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HOWTO: Get Your Teeth Fixed in Mexico

By localroger in Culture
Sat Dec 20, 2003 at 06:36:52 PM EST
Tags: Culture (all tags)

In the United States, major dental work can be financially ruinous. Without belaboring the lively political topic of why this is, I am here to report that it is possible for a US resident to save 75% or more on major dental work by the simple expedient of having it done in Mexico.

Inside, my story and practical details for others whose dentists may be about to give them a nasty surprise.

My Story

About a year ago I went to have my first dental checkup in nearly two years. My dentist didn't even bother to X-ray my front teeth. He hung the back X-rays up for me to see, comparing them with my two year old X-rays, and announced "if you don't have these teeth capped soon, you are going to lose them."

"And how much does that cost?" I asked. Two years before, Dr. S had tried to sell me a splint to ward off the effects of my bruxism (teeth grinding). But I couldn't figure out how this $125 implement was supposed to help and he didn't really explain it, so I passed on it.

"Seven hundred and fifteen dollars per tooth," he said with what I hope wasn't really the I-told-you-so air I seem to remember in his voice. "At a minimum, we need to cap these five, which are almost down to the nerve, immediately." To "cap" or "crown" a tooth, the dentist grinds the original dooth down to a post or cone shape, and creates a sculptured replacement tooth which is cemented to this sculpted receiving surface. I would later learn that $715 is actually a very reasonable rate in the US; I've spoken to people who paid from $850 to $1,400 for the same procedure, and to only one whose rurally located dentist charged "only" $650.

I had a once-slight underbite which was no longer slight. My top teeth were sliding down behind my lower teeth instead of meeting them, and my back teeth were all worn down to varying degrees so that the tips of my incisors nearly met the opposing gums. All in all I had seven front teeth that weren't disastrously worn -- and they were badly misaligned, as well as discolored.

What Dr. S was proposing was nearly four thousand dollars worth of work which would be little more than a stopgap measure, leaving me with the same messed up bite and at least 15 more teeth waiting to give me trouble in the future. I really couldn't see spending that much money to end up with the same problem. Getting them all pulled and having dentures made was looking like a very reasonable alternative.

It was obvious to me, even though Dr. S didn't seem interested in telling me, that what I really needed was to have all of my teeth capped at the same time so that instead of simply duplicating my messed-up condition, my bite could be elevated and corrected. I didn't know it at the time but this is a somewhat standard procedure called "full mouth rehabilitation." If Dr. S considered me a candidate for such a procedure, he probably figured I was too cheap to pony up for it -- which was at least partially true.

I mentally multiplied $715 by 28 and groaned. Either my teeth were about to become the most expensive thing I ever owned, or I was going to lose them and likely have to start wearing dentures at the age of 39.

The Idea

Some of you may remember that one of the good things that happened to me during the rollercoaster year of 2003 is that a nice person gave me a perfectly driveable 1982 Chevy van. The nice lady who gave us the van did so because she had only recently become a nice lady instead of a nice guy after her sex change operation. And the van, as she said, "just wasn't me any more." In the process of collecting this gift we heard her story, which included how she had travelled to Thailand to have both her sex reassignment and gender enhancement surgery performed, because it was so much cheaper and there was no waiting list there.

A few days after getting the news from my dentist I put the words "Dentistry" and "Thailand" into Google and my jaw hit the floor. The ceramic-over-metal caps my dentist wanted $715 for could be had for $125 at several places that would even make my appointment and plot my course of treatment over the Internet.

It was still an iffy proposition, though, what with that $3,000 round-trip airfare to consider.

Thinking of other places, I remembered that Costa Rica has one of the best medical systems anywhere and is also much cheaper than the USA. Googling "Dentistry" and "Costa Rica" revealed that I could have the services of a world-class expert who had a lot more experience than Dr. S, at $350 per tooth.

I have to admit it was the girlfriend elsewhere known as "Y" who thought of Mexico. Once again we found tales of $120 caps, and of an entire industry catering to American medical tourists. In several places along the US-Mexico border, clusters of dentists operate within convenient driving distance so that an inexpensive bus tour from Las Vegas or a trolley ride from San Diego could bring you to where this cheap care was available.

Nowhere did we find a horror story -- indeed, everything we read was very enthusiastic. We did research and began to lay plans.

Who Should Consider This?

First of all, if you live any distance from the Mexico border you should need a fair amount of work -- at least two or three caps, or bridgework or some similar work that would run a few thousand dollars at home. Depending on what you need done it is likely to take three or more trips to complete your course of treatment, and it's silly to let travel expenses eat your savings.

Second, you may want to be wary of any procedure that involves major anesthesia, such as removing impacted wisdom teeth. The drug laws make it practically impossible for a Mexican dentist to prescribe the most potent pain therapies for you; an American pharmacist can't fill the prescription, and you can't bring scheduled drugs back across the border if you fill it in Mexico. On the other hand there is also a lively cosmetic surgery business operating in the same way, doing liposuction and facelifts and similar procedures, so there may be a way to deal with this. It might involve staying in Mexico for a few days to recover; more on that below. My procedure was extensive but involved no drugs other than novacaine and antibiotic mouthwash.

Third, the work you need should not be just-invented cutting-edge stuff. Most Mexican dentists will have access to state of the art adhesives, crown and facing materials, whitening agents, and so on; but only the top tier will have lasers, computer models, and other recently introduced high-tech tools. While my procedure was extensive it was done entirely with equipment that hasn't changed much since 1950.

Finally, you should be able to take the time off of work for the travel and "slop" days you'll want to schedule in case something needs retouching. Like the travel itself, the lost work can quickly eat up your savings on a modest job that requires multiple trips.

How do you Find a Dentist?

I did not do this, but most of the people who have had dental work done in Mexico tell you to go to Tijuana or wherever it is convenient and look for a dentist. If you live in the Southwest you can probably find a tour service that will make travel arrangements for such a "dental vacation." And if you just have one tooth that needs a cap or similar minor work and you live within easy travel distance of a Mexican dental destination, it might even make sense.

I have never felt comfortable taking such an informal approach with something so expensive and important, though. I had to travel over a thousand miles and take significant time off of work, so I wanted to know what I was getting into before getting on an airplane. So I waited to find a dentist who had e-mail. This is still an unusual thing among Mexican dentists but I expect it to catch on fast. This way you can e-mail photos and X-rays, and make travel accommodations sensibly. I found Dr. T in Tijuana, which is not very close to New Orleans but makes for very convenient air transportation from just about anywhere in the US.

If anyone reading this needs work like mine done, e-mail me in private and I'll refer you to Dr. T. But if you Google for tijuana-dental you will probably find him anyway.

Once I sent him my X-rays and photos of my teeth, Dr. T confirmed my own self-diagnosis and told me about "total oral rehabilitation." He gave me several references who had had very similar work done, and indeed on my first visit he showed me a study model of another patient whose condition was nearly identical to my own.

How Long Does This Take, and How Much Does it Cost?

I had to send Dr. T my physical X-rays, since scanning them doesn't do justice to the details. Like all the dentists I contacted about this he warned me that I would probably need an unknown number of root canals in addition to 28 caps. (Depending on one's condition, bridgework and facing may also be part of the mix.)

Generally, it takes five days or so to make a cap, so you need two visits -- one to prepare your mouth, and one to install the cap. The days in between can be vacation time in your strange destination or you can go back home, whichever makes more sense.

In my case the extensiveness of the problem meant that before Dr. T could make caps, he had to make a study model of my mouth and plan a course of action. He did not use any computer models to do this -- it was all done with impressions, casts, and plaster models. He also had to verify, as I suspected from my local dentist, that I didn't need any root canals after all. Root canals greatly stretch out your treatment because it's unwise to do more than one or two at a time. They also add cost, because the root canal (extracting the diseased nerve tissue and replacing it with inert material) must be followed by inserting posts into the tooth to receive the cap. So you still have the cap, plus the posts, plus the root canal. This is why some people who have this kind of work done in the US end up spending $40,000 on their teeth.

The study model delay meant that my eight-day stay wasn't long enough to have caps made and installed, so my first visit to SoCal was almost a pure vacation -- or it would have been, if half of San Diego County hadn't burned while I was there. My advice is to plan the first trip as a short one for your dentist to inspect your condition and create a plan of attack.

Trip #2 was originally going to be to completely prepare and finish about half of my teeth, so I booked another week in San Diego. After further study, though, Dr. T decided to do everything at once; trip #2 would be all preparation, and I'd have to wear temporary (plastic) caps while my real caps were being made. In this way my bite could be corrected all at once. Alas, the airline reservations were already made so once again I spent a couple of extra days out of town.

Trip #3 was to be a short one to install the caps and perform adjustments, but by now I was used to spending a week in San Diego so I did it again. This gave me a chance to try out my new teeth at some of the great restaurants I'd discovered on trip #1.

Meanwhile, the basic cost for work which would have run at least $20,000 in the US was around $8,000. Even with all the travel and lost work I have saved between $10,000 and $20,000 by doing it this way.

How Do You Get There?

If you live in the US Southwest you have several options, but the simplest thing if you live any distance away seems to be to fly to San Diego and get the work done in Tijuana. That's what I did, so that's what I'll describe. (If you have a similar experience with another destination, please do comment on it.)

The key to using San Diego as a gateway is the Blue Line Trolley, a high-performance public transit system that goes all the way from north San Diego to the border. Having travelled the entire Blue Line scouting for hotels I can save you a lot of work and grief by telling you to stay on E street in Chula Vista:

  • You can find a hotel in the $40 to $80 a night range. A Best Western, Days Inn, and Motel 6 are located within rock-throwing distance of the E Street trolley terminal. Elsewhere the hotels are either very expensive ($120 a night and up in San Diego) or a real hike from the trolley.
  • Cab fare to and from the airport is a reasonable $25 or so. If you're adventurous you can also take the 992 bus from the airport to the America Plaza trolley stop, but it's a pain to do that with luggage.
  • At the E street trolley stop there is a tourist information center that can tell you how to get anywhere with public transit, sell you discount tickets to things like the zoo and Seaworld, and so forth.
  • The E street hotels are a manageable walk or short bus ride from a public library which offers free unfiltered Internet access. While there is a library just off one of the northern trolley stops, the Internet access is limited.
There are vending machines at the trolley terminal. You can get a one-way or round-trip pass for a few dollars based on your starting and ending destinations, or a "day tripper" that gives you unlimited riding on all the trolleys and buses for $5.00. You can also get discounted Day Trippers for two three, and four days, with four days coming in at $15.00. (You can also pay the San Diego Stupid People Tax by buying a one day round trip ticket from San Ysidro to the opposite end of the line at Mission San Diego, which they will cheerfully sell you for $6.00 -- a buck more than the unlimited use day pass. Go figure.) You can get a lot more transit information online

The trolley has no access controls. Just buy your ticket, stand on the appropriate platform for the direction you want to go, and when the trolley shows up press the button to open the door and climb aboard. They do random spot checks for tickets, and you can expect to pay a hefty fine if you game the system by riding ticketless. I've experienced four of these spot checks in the time I've spent riding.

Once you reach the border, follow the stream of humanity into the spiral ramp building to the pedestrian bridge over the border. On the ground on the other side you'll pass through two turnstiles, and find yourself at a cab stand.

Do not try to walk from the border into Tijuana. Trust me on this. My dentist e-mailed me a map and said to show it to the taxi driver, but he did not count on the fact that a lot of taxi drivers in Tijuana can't read. You need the local map yourself, but find a landmark on it. In my case the Plaza Rio shopping center was the thing every taxi driver knew, with a convenient taxi stand to catch one going back to the border, and about two blocks from my dentist. When you go through the turnstile you will be beckoned by eager taxi hawkers. Ask one of them "How much to Plaza Rio?" (or wherever your dentist is near.) Always get the price first in Tijuana. Border to Plaza Rio should be five dollars, and it's well worth it even though it's a short ride. The area around the border in Tijuana is unbelievably snarled and confusing.

On your return, tell the cabbie "to the border" and you will be dropped off at an entirely different place. Again follow the sidewalk and the drift of people to the customs station. You will have to go through a metal detector and show your ID to an immigration official. You do not need a passport, but I have one so that's what I used. At some peak periods there are long lines; if you make the mistake of taking your car there are always long lines of traffic.

While you are in the Plaza Rio area, you can shop for your one permitted bottle of cheap liquor at the Comercial Mexicana (think "Mexican Super Wal-Mart") in the Plaza Rio Mall, which is about 30% cheaper than the tourist traps in walking distance of the border. Every business in Tijuana seems to take US currency, and most are used to dealing with gringos like me whose entire Spanish vocabulary consists of "por favor," "gracias," "si," and "non." If you buy rum or tequila make sure it isn't made in Cuba -- Mexico trades with them, but the US customs people will take it from you at the border.

What Other Ways Are There?

If you have or rent a car, do not take it into Mexico. This is a Very Bad Idea for a lot of reasons. You can park at several places along the route between San Diego and Tijuana which offer bus service into Tijuana, but most of these will drop you off at a place where you will be mobbed by vendors trying to sell you stuff, and probably not very convenient to your dentist. Frankly I think you'd be better off parking at the Beyer Street trolley stop in San Ysidro and buying a round trip ticket.

There is also a bus which has stops much more convenient to the hotels along I-5 in San Ysidro, but most of the buses only offer half-hour service while the trolley offers 15 minute service most of the day. The closer you stay to the border the more expensive it is to get to your hotel from the airport, too.

The border is not a pleasant place; it's the economic version of an "edge ecology." Edges where different environments meet make for interesting animal and plant species, because you get all kinds of specialized predators and prey adaptations. If you are going to Tijuana to spend thousands of dollars on your teeth, there is a wide array of predators ranging from the over-aggressive merchant to the pickpocket who will want your money. My advice is to limit their access to you. For the same reason I advise even more strongly against staying in Tijuana itself unless you are very comfortable with the language and culture.

Even Chula Vista may be a little close for some peoples' comfort; it's a stereotypical Southern California city that has grown too fast, planted in the desert where there is no particular reason for humans to live, overpopulated with disaffected youth and poor people who struggle to pay the outrageous rents. There is a lot of evidence of gang activity. The inexpensive hotels on E street get a bit rowdy on the weekend. It was within my comfort zone but then I once lived in a similarly blighted neighborhood in New Orleans. The main thing is to use common sense and avoid looking too affluent.

How Will the Work Go?

Here is where one caveat is in order. If you expect a medical facility to be in a nice glass and concrete building with Muzak drifting from hidden speakers and a statuesque receptionist, you're going to be in for a bit of a shock. Dr. T's office was small, in a building that needed some obvious repairs that were never going to happen. The trimwork was uneven. And the receptionist doubled as his dental assistant, so she sometimes had to leave my ongoing procedure to answer the phone.

This is all, however, in keeping with the Third World philosophy of putting the money where it's needed. The equipment was all in good working order, everything was clean, and most of all I was very impressed with both the doctor's bedside manner and his skill. After examining me on my first visit he explained exactly what he was going to do, and added up how much it would cost before breaking out the novacaine.

