit... Tony Cenicola/The New York Times

Supported by

By Michael Harmon

Photographs and Video by Tony Cenicola

• Published July 5, 2024 Updated July 7, 2024

Mention the Orient Express to most people, and you’re likely to conjure up visions of the private five-star luxury train — Belmond’s Venice Simplon-Orient-Express — whose meticulously restored coaches feature every conceivable Belle Epoque bell and whistle: acres of mirror-finish mahogany, sophisticated silver service, a pianist taking after-dinner requests at the lounge car’s baby grand.

That train primarily runs overnight excursions between Paris and Venice. For two travelers sharing a sleeper, prices start at 3,530 British pounds, or around $4,500 per person — but once a year, the V.S.O.E. takes five nights to retrace the classic route from Paris to Istanbul. For a solo traveler, the cost of admission is £35,000 — and that’s for the smallest cabin.

Thanks to Europe’s ongoing night train renaissance, though, it’s now possible for the first time in years to travel from Paris to Istanbul by regularly scheduled sleepers, with just two planned changes of trains, in Vienna and Bucharest. And not only can you book this D.I.Y. Orient Express online, you can reserve private sleeping compartments for the entire trip for less than $1,000.

It was a trip I had always wanted to take. And so, one balmy evening last July, I found myself under the soaring glass canopy of the Gare de l’Est in Paris — from which the first Orient Express departed 140 years earlier — with tickets in my pocket for a trip 2,000 miles east to the shores of the Bosporus, on an unbroken ribbon of rail.

Route of the D.I.Y. Orient Express

Châlons-en-

Dacia Express

Gorna Oryahovitsa

Dimitrovgrad

Bosporus Express

Mediterranean Sea

Sure, there’d be no pianist in the lounge car — nor a piano, nor a lounge car. And the trip takes at least four days, with two lengthy layovers. But not even a surprise downgrade to third class (that would come later) could have lessened my excitement when “Wien” flashed onto the digital departure board. I didn’t even wait for a track announcement; I spotted the rake of blue sleeper cars across the station and lit out for Track 5 and the far edge of Europe.

The Nightjet to Vienna

The Austrian Railways (ÖBB) Nightjet train to Vienna left with little fanfare: just a blast of the whistle and we were off.

The sun was streaming into my compartment as we picked up speed through the outskirts of Paris, and there was a laid-back camaraderie on the train as everyone settled in for the 15-hour journey ahead. In the corridor, I met a music student on his way back to school in Vienna and an Austrian couple heading home to Linz, a reminder that overland travel in Europe is a fact of life rather than a novelty or an exercise in nostalgia.

That said, this train does have a claim to the Orient Express name. Between Belmond’s V.S.O.E. and Accor’s ultra-luxe rival launching next year , it’s easy to forget that the real Orient Express trundled on for decades after its interwar heyday: Following its final Paris-Istanbul run in 1977, the train was cut back to Paris-Bucharest, then Paris-Budapest, then Paris-Vienna, before fading from the timetable altogether in 2009. Since then, ÖBB has led the charge of reviving Europe’s night trains, adding Paris to its expanding Nightjet sleeper network in 2021.

For this trip, I’d sprung for the top-of-the-line single deluxe sleeper with an en-suite toilet and, sensationally, a shower.

“Breakfast will be around 8 o’clock,” said our sleeping-car attendant, Melanie, stopping by to take my order. The scenery had opened up, and our train was blasting through the French countryside as I tucked into the Algerian mhadjeb wrap I’d bought at Paris’s Belleville street market. (While the Nightjet does have a room service dinner menu, it lacks a communal restaurant car.)

An unplanned stop at Châlons-en-Champagne gave me a chance to talk to some fellow overlanders, as we stretched our legs on the platform waiting for a freight train to pass. One young man, grounded from flying by an ear condition, had come by train and ferry all the way from Ireland; a couple from London, grounded by Daisy the cockapoo, were en route to Croatia.

We stood marveling at the fiery sunset until the whistle called us back onboard, and after the wobbly thrill of showering on a speeding train, I climbed into bed, catching a glimpse of the Big Dipper before the electric whine of the Nightjet lulled me to sleep.

The Dacia Express to Bucharest

The next morning in Vienna, I stepped out of the train and into a July heat wave, which melted away most of my grand ambitions for the 10-hour Viennese layover the journey requires. Catching a tram to the city center, I decided, in the spirit of the trip, to stay on until the end of the line in leafy Nussdorf, a ride of about 40 minutes, where the stately old terminal now houses a restaurant; its back garden beckoned me to fully embrace “slow travel” and linger over a long lunch with a book and some ice-cold white wine.

I was back at the station by 7 p.m., armed with a schnitzel sandwich for dinner — I had read there’d be no dining car on this train, either (nor the next one, for that matter). Eventually, after an hour delay (they’d been looking for a driver), the night train to Bucharest barreled in, its sky-blue sleeping cars, emblazoned with VAGON DE DORMIT and the logo of CFR Calatori, the passenger division of Romanian Railways, giving it an exotic air of having come from far away.

The Dacia Express takes more than 18 hours to travel from Vienna to Bucharest, where it arrives in the afternoon; for anyone catching the last leg of a D.I.Y. Orient Express trip, the 10:50 a.m. Istanbul train, this means spending a night in a Bucharest hotel. Taking advantage of the fact that the Dacia passes through Transylvania, I opted to further break up my trip with two nights in the preserved medieval citadel of Sighisoara, about six hours up the line from Romania’s capital.

It’s luck of the draw if you’ll land a sleeper with an en suite bathroom on the Dacia , which like most night trains has shared toilets and showers at the end of each car; mine had only a wash basin, but my compartment was clean, cool and spacious. It felt great to be on the move again, and as we hurtled toward Hungary I poked my head through the open door of my neighbors’ compartment and asked cheerily where they were going.

“Istanbul!” answered Sabine Mader, 57, traveling with her son Josef, 17, on a rail adventure from Berlin. “At least, we are trying to! We hope to get tickets as soon as we arrive in Bucharest.”

The direct Bucharest-Istanbul service, reintroduced in 2022, is in fact a single Turkish Railways couchette car (a notch below a proper sleeper, with padded bunks rather than real beds) carried relay-race style by three connecting Romanian, Bulgarian and Turkish trains. Called the Bosporus Express, it’s a multinational effort that can be elusive in online timetables (and requires picking up a physical ticket), but it can be reserved online , news which delighted my neighbors.

With tickets secured through Josef’s phone, Sabine opened a bottle of sparkling wine to toast our success. Sitting in their compartment swapping stories felt like the Platonic ideal of night train travel, and the Dacia had more in store: a stop at Budapest’s breathtaking Keleti station, bathed in yellow lamplight, followed by the sleeper train ritual of middle-of-the-night passport checks in one’s pajamas.

The next morning, I hopped off in Sighisoara for some medieval R & R, catching the Dacia again two days later for the dramatic daytime ride through the Carpathian Mountains — past Saxon fortified churches and donkey carts waiting patiently at grade crossings — and finally into Bucharest’s bustling Gara di Nord, where I picked up my ticket for the next train to Istanbul.

The Bosporus Express to Istanbul

“Where’s the Turkish car?”

I stared, slack-jawed, at Train 461. The Turkish couchette car was nowhere in sight. In its place was a forlorn-looking two-car Romanian train — the one the couchette car should have been attached to — and a vague explanation from a Romanian conductor that yes, the Turkish car was “broken,” so yes, this was today’s train to Istanbul.

My heart sank.

