Costa Rica cosmetic dentistry, zirconium crowns, dental implants, porcelain veneers, Costa Rica Dentist, implantology costa rica, porcelain, laser whitening

The fancy computer monitor displayed a vivid picture of my mouth. Not a pretty sight. 53 years of gnawing, chewing, flossing not, brushing with the likes of an electric sander, and avoiding the pick-n-drill had finally caught up with me.

Before my eyes were 28 teeth, two of which were false and hanging from a 40-year-old removable partial. A good number of them caps that look like a patchwork quilt, and whats left were ground down, crooked, yellow, and overall yech! And if this wasn't enough, there were all kinds of cavities and problems with my gums. Indeed, time for a dentist.

Crowns for 18 teeth, attach a permanent bridge, sculpture the gums, and fill the cavities.

Out of the corner of my eye I see on the wall several framed parchments with foxy calligraphy all over them. The camera used to shoot my mouth was a good one, and the doc wore a neat tie. Must know what hes doing. We met via some research Id done on the Internet for cosmetic dentists in the Salt Lake City area. His site and credentials impressed me.

Now its been a long time since Ive done math without a calculator, but somehow my mind kicked in quick with a translation: $30,000 after-tax means something like $40,000 before. And thats 18 teeth. What about the other 10 remaining lost souls? Like many, no dental insurance. Im not so endowed as to be able to reach into my cookie jar and pull out this size of wad. Sell my house? Take on a night job? Make payments until Im 200? Whew!

Thats fine. We do great work and youll be very pleased. Let us know your decision.

After coming out of stunned, I said to myself, Self! you need dental work. Do it now, or do it later, but its ultimately got to be done. I then made some calls to other Salt Lake dentists and found crowns run in the range of $700 (a new-to-practice D.D.S.) to $1,500 each, with an average of $1,100-ish. And the other procedures I needed were all over the map. Any way I sliced it a big investment, be it 18 teeth or the 28 that should be done.

Comes now the laptop and a fast moving mouse. I type into Google cosmetic dentistry international. Theres been enough on the news about people going to other countries to get health care that I decided to look into it. After routing through a couple of pages of listings up pops Costa Rica. Lurking in some corridor of my memory was a recollection that this country gets big kudos for its health care system. I dont remember how this memory got there (another Ginkgo moment), but it was there nonetheless. So I started studying and liked what I found.

Of course, there are risks going abroad and having someone you dont know take a run at your bod. And perhaps some arrogance to the effect that foreign facilities wont be as groovy as those in the U.S. But there are risks here at home as well. Spend a day in an ER ward and youll most likely have a doctor you dont know working on you; several for that matter. Ive had some bumpy experiences with locally-provided dentistry, and to avoid coming across as snippy, Ill not belabor them here. Suffice it to say my psyche was cool with doing what needed to be done with a foreign provider. My research revealed that a group of Costa dentists focus on servicing multi-national clients; speak fluent English; many have been trained in the U.S. and regularly submit to advanced continuing education stateside and beyond; and, the products they use are all FDA approved. So my confidence grew.

All kinds of things have to be considered: What are the costs, including lodging, food, airfare, and time off. What if something goes wrong then or later? Or the procedures take longer than the planned trip. Or you show up with a violent case of the flu as youre about to confront 8 hours in The Chair. In my case, a 10-hour flight was the prelude to doing things this way. Once on the plane, cold feet pretty much expires as an option. And lurking in my mind was, Okay, I get there. Im captive. What will be the surprises? Of course, most of this anguish revolved around cost.

The cost-thing is tricky. Patently, a full diagnosis cant be made until the dentist has stared in your mouth. Until this happens, you cant pin down the impact on your wallet. This will surely drive your decision to hop on a plane or drive to your local clinic. The way I did it was get the records (digital picture-files of my mouth and x-rays) from my SLC dentist and E-mail them over to the dentists I selected. Well talk about this selection process in the next paragraph. With them, they were able to give me an idea about costs. It was such a compelling savings that I threw my taw in the ring and went for it. I did this knowing I should build a budget-buffer for unforeseen. And indeed, there was unforeseen. More about this later.

Theres a website called www.arrivacostarica.com. Its dedicated to cosmetic health care, which is an international niche Costa Rica has wrapped its arms around. There is a lot of information on this site about procedures and their costs. This is where I bumped into several provider-candidates. I sent some pings to those bios that most impressed me, and got replies from all of them. After carving through literal piles of information, I made my final cut: Telma Rubinstein and Josef Cordero Pinchanski, a spouse-team that owns Prisma Cosmetics-Dentistry in San Jose (www.cosmetics-dentistry.com). The scale was tipped by their respective 25 years of experience; on-going training and the conducting of it in many countries; and, a fully-integrated facility. This folds into one location a clinic hosting all dentistry specialties (general dentistry, surgery, implants, endontics, maxio-facial, orthodontics, periodontics, prosthodontics, cosmetic dentistry); a lab that does all of the stuff (e.g., caps, crowns, bridges, braces, etc.) and a supply store that sells to other dentists throughout Latin America. Indeed a very rare combination of resources given how the industry traditionally operates.