Another item is interesting. He said that, normally, as part of an oral rehabilitation procedure that my wisdom teeth would be extracted as a hygienic measure, because they can't be capped. (Think of where they are, and the size of the tools.) I balked at this, because my wisdom teeth are one of the things my body has managed to get right. They all came in perfectly and have never presented a problem, except for their participation in the bruxism disaster. Where I'm sure an American dentist would have said "no, they need to come out," Dr. T asked a couple more questions and finally said there wasn't really any need to pull them now; if they ever become a problem I can always have them pulled. And furthermore, once the pressure is off of them because the other teeth are crowned, they'll tend to rise, making them easier to extract in the future. That settled it, and at the moment I still have my wisdom teeth.

It was clear to me that Dr. T was very experienced. He performed all aspects of my rather complicated procedure with a manner of unhurried confidence. A procedure like mine is as much an art as it is a medical procedure; working with hand tools the dentist must sculpt the living teeth into appropriate shape to receive caps, and then must create caps which are not copies of existing teeth but instead are an original sculpture which must both look good and function mechanically for eating. It may be important to note that Dr. T is not at the bottom of the Tijuana price scale; while there are dentists who will do a single cap for $120 he is not one of them. His prices run $280 to $350, and no doubt reflect his experience.

On my first visit Dr. T cleaned my teeth and took impressions; it then took him awhile to make the study model and plan my treatment. On my second visit to San Diego I made two trips to Dr. T's office, spending about 4.5 hours each time as he prepared my teeth and took more impressions. On my final trip, as I walked in he told me "yours was an especially difficult case." In addition to the grinding down my TMJ (jaw joint) had worn so that my jaw was a tiny bit to the left of where it is supposed to be. Nevertheless he felt that with a couple of caveats my new bite would be acceptable. After about 3 hours of work he announced that the caps were in, and while we would still need to adjust my occlusion I could now see how they would look.

What I saw in the mirror made me gasp. My teeth weren't just acceptable; for all intents and purposes they were perfect. Although I could see the "cheats" Dr. T had had to accept in order to make my teeth meet, they are not apparent to anyone who isn't an expert. My teeth which had never been straight or properly aligned even in my childhood now looked like the "after" image from a toothpaste commercial.

That night I ate a steak at the Stuart Anderson's in Chula Vista. (I had been planning to go downtown on the trolley and eat at Ruth's Chris, but I was just too tired.) After three weeks of eating mush and liquid food because the plastic temporaries didn't function very well, and sensing with every bite how my new teeth met properly, I think that is the single most enjoyable steak I have ever eaten.

Paying For It

The logistics of payment are pretty much the same as they are in the US. Dr. T accepts all major credit cards, and that's how I paid him. He also will arrange payment plans and accepts US dental insurance. It's worth mentioning that even if you have dental insurance, it won't cover a procedure like this in full; you will probably still save a lot of money by going to Mexico. It's worth checking with your provider.

Dr. T quoted me a price in dollars and accepted payment in dollars. This seems to be fairly standard in Tijuana. At the Comercial Mexicana, the cash registers do automatic currency conversion and they keep American change.

What Else Is There To Do?

On your recuperative and slop days in San Diego, there is plenty to do.

You can take the trolley from Chula Vista to the College Station stop, then walk up C street and catch the #7 bus (or just walk north another half-mile) to Balboa Park and the world-famous San Diego Zoo. You can easily spend a week on the attractions at Balboa Park. The zoo alone can fill a couple of days, and you won't want to miss the aerospace museum with its SR-71 Blackbird mounted on a pylon out front or the automotive museum with its actual Tucker Torpedo. I also highly recommend the Model Railroad Museum, which is much more impressive than you might guess even though it's a work in progress. There is excellent (if expensive) food both at the zoo and in the park, or you can bring your own and picnic.

You can also take the trolley to the Little Italy exit, walk to the waterfront, and explore antique ships at the Maritime Museum. If you're into steampunk the 140 year old metal sailing ship Star of India will make you swoon. And hopefully there'll be someone aboard the Berkeley who can run its triple-expansion steam engine for you to admire. You can also board the Surprise, the boat featured in the film Master and Commander which they recently acquired on loan.

Or you can take the trolley to Old Town, cross the tracks and catch the #9 bus to Seaworld and see Shamu. (Frankly I was more impressed by the penguins than the orcas, but that's just me.) Be warned, the food at Seaworld is just expensive, and you can't bring your own. You can get two small free beers from the Budweiser pavilion, though.

If you want to catch a movie, take the trolley up to the Fashion Valley stop where there is a large mall with a nice stadium-style cinema. (I made the mistake of seeing The Matrix Revolutions there.) There is also other shopping at the stops north of Fashion Valley if you want to go exploring.

Or you can just walk across the Chula Vista I-5 overpass to the parking lot for the nature center, and catch the free shuttle to the interpretive center. If you're into birdwatching you can spend a whole day or more there at Gunpowder Point, looking up shorebirds in your field guide.

You can also schedule a tour of the wineries (with samples!) or a boat trip in San Diego Bay. The tourist center in Chula Vista was amazingly helpful, right down to reminding me of the bus connections I'd need.

So how did it come out?

Since a picture is worth a thousand words, here are the ones Dr. T took of my teeth:

  • Before (warning, image may cause loss of appetite)
  • After
I have noted with interest that a lot of online brag pages for dentists show off rehabilitations that didn't come out as good as mine. I credit that partly with the fact that I got to Dr. T before there was serious root damage -- it was another dentist's warning, not pain, that sent me on this quest. But a lot of it goes to Dr. T's very high level of skill and expertise. In particular, he completely fixed my underbite. If I didn't see it in the mirror, I wouldn't have believed it to be possible. Dr. T is the very opposite of a "discount" dentist, even if his rates were unbelievably low compared to US dentists.

If you've read this far, one thing I can't stress enough is to go to the dentist once in awhile. The amount of grief a thing like this can cause increases exponentially past a certain point; catching it as early as possible is key. One dentist I talked to in Costa Rica had a patient similar to me who was flying down from Alaska once a month for five months to complete his treatment. In my case it came on suddenly late in life, due almost certainly to work related stress. According to Dr. T, my X-rays show that four years ago my teeth were in pretty good shape. Between the ages of 35 and 39 everything went to hell, and because I skipped going to the dentist for two years it went to hell more than it needed to before I realized drastic action was necessary. The occasional checkup can make the difference between minor work, a smile that can be saved with major effort such as I just did -- or dentures, and all the hassle that entails.


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Display: Sort:
HOWTO: Get Your Teeth Fixed in Mexico | 163 comments (161 topical, 2 editorial, 6 hidden)
Invitation for Comments (2.71 / 7) (#1)
by localroger on Sat Dec 20, 2003 at 12:13:46 PM EST

I realize this is a bit US-centric, but there are other destinations accessible from other places to realize similar savings. Dental work also isn't the only thing you can save on by crossing a border. If you have a story of some other border crossed to save money on health care, please share it with us, either in a comment here or another story. It's a small idea that can make a major difference for someone who is in a bind.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
Lasik? (none / 3) (#42)
by emmons on Sun Dec 21, 2003 at 03:10:44 AM EST

I've heard that there's an enormous amount of money to be saved by having lasik and other eye surgeries done in other countries.. some day I will look into it as I have terrible eyes that badly need correction.

In the beginning the universe was created. This has made a lot of people angry and been widely regarded as a bad move.
-Douglas Adams

[ Parent ]
You can get it done cheaply ... (none / 2) (#45)
by alecsmare on Sun Dec 21, 2003 at 06:00:12 AM EST

... in Romania. In my hometown a laser surgery to correct nearsightedness costs about $600 per eye.

Dental work is also pretty cheap here ... I payed about $30 for a nice filling at the best dentist I could find :)

A flash of light, a cloud of dust and ... what was the question?

[ Parent ]

LASIK is getting pretty cheap in the US (none / 3) (#54)
by localroger on Sun Dec 21, 2003 at 09:37:19 AM EST

The interesting thing about LASIK is that once you have the machine, improvements in the procedure are almost all software. GF had her eyes done a few years ago when it was still $2,000 an eye, and she swears it's the best thing she ever did for herself. Nowadays local doctors are advertising LASIK at $600 an eye and are correcting an ever-larger range of defects.

There was a period a year or two ago when LASIK was also significantly cheaper in Mexico. In the course of researching my dental treatment GF talked to a Las Vegas casino worker who had her eyes fixed as part of a mass bus trip set up by a bunch of her coworkers. Today, though, I don't think the savings would justify the travel expense.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

Hmmm. (none / 2) (#126)
by Phillip Asheo on Mon Dec 22, 2003 at 03:37:44 PM EST

If someone's going to mess around with my eyes, I'm not sure I would want to go cheap...

"Never say what you can grunt. Never grunt what you can wink. Never wink what you can nod, never nod what you can shrug, and don't shrug when it ain't necessary"
-Earl Long
[ Parent ]

You can get cheap cigarettes (none / 2) (#44)
by omrib on Sun Dec 21, 2003 at 05:04:54 AM EST

if you go to France from the UK. You might want to call it medical treatment.

I don't smoke, but I like second-hand smoking, so I encourage people to smoke so I can have some without paying.

[ Parent ]

Jeez, what a troubled person you are! (none / 0) (#123)
by vyruss on Mon Dec 22, 2003 at 03:06:13 PM EST

No, seriously now, I smoke too and while I like to respect nonsmokers, they sometimes go too far in their hysteria, like the bloke that asked me not to smoke in the middle of the street (open air & extreme wind).

  • PRINT CHR$(147)

[ Parent ]
Ha ha ha (none / 0) (#134)
by omrib on Tue Dec 23, 2003 at 07:23:07 AM EST

My wife smokes, and I couldn't care less. I believe noise does more harm than smoke, becuase noise irritates and causes heart diseases.

Some people are so very hypocritical, driving their SUVs in traffic jams, but they'd ask you not to smoke in the street. I mean, I live in a city, and when you look from a distance, you can see a nice black cloud of smog. Trust me, it's not from cigarettes... And this is what goes into my lungs every day.

And no, I don't own a car. But I don't preach about that either. Next time someone tells you anything about your smoking, tell them the noise they make really irritates you and blocks your veins, and you'd appreciate it if they fought for your right to have a quiet surrounding.

[ Parent ]

Good for you, man (1.00 / 15) (#2)
by Single White Coder on Sat Dec 20, 2003 at 12:52:08 PM EST

It's refreshing that at least ONE PERSON around here appreciates self-improvement and the ways it can benefit your life.

Now it's time to ditch your current significant other (you can do MUCH BETTER now with the new teeth) and start meeting new people.

Good luck, bra!

I Offer No Apologies For Being Motivated By The Basest Desires (Excessive Amounts Of Sex, Food, & Sleep)

[ Biker Blog ]

Have you been AIDS tested? (1.88 / 9) (#4)
by theElectron on Sat Dec 20, 2003 at 01:16:31 PM EST

After spending any time in Mexico (for medical treatment or otherwise), this is a must.

Join the NRA!
Wrong Tijuana Activity (2.60 / 5) (#5)
by localroger on Sat Dec 20, 2003 at 01:47:06 PM EST

I was there to get my teeth worked on, not to patronize the supposedly very inexpensive hookers.

In any case Dr. T exercised all the same precautions any American dentist would, such as gloves, face mask during grinding, and so on. Which makes sense, because your dentist has to worry a lot more about getting AIDS from you than vice-versa. After all, whose blood is more likely to be found in your mouth?

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

that is not the problem with HIV/AIDS (3.00 / 6) (#29)
by livus on Sat Dec 20, 2003 at 08:16:47 PM EST

and I'm now wishing you'd read a booklet or something.

Your dentist can only get HIV off you if he has an open skin lesion or some of your blood gets into cuts or ulcrs in his mouth or mucous membranes.

You can only get HIV off your dentist if his bodily fluid gets in open wounds in your mouth or into your mucous membranes (eyes, etc).

I'm going to take a wild guess here and state that your dentist has probably had contact with the body fluid (blood, saliva) of a lot more people than you have, including people with HIV. You also have no way of knowing how many hookers he patronises.

Therefore, it is definately you who has more to fear from him. And you were the one lying there with receptive wounds in your mouth.

HIREZ substitute.
be concrete asshole, or shut up. - CTS
I guess I skipped school or something to drink on the internet? - lonelyhobo
I'd like to hope that any impression you got about us from internet forums was incorrect. - debillitatus
I consider myself trolled more or less just by visiting the site. HollyHopDrive

[ Parent ]

Sterilised (2.50 / 4) (#48)
by hbiki on Sun Dec 21, 2003 at 08:45:59 AM EST

In any case Dr. T exercised all the same precautions any American dentist would, such as gloves, face mask during grinding, and so on.

how were his instruments sterilised? how regularly? i hope he did it fine... but given how expensive some of that IMS stuff costs, he might be cheap because he ignores it.

After all, whose blood is more likely to be found in your mouth?

The aids infested schmuck before you who bled all over that endo file thats inside of your mouth :)

I take all knowledge to be my province.
- Francis Bacon
[ Parent ]

Sterilization (3.00 / 4) (#52)
by localroger on Sun Dec 21, 2003 at 09:33:39 AM EST

Every instrument Dr. T used came out of a sealed bag and went into either the trash or a sterilize and reuse container. Absolutely nothing went into my mouth that might have been in someone else's mouth before. Believe me, I am not that stupid and it's one thing I paid attention to before agreeing to have the work done.

I think you don't realize where the savings come from. It's not the $5 throw-away burr that makes American dentistry so expensive, it's the ghastly overinflated prices of insurance and lab work which make the cost of an effective sterilization program look trivial by comparison.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

Excellent story (2.83 / 6) (#8)
by skim123 on Sat Dec 20, 2003 at 02:23:20 PM EST

A first-class piece of writing, as usual.

I have a friend whose parents live in Yuma (along the border of Mexico/California/Arizona), and they both have gone into Mexico for dental work there many times without complaint or mishap.

I liked your description of Tijuana. I live in San Diego (in Pacific Beach, if you know where that is), and have gone down to Tijuana a couple of times. Like you said, do NOT drive there unless you are planning to drive past Tijuana, to someplace like Rosarito or further on down Baja. Rather, take the trolley or park on the US side of the border. Be prepared to be harassed by dozens of taxi drivers angling for your business. If you want viagra or ridalin, or any other perscription drug, you don't have to walk far before you'll see rows of buildings with big signs on them saying "VIAGRA HERE!".

As far as things to do in San Diego, get your butt north of downtown. Yes, downtown has some nice touristy areas - Sea Port Village, Little Italy, the Gaslamp District, etc. - but go up to Hillcrest for the metrosexual experience of a lifetime. Or go to the beaches at P.B. or O.B. or, heck, even La Jolla or Del Mar, or the lighthouse in Point Loma. (Of course travel to these places may be a bit difficult without a car... I guess you could take the Coaster or the bus...)