I climbed onboard, and before my disappointment could turn to panic (the two cars were “sitters,” not sleepers, and Istanbul was a 19-hour ride away), a whistle blew and I flopped into a seat next to three young men speaking quietly to each other in French.

“Istanbul, right?” I asked anxiously.

“Yes, we hope!” Our train had just lurched forward, so this was mildly reassuring.

Eliaz Bourez, Adrien Godefroy and Yann Berthier, all 24 and traveling across Europe on Interrail passes, were riding the rails to Istanbul because it’s “as far as you can go,” said Mr. Godefroy. “And we’ve been dreaming about this train the whole trip.”

“With the plate on the side saying ‘Istanbul!’” jumped in Mr. Berthier, framing it with his hands. “But where is it? I was so ready to take that photo!”

We were all a little nervous about what lay ahead, a question the entire train car was soon pondering in a scene that would have made Agatha Christie proud. We reasoned we would have to catch the three successive trains that normally haul the couchette car to Istanbul, but one question loomed large: whether the Turkish sleeper from Sofia, our final train, would have beds for us for the overnight leg of our odyssey.

Mr. Bourez shrugged hopefully. “We have to roll with it.”

And we did. Six hours, two passport checks, and one locomotive swap later, after rolling through sunflower fields and clattering across the enormous “Friendship Bridge” over the mighty Danube, we reached the Bulgarian junction town of Gorna Oryahovitsa, where we said goodbye to our first train and apprehensively eyed our next ride.

Baking in the 90-degree heat two platforms over, the Gorna-Dimitrovgrad train’s two graffitied coaches made our Romanian railcar look like the V.S.O.E. Its wide-open windows confirmed our worst fears — no air conditioning — as we hoisted ourselves onboard. I slumped into a stuffy sitting compartment with Jan Géhant, another young Interrailer, and our French friends.

“How long are we on this one?” Mr. Géhant, 19, wondered aloud. The group turned toward me; I had studied the timetable.

“Five hours.”

They groaned. “But,” I added, “it should be a scenic ride.”

It was magnificent. As we climbed slowly into the mountains along the snaking single-track line, the jointed rail clack-clacking beneath us, a staggering panorama unfolded, each S-turn revealing a more spectacular gorge or lushly green peak than the last.

I drank in the deliciously cool air and considered my luck. Had it been a normal day on the Bosporus Express, ensconced in a private air-conditioned couchette, I couldn’t have stuck my head out the window like a golden retriever, or flung open the manual doors at every remote alpine halt to wave to the uniformed stationmasters. I might have missed the invigorating chill of each tunnel lit up by sparks flying off our locomotive, or the elation of joining in a Beatles singalong in the next car up, or the joy of a picnic with new friends as we descended the mountain pass and rumbled on into the night.

And we certainly wouldn’t have arrived in the humid purgatory of Dimitrovgrad euphoric to find that the sleeper from Sofia, just by luck, had exactly enough spare beds for everyone. Bunking with Mr. Géhant in an immaculately clean two-bed compartment, I spotted the Turkish crescent on the window and broke into a huge grin.

It was almost midnight, but we were all high-fiving in the corridor, ecstatic. Spirits stayed high even through the everybody-off-the-train Kapikule border crossing, and I woke the next morning to our train racing past distant minarets under a piercing blue sky.

A few hours later, we reached the suburban station of Halkali, the current end of the line for international trains to Istanbul. There, I caught the Marmaray — the world’s only intercontinental commuter train — for the short ride to its last stop in Europe, in a tunnel built 200 feet below Sirkeci station, the historic terminus of the Orient Express.

Six days after leaving Paris, I was in Istanbul. The trip had stayed true to the myth of the train that inspired it: comfortable, convivial — and a genuine adventure.

For planning a train trip across Europe (or anywhere), Mark Smith’s website The Man In Seat 61 is an indispensable resource. Check for the latest timetables and booking instructions.

I paid 371 euros, about $398, on the Nightjet and €253 on the Dacia, for top-end, private sleeping compartments; choosing a shared sleeper or couchette cuts the cost considerably. Both trains run year-round and can be booked through ÖBB , while the summer-only Bosporus Express can be reserved through CFR (I paid about 1,093 Romanian lei, or $242 to buy out an entire four-berth couchette, though Turkish Railways had other plans).

In Istanbul, until the classic line to Sirkeci reopens to international trains, buy a reloadable Istanbulkart at Halkali to ride the Marmaray. For maximum historical accuracy, continue to the Pera Palace hotel (rooms from about €263), built in 1892 to host passengers of the Orient Express.

Follow New York Times Travel on Instagram and sign up for our weekly Travel Dispatch newsletter to get expert tips on traveling smarter and inspiration for your next vacation. Dreaming up a future getaway or just armchair traveling? Check out our 52 Places to Go in 2024 .

Tony Cenicola is a Times photographer. More about Tony Cenicola

Open Up Your World

Considering a trip, or just some armchair traveling here are some ideas..

52 Places:  Why do we travel? For food, culture, adventure, natural beauty? Our 2024 list has all those elements, and more .

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• Introduction
• Conclusions
• Article Information

Evidence reviews for the US Preventive Services Task Force (USPSTF) use an analytic framework to visually display the key questions that the review will address to allow the USPSTF to evaluate the effectiveness and safety of a preventive service. The questions are depicted by linkages that relate interventions and outcomes. A dashed line depicts a health outcome that follows an intermediate outcome. For additional information, see the USPSTF Procedure Manual. 16

a This is the same as key question 2b from the screening analytic framework ( Figure 1 ).

Evidence reviews for the US Preventive Services Task Force (USPSTF) use an analytic framework to visually display the key questions that the review will address to allow the USPSTF to evaluate the effectiveness and safety of a preventive service. The questions are depicted by linkages that relate interventions and outcomes. For additional information, see the USPSTF Procedure Manual. 16

The sum of the number of studies per key question (KQ) exceeds the total number of studies because some studies were applicable to multiple KQs or topic areas.

a One trial addressed both topical fluoride and silver diamine fluoride.

