chgoeditor

I don't have dental insurance, and--thanks to a broken porcelain veneer--estimate that I now need about $2K+ of dental work (replace the veneer, get a cleaning & exam, I may have a couple cavities filled, I'd get whitening if it was a great deal, and, depending where the cavities are, might need a new mouthguard).

Unfortunately, I don't have a lot of time for an extended vacation, so I'd prefer seeing a doctor in a Mexican border town, or someplace else that's <5 hour flight from Chicago. Does anyone have personal experience with a dentist they'd recommend? It's a plus if the dentist has an onsite lab or offers quick turnaround on the veneers, since I'll want to do this in one trip that lasts no more than a week. Ultimately I'm looking for a total cost, including hotel & meals (I'd use miles) that's less than what I'd spend out of pocket in the US.

Incidentally, has anyone had experience negotiating rates with dentists in the US?

biggestbopper

I negotiated with a root canal guy recently, on the theory that I wouldn't be going back. He was sympathetic to my argument that the stock market had tanked and I was retired--told me that he was down 70% himself and cursed out George Bush (this was last year). But, I only got a 10% discount and I don't think I'd do it again for the not very big savings.

I want the guy to be helpful if I have to come back. @:-)

IMHO, the idea of paitents negotiating with medical providers is deeply flawed. ("My little girl is in a coma and could die, but, before you treat her I want to negotiate your charges.").

chgoeditor

Once upon a time, I would have agreed with you. But what makes you think that the doctors aren't viewing you, the patient, with an eye toward the money? A couple examples:
1. Try to make an appointment with a dermatologist for a cosmetic treatment that you'd pay for out of pocket (such as botox). Then try to make an appointment with the same dermatologist for a medical problem like acne. I guarantee that at 9 out of 10 dermatology practices, you that you'll be able to get an appointment more quickly for the cosmetic treatment.
2. I have a friend who used to be a pediatric oncologist. One of the biggest reasons he left the medical profession? He told me he was disgusted by the fact that they accepted or rejected patients based on whether their family had deep pockets.

Apologies for the thread hijack.

tjl

It is the norm for the payer to negotiate with the medical provider.

In most cases in the US, the payer is a government or private insurance company. If the payer is big enough (Medicare), it can just set rates and tell providers to take it or leave it.

Note that for things which are optional and non-urgent, such as cosmetic surgery and dentistry and LASIK, there can be significant price competition (aimed at the patient, who is typically self-paying for such services) between providers.

SuzanneFromSeattle

I've had a lot of dental work done at Dental Bernal in Los Algodones, just across the border from Yuma, Arizona.

My first trip was in October, 2006 and I ended up writing a 30-page journal of my experiences (mostly because I had to email 14 friends and coworkers every day so they knew I hadn't been kidnapped and held hostage).

In four trips, I've had five extractions, one root canal, one sinus boost, 18 crowns, six implants/crowns. In Seattle it would have cost between $75,000 and $100,000; in Algodones, it's been under $10,000 plus airfare, etc.

For example, I needed a root canal/post/buildup/crown. In Seattle, it would have been $2,400. I had it done in June, 2008 by Dr. Bernal for $1,200 -- and that included round-trip airfare, and hotel and car for a week.

If you'd like to read the 2006 journal, email me at my yahoo.com address (SuzanneFromSeattle@).

Suzanne From Seattle

chgoeditor

Four months later I still haven't had a chance to get my broken veneer fixed, but I just booked a trip to Tokyo & Hong Kong. Does anyone know if there are savings to be had from getting dental work done in either of those countries (compared to US costs)? Any firsthand dentist recommendations?

violist

For some reason it tickled me that this thread has reappeared adjacent to this
one: Devil Woman Hits Me in the Mouth.

biggestbopper

I am bringing the Devil Woman in with me to the dentist as my negotiator.

pdx_fam

I just came across this bumped thread. I used to practice dentistry here in the U.S. The staffing and equipment overhead of your typical U.S. dental office is unreal. As an extreme example, I would do single, simple exposed third molar extractions under preferred provider plans for a $78 fee, and after paying my overhead and my practice loan, I would end up with $13 in my pocket. My hygienist made more money than I did. But then again I was a "working man's dentist" and wasn't interested in selling the cosmetic stuff. I sold the practice and haven't performed dentistry in over four years.