I've only been in Chula Vista a couple of times, and while there are nice areas further to the east, the Chula Vista area by the highway is especially meh. There are cheap-o hotels in Hotel Circle up in Mission Valley (about ten miles north of downtown), which are right next to the trolley line. Yes, it will increase your roundtrip time to the border by an hour or so, but you'll pay the same and there will be less shady people around you.

One final word of advise: go to the dentist regularly! Brush your teeth, floss, blah blah blah, and then you likely won't have to research dental care in a third-world nation. :-)

Money is in some respects like fire; it is a very excellent servant but a terrible master.
PT Barnum

Mission Valley, eh? (none / 1) (#21)
by localroger on Sat Dec 20, 2003 at 05:26:00 PM EST

I thought of exploring the Orange Line on my second trip but ran out of time. In my case I was comfortable with Chula Vista and I found the nature center and tourist info center to be big pluses, but it's good that there is an option for someone who might be squicked by the kids playing loud music at 2 AM on Saturday morning :-)

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]
In defense of TJ (none / 3) (#35)
by mtpruitt on Sat Dec 20, 2003 at 11:02:36 PM EST

As an American who lived in Tijuana while working in San Diego for a year (a long story in itself) I have to stand up for the city.

As the story notes, and anyone will agree, the area directly across the border is horrible. However, it has grown there out of the dynamics of the tourist trade, and it should not be taken as an indicator even of the rest of the city. Just about anywhere outside of the region between the border crossing and Revolucion, where the bars abound, is much more enjoyable. The funny thing is that just to the East of this strip (making a left instead of a right when you cross the border) it gets a lot less seedy (but no more navigable). In fact, the Plaza Rio area itself is kinda nice, with a very active cultural center and museum, night clubs, and a bunch of high quality / low (USD) cost restaurants.

Some often overlooked factoids about TJ are that it is (roughly) the third largest economy in Mexico, the world's largest producer of televisions, the home of the Ceasar Salad (a great salad that is still served in a small sports bar on Revolucion), and that the border crossing and economic opportunities have caused it to double in population every ten years.

My impression from the Tijuanenses that I knew was that everyone around agreed it was an ugly city, but that it was an exciting city. On any given weekend there is much more cultural activity happening than in San Diego, especially related to music. (For instance, in addition being one of the hotbeds of norteno, a sort of polka-meets-country style, there is also the nortec sound that was all the rage in electronica a few years back.) There is also a (small) theater crowd, nationally famous writers' group, and a decent visual arts movement.

In comparison, I never felt anything of a draw for stuff to do in San Diego. The Gas Lamp is a great place to spend too much money on drinks while surrounded by loud and obnoxious people, but the only things offered I couldn't find down south were new release art films and a couple of US touring bands at the two decent clubs. And, I guess, also some nice restaurants and the above mentioned parks.

Basically, there is a lot that is going on in Tijuana aside from what you see at the border. The beach towns down the coast are nice, but don't write TJ off too soon.

[ Parent ]
Excellent, thanks (none / 1) (#37)
by localroger on Sat Dec 20, 2003 at 11:41:55 PM EST

I will keep this in mind if I'm ever back in the area. Thanks for the heads-up.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]
I'd be wary. (2.80 / 5) (#14)
by /dev/trash on Sat Dec 20, 2003 at 04:41:59 PM EST

What if I pick a bad dentist and he messes up my teeth or whatever?  Who can I sue?  In all likelihood hed be gone after I left.

Also did you check out Canadian dentists?

Updated NEW 10/15/2003!!
New Site, More Parks

Good point (3.00 / 4) (#16)
by localroger on Sat Dec 20, 2003 at 04:48:08 PM EST

This is why I didn't just go down to the border and start looking for "dentist" signs. It's good to get references and communicate with your doctor before committing to him. I was very confident in the level of care I could expect because I contacted people he treated.

I didn't check out Canadian dentists because AFAIK they are not as cheap as Mexican dentists and it's even more expensive to get to Canada from New Orleans than it is to get to Mexico. I'd be very interested to hear from someone up north, though, what the economics and practicalities are of getting it done in Canada.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

Canadian Dentists (none / 2) (#30)
by lurker4hire on Sat Dec 20, 2003 at 08:20:56 PM EST

... I just had a crown done, cost me $723CAD. I had an emerg root canal a few years previously (same tooth) which ran me approx $950CAD.

I think my prices are on the higher range of the cost scale for canadian dental work, but both the root canal guy and my dentist are really really good, and I'm in an expensive city (YYZ). Dental work isn't covered by the gov't here, so we pay market rates for these things.

I suppose if you live close enough to the border to drive to a dentist in a day you may save a bit, however nothing as substantial as you would save going to mexico. Heck, for major work, it's probably cheaper for a canadian to go to mexico too!

[ Parent ]

Canadian dental costs (3.00 / 4) (#31)
by drakosha on Sat Dec 20, 2003 at 08:33:11 PM EST

Nowhere near as extensive as yours, I had three wisdom teeth and two stubborn baby teeth removed, under full anaesthesia. The total cost was about $1,600, which works out to about $250/tooth, plus anaesthesiologist fees of about $200. This included the extra costs because one of my teeth proved to be "difficult" and took longer than expected. Divide all of the above by 1.4 to get US$ value. However, there is also the question of insurance. I'm paying CDN$39/month, and after a two-month zero coverage period, my insurance covered just about %50 of the cost, leaving me with, I believe, $870 to pay. The insurance company uses some arcane government-prescribed fee guideline for how much a dentist or a maxillofacial surgeon *should* be charging. I was unable to google up any such thing, so good luck to you. I am not sure if you have to be Canadian to qualify for one of these insurance plans. If you don't, simply plan ahead and get one two-three months before going to find a dentist.

"Technologists often forget the general user. Technology is only as good as the user experience. That is something that technology groups very often forget."

--Linus Torvalds, keynote address, LinuxExpo 2000.
[ Parent ]

Who can you sue? (3.00 / 5) (#28)
by Tachys on Sat Dec 20, 2003 at 07:58:00 PM EST

Who can I sue?

Some would argue that this is why dentists costs so much in the US

Any game that gets banned by the Austrailian govt can't be all bad... - Armaphine

[ Parent ]
perhaps. (none / 3) (#32)
by /dev/trash on Sat Dec 20, 2003 at 08:41:17 PM EST

But honest malpractice is something that can't just be brushed aside because insurace rates are a little high.

Updated NEW 10/15/2003!!
New Site, More Parks
[ Parent ]
A few minor comments (2.80 / 5) (#17)
by Kasreyn on Sat Dec 20, 2003 at 04:58:43 PM EST

First off: agreed with you on your analysis of Dentists in America (hell, the entire medical profession in America is like this, not just the dental). I don't know how many times I've had quacks try to push unneccessary procedures on me. Like you, my wisdom teeth came in perfectly and have never given me even 5 minutes' worth of trouble or pain, and yet most dentists who take a look in my mouth advise me to have them out. Usually I can see the dollar signs behind their eyes, and their hand reflexively molding into money-accepting shape...

But could you please tell me a bit more about what bruxism is? I'm *guessing* it's a nervous disorder ("teeth-grinding"). If this is so: are you still doing it? Little point getting your choppers fixed if you just wear them away again. Would counselling or psychotherapy help remove the source of the problem, or is it already a thing of the past?

As to Dr. T: is this him? http://www.dental-implants-center.com/ (didn't insert as link in effort to avoid slashdotting his server...)

The bit about warning you about costs is a HUGE plus, in my opinion. Health professionals in America seem to think I'm made of money, and that price is no object where my health is concerned. They really should start teaching economics in American med schools. :-P

As to your very nice lady friend: did her gender reassignment surgery include removing / grinding down "her" adam's apple? Dead giveaway in every transvestite I've ever met, but I've heard they can do that for transgendered folks now.

Before: Yikes! Louisiana Hillbilly Attack! j/k Roger, mine are almost as bad, just without the underbite... :-)
After: Niiiiiiiice. :-D

It's been a while since I've seen a dentist, so I think I should go. Thanks for the interesting story, +1S from me.


"Extenuating circumstance to be mentioned on Judgement Day:
We never asked to be born in the first place."

R.I.P. Kurt. You will be missed.
...and replies (none / 3) (#18)
by localroger on Sat Dec 20, 2003 at 05:09:54 PM EST

Bruxism is (usually unconscious) grinding of the teeth, often (as in my case) at night. Since I did it in my sleep I don't really know whether I still do it or not, but the night guard ("splint") Dr. S tried to sell me would have prevented the damage from getting worse. And Dr. T made a splint for me in the shape of my new teeth. Basically the splint fits over my lower teeth and pads them so that if I do grind, it's teeth against rubber instead of teeth against teeth.

(My new teeth are harder than real teeth so it's also less of a problem in some ways, but the caps can be loosened by excessive force so it's just as well to be careful with them.)

The link you found isn't Dr. T, though I did communicate with that guy. His prices are more in the $500 per tooth range, and he works only in noble metals. I think he actually does have a nice glass and concrete medical center. I'm sure he would have done an even better job than Dr. T, but I was trying desperately to keep the whole cost below $10K.

The "gender enhancement" our friend underwent included mods to the Adam's apple, a facelift, and grinding of the forehead bones to reshape them in a more feminine way. I'd refer you to her blog but she took it down last month since she is trying to move on into her new female life, and she considers the transition to be complete.

And to the dentist: Go once in awhile, definitely. I shudder to think what I'd be faced with if I'd waited longer than I did to get a "simple cleaning."

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

If you weren't so mad and jealous all the time. (1.75 / 3) (#23)
by International Bestseller on Sat Dec 20, 2003 at 05:40:20 PM EST

You wouldn't grind your teeth.

#1 on the NY Times bestseller list 37 weeks in a row.
[ Parent ]

Did you write the novel Jaws? (none / 1) (#25)
by houseof3bees on Sat Dec 20, 2003 at 05:46:17 PM EST

I enjoyed that book immensely.

You are my honey, honeysuckle, I am the bee.
[ Parent ]

night guard (none / 2) (#59)
by majik on Sun Dec 21, 2003 at 01:47:20 PM EST

Be careful with that night guard. I stopped using mine about 3 or 4 months after I got it. I found that rather than grind my teeth, the dream-time jaw action (with night guard) ended up actually loosening my teeth. Between the two options, I decided to try and cure the problem rather than the symptom. I tend to do simple relaxation techniques before bed, and I try to keep from going off to bed agitated or excited. Being well over 10 years your junior, this story makes me both sad and happy. Sad that I probably have this to look forward to... happy that I live in San Diego =)
Funky fried chickens - they're what's for dinner
[ Parent ]
I'll keep it in mind (none / 2) (#70)
by localroger on Sun Dec 21, 2003 at 05:45:53 PM EST

Be careful with that night guard. I stopped using mine about 3 or 4 months after I got it.

Dr. T asked me to wear mine for six months; I think it's more to keep me from damaging the teeth while my brain gets used to the new TMJ configuration than as a permanent bruxism fix. Although your story shows me another way in which my American Dr. S's approach was a couple of cans short of a six-pack.

I used to grind my teeth when awake, especially when listening to music, and I pretty much stopped doing that once I was warned about the problem a couple of years ago. But I didn't know I was still doing it in my sleep. Where is that owner's manual I was supposed to get with this body, anyway?

Sad that I probably have this to look forward to... happy that I live in San Diego =)

Yeah. Well, keep on top of it and maybe if you do have to visit TJ one day for some work, it won't be *quite* the adventure I just had ;-)

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

Well... (2.75 / 4) (#34)
by skim123 on Sat Dec 20, 2003 at 08:57:00 PM EST

I don't know how many times I've had quacks try to push unneccessary procedures on me. Like you, my wisdom teeth came in perfectly and have never given me even 5 minutes' worth of trouble or pain, and yet most dentists who take a look in my mouth advise me to have them out.
While I may not be able to convince you that your dentist isn't out to make a quick buck, realize that there is a medical reason for pulling wisdom teeth. Namely, they are much more likely to develop cavities than the other teeth, and there is always the chance that as you age they'll begin to move forward and push your other teeth forward as well. Too, I don't know how much a dentist makes on such an operation. Even if he charges, say, $400 per tooth, he may get only half of that from your insurance company.

That being said, I'm in my mid-20s and still have my wisdom teeth. They came in perfectly and have yet to have any problems.

Money is in some respects like fire; it is a very excellent servant but a terrible master.
PT Barnum

[ Parent ]
Hmm (2.83 / 6) (#24)
by gibichung on Sat Dec 20, 2003 at 05:40:31 PM EST

While I may have missed it, you don't seem to address the reasons *not* to have these things done in a foreign country. Maybe you should...

That said, I have had both of my front teeth crowned (about 12 years ago) as a result of an injury. I think I had chipped them at least three times previously.

It didn't go well. My dentist had intended to do both at once, but he managed to damage the second original after cementing the first one on. He ordered another from a new mould and it didn't match -- it was about twice as thick. There was a gap on the second between the crown and the gum line that I was told would "fill in" but never did. Also, in the last few years, I managed to chip the first.

So here I am with one that doesn't fit and one that's broken. I have insurance [I believe it would cost me about $30 to have them fixed] but I am tempted to just leave well enough alone. Out of curiosity, does anyone know crowns are removed?

"No man is above the law and no man is below it; nor do we ask any man's permission when we require him to obey it." -- Theodore Roosevelt

Yikes (3.00 / 4) (#26)
by localroger on Sat Dec 20, 2003 at 05:47:35 PM EST

The scenario of your story is one reason I favored Dr. T, who unlike even most American dentists has his own lab.

Crowns are removed the same way teeth are prepared to receive them -- by grinding them away. I had a couple of huge old amalgam fillings sticking up that had to be removed in the course of my own treatment, and the technique is similar.

Crowns have improved a lot in recent years, so I'd advise at least seeing about having them redone. By a different dentist :-)

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

at least for molars (none / 0) (#131)
by paulerdos on Tue Dec 23, 2003 at 01:32:04 AM EST

they cut them away. i got a crown on a molar this year (my first crown - i'm only 22). i asked my dentist how they remove these, and she said they "cut" it off: they make a vertical cut into the tooth as though you're cutting the tooth in half, except u stop when u get past the crown. i asked how you stop, and she said "very carefully," that it takes a long ass time b/c you do it tiny bit by tiny bit. once you cut it into half, you kind of repeat the process until the surface area of each piece attached to the crown is small enough that you can pry it off or whatever. maybe it is different depeding on what tooth it is, i don't know - just thought i'd share what my dentist told me.

[ Parent ]
ummm (1.57 / 7) (#27)
by modmans2ndcoming on Sat Dec 20, 2003 at 07:18:16 PM EST

why didn't you go to another dentist that did not know you and get a second opinion?

but my first thought about your case was "get them pulled and get dentures"

you have a seriously fucked up mouth that should have been fixed when you were in your teen years. trying to save them at 39 is a waste of money and time.