eMethods 1. Search Strategies

eMethods 2. Inclusion and Exclusion Criteria

eMethods 3. Criteria for Assessing Internal Validity of Individual Studies

eFigure 1. sROC for Periodontitis versus No Periodontitis

eFigure 2. Sensitivity and Specificity of Questionnaire for Severe Periodontitis

eFigure 3. sROC Curve for Severe Periodontitis versus No Severe Periodontitis

eTable 1. Data Abstraction of Screening Trial

eTable 2. Quality Assessment Screening Trial

eTable 3. Data Abstraction of Diagnostic Accuracy Studies

eTable 4. Quality Assessment of Diagnostic Accuracy Studies

eTable 5. Data Abstraction of Topical Fluoride Trials

eTable 6. Quality Assessment of Topical Fluoride Trials

eTable 7. Data Abstraction of Sealant Trials

eTable 8. Quality Assessment of Sealant Trials

eTable 9. Data Abstraction of Silver Diamine Fluoride Trials

eTable 10. Quality Assessment of Silver Diamine Fluoride Trials

eReferences

• USPSTF Recommendation: Oral Health in Children and Adolescents Aged 5 to 17 Years JAMA US Preventive Services Task Force November 7, 2023 This 2023 Recommendation Statement from the US Preventive Services Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening and preventive interventions performed by primary care clinicians for oral health conditions, including dental caries, in children and adolescents aged 5 to 17 years (I statement). US Preventive Services Task Force; Michael J. Barry, MD; Wanda K. Nicholson, MD, MPH, MBA; Michael Silverstein, MD, MPH; David Chelmow, MD; Tumaini Rucker Coker, MD, MBA; Esa M. Davis, MD, MPH; Katrina E. Donahue, MD, MPH; Carlos Roberto Jaén, MD, PhD, MS; Li Li, MD, PhD, MPH; Gbenga Ogedegbe, MD, MPH; Lori Pbert, PhD; Goutham Rao, MD; John M. Ruiz, PhD; James Stevermer, MD, MSPH; Joel Tsevat, MD, MPH; Sandra Millon Underwood, PhD, RN; John B. Wong, MD
• USPSTF Review: Screening and Prevention for Oral Health in Children and Adolescents JAMA US Preventive Services Task Force November 7, 2023 This systematic review to support the 2023 US Preventive Services Task Force Recommendation Statement on oral health screening and prevention in children and adolescents summarizes published evidence on the benefits and harms of screening, referral, behavioral counseling, and preventive interventions for oral health in asymptomatic children and adolescents aged 5 to 17 years. Roger Chou, MD; Christina Bougatsos, MPH; Jessica Griffin, MS; Shelley S. Selph, MD, MPH; Azrah Ahmed, BA; Rongwei Fu, PhD; Chad Nix, MSc; Eli Schwarz, DDS, MPH, PhD
• Aligning Prevention Evidence Gaps With Prevention Research JAMA Viewpoint November 7, 2023 This Viewpoint describes the development of tools to communicate actionable steps to address research needs and gaps for USPSTF recommendations that have insufficient evidence to make definitive guidance. Wanda Nicholson, MD, MPH, MBA; Michael J. Barry, MD; Carol M. Mangione, MD, MSPH
• A Call for More Oral Health Research in Primary Care JAMA Editorial November 7, 2023 Michael S. Reddy, DMD, DMSc; Rena N. D’Souza, DDS, MS, PhD; Jennifer Webster-Cyriaque, DDS, PhD
• Patient Information: Dental Caries in Adults, Adolescents, and Children JAMA JAMA Patient Page November 7, 2023 This JAMA Patient Page describes oral health, particularly care of the teeth and prevention of tooth and gum disease, and discusses the pros and cons of screening for dental caries by primary care clinicians. Jill Jin, MD, MPH
• USPSTF Recommendation: Screening and Preventive Interventions for Oral Health in Adults JAMA US Preventive Services Task Force November 14, 2023 This 2023 Recommendation Statement from the US Preventive Services Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening and preventive interventions performed by primary care clinicians for oral health conditions, including dental caries, in adults (I statement). US Preventive Services Task Force; Michael J. Barry, MD; Wanda K. Nicholson, MD, MPH, MBA; Michael Silverstein, MD, MPH; David Chelmow, MD; Tumaini Rucker Coker, MD, MBA; Esa M. Davis, MD, MPH; Katrina E. Donahue, MD, MPH; Carlos Roberto Jaén, MD, PhD, MS; Li Li, MD, PhD, MPH; Gbenga Ogedegbe, MD, MPH; Lori Pbert, PhD; Goutham Rao, MD; John M. Ruiz, PhD; James Stevermer, MD, MSPH; Joel Tsevat, MD, MPH; Sandra Millon Underwood, PhD, RN; John B. Wong, MD

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Chou R , Selph SS , Bougatsos C, et al. Screening, Referral, Behavioral Counseling, and Preventive Interventions for Oral Health in Adults : A Systematic Review for the US Preventive Services Task Force . JAMA. 2023;330(18):1780–1790. doi:10.1001/jama.2023.20685

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Screening, Referral, Behavioral Counseling, and Preventive Interventions for Oral Health in Adults : A Systematic Review for the US Preventive Services Task Force

• 1 Pacific Northwest Evidence-based Practice Center, the Department of Medical Informatics and Clinical Epidemiology; Oregon Health & Science University, Portland
• 2 Division of General Internal Medicine; Oregon Health & Science University, Portland
• 3 School of Medicine; Oregon Health & Science University, Portland
• 4 School of Dentistry, Division of Dental Public Health, Oregon Health & Science University, Portland
• Editorial A Call for More Oral Health Research in Primary Care Michael S. Reddy, DMD, DMSc; Rena N. D’Souza, DDS, MS, PhD; Jennifer Webster-Cyriaque, DDS, PhD JAMA
• US Preventive Services Task Force USPSTF Recommendation: Oral Health in Children and Adolescents Aged 5 to 17 Years US Preventive Services Task Force; Michael J. Barry, MD; Wanda K. Nicholson, MD, MPH, MBA; Michael Silverstein, MD, MPH; David Chelmow, MD; Tumaini Rucker Coker, MD, MBA; Esa M. Davis, MD, MPH; Katrina E. Donahue, MD, MPH; Carlos Roberto Jaén, MD, PhD, MS; Li Li, MD, PhD, MPH; Gbenga Ogedegbe, MD, MPH; Lori Pbert, PhD; Goutham Rao, MD; John M. Ruiz, PhD; James Stevermer, MD, MSPH; Joel Tsevat, MD, MPH; Sandra Millon Underwood, PhD, RN; John B. Wong, MD JAMA
• US Preventive Services Task Force USPSTF Review: Screening and Prevention for Oral Health in Children and Adolescents Roger Chou, MD; Christina Bougatsos, MPH; Jessica Griffin, MS; Shelley S. Selph, MD, MPH; Azrah Ahmed, BA; Rongwei Fu, PhD; Chad Nix, MSc; Eli Schwarz, DDS, MPH, PhD JAMA
• Viewpoint Aligning Prevention Evidence Gaps With Prevention Research Wanda Nicholson, MD, MPH, MBA; Michael J. Barry, MD; Carol M. Mangione, MD, MSPH JAMA
• JAMA Patient Page Patient Information: Dental Caries in Adults, Adolescents, and Children Jill Jin, MD, MPH JAMA
• US Preventive Services Task Force USPSTF Recommendation: Screening and Preventive Interventions for Oral Health in Adults US Preventive Services Task Force; Michael J. Barry, MD; Wanda K. Nicholson, MD, MPH, MBA; Michael Silverstein, MD, MPH; David Chelmow, MD; Tumaini Rucker Coker, MD, MBA; Esa M. Davis, MD, MPH; Katrina E. Donahue, MD, MPH; Carlos Roberto Jaén, MD, PhD, MS; Li Li, MD, PhD, MPH; Gbenga Ogedegbe, MD, MPH; Lori Pbert, PhD; Goutham Rao, MD; John M. Ruiz, PhD; James Stevermer, MD, MSPH; Joel Tsevat, MD, MPH; Sandra Millon Underwood, PhD, RN; John B. Wong, MD JAMA

Importance   Dental caries and periodontal disease are common adult oral health conditions and potentially amenable to primary care screening and prevention.

Objective   To systematically review the evidence on primary care screening and prevention of dental caries and periodontal disease in adults to inform the US Preventive Services Task Force.

Data Sources   MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (to October 3, 2022); surveillance through July 21, 2023.

Study Selection   Diagnostic accuracy studies of primary care screening instruments and oral examination; randomized and nonrandomized trials of screening and preventive interventions; cohort studies on primary care oral health screening and preventive intervention harms.

Data Extraction and Synthesis   One investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality. Diagnostic accuracy data were pooled using a bivariate mixed-effects binary regression model.

Main Outcomes and Measures   Dental caries, periodontal disease, morbidity, quality of life, harms; and diagnostic test accuracy.