I E-mailed Telma and said, Youre the one! She near immediately called me. I was taken by her most excellent English, which put me at ease about awkward communications. (I later learned that she and Josef speak 5 languages anywhere from fluently to very close to it.) She asked for some time for both of them to review my dental records, and about a week later called me with the preliminary diagnosis: Dont even think about doing this unless you do all of the teeth (28) and 3 root canals. After spending a lot of time explaining to me the whys, I knew she was right on.

With over 2 months invested in research, selection and booking the adventure, I walked down the plank for a flight to Houston. And then connected with another carrier to San Jose. Though a long day with all of the customary hassles (just love the take-off-the-shoes bit) and exhaustion associated with international travel, I got there without tribulation.

As part of my earlier research I Google-ized and found an aparthotel a few minutes drive from Prismas building. It made arrangements for a driver to pick me up at the airport. I see him with a sign bearing my name out in front of customs check-out; the clock is grabbing at 11:00 p.m. I greet him with some of the only Spanish I know: Hola seor! Me llamo Juan. Ive had the good fortune of considerable travel, and this is a good time to make a statement: The Costa Rican people are among the most friendly, sweet, caring, and accommodating Ive met. This experience began its manifestation with Noel, my driver.

The trip to the hotel took about 30 minutes, and as we turned to the street harboring it, I slumped into a bit of depression. The area was quite industrial given its location right by the ICE building and its massive work-lot. This is San Joses electricity company. We pull up to the door of the Cristina, a 3-Star hotel. My spirits began to lift as the lobby was very attractive very tropical. I then get slotted into a room that again lowered my mood. But I was tired, and so just flopped. The next morning I went to the front desk and asked for a room change, and was immediately moved from the borderline of purgatory to the edge of heaven. Just a great room with a nifty kitchenette and all kinds of beautiful plants right out my front door. As the days marched on, I came to adore the Cristina (www.apartotelcristina.com). Immaculate, lively, comfortable, and every morn a Costa Rican breakfast that was superb. But best of all was those in charge of recepcin, Alexandra, Elizabeth and the one they call The Boss. They each attended to me as if I were the center of their universe. And I watched them do the same with their other patrons. The nightly cost was very, very humble. When check-out day came, I was sad. This place had become home for nearly two weeks, and among the best residences Ive experienced.

The time had come with Prismas driver in the lobby. My feeling was the rooster had not yet stopped crowing, but it was 8:00 a.m. With me in sweat pants and bedroom slippers, and a gurgle in my tummy, I stepped into the car. We pull up to the Prisma building (5 stories and very modern) and take the elevator to the third floor. I walk into the lobby. Great first impression: Pristine clean and delightful American Tiffany was there to greet me. She had me fill out a form about the size of a postage stamp, and then escorted me to Room 2. It was spotlessly clean (there was always a full-time cleaning lady working the clinic and sometimes two) and loaded with my view of what composes all of the customary dental toys, near brand new.

Telma soon appeared and warmly affected introductions. Then came the, Open wide. As the days marched on I watched her and Josef move around as if they were riding a laser beam. The whole operation clinic, lab and supply-house is a virtual beehive of activity sublimely orchestrated by Josef and Telma. But when they were with me they were attentive, focused and sensitive. After about an hour of probing and poking she asked me to join her in her office. We went through the diagnosis. She revealed that I wasnt signing the dance card for cosmetics, but instead, a full-mouth restoration. And this is a whole new universe of complication beyond a few pretty caps. Then the good news: 8, yes 8! root canals. Now Im one that would rather be sentenced to a medieval stretching-rack than a root canal. So this wasnt cool. And I could only wonder why my SLC dentist didnt say anything about them. Many times what motivates us to charge through the dentists door is cause were hurting. And I was. The naughty roots explained why.

Her fingers started to set fire to the calculator and I thought, Here we go. In a land far, far away. Procedures my SLC dentist didnt mention. New info about a mouth guard. Gold vs. metal. My cookie jar started aching. She looks at a long tape and then declares: $13,000-ish with metal; $15-ish with gold. (When we did the E-mail diagnosis a cost of $12,000 was presented. So heres the unforeseen I earlier referenced.) I simply said, Okay. Ill decide if I want gold later. Do you take VISA? She said, Yes and escorted me back to Room 2.

Then appears the endodontist, Roberto Hernandez. He looked barely old enough to have a drivers license so I just had to ask: How long have you been doing this? Confidently he replied, 10 years. He was truly a Jedi Master at his craft, and though nearly eleven hours with him doing the zisssss to me, I experienced more pain from the act of the Novocain injections than from the canals.