Extremely bad advice (3.00 / 6) (#43)
by mstefan on Sun Dec 21, 2003 at 03:12:53 AM EST

but my first thought about your case was "get them pulled and get dentures"

This is extremely bad advice. Having your teeth pulled and replaced with dentures is absolutely the last thing that anyone should do. And I mean the last, with zero options remaining.

Why? Your teeth are an integral part of your mouth and provide structural support for your jaw. Once those teeth are gone, the jawbone starts to deteriorate. I've seen xrays of folks who've had their teeth pulled at a relatively young age and wore dentures; by the time they're in their 70s or 80s, they've lost a great deal of bone density in their jaw (and its even worse for women). In many cases they can't even wear their dentures anymore, and for those that can it is still very difficult for them to chew. So unless you are looking forward to sucking dinner through a straw in your later years, keep those teeth.

If your natural teeth must absolutely go, then investigate dental implants.

[ Parent ]
well, I probably would have done the implants too (none / 1) (#61)
by modmans2ndcoming on Sun Dec 21, 2003 at 02:36:52 PM EST

but I consider them dentures since they are fake teeth.

I was not up on the lingo, sorry.

[ Parent ]

Implants (3.00 / 4) (#66)
by mstefan on Sun Dec 21, 2003 at 04:45:32 PM EST

Dental implants are more like real teeth; they're anchored in your jaw and function like the real thing. The downside is cost. A full set of implants typically costs between $50,000 and $70,000 US and most insurance companies still don't cover the procedure.

[ Parent ]
when synthetic teeth become cheap (none / 1) (#79)
by modmans2ndcoming on Sun Dec 21, 2003 at 07:01:56 PM EST

I bet most adults who have cavity problems will opt for fake teeth than fillings.

[ Parent ]
Too much pain and inconvenience (none / 2) (#136)
by jester69 on Tue Dec 23, 2003 at 11:59:58 AM EST

My boss' girlfriend got an implant. She likes it a lot better than having no tooth there, but he said the procedure sucked eggs.

Basically they drill a painful hole into your jaw and insert a titanium rod. You have to live with the rod sticking out for some nontrivial length of time (1-2 months) until bone grows into its voids and it is fused to your jaw, you can't chew on it much before that.

Then they glue a fake tooth onto the rod.

All in all better than the other options, but I would never take that over a filling thats for sure. Maybe over a root canal, but not a simple filling.

take care,

Its a lemming thing, Jeep owners would understand.
[ Parent ]

In Halifax Nova Scotia you can get the same done (2.88 / 9) (#33)
by xutopia on Sat Dec 20, 2003 at 08:42:25 PM EST

for even cheaper than what you paid in Mexico.

I went to the Dalhousie University Dental school a few times to get some teeth work done. The only bad thing about this is that it takes maybe 4 times the time to do an operation for them because 10 students have to each look into your mouth one after the other. The good thing is that they are supervised by really experienced dentists that explain everything in front of you so you know what is going on.

Why? (2.40 / 5) (#36)
by virtualjay222 on Sat Dec 20, 2003 at 11:27:56 PM EST

Does anyone know why it's that much cheaper outside the US for such a procedure?? Is it simply the regulations, the HMOs, or something else?

Perhaps this will help my parents understand why my dream to be a doctor will never be...


I'm not in denial, I'm just selective about the reality I choose to accept.

-Calvin and Hobbes

Dentistry is Expensive (none / 2) (#47)
by hbiki on Sun Dec 21, 2003 at 08:42:46 AM EST

Does anyone know why it's that much cheaper outside the US for such a procedure?? Is it simply the regulations, the HMOs, or something else?

Infection Control impacts a lot. For example, these days you throw away a burr after every procedure rather than every day. Considering a burr is around $5-10 a pop... that's just added the patient's bill. There's also the extra labor of bagging and tagging everything. Then there's all the cutting edge technology (digital x-rays, CEREC machines, NiTi drills)... (A CEREC machine will give you better fitting and longer lasting crowns than traditional techniques. It may be cheaper now but if it saves you getting them again in 10-15 years... well.... its worth getting)

Then, more importantly, there's insurance !

Then there's general cost of living. A Dentist tries to make enough of a margin (40% in the US I believe?) to give them the lifestyle in which they want to live...

BTW, HMOs are the antithesis of good health care. It costs Dentists money to give you good treatment. It encourages neglect.

Perhaps this will help my parents understand why my dream to be a doctor will never be...

I belive Dentists now make more than Doctors in the US...

I take all knowledge to be my province.
- Francis Bacon
[ Parent ]

basically, (none / 3) (#82)
by werner on Sun Dec 21, 2003 at 07:21:22 PM EST

as far as i can tell, folk don't learn dentistry for fun. there are certain expectations regarding income, and that is why people become dentists.

while a US dentist may cost 2 to 5 times more than a Mexican one, i'm pretty sure they enjoy the same standard of living in their respective countries.

dentists are more expensive in the US/Germany/UK than in Mexico/Bulgaria/Slovakia because folk there have more money. simple as that.

dentistry is one of those professions where you can't put a realistic price on what you get because dentists are only interested in getting as much money out of their patients/patients' insurers as possible.

the situation is similar in germany - they are going to change the rules, so you have to pay considerably more yourself towards treatment by dentists. fact is though, every dentist has at least 2 very nice cars and most likely a couple of houses, to boot. it costs so much because dentists want to make disgusting profits. period. under a fully-privatized health system, i can understand that dentists get to set the prices, but under a system such as the german one, where 99% of dental work is paid for by the state, that's not right. do you think wal-mart lets anyone dictate prices to it?

[ Parent ]

wal-mart (none / 1) (#121)
by ckaminski on Mon Dec 22, 2003 at 02:41:47 PM EST

do you think wal-mart lets anyone dictate prices to it?

As someone who sells products to Wal-Mart on a daily basis, I can indeed tell you that yes, people dictate prices to Wal-Mart.  If you have a product Wal-Mart wants, they'll pay the price.  

Wal-Mart gets it's cheap prices by cutting out distributor channels and their 20-30% mark-ups.  

[ Parent ]

Dentistry market (none / 3) (#142)
by dn on Tue Dec 23, 2003 at 11:39:20 PM EST

dentistry is one of those professions where you can't put a realistic price on what you get because dentists are only interested in getting as much money out of their patients/patients' insurers as possible.
But that only works because people want to pay that much. The reason for that is that they don't just want industrial food macerators, they want nice-looking teeth of precisely the right color, texture, shape, size, and location.

Dentistry is also unforgiving compared to other specialties. Teeth don't heal; mistakes are hard to correct. That draws a huge premium compared to soft-tissue surgeons who can get away with insane levels of sloppiness (by comparison).

the situation is similar in germany - they are going to change the rules, so you have to pay considerably more yourself towards treatment by dentists. ... under a fully-privatized health system, i can understand that dentists get to set the prices, but under a system such as the german one, where 99% of dental work is paid for by the state, that's not right.
(1) State-supplied health care is always rationed, but it's hard to draw the line between health and cosmetics in dentistry. Making people pay part of the bill, especially for more cosmetic procedures, allows limited public funds to be more fairly allocated to necessary care for those who can't afford it. (2) German dentists and dentistry students are free to leave and practice somewhere more lucrative. If the nation wants to keep a supply of dentists, it has to offer competitive compensation.

    I ♥

[ Parent ]

Brush (1.00 / 32) (#38)
by nxor on Sun Dec 21, 2003 at 12:31:16 AM EST

Brush your fucking teeth, you stupid cock.

flossing more important (none / 2) (#51)
by speek on Sun Dec 21, 2003 at 09:32:03 AM EST

If you really want to help, tell him to floss - it's much more important than brushing.

al queda is kicking themsleves for not knowing about the levees
[ Parent ]

I just want to say (2.80 / 5) (#39)
by br14n on Sun Dec 21, 2003 at 12:51:36 AM EST

that the before and after photographs are simply amazing. We should count ourselves very fortunate to live in a time when such amazing repair work is possible. Sounds to me like money well spent. Good for you.

Comments and advice for the young and healthy (3.00 / 11) (#40)
by enkidu on Sun Dec 21, 2003 at 12:57:13 AM EST

Great story. It really is quite surprising how quickly your teeth (which when you are young feel like they're going to last forever) can go downhill. I myself lucked out, having avoided the dentist for 10 years (20-30) I went back and aside from having to have several fillings (both new and replacement), and a touch of gum disease, I was OK. I now go regularly every 6 months, just like the book says.

The advice:

  • You only get one set of adult teeth. Cherish them. Bridges and Dentures work, but are magnitudes less fulfilling than keeping your own teeth (even if they're capped).
  • Floss: I know it's a cliche and everybody says it but few seem to do it. When I started flossing, my gums bled every time and it wasn't fun. Now, I floss daily and my gums are healthier and I can feel the difference in my teeth. Once a day is enough. It only takes about a minute or two and your teeth and gums will thank you when you're sixty.
  • Get an electric toothbrush. I use Sonicare, but there are lots of alternatives. They aren't THAT expensive and do a much better and more consistent job of brushing your teeth than manual agitation can ever hope to accomplish. Think of the difference between sanding by hand and using an orbital sander.
  • Visit your dentist. Pain delayed is pain increased. I know for some this is economically difficult. Seek out alternatives, free clinics, dentist schools etc. but go at least once a year at a minimum and twice a year if at all possible.
that's it for me. I wish you happiness and healthy teeth.

Putting off the dentist visit is too easy. (none / 2) (#77)
by trejkaz on Sun Dec 21, 2003 at 06:54:20 PM EST

That reminds me I keep putting off going for my free checkup and/or free fixit jobs. They only do one or two teeth each visit but I'm sure after 16 visits (roughly 16 months of total waiting time) mine would be in order. It's the time which hurts the most. :-/

Putting off the dentist visit is too easy because as a kid, all they teach you is dentist == pain.

[ Parent ]
More adult teeth, please! (none / 2) (#93)
by CubeDweller on Sun Dec 21, 2003 at 10:17:42 PM EST

You only get one set of adult teeth. Cherish them.

This is an issue that I wish science would change. If a procedure were developed where a dentist would cause you to grow a new adult tooth semi-naturally, replacing a worn out tooth, the field would be revolutionized. Such a procedure would be so valuable, my naive little mind believes it would almost certainly become commonplace and therefore relatively cheap.

There's a question I've asked my dentist before and I've never received a satisfying answer. Perhaps someone in the K5 group knows.

What is the trigger that causes a child's teeth to fall out and new ones to grow in to replace them? Is it simply a function of growth where the child's jaw has gotten larger? Are we born with two sets of teeth and the growth of the later set is on time delay?

In orthopedic medicine I see the beginnings of a revolution where mechanical devices like pins and metal plates are replaced with growth mediums that stimulate the body to grow new bone in controlled ways.

I've found very little similar research in the dental field. After searching google on a couple of occasions over the last year or two, I either find sites like the International Association for Dental Research that are unreadable by the uninitiated, or I find marketing and stock research articles by drug and medical equipment companies which are equally useless due to their thick coating of bull.


[ Parent ]
Why no more sets of teeth (none / 1) (#137)
by Silh on Tue Dec 23, 2003 at 01:50:11 PM EST

A tooth itself does take years to develop, and as far as I know, we do not yet completely understand the signalling involved in causing a tooth to develop in a specific location, or what causes it to turn into a molar, premolar, etc. In any case, when a child is born, the primary teeth (or at least the crowns of; the roots keep on growing as the tooth comes in) are mostly formed, and portions of some of the permanent teeth are starting to develop. The growth of a tooth is quite a complex process, involving the interaction between several types of embryonic tissue.

So even if you could somehow set things up to grow a new tooth in the jaw, it would be a while before you'd have a tooth.

(Sending a salute out to littlelew, good to see another dentist arond here).

[ Parent ]

Sonicare advice (2.75 / 4) (#96)
by fencepost on Mon Dec 22, 2003 at 01:06:34 AM EST

They're great, and if you don't already have one of these toothbrushes you should really consider getting one.

Spend the extra few dollars to get the slightly more expensive model with "quadpacer" or whatever they call it now. Basically, it pulses the vibration every 30 seconds to let you know you should move to the next quarter of your mouth. The more expensive model is often ~$10-15 more expensive but also often includes an extra brush head so the price is pretty comparable. If you want to go the full fancy route you can even order it at Costco.com (though you'll pay an extra 5% if you don't have a membership, some of their prices are still very good).

When you first get one you'll want to use the "damper ring" or lower-speed mode while you get used to it, but once you're used to the vibration and your gums get healthier you'll be fine using the normal unrestricted vibration, and you'll be astonished how smooth your teeth feel.

"nothing really says "don't hire me, I'm an idiot" quite as well as misspelling "pom-pom" on your resume." -- former Parent ]

I miss mine (none / 0) (#108)
by MicroBerto on Mon Dec 22, 2003 at 10:33:09 AM EST

I used to have one of those, and let me tell you, I miss it. I now have an Oral B, and it's just not as good, I don't care what my dentist thinks. We had a party here at school, and that was the last I saw of my Sonicare. The joke is that some girl took it to use it as a vibrator. For once, i'd rather just have a toothbrush!

- GAIM: MicroBerto
Bertoline - My comic strip
[ Parent ]
i like my oral b (none / 0) (#130)
by paulerdos on Tue Dec 23, 2003 at 01:27:00 AM EST

don't mean to start a war about which one is better (and in fact i have no idea, as i've never used a sonicare and therefore have no basis for comparison), but i have a oral b and I ABSOLUTELY LOVE IT. my dentist recommended that i get one about a year ago, so i got one, and i just cannot imagine my teeth being any cleaner than my oral b gets mine. i think the truth is exactly what the grandparent said - that electric toothbrushes are just orders of magnitude better than manual, and that's all there is to be said about that.

[ Parent ]
Infection control (2.57 / 7) (#41)
by saqibqazi on Sun Dec 21, 2003 at 01:15:47 AM EST

I am a dentist practicing in a so called third world country. Infection control standards in most developing/under-developed countires are poorly enforced and implemented (one of the reasons treatmment is cheap). Dental treatment may be less expensive but some caution may be in order: the risk of contracting hepatitis B/C or HIV are significantly higher.

Not my experience (none / 1) (#50)
by localroger on Sun Dec 21, 2003 at 09:25:17 AM EST

Dr. T used all the same infection control procedures any US dentist would use. Every tool came out of a sealed bag and was either discarded or sent out for sterilization after use. Dr. T himself wore gloves at all times and a face shield when grinding. There may be third world dentists who take the shortcuts you warn about, but not all of them do.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]
i would hope (none / 0) (#81)
by werner on Sun Dec 21, 2003 at 07:06:55 PM EST

you are speaking for you colleagues, not yourself...

[ Parent ]
Length of daily treatments? (none / 1) (#46)
by weave on Sun Dec 21, 2003 at 08:15:39 AM EST

I've had most of my teeth capped, about half of them requiring root canals. Fortunately I was able to spread the entire treatment over about 10 years since my dental insurance had a $2,500 annual benefit cap. The dentist grinding and shaping the teeth down was a pretty long activity. I found that if I had appointments that lasted more than two hours and more than a two teeth, it was quite stressful and strenuous, even if it wasn't really painful.