Results   Five randomized clinical trials, 5 nonrandomized trials, and 6 observational studies (total 3300 participants) were included. One poor-quality trial (n = 477) found no difference between oral health screening during pregnancy vs no screening in caries, periodontal disease, or birth outcomes. One study (n = 86) found oral health examination by 2 primary care clinicians associated with low sensitivity (0.42 and 0.56) and high specificity (0.84 and 0.87) for periodontal disease and with variable sensitivity (0.33 and 0.83) and high specificity (0.80 and 0.93) for dental caries. Four studies (n = 965) found screening questionnaires associated with a pooled sensitivity of 0.72 (95% CI, 0.57-0.83) and specificity of 0.74 (95% CI, 0.66-0.82) for periodontal disease. For preventive interventions no study evaluated primary care counseling or dental referral, and evidence from 2 poor-quality trials (n = 178) of sealants, and 1 fair-quality and 4 poor-quality trials (n = 971) of topical fluorides, was insufficient. Three fair-quality trials (n = 590) of persons with mean age 72 to 80 years found silver diamine fluoride solution associated with fewer new root caries lesions or fillings vs placebo (mean reduction, −0.33 to −1.3) and decreased likelihood of new root caries lesion (2 trials; adjusted odds ratio, 0.4 [95% CI, 0.3-0.7]). No trial evaluated primary care–administered preventive interventions.

Conclusions and Relevance   Screening questionnaires were associated with moderate diagnostic accuracy for periodontal disease. Research is needed to determine benefits and harms of oral health primary care screening and preventive interventions.

Oral health issues in adults are common, are often untreated, and can lead to tooth loss or irreversible damage and other adverse health outcomes. 1 - 5 For patients who lack access to dental services, oral health screening and preventive interventions for dental caries and periodontal disease, the most common oral health conditions in adults, could potentially be provided in primary care settings and reduce associated negative health consequences and observed disparities related to race and ethnicity, socioeconomic status, or other factors. 6 - 10 This evidence report was conducted to inform the US Preventive Services Task Force (USPSTF) for a new recommendation on primary care screening, dental referral, behavioral counseling, and preventive interventions for oral health in adults. A complementary evidence report was conducted for the USPSTF on oral health screening and prevention in children and adolescents aged 5 to 17 years. 11 , 12 The USPSTF addressed oral cancer screening separately 13 and previously addressed screening and prevention of dental caries in children younger than 5 years. 14

Detailed methods and evidence tables with additional study details are available in the full evidence report. 15  Figure 1 and Figure 2 show the analytic frameworks and key questions (KQs) that guided the review. Separate analytic frameworks were used to distinguish treatment of adults with existing dental caries or periodontal disease (screening) from treatment of adults without those conditions (preventive interventions). The full report 15 includes findings for contextual questions (not systematically reviewed) on the association between dental caries and long-term health outcomes, oral health disparities, and primary care interventions to reduce disparities.

A research librarian searched MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews from inception to October 3, 2022 (eMethods 1 in the Supplement ). Searches were supplemented by reference list review of relevant articles. Since October 3, 2022, ongoing surveillance was conducted through article alerts and targeted searches of journals to identify major studies published in the interim that could affect the conclusions or understanding of the evidence and the related USPSTF recommendation. The last surveillance was conducted on July 21, 2023, and identified no eligible randomized trials.

Two investigators independently reviewed titles, abstracts, and full-text articles using predefined eligibility criteria (eMethods 2 in the Supplement ). The population was asymptomatic adults (≥18 years) who were not selected on the basis of having existing dental caries or periodontal disease. Screening and diagnostic accuracy studies conducted in primary care settings of oral health examination or risk assessment instruments were eligible. Studies of risk instruments that were not administered in primary care settings were also eligible if they were primary care relevant (did not involve a dental professional examination or specialty tests [eg, dental radiographs, cariogenic bacteria levels, salivary flow rates]).

Eligible preventive interventions were primary care oral health behavioral counseling, referral to a dental professional, and preventive medications potentially feasible for primary care administration (not requiring extensive dental training): topical fluoride (varnish, foam, or gel), silver diamine fluoride (SDF) topical solution, dental sealants, and xylitol. Comparisons were against placebo or no intervention. Outcomes were dental caries (incidence or caries burden, often measured as the number of decayed, missing, or filled permanent teeth [DMFT index] or surfaces [DMFS index]), periodontal disease presence and severity, morbidity, quality of life, functional status, and harms. Randomized or nonrandomized trials and diagnostic accuracy studies were eligible; cohort studies were also eligible for screening and preventive intervention harms.

One investigator abstracted details about the study design, patient population, setting, interventions or screening instruments, analysis, follow-up, and results from each study. A second investigator reviewed abstracted data for accuracy. Two independent investigators assessed the quality of each study as good, fair, or poor using predefined criteria developed by the USPSTF (eMethods 3 in the Supplement ). Discrepancies were resolved by consensus. In accordance with the USPSTF Procedure Manual, 16 studies rated poor-quality were only included if higher-quality evidence was unavailable.

For all KQs, the overall quality of evidence was rated as “good,” “fair,” or “poor” based on study limitations, consistency, precision, reporting bias, and applicability, using the approach described in the USPSTF Procedure Manual. 16

For diagnostic accuracy, a bivariate mixed-effects binary regression model with xtmelogit in Stata version 14.2 (StataCorp) was used to summarize sensitivity and specificity of screening tests for periodontal disease or dental caries. The bivariate mixed-effects model was also used to create summary area under the receiver operating characteristic (AUROC) curves. Statistical heterogeneity was assessed using the I 2 statistic, and stratified analyses were conducted by setting (medical or dental) and risk of bias. All significance testing was 2-tailed; P values .05 or less were considered statistically significant. Meta-analysis was not conducted for preventive interventions, due to small numbers of studies with methodological limitations.

Across all KQs, 16 studies (in 17 publications; total 3300 participants) were included ( Figure 3 ). 17 - 33 One randomized clinical trial (RCT) 17 and 7 diagnostic accuracy studies addressed screening, 18 - 24 and 4 RCTs 25 - 28 and 5 nonrandomized trials 29 - 33 addressed preventive interventions. The Table summarizes the evidence reviewed for this report.

Key Question 1. How effective is screening for oral health performed by a primary care clinician in preventing negative oral health outcomes?

One poor-quality trial (n = 477) conducted in Australia in persons in the first trimester of pregnancy found no statistically significant differences between a midwife-led oral health screening intervention vs no screening in the mean number of third trimester decayed teeth (1.47 [SD, 2.51] vs 2.01 [SD, 2.55]) or filled teeth (3.06 [SD, 3.94] vs 2.09 [SD, 2.53]) (eTable 1 in the Supplement ). 17 Periodontal disease and birth outcomes were very similar between groups. The screening intervention consisted of a 2-item questionnaire, midwife-performed oral health examination, and provision of oral health education and dental referral if indicated. Trial methodological limitations included open-label design, unclear allocation concealment methods, and high (44%) attrition (eTable 2 in the Supplement ).

Key Question 2a. How accurate is screening for oral health performed by a primary care clinician in identifying adults who have oral health issues?