I was driven back to the Cristina and pretty much stared at the ceiling. It was a rugged and long day, but with some Cataflan (seemingly Costa Ricas version of muscled-up Ibuprofen) I made it through the night without much discomfort.

The next day I got to the clinic at about 10:00 a.m. and was immediately taken to a new room. For the next 7 hours Telma grinds 26 teeth to eventually harbor the new crowns; Josef puts posts in the weak ones; casts are taken for the temporary teeth and to create the new crowns (the temporary teeth work, but theyre no bundle of joy); and finally, Telma does something to my gums to make them look purdy and even (called gingivoplasty). Yes, Im a big baby when it comes to things like this, but even for those that enjoy the likes of bamboo under their fingernails, this day was brutal. Not because of any short supply of skill on the part of Telma and Josef simply because its a lot of work and very invasive. With some more Cataflan and about a six-pack of Costa Ricas favorite cerveza (beer) affectionately called Imperial, I survived the night. I should note it was a neat deal to do this cram-for-finals approach to getting my mouth restored. What got done in 14 days by Prisma Im speculating would have taken months maybe into a year at my local dentistry.

10 days downtime to create the new teeth and allow the gums to heal. (Creating the crowns is both art and science. As Telma so cutely put it, Each one is an alive personality. It takes massive hours to give birth to a mouth full.);

During the downtime I toured Costa Rica. Its no shabby place to visit. In fact, youll dip your cup into paradise. A country about the size of West Virginia, and some 3.5 million people, it is way into natural beauty and keeping it that way. Palm trees, pristine beaches, colorful birds, and belching volcanoes. Summarily, an awesome place. Be advised my command of the Spanish language is VERY limited (un poquito) but I experienced no material problems communicating, and I put on lots of miles alone.

The night of getting my new teeth became a celebration: Josef and Telma took me out to dinner. She sweetly said, I want to see how you chew! And I did just grand with no pain. Yahoo!

During the guacamole appetizer I put it to them bluntly: How come its so much less here in Costa Rica? Do you cut corners on materials? Josef was quick to respond, Labor cost. He stated emphatically that materials are not compromised whatsoever, and in fact, may be superior to whats found in many dentistry practices in the U.S. because they search for the best products around the world and bring them in. He went on to say that there really isnt much in the way of materials that goes into creating a tooth a crown so it makes no sense to compromise quality. Most of the cost is found in the labor. But there are other considerations that drive costs down: Lower rents and taxes, and very, very low incidences of malpractice. Seemingly none of the Costa dentists carry malpractice insurance, but there are laws in the country that speak to such an event. I can only think a negative experience in this dimension would become a hornets nest (travel issues, foreign lawyers and legal system, etc.), so its something to be considered before going abroad.

Now lets compare. Had I gone with the top-shelf Utah dentist and a full-mouth restoration (28 teeth), with the 8 root canals, Id confront a bill north of $45,000. I get to this thusly: $30,000 divided by 18 times 28, plus $6,400 for the canals (8 times $800) and then whatever would have been the cost of a mouth guard to be worn at night (which I came to learn is critical; odd it wasnt mentioned in SLC). And then some reductions for things that are not per-tooth based. Heres how my bill came together at Prisma:

Root Canals	$250.00 each
Posts	$190.00 each
Gingivoplasty	$350.00 for each (upper and lower)
Crowns	$250.00 each
Mouth Guard	$350

Okay, lets get to the bottom-line. Am I happy? A resounding YES! In my view, my mouth looks pretty snappy. From a technical view, Im way healthier than when I started this adventure. I can now drink a triple-chocolate malt without it sending me through the rafters, and bite on a piece of grisly steak without jolts of pain shooting through my head. And I dont have to take on a night job. Beyond, $45,000 in the U.S.; $13,000 in Costa Rica. Lets add another $2,000 for lodging, food and fun. Seems like a win to me. Am I having any problems? None as of this writing. And I got to hang out with howler monkeys and orange iguanas for a few splendid days.

John Barrett is a freelance writer from Salt Lake City, Utah. He specializes in travel related topics and photographs, B2B copywriting and marketing, and website design for businesses. For more information visit www.quillpro.com or write him at jbarrett2@comcast.net.

Authors Disclosure: This article travels with photographs. Both the article and the photographs are copyrighted, QuillPro, All Rights Reserved, 2006. They (the article or photographs) may not be used for any commercial purpose until governed by a Licensing Agreement between QuillPro and the user. QuillPro strictly enforces its protections under U.S. and International copyright law. It is the option of a publisher to include photos; however, compensation will be negotiated based on with or without them. If included, high-res .jpeg files will be sent. Other related images exist, so if youre not thrilled about what is set forth herein, Ill send some options.