How long were your appointments? Did he spend all day on you for example?

Length of appointments (none / 2) (#49)
by localroger on Sun Dec 21, 2003 at 09:21:22 AM EST

On my first trip to San Diego I had one short visit during which Dr. T examined me, cleaned my teeth, and took impressions for making his study model. This took about two hours and didn't even involve novacaine.

On my second trip I had two appointments for grinding, each about 4.5 hours on the Monday and Wednesday. On Monday he completely prepared my upper palate, and on Wednesday he did the lower. Although these visits involved a lot of work, I didn't find them that bad. Then again, I didn't need root canals, so it was all superficial.

On my final trip the Monday appointment took about four hours to fit and cement the 28 caps, adjust my occlusion, and take an impression for my splint. At the final Wednesday appointment he gave me my splint and made minor adjustments to my occlusion.

I was very fortunate that no root canals were necessary; my treatment would have been a lot more involve if they were.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

weird... (2.66 / 6) (#53)
by infinite jest on Sun Dec 21, 2003 at 09:34:27 AM EST

Every time I go to Mexico, I manage to lose a couple teeth.

Well (3.00 / 6) (#102)
by rusty on Mon Dec 22, 2003 at 08:57:25 AM EST

Now you know where they end up. :-)

Not the real rusty
[ Parent ]
You make many unsubstantiated claims (2.40 / 10) (#55)
by coward anonymous on Sun Dec 21, 2003 at 10:57:28 AM EST

You make many value judgements with very little to no substantiation, examples:

"The equipment was all in good working order, everything was clean, and most of all I was very impressed with both the doctor's bedside manner and his skill."

What do you know about Dental equipment to judge its readiness? Do you know the difference between a high-speed and a low-speed handpiece for example? What about an electrosurge?
What qualifications do you have to gauge a dentist's skill?

"It was clear to me that Dr. T was very experienced."

"Although I could see the "cheats" Dr. T had had to accept in order to make my teeth meet, they are not apparent to anyone who isn't an expert"

Making you an expert?

"But a lot of it goes to Dr. T's very high level of skill and expertise"

The problem you suffer from, as do many other people, is that you somehow believe that you can make judgement calls about dental work and dentist's skills. Judgement calls you would never make with any other medical profession and its practitioners.

"No doctor, I don't believe my brain tumor needs radical surgery. I just need Tylenol."

Beyond these subtle points it is important to note that you were lucky. You are happy with your mediocre dental work. What would you have done had you found your teeth in a more horrible mess than you started with?

Evaluation of Skill (3.00 / 9) (#57)
by localroger on Sun Dec 21, 2003 at 12:54:47 PM EST

You do not have to be an expert in a field to recognize expertise.

I have worked for almost twenty years in a field that puts me in contact with a wide variety of people whose jobs I can't do and whose skills I don't share. And I have found that I can usually tell within sixty seconds of starting to talk to someone about their work whether they are any good at it or not.

People who are highly skilled share similar characteristics whether they are building a wall or performing open-heart surgery. They assemble the tools they need before a job and there are no missing tools when the job gets underway. They move from step to step without hesitation. They perform manual skills with a certain manner of unhurried confidence that is very hard to fake.

The specific point when I knew I had made the right decision was when Dr. T began to grind my teeth. While I may not be a doctor I am an amateur lapidarist, and so I am familiar with the art of grinding solid objects to shape. I even made the remark to Dr. T during my procedure that I now knew what it was like to be the stone. I have carved gemstones and I have watched many other people both skilled and amateur do carving, and it is not something you can learn from a book. Although it is essential to dentistry it really has nothing to do with dentistry. Science may tell you the shape you want, but it is art that allows you to achieve that shape.

Dr. T wielded his tools like a master. This is not something all dentists can do. In fact, I'd be very wary of even having an American dentist whose main trade was filling cavities and cleaning teeth attempt a job like this. Before I ever travelled to San Diego I contacted people who had work similar to mine done by Dr. T. This is why I advise against the "just go to Tijuana and look for a dentist" approach.

Judgement calls you would never make with any other medical profession and its practitioners.

I jake judgement calls about the skills of people whose jobs I can't do all the time. I have to, because my job is writing computer software that they will have to use. Your attitude reminds me of an old joke:

There's a long line to get into Heaven, what with the paperwork at the Pearly Gates and all, but Sam waited patiently taking occasional refreshments from helpful angels as he waited his turn. Then, suddenly, someone wearing a white coat and stethoscope marches boldly to the head of the line and right through the gates.

Sam asks the next angel, "Who was that guy? Why does he get to go to the head of the line?"

The angel answers, "That was no guy, that was God. Sometimes he likes to pretend he's a doctor."

Doctors are no different than any other highly trained workers. There are good doctors and poor doctors, and it is silly to pretend that there is some aura over their presence that prevents us mere mortals from distinguishing one from the other.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]
Hunches and holiness (none / 3) (#116)
by coward anonymous on Mon Dec 22, 2003 at 12:09:25 PM EST

Your way of classifying expertise is on the whole just a hunch. If it works for you, that is fine however you still know nothing about dentistry to make calls about the quality of a dentist in the way you described in the article.

Let me clarify your confusion about my attitude regarding doctors. I did not claim doctors are holy. Doctors are only human and should be questioned whenever doubt arises. I have no argument with that.
What I wrote, "Judgement calls you would never make with any other medical profession and its practitioners.", quite simply states that you would sooner question a dentist than you would any other medical practitioner.

[ Parent ]

Clarification (none / 2) (#120)
by localroger on Mon Dec 22, 2003 at 02:06:39 PM EST

...quite simply states that you would sooner question a dentist than you would any other medical practitioner.

Well you're wrong. I treat all professionals the same, whether they are doctors or bricklayers. I think you are just offended that someone without your training dares offer a judgement on something you consider your private domain of expertise. Sorry, but it's not about dentistry; it's about the human condition.

If I had a doctor who expressed surprise or uncertainty during my treatment, who told me things that disagree with the research I've done on my own, who was fumble-fingered when my treatment required manual dexterity, or whose tools clearly weren't performing as he expected them to, and who couldn't point out any examples of successful procedures like mine he'd treated in the past, I'd question him just as quickly as I'd question a bricklayer or carpenter whose wall appeared crooked to me.

Of course it's true that I can't appreciate the fine points of what a doctor or dentist does. But part of a dentist's job involves things I can appreciate, and when those things are going right it's natural and appropriate to extrapolate. It is more than just a "hunch" to observe whether someone is comfortable performing their job, and how their past jobs have come out, and make a determination based on this.

You seem to have the attitude that no one should dare judge the skills of another unless you have those skills yourself. That attitude is arrogant and unworkable. Life requires us to pass judgement on every service and product we use, from the laundry detergent that might not clean so well to the car that seems to break more often than necessary. If this bothers you, then my advice is not to enter a service profession such as dentistry. I go into every job I do knowing that people who can't even turn a computer on without help will be evaluating me and my company based on their experience with what I do, and I conduct myself accordingly.

One interesting thing I noted in my dental adventure is that all the American information sources quote the average length of a crown at 10-15 years. (This is one reason I didn't want to spend $25,000 having the reconstruction done.) But Dr. T told me there is no reason my reconstruction shouldn't last 30 or 40 years, with perhaps the occasional need to re-cement a crown that might come loose. Now why do you suppose the "inferior" dentist using outdated techniques would promise better performance? I strongly suspect it's because he isn't planning on soaking me again in 10-15 years.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

mediocre? (none / 3) (#80)
by werner on Sun Dec 21, 2003 at 07:04:59 PM EST

You are happy with your mediocre dental work
I can only assume from such an inane comment that, for you, either all non-USian or all reasonably-priced professionals are incompetent.

That's fine by me, if your only criterium for judging quality is price, but if I were you, I'd keep it to myself. Makes you look at best like a proper snob and at worst like a snobbish retard.

From the photos I saw, it looked like pretty good work to me. Of course, I'm no expert in dentistry, but then again, neither are you.

[ Parent ]

Just look at them (none / 3) (#90)
by coward anonymous on Sun Dec 21, 2003 at 09:47:14 PM EST

Your assumptions are wrong. It appears to me they reflect on your itching beliefs more than on anything I said.

Believe it or not, you don't have to be a dentist to gauge the esthetic quality of dental work. It is actually very simple and is done trivially by every single person every time he or she looks at another's face. People are very good at recognizing and classifying faces and an integral part of every face is that shiny row of teeth. It is easy to spot rotten decaying mouths and it is just as easy to spot poor dental work.  

localroger helpfully supplied us with a photo of the results in his mouth. A few more photos (preferably in natural sunlight) would give a better idea of them. However, from the one photo, to me, they shout "FAKE" as they would instantly do to anyone else perusing localroger's face.


[ Parent ]

You betray your own lack of skill (1.80 / 5) (#92)
by localroger on Sun Dec 21, 2003 at 09:54:17 PM EST

The photos were taken by my dentist using a digital camera at very close range. Everyone who has seen me in real life has been most impressed with the new teeth, and nobody has thought them "fake." But then, you're probably just an asshole, self-admitted by the local synonym of "troll."

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]
Wow! (none / 3) (#94)
by coward anonymous on Sun Dec 21, 2003 at 10:18:56 PM EST

Yikes, are you virulent.

Anyway, enjoy them while they last.

[ Parent ]

confused troll (none / 1) (#107)
by werner on Mon Dec 22, 2003 at 10:25:29 AM EST

The problem you suffer from, as do many other people, is that you somehow believe that you can make judgement calls about dental work and dentist's skills.
Believe it or not, you don't have to be a dentist to gauge the esthetic quality of dental work. It is actually very simple.
So which is it? Contradicting yourself in the same thread. Talk about a bad troll.

[ Parent ]
Let me simplify for you (none / 1) (#115)
by coward anonymous on Mon Dec 22, 2003 at 11:57:26 AM EST

Look carefully at what was written, one mentioned "quality" as in general quality and the second sentence mentioned "aesthetic quality" a specific attribute of quality.

General dental quality has many facets. Most of them, like tool readiness, grinding ability and crown bonding skill, are something most non-dentists, including localroger, know nothing about. Aesthetic quality of teeth on the other hand is one aspect of the general quality of dental work that practically everyone can judge since they are born with the ability.

[ Parent ]

esthetics and dental work (none / 2) (#114)
by littlelew on Mon Dec 22, 2003 at 11:56:42 AM EST

While you don't have to be an expert to have an opinion on the esthetic level of dental work, you do have to be something of an expert to judge how good the work was technically.

The work may look good but if it is poorly done, there can be problems later ranging from periodontal disease, recurrent decay or temperomandibular joint problems.

You generally can't jusge technical quality from pictures alone (no matter how detailed) but need x-rays and an exam. (I am an 'expert', at least by formal qualifications, having completed both dental school and a 2 year post doc in prosthetics. My practice was limited to crown and bridge)

A big danger in full-mouth rehabilitation (getting all your teeth capped) when there has been a lot of bruxism is that the occluson (bite)is a very delicate issue and the temperomandibular joint may not react well to the increased dimension needed to find room for the crowns.

A big factor in cost is the time taken both to do the preparation, to create the crowns and to adjust the occlusion (bite) after the crowns are inserted. Travelling a long distance to get dental work is not the same as flying to buy a car.

In regards to root canals. Root canals are generally done when the tooth structure remaining after prep for crowns is too little to risk putting a crown on. This is often the case in bruxism because the wear of the front teeth is often results in a very thin or short tooth. In a large bridge, if one of the covered tooth breaks or the crown fails, the whole bridge is compromised

[ Parent ]

I agree (none / 1) (#118)
by coward anonymous on Mon Dec 22, 2003 at 01:02:20 PM EST

[ Parent ]
I agree (none / 3) (#145)
by drstrangelove on Wed Dec 24, 2003 at 09:39:20 AM EST

Simply put: a lay person is not qualified to judge the skill of a dentist. Yes, your result may look nice, but what about the margins? Have you taken post-operative bitewings to determine if the margins are closed? Did you use an explorer to feel the integrity of the margins? What about the emergence profile of the crowns? How about the occlusion? For a full-mouth rehab you'd better be damned certain that your functioning in centric, because if the VDO is off by much you'll wind up having TMD. What kind of lab did your dentist use? You know, that's partly the reason why we American dentists are so expensive- we simply can't get away with using fly-by-night labs that charge only $25 per unit. When the porcelain fractures off (which I've seen plenty of times with foreign dentistry) then you'll be questioning the wisdom of your decision. As I've mentioned elsewhere, dentistry is expensive for a reason. Going to Mexico to have work done is no different than multinationals moving US factories to Mexico for cheaper labor. You see, in my office (which has some of the lowest fees around,) I provide full benefits for my employees (100% medical insurance coverage, free dentistry for them and their families and I put 25% of their income into our retirement plan.) I try to use a good-quality lab (although I'm perpetually frustrated because I demand quality.) I tend to sterilize my instruments and spray down my rooms with a disinfectant that kills even Hepatitis B. (Many foreign offices don't do these things.)

[ Parent ]
More FUD (3.00 / 2) (#148)
by localroger on Wed Dec 24, 2003 at 03:24:46 PM EST

Well I can understand why you'd not want me advising your patients to skip your practice and run to the border, but your are both being insulting and spreading FUD, neither of which is an attractive quality in a health care professional.

Even though I am not a dentist I did not fall off the turnip truck yesterday and your assertion that...

a lay person is not qualified to judge the skill of a dentist

...is simply not true. Let us say, for example, that there are twenty skills and expenses which are necessary to perform a reconstruction, lack of any of which would jeopardize the result. I am obviously not familiar with many of these. For example, while he did spend several hours adjusting my occlusion I have to admit I don't know yet whether he did it right.

However, some of those skills are things I can evaluate. I observed much of his sanitary procedure and the rest which is described in his literature would be up to US standards if he followed it, including discarding burrs and spraying down the room after each procedure. Since he followed the parts I could observe, I have no reason to doubt that he followed the parts I didn't.

More than that, I have done precision grinding with tools very similar to dental tools. (In fact a lot of lapidarists use dental tools because they're better made than comparable lapidary tools.) I know how someone works when they have experience with those tools. I also know the difference between such tools that are in good repair and those which are worn out or balky. When I say he has skill with grinding equipment and that his equipment was in good repair, I know what I am talking about.

As for labwork, Dr. T has his own lab. This seems to be common among the top-tier third world dentists, presumably for the very reasons you complain about.

If I am in a position to properly evaluate four of Dr. T's twenty skills that went into my procedure and I observe that he is at the top of his form in all of those, by what logic (other than his location and price) should I doubt the ones that are a mystery?

There is definitely the question of what did not get bought with the $15,000 or so I didn't spend. I can think of a few things:

  • I didn't buy Dr. T a Beemer.
  • I didn't pay a note on his $500,000 house.
  • I didn't pay his $10,000 a month office rent.
  • I didn't buy him a new digital X-ray machine.
  • I didn't pay his outrageous American malpractice insurance.
Now before you leap on those last two items I have to remind you that this wasn't about whether I would spend $10,000 or $25,000 on my reconstruction. It was about whether I would spend $10,000 on the reconstruction or not have it done at all. The alternative to what I did was not to pay your employees' nice benefits. The most likely alternative would have been dentures, which I'm sure you will agree are not such a good option at the age of 39.