Six fair-quality, primary care–relevant studies (in 7 publications; n = 1184; range, 88-408) assessed the diagnostic accuracy of oral health questionnaires for periodontal disease (eTable 3 in the Supplement ). 17 - 23 Mean study age ranged from 40 to 58 years, except for 1 study of pregnant persons (mean age, 29 years). The prevalence of at least mild periodontitis ranged from 39% to 100%, and the prevalence of severe periodontitis ranged from 20% to 39%. Four studies were conducted in a dental setting 19 , 20 , 22 , 23 and 2 studies in an outpatient medical setting. 17 , 18 , 21 Three studies evaluated the same or a similar 8-item questionnaire on self-perceived dental health, 19 , 21 , 23 1 study evaluated a more detailed 21-item questionnaire on self-perceived dental health, 20 1 study evaluated a 7-item questionnaire that combined items on self-perceived dental health with patient demographics and smoking status, 22 and 1 study assessed a brief (2-item) questionnaire in pregnancy. 18 Methodological limitations included unclear blinding of screeners to the reference standard and use of nonpredefined thresholds for a positive screen result (eTable 4 in the Supplement ). In addition, the questionnaires included items on prior treatment for periodontal disease, potentially reducing applicability to screening.

A pooled analysis of 4 studies (n = 965) found screening questionnaires of self-perceived dental health associated with sensitivity of 0.72 (95% CI, 0.57-0.83, I 2  = 91%) and specificity of 0.74 (95% CI, 0.66-0.82, I 2  = 73%) for periodontitis (defined as stage I through IV periodontitis, Community Periodontal Index of Treatment Needs [CPITN] scores 3 and 4, moderate and severe periodontitis, or ≥2 teeth with alveolar bone loss ≥5 mm) ( Figure 4 ). 19 - 21 , 23 Statistical heterogeneity was high. One study 21 of an 8-item questionnaire administered in a medical setting reported lower sensitivity (0.49 [95% CI, 0.38-0.60]) compared with 3 studies conducted in dental settings (sensitivity ranged from 0.68 to 0.85), although its specificity (0.68 [95% CI, 0.56-0.79]) was within the range reported by the dental setting studies (range, 0.63-0.84). The summary AUROC value was 0.79 (95% CI, 0.75-0.83), 19 - 21 , 23 indicating fair discrimination (eFigure 1 in the Supplement ).

When the analysis was limited to identification of more severe periodontitis (ie, stage III/IV periodontitis, CPITN score 4, severe periodontitis, ≥3 teeth with alveolar bone loss ≥6 mm), the pooled sensitivity was similar (0.68 [95% CI, 0.61-0.75]; I 2  = 40%) and specificity slightly higher (0.80 [95% CI, 0.71-0.87]; I 2  = 90%) than for any periodontitis, although confidence intervals overlapped (4 studies; n = 965) (eFigure 2 in the Supplement ). The summary AUROC value was similar (0.76 [95% CI, 0.72-0.80]) (eFigure 3 in the Supplement ). 19 - 21 , 23

Two other studies evaluated questionnaires dissimilar to the other 4 studies and were not pooled. One study 22 (n = 88) used a 7-item questionnaire that included items on patient demographics and smoking status as well as self-reported oral health to generate a patient-reported Periodontitis Risk Score (pPRS; range, 0-20; higher scores indicate greater risk). A cutoff of 7 or greater on the pPRS was associated with a sensitivity of 0.87 (95% CI, 0.78-0.94), specificity of 0.84 (95% CI, 0.67-0.95), and odds ratio of 39.09 (95% CI, 9.82-132) for periodontal inflammation, and the pPRS was associated with good discrimination for periodontal inflammation (AUROC value, 0.86 [95% CI, 0.76-0.95]). The other study (n = 131) found a 2-item screener in pregnant women (“Do you have problems in your mouth?” and “Have you seen a dentist in the last 12 months?”) associated with sensitivity of 0.88 (95% CI, 0.80-0.96) and specificity of 0.14 (95% CI, 0.05-0.23) for identifying those with a Periodontal Screening and Recording Index score 2 or greater (indicating early signs of periodontitis or presence of any tooth decay). 17 , 18

One good-quality study evaluated the diagnostic accuracy of an oral health examination in primary care (eTables 3 and 4 in the Supplement ). 24 Eighty-six patients (mean age, 66 years; 99% male) at a Veterans Affairs medical clinic were screened independently by 2 primary care clinicians. The reference standard was a same-day dentist examination. Primary care oral health examination was associated with high specificity (range, 0.80-0.93) for periodontal disease or caries. However, sensitivity was low for periodontal disease (0.56 [95% CI, 0.38-0.74] and 0.42 [95% CI, 0.24-0.56] for 2 examiners) and variable for caries (0.33 [95% CI, 0.12-0.62] and 0.83 [95% CI, 0.52-0.96]).

Key Question 2b. How accurate is screening for oral health performed by a primary care clinician in identifying adults who are at increased risk for future oral health issues?

No study addressed this KQ.

Key Question 3. What are the harms of screening for oral health performed by a primary care clinician?

One trial of oral health screening of pregnant persons vs no screening did not report harms. 17

Key Question 1. How accurate is screening performed by a primary care clinician in identifying adults who are at increased risk of future oral health issues?

Key Question 2. How effective is oral health behavioral counseling provided by a primary care clinician in preventing oral health issues?

Key Question 3. How effective is referral by a primary care clinician to a dental health care provider in preventing oral health issues?

Key Question 4. How effective are preventive interventions in preventing oral health issues?

One fair-quality 25 and 4 poor-quality trials 29 - 32 evaluated topical fluorides (varnish or gels/solutions) vs placebo or no topical fluoride for prevention of dental caries in adults (eTables 5 and 6 in the Supplement ). In all trials, topical fluorides were applied by dental professionals. Sample sizes ranged from 104 to 318 (n = 971). Two trials were conducted in Europe, 2 trials in the US, and 1 trial in Hong Kong. One US trial described water fluoridation status as “optimal,” 32 and the water fluoridation level in Hong Kong is 0.5 ppm F 25 ; water fluoridation status was otherwise not reported. Three studies were published between 1993 to 2021 and two between 1955 to 1979; the older trials may have reduced generalizability to current practice due to marked decreases in caries burden in US adults since the 1970s. 34 Only 1 trial was randomized 25 ; the other trials were nonrandomized or use of randomization was unclear. Methodological limitations in the randomized trial included unclear allocation concealment methods, open-label design, and failure to report attrition or use of intention-to-treat analysis. The nonrandomized trials also had high or unclear attrition and open-label design and unclear baseline similarity of groups; all but 2 trials 30 , 32 did not adjust for potential confounders.

The RCT 25 and 1 nonrandomized trial 30 evaluated sodium fluoride varnish (22 600 ppm F). The other trials evaluated sodium fluoride (2%) solution, 29 stannous fluoride (30%) paste followed by a stannous fluoride (10%) aqueous solution, 31 and acidulated phosphate fluoride (1.2%). 32

Two trials evaluated sodium fluoride varnish (22 600 ppm F) in older adults and reported inconsistent results. 25 , 30 One RCT (n = 104) 25 performed in Hong Kong enrolled older adults (mean age, 79 years) in residential and nursing homes. It found fluoride varnish every 3 months associated with a small, statistically nonsignificant reduction in dental caries burden at 1 year (mean difference in new active caries or fillings, 0.7; P  > .05), although differences were larger and statistically significant at 3 years (mean difference, 1.6; P  < .001). Varnish was also associated with decreased risk of developing new caries (relative risk [RR], 0.25 [95% CI, 0.10-0.63]). A nonrandomized cluster trial (n = 232) 30 of older adults in long-term care facilities (mean age, 84 years) found sodium fluoride varnish (22 600 ppm F) applied every 6 months associated with no difference in caries burden based on DMFT index at 1 year (adjusted mean difference, −0.04 [95% CI, −0.10 to 0.03]).