In my practice, I saw a few cases that were performed elsewhere.The quality can vary widely, and the patient may be initially satisfied, but problems can easily develop after several years. This can be due to leakage and shape problems with the new crowns and fillings. If it was me, I would guess that most extractions could be performed well (if the clinic is sanitary), as foreign dentists may be more experienced at them than your typical U.S. dentist. Fillings and crowns will vary. Root canals can be very technique sensitive, and if I needed one, I personally would not see a dentist, but would most likely see an endodontist (root canal specialist) here.

Foreign dental care is definitely a case of caveat emptor... Check out any reviews that you can.

Jaimito Cartero

As with everything, I'd get some first hand info from someone you trust before investing the time and money to get dental work from Costa Rica.

I absolutely love my dentist there, but her English is quite limited. I had one of my rear molars extracted about 4 years ago, since they said it need a root canal and were quite iffy about whether it would be right when it was done.

The missing space bothered the hell out of me, so went to my dentist there to put a bridge between the adjacent teeth. I was really surprised at all the work done on the job. A mold, preliminary fitting and final fitting. Total cost was less than $250. (This was in 2007, I think)

She does my cleanings when I get there, and they're pretty painless ,and cost $20, I think. No dental hygienist at all.

Part of the reason I went outside the US the first time (to Rocky Point, Mexico) was that I had an expensive and improperly done one in the US. He didn't get all the root out, so it got infected. Yuck!

My daughter had her braces done in SJO, and I think we paid $1200 or so over the 2+ year course of having them.

There are a lot of glossy dentists you'll see advertised here. If that's what you need, great. Of course you'll pay 2x-3x what normal middle class Ticos pay.

Witold

If you have the foresight to plan a trip across the world, you should have the foresight to just buy a dental insurance policy. Dental insurance is dirt cheap and covers most things.

When people compare prices, they always look at retail US prices, even though almost no one pays retail. If you compare after insurance/out of pocket US costs to foreign prices, US is almost always cheaper - and that is not even including travel/hotel costs.

Generally, the only time it actually makes financial sense to go abroad is if it's a pressing emergency for someone who doesn't have insurance, or someone wants one of the few procedures not covered in the US - implants/veneers/similar.

Still, it is important to note that part of what you are paying for in the US is recourse avenues. When things go wrong - and they DO go wrong for X % of people - you have legal avenues to make things right or practical avenues like getting work fixed. What are you going to do after getting work done in Phuket? Even if corrective work is done at no cost, are you going to keep paying $2000 for flight and hotel, not to mention wages/vacation lost to get the work? This is part of the premium you are paying for in the US.

acunningham

A relation of mine had implants done in Bulgaria. The cost was a small fraction of what it would have been in the UK, and they were delighted with the results.

Jaimito Cartero

I had my yearly dental cleaning in Costa Rica, along with a few fillings. Cost was about $75 for everything.

Dental insurance is not dirt cheap, at least not for the coverages that many people need.

I can honestly say that I've had more problems with dental work in the US than I have in Mexico or Costa Rica. In fact, I first went to Mexico to get a root canal redone, since the US dentist had messed it up. As always, make sure your dentist is a quality provider.

pinworm

I have dental insurance in the US. Great for cleanings, but a root canal, even with my insurance, will still run about $1400 out of pocket. I live in Phoenix, where in 2 hours I can be in Mexico and have the same work done for 300. As a matter of fact, it is such a huge business in Mexican border towns that the pool of quality dentists is better there than in the US.

Jaimito Cartero

The Mexican dentist I used in Rocky Point actually owns a house in the Phoenix area.