So the question is whether what I lost by not taking out a mortgage on my house is worth the amount I saved by not taking out the mortgage. Here's where it gets interesting. I cannot for the life of me think of a disaster scenario that would cost me anything approaching $15,000 to fix even if I stayed home to have it done. TMJ trouble with the occlusion maybe, but fixing that wouldn't require replacing all the caps. If one or two of them actually do break, I can take care of them as it happens.

In the worst-case scenario -- I have long-term problems, Dr. T is no longer in business to honor his guarantee, and I have to have more work done in the US to fix it -- I am still ahead. I have saved my teeth, and at a cost that didn't require me to mortgage the house. Potential problems are unlikely to require a mortgage either. And they are deferred for at least a few years, while the original situation was a dental emergency that could have struck me any day.

I know many people who are in a similar situation -- they need major work which they aren't having done because they simply can't afford it. Often an inferior job that actually gets done (if it really is inferior) is still better than letting the situation get progressively worse until teeth are permanently and irreplaceably lost.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

long live the NHS (1.20 / 5) (#56)
by reklaw on Sun Dec 21, 2003 at 10:59:42 AM EST

I'm so glad I don't live in America.
Yeah (2.25 / 4) (#62)
by wij on Sun Dec 21, 2003 at 02:46:01 PM EST

Thank God I don't live in a country where the healthy don't have to pay for the sick's healthcare. Given how often I need it, I'd be bankrupt if I wasn't able to use others' money to pay for the services I need.

"I am an intellectual of great merit, yet I am not adequately compensated for this by capitalism; this is the reason for my opposition to it."
[ Parent ]
You'd be bankrupt? (none / 2) (#124)
by Dr Caleb on Mon Dec 22, 2003 at 03:21:24 PM EST

I have no problem paying $34 a month. In fact, when my friends child was born with a heart defect, they only had to pay $34 that month too. Guess my $34 the month before saved them from having to go hundreds of thousands of dollars in debt for the multiple operations the kid has had in his 10 year old existance.

When some goof ran a red light and t-boned my car, I guess that $34 didn't save me thousands in medical bills when they had to put pins in my arm. When my mother was dying from lung cancer, I guess the morphine that she needed daily wasn't worth my $34 a month.

I see what you mean. I shoulda saved my $34 a month, and second mortgaged my home to some HMO for my care. Great system you have there. Keep up the good work.

Vive Le Canada - For Canadians who give a shit about their country.

There is no K5 cabal.
[ Parent ]

i wouldn't go that far (none / 1) (#78)
by werner on Sun Dec 21, 2003 at 06:54:26 PM EST

i remember vividly my father complaining how he couldn't afford to have gold crowns (i think), which is what he needed, on the NHS.

his unemployed brother got all his gold crowns for free. wanker.

[ Parent ]

In general... (none / 1) (#104)
by gordonjcp on Mon Dec 22, 2003 at 09:54:42 AM EST

... you can get whatever you want from the NHS. If it's more than they're prepared to pay for, you can make up the difference yourself.

Even so - private healthcare is a fuckload cheaper in the UK. Getting two impacted molars out at my dentist cost me all of £45 - how this even pays for two hours of work, never mind implements and consumables, beats me.

Give a man a fish, and he'll eat for a day. Teach a man to fish, and he'll bore you rigid with fishing stories for the rest of your life.

[ Parent ]
that was my point (none / 0) (#106)
by werner on Mon Dec 22, 2003 at 10:22:21 AM EST

he couldn't afford to make up the difference. unemployed people get it all done for free though, which is wrong. they should get the absolute minimum for free. no gold. no white fillings etc.

[ Parent ]
It's TCO (kind of) (none / 0) (#110)
by gordonjcp on Mon Dec 22, 2003 at 11:24:01 AM EST

If you do a cheap shoddy job on fixing someone's teeth, they're going to be back in *months* with even more problems. Better to spend the money once, and never see them again.

Give a man a fish, and he'll eat for a day. Teach a man to fish, and he'll bore you rigid with fishing stories for the rest of your life.

[ Parent ]
missing the point... (none / 0) (#122)
by ckaminski on Mon Dec 22, 2003 at 02:56:11 PM EST

Yes, it's always best to do the job right the first time... especially if it's on someone elses dime.  But he's complaining about what is true discrimination, middle class discrimination, really.  Now, if there'd been an NHS payment plan...

[ Parent ]
There is. (none / 0) (#133)
by gordonjcp on Tue Dec 23, 2003 at 06:43:20 AM EST

He's just whining because he can't get the top whack treatment for free, even though he can afford it himself.

Give a man a fish, and he'll eat for a day. Teach a man to fish, and he'll bore you rigid with fishing stories for the rest of your life.

[ Parent ]
The Doctor Will See You... (none / 3) (#103)
by op00to on Mon Dec 22, 2003 at 09:24:58 AM EST

In the next 3 years. Thank you.

[ Parent ]
Halfway through I just HAD to go & brush teeth (2.50 / 4) (#58)
by laotic on Sun Dec 21, 2003 at 01:16:19 PM EST

Nice article, even though myself I'll hopefully escape the tooth-plight for some years.

The prices seem to be very high - last time I had a filling done here in Slovakia, it cost me to the tune of $7. My relative had a full bridge done for (I believe) about $400.

Laser eye correction costs about $350 and although I would have thought Romania would is on a similar price level (having been in the same camp), an earlier commenter mentions prices which seem rather high to me.

And for those on a crusade about the perception of dentistry quality: it's the end result that counts. Say what you want, the dirty east bloc/mexico/wherever outside U.S. may lag so much, yet our teeth work just as well. Anybody from Russia care to comment?

Sig? Sigh.
How do you feel about arsenic? (none / 3) (#144)
by drstrangelove on Wed Dec 24, 2003 at 09:27:41 AM EST

Those prices "seem" "very high" because the cost of doing business in the United States is also very high. I run a very low-cost dental office, and I couldn't afford to charge less than the $610 fee for a crown that I do. After the lab fees, material costs, etc, etc there's not much left over. Remember, one of the benefits of having work done in the United States is the ability to seek recourse if something goes wrong. That's another reason for higher fees: a litigious society means expensive (yet mandatory) malpractice insurance. Also, as far as Eastern Block dentistry is concerned- I used to see many Russian patients and rarely saw anything that was even "clinically acceptable" (a euphemism that damns with faint praise.) Root canals were completed with arsenic, which essentially kills any living tissue within the tooth, and continues doing so for many years. Would you like arsenic in your tooth? A dentist.

[ Parent ]
I dont know about Russian dentistry... (none / 0) (#155)
by laotic on Sat Jan 03, 2004 at 09:21:40 AM EST

and you are perfectly right about the cost of business in the US, although I wouldn't boast the right of monetary recourse as a big benefit that should be paid everytime I go to a doctor.

When I said the prices seemed high I meant the Romanian prices, which should be more on par with our country. Remember, we still earn 5x less in real terms than the west.

And about those Russian fillings with arsenic - every person who came to do some work on my appartment, be it plumbing, paintwork, plaster or what-not, every single one of them, said that what the others do, and more specifically, what their predecessor had done, was just utterly, completely, totally bad. And of course, they themselves do it best.

Sig? Sigh.
[ Parent ]
Congratulations. (1.69 / 13) (#60)
by Trollaxor on Sun Dec 21, 2003 at 01:59:37 PM EST

You out-clevered the system and only blew $10,000 instead of $20,000. You are vary clevar as your write-up about the experience proves, but it seems that even the clevarest of the clevar aren't perfect in every aspect of this human life. I do believe I have some small bugget of knowledge that you were painfully ignorant of and I would be remiss not to suggest something that may prevent you from having to research foreign countries and black-market doctors again.

It is a simple fact, and one that will cost less than $24 a year, which boiles down to less in your entire lifetime than you just paid for the procedure in Tijauna. Don't be offended and don't take it the wrong way; I just like helping people. Without further ado here is my sliver of wisdom that I now pass on to you:

Brush your teeth.


About brushing my teeth... (2.16 / 6) (#63)
by localroger on Sun Dec 21, 2003 at 03:20:53 PM EST

Lack of brushing my teeth didn't cause the problem. Griding them in my sleep did.

The fact is my teeth were and still are quite healthy, other than this mechanical damage, which is why I didn't need root canals.

No amount of brushing and flossing will keep your teeth from wearing down if you have bruxism.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

I dunno buddy (2.10 / 10) (#67)
by Hide The Hamster on Sun Dec 21, 2003 at 04:58:22 PM EST

Even if you grind your teeth, I would say that it would be possible for all of your teeth not to look like you've been rimming a horse with digestive problems.

Free spirits are a liability.

August 8, 2004: "it certainly is" and I had engaged in a homosexual tryst.

[ Parent ]
Dentist wouldn't clean them (2.80 / 5) (#68)
by localroger on Sun Dec 21, 2003 at 05:35:29 PM EST

The problem is that with the dentin exposed, they become sensitive to the measures you'd use to clean them. The discoloration was not the problem, and could have been fixed much more easily if it was.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]
re: I dunno buddy (1.16 / 6) (#86)
by Trollaxor on Sun Dec 21, 2003 at 08:34:30 PM EST

omfg rorlolf

[ Parent ]
ror (1.16 / 6) (#87)
by Hide The Hamster on Sun Dec 21, 2003 at 08:51:49 PM EST


Free spirits are a liability.

August 8, 2004: "it certainly is" and I had engaged in a homosexual tryst.

[ Parent ]
The British have the answer. (1.28 / 7) (#71)
by Phillip Asheo on Sun Dec 21, 2003 at 05:50:55 PM EST

Eschew dentistry altogether!

"Never say what you can grunt. Never grunt what you can wink. Never wink what you can nod, never nod what you can shrug, and don't shrug when it ain't necessary"
-Earl Long

we do not "eschew" dentistry (none / 3) (#76)
by werner on Sun Dec 21, 2003 at 06:50:57 PM EST

fact of the matter is, in britain we ain't so hung up over physical appearances as you yanks and we don't go in for corrective surgery if there's nothing wrong with your teeth (or nose, tits, arse etc.) other than they ain't as straight or as white as they could be. we are, fortunately, not obsessed with physical appearance, like oh so many americans.

fine, if you don't mind being milked for every penny by your dentist for unnecessary treatment. your premiums go up, not mine.

[ Parent ]

Pride is bad enough. (2.00 / 5) (#83)
by International Bestseller on Sun Dec 21, 2003 at 07:38:13 PM EST

Pride in ugly takes a Brit. Did the vicar teach you to hate Americans because they're beautiful?

#1 on the NY Times bestseller list 37 weeks in a row.
[ Parent ]

Hardly the dominant factor (none / 3) (#101)
by thewookie on Mon Dec 22, 2003 at 08:55:39 AM EST

'Beautiful' as a national attribute eh, by what criteria was that selected?

I'd say the evidence would point towards obesity being a more dominant cosmetic attribute in the US - by quite some margin - sure, fix your teeth up, maybe someone will actually see them over your volumous waistline before you keel over at 40 with a coronary.

[ Parent ]

funny (none / 3) (#105)
by werner on Mon Dec 22, 2003 at 10:20:54 AM EST

everyone i know who's been to america says the defining characteristic of americans - excepting their perfect teeth, of course - is that they are obese. and ignorant.

couldn't say whether or not you're a big fat bastard, but you sure as hell are an ignorant one.

[ Parent ]

I don't know any fat people. (none / 2) (#109)
by International Bestseller on Mon Dec 22, 2003 at 11:17:52 AM EST

Everyone you know? Everyone you know is tainted by association.

#1 on the NY Times bestseller list 37 weeks in a row.
[ Parent ]

is that how it works? (none / 3) (#111)
by werner on Mon Dec 22, 2003 at 11:24:10 AM EST

then i'd best stop talking to you then, before your laughable idiocy starts to rub off on me.

[ Parent ]
It seems you are too late. (none / 2) (#113)
by International Bestseller on Mon Dec 22, 2003 at 11:50:07 AM EST

That's funny, that crack about associating with idiots. I'll try to remember it.

#1 on the NY Times bestseller list 37 weeks in a row.
[ Parent ]

British Prick (none / 0) (#159)
by kurioszyn on Sat Jan 31, 2004 at 01:31:11 PM EST

Man you truly a cocky mothefucker for a idiot who owns his freedom to these very Americans.

[ Parent ]
hardly (none / 1) (#100)
by thewookie on Mon Dec 22, 2003 at 08:38:03 AM EST

I've had various treatments, including full root canal work, done here for nothing, nada, not a penny/dime - just pop in to my local NHS dentist, make an appointment & get it done. No need to mess around crossing borders etc.

It's gotta suck not having a national health service, you bitter by any chance?

[ Parent ]

Fixing (none / 1) (#84)
by veldmon1 on Sun Dec 21, 2003 at 08:08:30 PM EST

Thank you for the grammar fixes. No, this is not supposed to be funny.

español (2.60 / 5) (#85)
by mlc on Sun Dec 21, 2003 at 08:28:17 PM EST

The Spanish word for “no” is “no.” “Non” is French.

Which I suppose only reinforces your point that your Spanish isn't all that great. (Not that mine is super...)

So the Berne Convention is the ultimate arbiter of truth and morality. Is this like Catholicism? -- Eight Star

My teeth hurt! (none / 2) (#89)
by dougmc on Sun Dec 21, 2003 at 09:26:16 PM EST

I had my wisom teeth out last thursday (3.5 days ago.) I'm 35. My top wisdom teeth came out with no problems, but the bottom were underneath the jaw and required some cutting through the jaw to get them out.

For the most part they didn't give me too much grief, but one of the bottom ones was half covered with skin, and kept getting food caught in there which would then rot and get infected. Not fun.

The dentist (a US oral surgeon, suggested by my regular dentist) knocked me out, and I think I'm glad. The bill? $1700, but I think my insurance will pay most of that. When I made the appointment, they said my part would be about $300. When I got there, they said they'd charge me $300 then and would see what my insurance paid -- sending up red flags. I probably should have negotiated right there, but I just wanted it over with and said `well, you said $300. If it's more, I'll be bitching ...' and went along with it.

I've now got two oozing sores in my mouth (the top two teeth have mostly healed already), two stitches have come out and I don't know where from, and I look like a chipmunk. Advil keeps the pain away for the most part (he gave me some stronger stuff, but I don't like how it makes me feel.) As long as I don't eat I do ok (and yet I'm supposed to eat!)

I have no idea how normal this is. I'll see the dentist tomorrow and find out what he thinks about it. For now, I think it's time for more advil ...

How is this relevant? It's not. But it's a very large thing in my life right now, so ...