Three trials evaluated other topical fluorides. 29 , 31 , 32 All were nonrandomized or had unclear randomization methods. Two trials evaluated younger adults. One nonrandomized trial 31 (n = 169) conducted in male college students in Poland (aged 19-20 years) found stannous fluoride (30%) paste followed by stannous fluoride (10%) aqueous solution applied every 6 months associated with lower increase in DMFS index relative to baseline, compared with no treatment at 3 years (6.10 vs 10.54, P  < .01). A nonrandomized trial (n = 148) conducted in women at a military training center in the US (mean age, 22 years; baseline caries status not reported) found sodium fluoride (2%) solution applied semiweekly for 36 months associated with no difference vs placebo (sodium chloride [0.9%]) in number of newly decayed teeth (0.95 vs 1.08, P  = .48) or likelihood of experiencing 1 or more new carious teeth (60% vs 68%; RR, 0.88 [95% CI, 0.68-1.13]) at 8 to 14 months. 29

A US trial (randomization unclear) of adults 60 years or older (mean age not reported; n = 318) living in the community found topical acidulated phosphate fluoride (1.2%) gel applied every 3 months associated with fewer new root caries surface lesions (mean, 1.36 vs 1.99; P  < .05) and lower increase in DMFS index relative to baseline, compared with placebo (mean, 0.27 vs 0.91; P  < .05) at 48 months. 32

Two poor-quality trials (n = 178) evaluated sealants vs no sealants in adults (eTables 7 and 8 in the Supplement ). 26 , 33 The trials evaluated fluoride-containing or non–fluoride-containing light-cured resin-based sealants applied by dental professionals to premolars and molars in young adults. One trial 26 was randomized but did not report allocation concealment methods, and the other trial 33 was nonrandomized. Other methodological limitations included open-label design and failure to report attrition; additionally, the nonrandomized trial did not control for confounders.

A randomized trial (n = 119; 719 tooth pairs) conducted in the US among military recruits (mean age, 22 years) found non–fluoride-containing sealants associated with a statistically nonsignificant reduction in the percentage of teeth with caries, with a low caries rate in both groups (1.7% vs 2.6%; RR, 0.63 [95% CI, 0.31-1.29]). 26 The nonrandomized trial (n = 59; 122 tooth pairs) was conducted in Turkey among dental students. 33 Sealants (fluoride-containing or non–fluoride-containing) were associated with a reduction in the proportion of teeth with caries at 24 months (5.7% vs 25.4%; RR, 0.23 [95% CI, 0.10-0.49]).

Three fair-quality RCTs evaluated SDF topical solution vs placebo for caries prevention (eTable 9 in the Supplement ). 25 , 27 , 28 Sample sizes ranged from 106 to 257 (total n = 590). The trials were conducted among older adults (mean age, 72-80 years) in Hong Kong (water fluoridation level, 0.5 ppm F) and focused on root caries outcomes. Two trials 27 , 28 were restricted to community-dwelling persons and 1 trial 25 included community-dwelling persons and those living in nursing homes. In all trials, 38% SDF solution was administered by a dentist annually. Methodological limitations included unclear allocation concealment, unclear or no masking of clinicians or patients, and high attrition (eTable 10 in the Supplement ).

At 2 to 3 years, SDF use was associated with a decrease in the number of new root caries lesions or fillings vs placebo, with a mean reduction at 24 to 30 months of −0.33 to −0.48 in 2 RCTs 27 , 28 and −1.3 in the other RCT. 25 In the latter trial, the mean difference in new root caries lesions or fillings was −1.8 at 36 months. 25 Two trials also found SDF associated with decreased likelihood of a new root caries lesion (adjusted odds ratio, 0.4 [95% CI, 0.3-0.7] 27 and RR, 0.19 [95% CI, 0.07-0.46] 25 ).

No study evaluated xylitol for prevention.

Key Question 5. What are the harms of specific interventions (behavioral counseling, referral, and preventive interventions) to prevent oral health issues?

Reporting of harms of oral health preventive interventions was very limited. Of 9 trials included for KQ4, 1 trial (n = 235) evaluated fluoride varnish or SDF vs placebo and stated that “no major side effects or discomfort was reported.” 25 Harms were unreported in the other 8 trials.

Evidence on screening was very limited. One randomized trial evaluated a midwife-led oral health screening intervention in pregnant persons but had serious methodological limitations and found no differences in caries outcomes, periodontal disease outcomes, or birth outcomes. 17 Studies on questionnaires for assessing presence of periodontal disease reported moderate diagnostic accuracy but had methodological limitations and included items on prior treatment for periodontal disease (which could limit applicability to screening); in addition, most studies were conducted in non–primary care settings. 17 - 23 No study evaluated the accuracy of primary care relevant questionnaires for identification of dental caries or the accuracy of questionnaires or oral health examination for identifying persons at increased risk for future caries or development of periodontal disease. Evidence on the accuracy of the primary care oral health examination was limited to 1 study that reported high specificity for periodontal disease or dental caries but variable or low sensitivity. 24

Evidence on preventive interventions was also limited. There were no eligible trials of primary care counseling or referral to a dental professional. Regarding preventive interventions, SDF solution was associated with a small decrease in the number of new root caries lesions or fillings vs placebo in older adults, but all studies were conducted in Hong Kong. 25 , 27 , 28 Evidence for sealants (2 trials) 26 , 33 and topical fluorides (5 trials) 25 , 29 - 32 was insufficient, as all trials had serious methodological limitations, with inconsistency in the topical fluoride trials. The trials of preventive interventions did not evaluate periodontal or health outcomes (quality of life, function, or tooth loss) or impact on conditions associated with poor oral health, such as cardiovascular disease. 35 In addition, factors that could potentially affect the effectiveness of oral health preventive interventions, such as water fluoridation levels, provision of oral health education, and oral health behaviors, were not consistently reported. There were no trials of xylitol for prevention and harms of preventive interventions were poorly reported, although serious harms were not described. When used as a treatment to arrest existing caries, SDF is associated with staining of active caries lesions. 36

This review had several limitations. First, non–English-language articles were excluded. However, non–English-language articles likely to affect conclusions were not identified. Second, the review did not search for studies published only as abstracts and did not formally assess for publication bias with graphical or statistical methods for small sample effects, due to small numbers of studies with serious methodological limitations. 37 Third, meta-analysis of preventive interventions was not performed, also due to small numbers of studies with serious methodological limitations. Fourth, the review did not evaluate the effectiveness of tooth brushing or flossing, as these are routinely recommended and performed outside the primary care setting. Rather, the review addressed the effectiveness of oral health counseling, which includes counseling on tooth brushing, flossing, and diet. Fifth, the review included poor-quality trials of preventive interventions, due to the lack of higher-quality evidence. The evidence for preventive interventions addressed only in poor-quality trials was assessed as insufficient. Sixth, some trials of preventive interventions were published more than 25 years ago and all trials of SDF were conducted in China, potentially reducing applicability to current US practice. Importantly, all trials evaluated oral health preventive interventions administered by dental health professionals, with unknown effectiveness and feasibility in primary care. Barriers to provision of oral health preventive interventions in primary care include uncertain acceptability and uptake; potential need for additional training and equipment, particularly for sealants; and uncertain reimbursement. 38 , 39

Screening questionnaires were associated with moderate diagnostic accuracy for periodontal disease. Research is needed to determine benefits and harms of primary care screening and oral health preventive interventions.

Accepted for Publication: September 22, 2023.

Published Online: November 7, 2023. doi:10.1001/jama.2023.20685

Corresponding Author: Roger Chou, MD, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code BICC, Portland, OR 97239 ( [email protected] ).

Author Contributions: Dr Chou had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Chou.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Chou, Selph, Bougatsos, Ahmed, Schwarz.

Critical review of the manuscript for important intellectual content: Chou, Bougatsos, Nix, Griffin, Schwarz.

Statistical analysis: Chou, Griffin.

Obtained funding: Chou, Bougatsos.

Administrative, technical, or material support: Bougatsos, Griffin, Schwarz.

Supervision: Chou, Bougatsos.

Conflict of Interest Disclosures: None reported.

Funding/Support: This research was funded under contract 75Q80120D00006, Task Order 75Q80121F32009, from the Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human Services, under a contract to support the USPSTF.

Role of the Funder/Sponsor: Investigators worked with USPSTF members and AHRQ staff to develop the scope, analytic framework, and key questions for this review. AHRQ had no role in study selection, quality assessment, or synthesis. AHRQ staff provided project oversight, reviewed the report to ensure that the analysis met methodological standards, and distributed the draft for peer review. Otherwise, AHRQ had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The opinions expressed in this document are those of the authors and do not reflect the official position of AHRQ or the US Department of Health and Human Services.

Additional Contributions: We gratefully acknowledge the AHRQ Medical Officer (Sheena Harris, MD, MPH). The USPSTF members, expert consultants, peer reviewers, and federal partner reviewers did not receive financial compensation for their contributions.

Additional Information: A draft version of this evidence report underwent external peer review from 3 content experts (Hugh Silk, MD, MPH [Department of Family Medicine and Community Health, University of Massachusetts Medical School; Center for Integration of Primary Care and Oral Health, Harvard University]; Robert Weyant, MD, MDM, DrPH [Department of Dental Public Health, University of Pittsburgh School of Dental Medicine]; Christine Riedy, PhD, MPH [Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine]) and 4 federal partner reviewers from the Centers for Disease Control and Prevention (1 reviewer) and the National Institute of Dental and Craniofacial Research (3 reviewers). Comments from reviewers were presented to the USPSTF during its deliberation of the evidence and were considered in preparing the final evidence review.

Editorial Disclaimer: This evidence report is presented as a document in support of the accompanying USPSTF recommendation statement. It did not undergo additional review after submission to JAMA .

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Announcing the NeurIPS 2023 Paper Awards 

Communications Chairs 2023 2023 Conference awards , neurips2023

By Amir Globerson, Kate Saenko, Moritz Hardt, Sergey Levine and Comms Chair, Sahra Ghalebikesabi 

We are honored to announce the award-winning papers for NeurIPS 2023! This year’s prestigious awards consist of the Test of Time Award plus two Outstanding Paper Awards in each of these three categories: 

• Two Outstanding Main Track Papers 
• Two Outstanding Main Track Runner-Ups 
• Two Outstanding Datasets and Benchmark Track Papers  

This year’s organizers received a record number of paper submissions. Of the 13,300 submitted papers that were reviewed by 968 Area Chairs, 98 senior area chairs, and 396 Ethics reviewers 3,540  were accepted after 502 papers were flagged for ethics reviews . 

We thank the awards committee for the main track: Yoav Artzi, Chelsea Finn, Ludwig Schmidt, Ricardo Silva, Isabel Valera, and Mengdi Wang. For the Datasets and Benchmarks track, we thank Sergio Escalera, Isabelle Guyon, Neil Lawrence, Dina Machuve, Olga Russakovsky, Hugo Jair Escalante, Deepti Ghadiyaram, and Serena Yeung. Conflicts of interest were taken into account in the decision process.

Congratulations to all the authors! See Posters Sessions Tue-Thur in Great Hall & B1-B2 (level 1).

Outstanding Main Track Papers

Privacy Auditing with One (1) Training Run Authors: Thomas Steinke · Milad Nasr · Matthew Jagielski

Poster session 2: Tue 12 Dec 5:15 p.m. — 7:15 p.m. CST, #1523

Oral: Tue 12 Dec 3:40 p.m. — 4:40 p.m. CST, Room R06-R09 (level 2)

Abstract: We propose a scheme for auditing differentially private machine learning systems with a single training run. This exploits the parallelism of being able to add or remove multiple training examples independently. We analyze this using the connection between differential privacy and statistical generalization, which avoids the cost of group privacy. Our auditing scheme requires minimal assumptions about the algorithm and can be applied in the black-box or white-box setting. We demonstrate the effectiveness of our framework by applying it to DP-SGD, where we can achieve meaningful empirical privacy lower bounds by training only one model. In contrast, standard methods would require training hundreds of models.

Are Emergent Abilities of Large Language Models a Mirage? Authors: Rylan Schaeffer · Brando Miranda · Sanmi Koyejo

Poster session 6: Thu 14 Dec 5:00 p.m. — 7:00 p.m. CST, #1108

Oral: Thu 14 Dec 3:20 p.m. — 3:35 p.m. CST, Hall C2 (level 1) 

Abstract: Recent work claims that large language models display emergent abilities, abilities not present in smaller-scale models that are present in larger-scale models. What makes emergent abilities intriguing is two-fold: their sharpness, transitioning seemingly instantaneously from not present to present, and their unpredictability , appearing at seemingly unforeseeable model scales. Here, we present an alternative explanation for emergent abilities: that for a particular task and model family, when analyzing fixed model outputs, emergent abilities appear due to the researcher’s choice of metric rather than due to fundamental changes in model behavior with scale. Specifically, nonlinear or discontinuous metrics produce apparent emergent abilities, whereas linear or continuous metrics produce smooth, continuous, predictable changes in model performance. We present our alternative explanation in a simple mathematical model, then test it in three complementary ways: we (1) make, test and confirm three predictions on the effect of metric choice using the InstructGPT/GPT-3 family on tasks with claimed emergent abilities, (2) make, test and confirm two predictions about metric choices in a meta-analysis of emergent abilities on BIG-Bench; and (3) show how to choose metrics to produce never-before-seen seemingly emergent abilities in multiple vision tasks across diverse deep networks. Via all three analyses, we provide evidence that alleged emergent abilities evaporate with different metrics or with better statistics, and may not be a fundamental property of scaling AI models.

Outstanding Main Track Runner-Ups

Scaling Data-Constrained Language Models Authors : Niklas Muennighoff · Alexander Rush · Boaz Barak · Teven Le Scao · Nouamane Tazi · Aleksandra Piktus · Sampo Pyysalo · Thomas Wolf · Colin Raffel

Poster session 2: Tue 12 Dec 5:15 p.m. — 7:15 p.m. CST, #813

Oral: Tue 12 Dec 3:40 p.m. — 4:40 p.m. CST, Hall C2 (level 1)  

Abstract : The current trend of scaling language models involves increasing both parameter count and training dataset size. Extrapolating this trend suggests that training dataset size may soon be limited by the amount of text data available on the internet. Motivated by this limit, we investigate scaling language models in data-constrained regimes. Specifically, we run a large set of experiments varying the extent of data repetition and compute budget, ranging up to 900 billion training tokens and 9 billion parameter models. We find that with constrained data for a fixed compute budget, training with up to 4 epochs of repeated data yields negligible changes to loss compared to having unique data. However, with more repetition, the value of adding compute eventually decays to zero. We propose and empirically validate a scaling law for compute optimality that accounts for the decreasing value of repeated tokens and excess parameters. Finally, we experiment with approaches mitigating data scarcity, including augmenting the training dataset with code data or removing commonly used filters. Models and datasets from our 400 training runs are freely available at https://github.com/huggingface/datablations .