Just had mine removed as well (none / 1) (#132)
by Osty on Tue Dec 23, 2003 at 03:40:26 AM EST

I had my wisdom teeth removed a week ago last Friday.  I'm 25, and the uppers were fully in (though tilted out to the side slightly), and the lowers were impacted, with one almost completely sideways (crown pointing towards the rear molar).

Regarding your current state and pain (though you've surely seen your doctor by now), what you described seems about normal.  I'm not so sure about the oozing part, since any major bleeding should've stopped on the first day.  The stitches came from the bottom incisions, as a preventative measure to keep foodstuffs out of the area, as well to help healing.  The stitches are usually degradable, and I had one come out the first day of the surgery, and the other one several days after that.  My dentist said it was normal and there was nothing to wory about.

Stick to the soft foods for now.  I got completely sick of scrambled eggs and soup, but it kept me alive and the dentist commented on how clean my holes were during the follow-up appointment.  You'll get a little syringe to flush out crap once you're sufficiently healed (about a week, though you may have it sooner), and use it every time you eat.

For the pain and swelling, I didn't really have any.  I did get a 600mg Ibuprofen prescription, and a Vicodin prescription, and while I used most of the Ibuprofen I used hardly any Vicodin.  The swelling can be helped by a cold compress during the first few days, and then with saline mouth rinses occassionally after that.

I'm pretty well healed now (a week and three days after the surgery), and have been eating solid food since last friday (a week after the surgery).  I'll be flushing my holes for the next couple weeks, but otherwise it's business as usual.

My only complaint is that the location of the roots of the teeth caused the dentist to bump (hopefully not damage!) a nerve, and now I have little feeling in the right side of my chin.  Worst case scenario is that it's permanent, but I won't know that for sure for 6 months (if the feeling isn't back by the end of this week, it won't fully recover for at least 6 months; any longer and the damage is permanent and I either have to live with it or have specialized nerve treatment surgery which is only performed in certain medical centers in the US by a handful of specialists and will almost definitely break the bank).

Buck up!  The worst is over.  If you haven't developed dry sockets by now, you're not going to, and from what I've been told dry sockets are the only really nasty thing you have to worry about with wisdom teeth (I didn't develop dry sockets, even though I smoke and one of my upper teeth had penetrated into a sinus cavity, leaving a hole when it was removed).


NoPopIE, Internet Explorer popup killer (win2k/xp only, for now).

[ Parent ]
Dry sockets (none / 1) (#135)
by rusty on Tue Dec 23, 2003 at 10:22:07 AM EST

I had my wisdom teeth out a few years ago, and the healing went swimmingly until one day, probably two weeks after the surgery, when I took a nap at a friend's house. I woke up from slowly increasing pain in my face, and by the time I was fully awake, it was agony. I drove home (about a half hour trip) feeling every tiny bump and jolt along the way. I can definitely say it was the worst pain I've ever felt which lasted longer than a few seconds. Hitting my thumb very hard with a socket wrench was worse, but that wore off quickly. This just kept going and going.

When I finally got home, I was in so much pain that I didn't recognize an uncle who was over visiting. "Some stranger in the family room. Whatever. Oh god it hurts." That sort of thing. I finally got my hands on the emergency Percocet that the surgeon had prescribed, and about ten minutes later the pain was finally gone. I was carted back to the surgeon in my drugged stupor, and he said I had developed a dry socket. It was re-closed, with a small wad of gauze soaked in clove oil inside it. This made everything I ate for the next few days taste strangely like a Christmas ham, but it did the trick.

All I can say is, if there's anything you can do to avoid dry sockets, do it. But mine happened while I was asleep, so  it might just be the luck of the draw. But I can say that 4 days is not enough time to say that you're out of the woods. Mine happened literally weeks later, when I wasn't even taking the regular mild pain medication anymore and had all but forgotten about the whole thing.

Not the real rusty
[ Parent ]

Pain (none / 1) (#143)
by lauraw on Wed Dec 24, 2003 at 03:56:10 AM EST

>For the pain and swelling, I didn't really have any.

I wonder if the pain level is correlated with age? I had mine out when I was about 19 or 20, and it wasn't very painful at all. I didn't take any of the serious painkillers and only a little bit of aspirin. (I even wanted to drive home after the procedure, but that probably had more to do with how high I was flying on the drugs they gave me during the extraction. :-) My uppers were coming in straight, but the lowers were severely impacted and were aimed forward and down. Those came out in small pieces. Fortunately I was unconscious

But when my father had his taken out in his late 20's, he was in lots of pain for quite a while. One of my earliest memories is of him stumbling around the house groaning like some sort of ogre for a few days. I don't know if the pain level is usually age-related, or if it was just a coincidence in this case. Any dentists out there?

[ Parent ]

Guatemala, as well (none / 2) (#95)
by frijolito on Sun Dec 21, 2003 at 11:34:53 PM EST

As a Guatemalan, I'll just quickly mention that many of my gringo friends have also made the quick trip down here and saved themselves quite a bit. But they don't come here just for dental: kneecap surgery, stomach surgery, and such other stuff. The major advice I would give, is find someone in the target country who you know has expertise and can lead you to the best local doctors. Since my mom's a doctor, and has many contacts, I have become that person to my cheapskate foreign friends. And, Roger, great stuff.

Cautionary tales (2.20 / 5) (#97)
by lauraw on Mon Dec 22, 2003 at 01:35:46 AM EST

Congratulations on getting your teeth fixed. It sounds like you did your homework and found a great dentist. I've started to have some teeth-grinding problems myself, probably due to stress from starting a new job. If it's still happening when I next see my dentist, I'm going to ask about getting some sort of guard to keep it from damaging my teeth. Especially after seeing those photos.

Unfortunately, I do know of a few counterexamples where people who've gone out of the country for surgery ended up unhappy. (Dead counts as unhappy, right?) I don't think any of these stories are reasons not to do it, they're just things to think about. And as will become obvious, I have some strange friends.

Five or ten years ago, a friend of mine decided she wanted breast implants. New breast implants, actually. She had some perfectly good ones (in my opinion, anyway), but wanted them taken out and replaced with bigger ones. She had the surgery done in Tijuana, for several reasons. First, she thought silicone-filled implants were better than saline ones, and at the time she couldn't find a US surgeon who would put in silicone implants even if she signed a liability waiver. Second, the surgeon she talked to in the US didn't want to put in implants that were that big. Finally, the surgeon in Tijuana was much cheaper.

You can probably guess what happened. She went to Mexico and got the big implants, and a few months later she started having chronic pain in her torso. It got pretty bad after a year or two, so she talked to some more surgeons and the consensus was that the new implants were too large. My friend, of course, decided to have them removed and replaced with smaller ones again. To do it, she went to the same surgeon in Tijuana, mostly for the same reasons: silicone implants and cost. The second surgery went semi-ok -- she now has normal-looking breasts but she still has chronic pain. This whole mess was pretty much self-inflicted. A more, er, deliberative person would have listened to the people who told her not to do it in the first place or would have gone to the surgeon in the US who she knew and trusted and let him put in the biggest ones he thought were safe.

The second case is the strangest one. An acquaintance of mine had finally saved enough money for sex reassignment surgery after living as a woman for several years. For some reason (like being totally #$%#@ crazy and somewhat self-destructive) she decided to go to a Dr. Brown in Tijuana. He's known in the community as "Butcher" Brown, and he lived up to his name. She got more or less butchered and ended up having to have multiple procedures to fix it. The fix-up procedures were from other surgeons, though, so at least she learned that lesson.

As a side note, this is the same Dr. Brown who was later jailed for amputating the leg of a patient who was an amputee fetishist. There was no medical reason for the amputation, but the guy wanted one, so what the hell. I'm impressed by a doctor who manages to get arrested for medical malpractice in Tijuana. And no, I did not know that patient. :-)

The last case is the scariest one. I heard about it third-hand, but from a physician who I think is a reliable source. A woman from Europe came to the US to have her sex reassignment done. She flew from Europe to Portland, Oregon (a 12 hour flight?) and had the surgery done a few days later. During the recovery period, which requires two days of total bedrest and then a week or so of minimal walking, she suffered a deep venous thrombosis. The clot escaped into her bloodstream and turned into a pulmonary embolism and she died from it.

I find this one scary because the woman pretty much did everything right. She went to an extremely good surgeon, arguably the best in the world and certainly in the top 5. It can probably be categorized as one of those "shit happens" incidents. Surgery is risky. But just in case, this surgeon now requires patients to wait a longer period of time after taking long flights to have surgery and before taking long flights home. I guess the moral of this story is that if you need major surgery, distance is a factor for medical reasons and not just convenience.

Finally, another side note. I've learned first-hand that the one thing you do not want to hear a surgeon say is "That never happened before!" It's much, much worse than "Oops!"

I didn't even finish the article... (none / 2) (#98)
by reeses on Mon Dec 22, 2003 at 02:39:39 AM EST

before I went into the bathroom and flossed and brushed the bejesus out of my teeth, and cleaned my nightguard and put it on. I'm screwed, because I can tell I'm close to the dentin on one molar, but I figure I don't need to rush it. :-) Yeesh.

me too! (none / 1) (#149)
by makohill on Wed Dec 24, 2003 at 11:32:44 PM EST

This story is responsible for the best toothbrushing I've had a in a long time. :)
Creativity can be a social contribution, but only in so far as society is free to use the results. --RMS
[ Parent ]
Did you try Canada? (none / 3) (#112)
by brunes69 on Mon Dec 22, 2003 at 11:40:20 AM EST

I see lots of mention of poorer South AMerican countries, and Thailand, but did you try comparing Canada?

I doubt it is *quite* as cheap for dental work up here as Mexico, but combined with the American dollar's higher buying power, you'd probably save at least 50%, and have the peace of mind of getting the work done in a first world country with plenty of protections against shoddy work an malpractice, things I wouldn't be nearly as confident about while getting medical procedures done in Mexico.

---There is no Spoon---

I had two wisdom teeth removed there. (1.80 / 5) (#117)
by UncannyVortex on Mon Dec 22, 2003 at 12:10:41 PM EST

A friend and I drove to Nuevo Laredo, where he took me to a dentist's office.  I had four "bony impacted" wisdom teeth that needed to be removed.

We had no appointment.  The dentist had no other patients -- he simply motioned for me to sit in the chair.  I looked around the little room -- it was not very clean or well organized, and the equipment was quite dated.  He spoke no English, so my friend talked to him for a minute.  The plan was for him to remove the upper and lower wisdom teeth on one side.  The price?  $40 per tooth.

Shortly afterward, he had a large syringe in my mouth and administered local anesthetic.  Then he got out a drill and began drilling.  He used the drill to break apart the teeth, then would reach in to remove the shards, or have me spit them out.  During the entire procedure I was seated upright, perhaps to keep pieces of tooth from going down my throat.

For a couple of months after the operation, shards of wisdom tooth kept working their way out of my gum.

Later, I had the other two wisdom teeth removed here in the states.  The price was around $550 per tooth.  Their office was clean, they used a general anesthetic, and I don't remember a thing.  There were no shards left stuck in my gums afterward, however.

Would I do such a thing again in Mexico?  40 bucks per tooth is an attractive price, and he did get the job done.  However, I'm sure that there's a greater risk of experiencing malpractice than you'd find in the states.


Not quite the way I'd have done it (none / 2) (#128)
by localroger on Mon Dec 22, 2003 at 04:20:41 PM EST

I don't consider the general anaesthetic a plus. There is a definite risk every time you go under general anaesthesia that you won't ever wake up. The dental operation, by contrast, is relatively safe by comparison. (And I am serious about this; I had my inguinal hernias repaired under local anaesthetic for the same reason.)

Impacted wisdom teeth are exactly the sort of thing that would make me put some care into the choice of dentist, though. Dr. T's rates are higher than standard, and I have a pretty good idea why after having him work on me.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

General anesthesia (none / 2) (#129)
by lauraw on Mon Dec 22, 2003 at 11:58:41 PM EST

>I don't consider the general anaesthetic a plus. There is a definite risk every time you go under general anaesthesia

Definitely. I had knee surgery last summer and tried to talk them into doing it with a local anesthetic. They ended up using a general, but I made them give me good reasons first.

However, the in-office anesthetics used for dental procedures and some other things like colonoscopies and bronchoscopies often aren't true general anesthetics. Most real general anesthetics suppress your breathing and require a ventilator (and an anesthesiologist), so there's a good reason to avoid them. Instead, they often use an IV "cocktail" of drugs like morphine, valium, and versed. It makes you totally zoned out but still marginally awake (the morphine and valium) and keeps you from remembering what happened (the versed).

Personally, I really dislike amnestics like versed. Every time I've been given the stuff I feel totally clobbered for several days. When I had the knee surgery last summer, I asked the anesthesiologist not to use any amnestics at all, and it was much less unpleasant this time.

[ Parent ]

General Anaesthetic (none / 0) (#156)
by hughk on Sun Jan 04, 2004 at 04:48:31 AM EST

It is not normal medical practise to give a general unless it is really needed. Generals are dangerous and a well known side-effect is bad depression after a procedure. Locals are less likely to cause complications during or after the procedure.

A dentist receives training in anaesthesiology but is not a specialist. You really don't want to have a general administered without a specialist anaesthesiologist to supervise.

As for pieces of Wisdon tooth emerging, I was warned this could happen after a procedure with a particularly nasty one. Fishing for bits of root when it doesn't come out cleanly isn't easy. You may just have been unlucky for that first tooth.

[ Parent ]

Dentistry even cheaper than mexico... (1.50 / 10) (#119)
by flippy on Mon Dec 22, 2003 at 01:49:19 PM EST

I had all FOUR of my wisdom teeth pulled at the same time, FOR FREE!... Thats right, FOR FREE!...  In fact I got paid to sit in the chair.  How did I do it?  Its easy.  Join the military!  Lets see, I had free surgury to remove a mole, all the MORTIN I could swallow, and many other benefits.  

Plus You get trained to be a baby killer.  Shhhwwweeeeet!   Unless you join the reserves, then you only get to clean up after I kill the babies.


you also get (2.25 / 4) (#141)
by Dirty Sardine on Tue Dec 23, 2003 at 07:42:06 PM EST

to have big daisy chains every night.  face it, there's nothing more homosexual than the US army.

hot gay sex now
[ Parent ]
a few questions (2.00 / 6) (#125)
by priior on Mon Dec 22, 2003 at 03:35:11 PM EST

if you needed open heart surgery or a liver transplant, would you still go to mexico to do it because "it costs less money"?

are dentists in mexico "certified" by the government? do they get inspected regularly for standards of practice?

things that bother me about the entire story:

(1) You got a full mouth rehabilitation done in 1 week!! full mouth rehabs are very delicate and could have long term consequences that might go unnoticed in the short term.

-> Do you have any form of protection if such a thing happens? (redo the work, pay for replacement, etc...)

(2) Did you get the work checked by a local dentist that u can trust? After dishing out thousands of dollars, it seems reasonable to spend another 50-100$ just to make sure the prosthetic work doesn't have any major flaws. ("pinching" of gum, hard to clean areas, bad occlusion, etc...)

i don't want to bash mexican dentistry or criticise your decision to valuate dental work purely based on its cost, since im not familiar with neither mexican dentistry nor your sense of good judgement.

i just feel the readers should be informed of the potential risks associated with getting major dental treatments done in other countries just because of financial reasons.

disclaimer: i'm a canadian dentist.
--- priior
Answers (3.00 / 4) (#127)
by localroger on Mon Dec 22, 2003 at 04:16:44 PM EST

if you needed open heart surgery or a liver transplant, would you still go to mexico to do it because "it costs less money"?

If the alternative was not having it done at all because I couldn't afford it, yes. And that was the case here.

are dentists in mexico "certified" by the government? do they get inspected regularly for standards of practice?

I don't know if Mexico has requirements, but my particular doctor claims to adhere to American standards, which may be necessary since he accepts American dental insurance. In any case I personally observed him faithfully following all the sterilization procedures he describes on his web page.

You got a full mouth rehabilitation done in 1 week!!

Where did you read that? It took six visits and three trips over a span of two months. And it would have almost certainly taken more if I'd needed root canals, etc.

Do you have any form of protection if such a thing happens? (redo the work, pay for replacement, etc...)

The work is guaranteed for life -- presumably either my life or the life of Dr. T's practice, whichever is shorter. Obviously, though, it would not be worth my while to fly to San Diego just to get something like a loose crown re-cemented, it would be if I develop a major problem with the work.

Did you get the work checked by a local dentist that u can trust?

I don't know any local dentists I would trust to do this job. I never bothered looking for one because I knew I couldn't afford what it would cost.

If I actually suspect a problem I'll certainly do that, but would you suggest I have the work of my American dentist which I have just done and seems fine double-checked just in case he's a quack?

As I explained below to another dentist, I work with a lot of professional people and I don't need to be able to do a job to tell whether the person doing it is exercising diligence or knows what he is doing. I did not, nor do I recommend, simply walking across the border and looking for the first sign that says "cheap dentistry."

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

Same for South Africa (3.00 / 3) (#138)
by Builder on Tue Dec 23, 2003 at 01:57:19 PM EST

As a South African living in London, I needed to have work done to my teeth last year. I needed the following done:

  • 2x Wisdom teeth removed
  • 2x teeth needed root canal
  • 2x crowns
  • 9x fillings
  • 6x fissure sealants

The amount quoted me was GBP2100.00. For this price I was able to get 2 return flights to .za (for my wife and myself), all of the dental work done, 2 nights accomodation in a fishing lodge, a weekend fishing on my dad's boat and a 2 week holiday.

All the work was done in 1 week, and the dentist who did the work caused me less pain than the dentist who did my checkup in London.

Bargain! :)
Be nice to your daemons
Why not walk? (none / 2) (#139)
by ucblockhead on Tue Dec 23, 2003 at 05:06:41 PM EST

I'm not sure why you suggest not walking across the border. When I lived in San Diego, this was the way we always did it. It was only a ten minute walk from the gate to Revolucion. You can generally do it quicker than a cab would take. The only real downside is the smell of the Tijuana river.
This is k5. We're all tools - duxup
You have to know the area (none / 1) (#140)
by localroger on Tue Dec 23, 2003 at 06:27:12 PM EST

I did walk around a bit and I could never figure out just where to go, and several folks warned me to be very careful about ending up in parts of TJ where a lone gringo with no Spanish definitely would not want to be. In the end I decided to err on the side of caution.

If I had a local to show me the best route I might have walked, but I didn't (and I anticipate that most of the people reading this won't, either).

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

capitalist decadence (1.20 / 5) (#146)
by chanio on Wed Dec 24, 2003 at 10:53:25 AM EST

  • action: dentist raise value of their work without loosing to much patients.
  • reaction: affected patients get outside US economical influence area to get their job cheaper.

Politics apart, these are signs of a deep future economical crysis.

People aware of this should start doing something to change this tendency.

An alternative economical system where everybody that share the same ammount of working efforts could have access to the same level of benefits. This is the same description of misery but applied long before it really happens!

People might unite and save some of their daily working efforts before it is too late and regret from not paying more attention to this tendency. It happens the same with ecology. Everybody sees these contradictions but are not able to do anything to stop it because the government doesn't seem to pay attention to it.

One solution might be to create a trust system based on cooperativism. There are lots of ways of sharing the benefits in order to ensure a normal living to everyone.

Get informed!
Farenheit Binman:
This worlds culture is throwing away-burning thousands of useful concepts because they don't fit in their commercial frame.
My chance of becoming intelligent!

er... (none / 0) (#157)
by joeyo on Tue Jan 06, 2004 at 01:46:13 AM EST

At the risk of feeding the trolls...

  • action: dentist raise value of their work without loosing to much patients.
  • reaction: affected patients get outside US economical influence area to get their job cheaper.

It seems to me that people leaving the country for a good or service actually leads to the market becoming more efficient, i.e. if a significant number of people go to Mexico to get dental work done, then local dentists will lower their prices.

This is how it should be. If "Free Trade" truly allowed for free movement of people as much as it allows free movement of companies and goods most of its ills would me mitigated.

"Give me enough variables to work with, and I can probably do away with the notion of human free will." -- Parent ]

yes, but... (none / 0) (#158)
by fab13n on Tue Jan 06, 2004 at 01:09:50 PM EST

An alternative economical system where everybody that share the same ammount of working efforts could have access to the same level of benefits.

Yes, this would be nice, but don't forget that USA is demographically not representative of the world. Therefore, what you (rightly IMO) advocate is to make USA lifestyle closer to the current mexican one rather than the other way around.

[ Parent ]

Similar to buying prescriptions out-of-country (none / 0) (#147)
by pspinler on Wed Dec 24, 2003 at 03:02:11 PM EST

Perhaps municipalities, state governments, and insurance companies will start encouraging their employees or customers to get off-shore medical treatment as a way to save costs, similar to the manner in which several are promoting purchasing drugs. -- Pat

My father is a dentist (none / 0) (#150)
by mcrbids on Sat Dec 27, 2003 at 01:01:50 PM EST

I have a significant amount of dental work that will need to be done. The condition of my teeth is probably similar to the condition of the author's mouth prior to the dental work.

I can say that I have no desire whatsoever to spend $20,000 on my teeth, and so far, that's been my cheapest option.

I live in Northern California, so the trip is probably not so bad. I am, however, rather concerned about the quality of dental care in Tijuana. Which leads me to my last point...

My father lives in southern Cal and is a competent, but retired dentist who also did a fair amount of orthodontestry. So, I'll be enlisting his help to oversee the entire operation... I'll be looking into it!

I kept looking around for somebody to solve the problem. Then I realized... I am somebody! -Anonymouse

Good luck, Ben (none / 0) (#152)
by localroger on Sat Dec 27, 2003 at 08:56:59 PM EST

Those who have weighed in here from the northern lands suggest you will save some by going to Canada, but not nearly as much as I saved going to Mexico. But there are other tradeoffs, such as liability, so all I can advise is to go with your best option.

Good luck!

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

Canada? (none / 0) (#151)
by Jumery on Sat Dec 27, 2003 at 01:54:02 PM EST

Anyone do any investigation on the costs to goto Canada for dental work?  They might be a good choice if you want to pay a little more for a better treatment.

grinding (none / 0) (#153)
by biguglysprawl on Mon Dec 29, 2003 at 11:50:29 AM EST

A couple years back, at my last dentist appointment, it was pointed out to me that I was showing some signs of bruxism. It wasn't too surprising, as someone I'd lived with mentioned hearing me grind away in my sleep. They wanted to fit me with a night guard for a couple hundred dollars, not covered by my insurance.

Of course, my cheapskate nature kicked in, feeling like the whole world is trying to nickle and dime me to death. I went to a sporting goods store and bought an athletic mouth guard, for maybe two bucks. I'm sure it's not as comfortable as the "real thing", and my gums feel a little odd in the morning, but I've cut the edges down to where it's tolerable. I suspect having it in my mouth reinforces the behavoir of biting down, but I imagine I'd wake in a panic if I wore something that kept my mouth open.

I've worn the guard only occasionally, when I think of it, or my teeth feel like they've been at it again. After reading this article, I've started putting it in every night. Is it the fear of losing my teeth, or of having to pay that much money? What a comment on things that I suspect it's more of question of economics than health for me.

Aw shit (none / 1) (#154)
by JayGarner on Tue Dec 30, 2003 at 11:56:44 PM EST

I had all my teeth pulled in 1999, I was worried about that Y2K thing. I got some cool jagged dentures like 'Jaws' from the Bond movies, though.

Some people go to Mexican dentists for the quality (none / 0) (#160)
by bryanth798 on Sun Oct 03, 2004 at 03:56:02 PM EST

It should not be assumed automatically that any American dentist is automatically superior to any Mexican dentist. I am reminded of Lenny Bruce's "Okay, you take Kate Smith and I'll take Lena Horne" statement, when someone suggested that any white woman was better looking than any black woman. One Mexican dentist, located in Ojinaga, Chihuahua, on the border across from Presidio, Texas, in the Texas Big Bend region, caters to mostly American patients who come to see her, not just for the prices she offers, but for the quality of her work. This is part of the reason why she has such a large case load and her practice keeps growing. It is because of the word of mouth recommendations that she gets from her patients.

The truth about dental work in Mexico! (1.12 / 8) (#161)
by qualident on Sat Nov 27, 2004 at 07:51:27 PM EST

Here is the truth about dental work in Mexico. Many dentists graduate and start a practice, and don't make money for many reasons. Poor marketing, competition, clients not paying, etc. This results in them not being able to afford the latest (expensive) supplies and equipment, and so they get stuck just getting by. Continuing education is also expensive, so many don't upgrade their skills. All of this results in Mexican dentists doing 50's dentistry in 2004.

How do I know all of this, a guy from Alberta, Canada? I have travelled to Mexico for dental work for many years. In my first visit, everything went great, except that both of my crowns came loose when I came home, and my wife's filling on her front teeth turned black.

The point is, many Mexican dentists will gladly take your money and do the work, but you may not be happy with the result.

Being the enterpreneur that I am, I saw an opportunity to make a lot of people happy, and to provide a good living for my family.

I leased a building right on the beach in Mazatlan, Mexico, built 4 dental rooms, and bought all of the latest equpment and supplies. I hired 2 English speaking dentists to work for us on commission, and opened for business. Sure, our prices are a bit higher than most dentists in Mazatlan, but in exchange we give you peace of mind, as we run our clinic like a U.S. or Canadian office.

Am I taking advantage of Mazatlan dentists by paying them on commission? Well, our dentist now makes more money with us, working the same hours, than he ever did in his own office. How about quality? Well, just last week, we had a couple come in who needed 8 crowns changed. Their work was previously done in Tijuana, and the crowns never fit properly. After 8 years of this, they decided to come to our clinic to get it done properly. We guarantee our work for 2 years.

Its very simple. You come here to save money on your dental costs, our dentist makes money, and I can provide a living for my family. The money you pay us gets distributed around Mexico, and in an indirect way, you are helping to aleviate some of the poverty in Mexico.

So, is this a big advertisement for our company? No, we do our advertising elsewhere, but after reading the some of these posts, I felt I had to tell the truth. There are safe places to go if you have thousands of dollars of dental work to get done, and you keep putting it off, and your dental health deteriorates. I urge you to visit our website, http://www.mexicandentalvacation.com and you will see that there is hope to have that smile of your dreams. It is safe and affordable. Then, make an appointment. Just that simple.

Visit http://www.mexicandentalvaction.com to save!
Arrrgh, topical spammation (none / 0) (#162)
by localroger on Sun Nov 28, 2004 at 11:56:43 AM EST

If this comment weren't *quite* so spammy in tone I'd thank you for leaving it; both the explanation of why some Mexican dentists are better than others and of how you set up your clinic are good things to know.

Of course, in several places I've expressly recommended against just hopping across the border and looking for the first sign that says "dentist." This is why I have referred almost 100 people to Dr. T in the year since this article went up.

If your tone was more like "here is what you should beware of, be careful which dentist you pick, here is how we tried to address the problem for you, good luck wherever you happen to go" it would be much better.

Incidentally, it has been just about a year since I had my work done and I have had none of the problems you mention with my 28 crowns.

I'm not going to rate your comment, but I have a feeling others will once it's noticed.

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]

heh (3.00 / 2) (#163)
by balsamic vinigga on Sun Nov 28, 2004 at 12:25:41 PM EST

I'm not going to rate your comment, but I have a feeling others will once it's noticed.

And you sure are making sure it gets noticed.

Please help fund a Filipino Horror Movie. It's been in limbo since 2007 due to lack of funding. Please donate today!
[ Parent ]

I didn't say I wouldn't do that :-) (none / 0) (#164)
by localroger on Sun Nov 28, 2004 at 12:42:32 PM EST

What will people of the future think of us? Will they say, as Roger Williams said of some of the Massachusetts Indians, that we were wolves with the min
[ Parent ]
some more information... (none / 0) (#165)
by qualident on Tue Dec 07, 2004 at 12:35:41 PM EST

It was certainly not my intention to offend anyone, I just wanted to tell people that there are some dentist who do good work, but it may take you a while to find them. I certainly don't want people to be a guinea pig on dentists who do crappy work, after all, I have done this myself, and it was not the best experience in the world. (Oh, how I have suffered, but for a good cause. lol!)

So what do I know about dentistry, a guy who does not have a dental background? In the last year, I have logged about 500 hours on various dental forums and websites, about 3-4 hours every day, as well as discussions with various dental business consultants, and this has given me a great picture of the way a dental business is run.

For example, graduating is just the first step. Every dentist in North America has to attend a certain number of courses for credits to keep their credentials in good standing, and if you want to be an excellent dentist, you will need to take more than the minimum requirement of courses. They are expensive, not to mention the lost income of taking days off from work. Here is an example. http://www.hornbrookgroup.com/ Check out the Full Mouth Synergy course, 9 days,(3 weekends) in Chicago for a cost of $9900. Here is another, in Las Vegas. $8495 http://www.lvilive.com/clinCourse_01.html So on and so forth. These are some of the investments that we are or will be making for our dentists.

Dentistry has a very high overhead, and here in Mexico, we can keep aour costs low because a lot of the supplies cost up to 90% less. The exact same package, the exact same item, but costs less. We pass the savings on to you.

We partner with a small lab, and as a result, are able to get our work back from the lab in 3 days. Same thing with the lab, if they need more equipment or an investment, we do it, because we don't want any delays for our customers. They are here for a week or 10 days mostly, and we get it done on time.

So is this us tooting our own horn? Well, some may see it that way, but I just want people to know that we are not just another clinic, we take our investment, our skills, and our customers VERY seriously. If no one tells you about us, you don't know, right? Our aim is, and always will be, to HELP people.

Visit http://www.mexicandentalvaction.com to save!
[ Parent ]
HOWTO: Get Your Teeth Fixed in Mexico | 163 comments (161 topical, 2 editorial, 6 hidden)
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