Direct Preference Optimization: Your Language Model is Secretly a Reward Model Authors: Rafael Rafailov · Archit Sharma · Eric Mitchell · Christopher D Manning · Stefano Ermon · Chelsea Finn

Poster session 6: Thu 14 Dec 5:00 p.m. — 7:00 p.m. CST, #625

Oral: Thu 14 Dec 3:50 p.m. — 4:05 p.m. CST, Ballroom A-C (level 2)  

Abstract: While large-scale unsupervised language models (LMs) learn broad world knowledge and some reasoning skills, achieving precise control of their behavior is difficult due to the completely unsupervised nature of their training. Existing methods for gaining such steerability collect human labels of the relative quality of model generations and fine-tune the unsupervised LM to align with these preferences, often with reinforcement learning from human feedback (RLHF). However, RLHF is a complex and often unstable procedure, first fitting a reward model that reflects the human preferences, and then fine-tuning the large unsupervised LM using reinforcement learning to maximize this estimated reward without drifting too far from the original model. In this paper, we leverage a mapping between reward functions and optimal policies to show that this constrained reward maximization problem can be optimized exactly with a single stage of policy training, essentially solving a classification problem on the human preference data. The resulting algorithm, which we call Direct Preference Optimization (DPO), is stable, performant, and computationally lightweight, eliminating the need for fitting a reward model, sampling from the LM during fine-tuning, or performing significant hyperparameter tuning. Our experiments show that DPO can fine-tune LMs to align with human preferences as well as or better than existing methods. Notably, fine-tuning with DPO exceeds RLHF’s ability to control sentiment of generations and improves response quality in summarization and single-turn dialogue while being substantially simpler to implement and train.

Outstanding Datasets and Benchmarks Papers

In the dataset category : 

ClimSim: A large multi-scale dataset for hybrid physics-ML climate emulation

Authors:  Sungduk Yu · Walter Hannah · Liran Peng · Jerry Lin · Mohamed Aziz Bhouri · Ritwik Gupta · Björn Lütjens · Justus C. Will · Gunnar Behrens · Julius Busecke · Nora Loose · Charles Stern · Tom Beucler · Bryce Harrop · Benjamin Hillman · Andrea Jenney · Savannah L. Ferretti · Nana Liu · Animashree Anandkumar · Noah Brenowitz · Veronika Eyring · Nicholas Geneva · Pierre Gentine · Stephan Mandt · Jaideep Pathak · Akshay Subramaniam · Carl Vondrick · Rose Yu · Laure Zanna · Tian Zheng · Ryan Abernathey · Fiaz Ahmed · David Bader · Pierre Baldi · Elizabeth Barnes · Christopher Bretherton · Peter Caldwell · Wayne Chuang · Yilun Han · YU HUANG · Fernando Iglesias-Suarez · Sanket Jantre · Karthik Kashinath · Marat Khairoutdinov · Thorsten Kurth · Nicholas Lutsko · Po-Lun Ma · Griffin Mooers · J. David Neelin · David Randall · Sara Shamekh · Mark Taylor · Nathan Urban · Janni Yuval · Guang Zhang · Mike Pritchard

Poster session 4: Wed 13 Dec 5:00 p.m. — 7:00 p.m. CST, #105 

Oral: Wed 13 Dec 3:45 p.m. — 4:00 p.m. CST, Ballroom A-C (level 2)

Abstract: Modern climate projections lack adequate spatial and temporal resolution due to computational constraints. A consequence is inaccurate and imprecise predictions of critical processes such as storms. Hybrid methods that combine physics with machine learning (ML) have introduced a new generation of higher fidelity climate simulators that can sidestep Moore’s Law by outsourcing compute-hungry, short, high-resolution simulations to ML emulators. However, this hybrid ML-physics simulation approach requires domain-specific treatment and has been inaccessible to ML experts because of lack of training data and relevant, easy-to-use workflows. We present ClimSim, the largest-ever dataset designed for hybrid ML-physics research. It comprises multi-scale climate simulations, developed by a consortium of climate scientists and ML researchers. It consists of 5.7 billion pairs of multivariate input and output vectors that isolate the influence of locally-nested, high-resolution, high-fidelity physics on a host climate simulator’s macro-scale physical state. The dataset is global in coverage, spans multiple years at high sampling frequency, and is designed such that resulting emulators are compatible with downstream coupling into operational climate simulators. We implement a range of deterministic and stochastic regression baselines to highlight the ML challenges and their scoring. The data (https://huggingface.co/datasets/LEAP/ClimSim_high-res) and code (https://leap-stc.github.io/ClimSim) are released openly to support the development of hybrid ML-physics and high-fidelity climate simulations for the benefit of science and society.   

In the benchmark category :

DecodingTrust: A Comprehensive Assessment of Trustworthiness in GPT Models

Authors: Boxin Wang · Weixin Chen · Hengzhi Pei · Chulin Xie · Mintong Kang · Chenhui Zhang · Chejian Xu · Zidi Xiong · Ritik Dutta · Rylan Schaeffer · Sang Truong · Simran Arora · Mantas Mazeika · Dan Hendrycks · Zinan Lin · Yu Cheng · Sanmi Koyejo · Dawn Song · Bo Li

Poster session 1: Tue 12 Dec 10:45 a.m. — 12:45 p.m. CST, #1618  

Oral: Tue 12 Dec 10:30 a.m. — 10:45 a.m. CST, Ballroom A-C (Level 2)

Abstract: Generative Pre-trained Transformer (GPT) models have exhibited exciting progress in capabilities, capturing the interest of practitioners and the public alike. Yet, while the literature on the trustworthiness of GPT models remains limited, practitioners have proposed employing capable GPT models for sensitive applications to healthcare and finance – where mistakes can be costly. To this end, this work proposes a comprehensive trustworthiness evaluation for large language models with a focus on GPT-4 and GPT-3.5, considering diverse perspectives – including toxicity, stereotype bias, adversarial robustness, out-of-distribution robustness, robustness on adversarial demonstrations, privacy, machine ethics, and fairness. Based on our evaluations, we discover previously unpublished vulnerabilities to trustworthiness threats. For instance, we find that GPT models can be easily misled to generate toxic and biased outputs and leak private information in both training data and conversation history. We also find that although GPT-4 is usually more trustworthy than GPT-3.5 on standard benchmarks, GPT-4 is more vulnerable given jailbreaking system or user prompts, potentially due to the reason that GPT-4 follows the (misleading) instructions more precisely. Our work illustrates a comprehensive trustworthiness evaluation of GPT models and sheds light on the trustworthiness gaps. Our benchmark is publicly available at https://decodingtrust.github.io/.

Test of Time

This year, following the usual practice, we chose a NeurIPS paper from 10 years ago to receive the Test of Time Award, and “ Distributed Representations of Words and Phrases and their Compositionality ” by Tomas Mikolov, Ilya Sutskever, Kai Chen, Greg Corrado, and Jeffrey Dean, won. 

Published at NeurIPS 2013 and cited over 40,000 times, the work introduced the seminal word embedding technique word2vec. Demonstrating the power of learning from large amounts of unstructured text, the work catalyzed progress that marked the beginning of a new era in natural language processing.

Greg Corrado and Jeffrey Dean will be giving a talk about this work and related research on Tuesday, 12 Dec at 3:05 – 3:25 pm CST in Hall F.  

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