"Do you want numbing gel?" the dental technician asked me as she prepared to plunge into my mouth.
In the entire history of dentistry, from caveman days to now, who has ever said no to more painkiller? Smear that gel around like spackle! She did. And then ground and scraped. And scraped and ground, for a full hour and a half.
Ninety minutes later, I was writhing in a different kind of pain. The office assistant handed me a bill for $930. That was $900 for root planing and $30 for the numbing gel. I had to bite my gel-numbed tongue to avoid asking why they stopped there. "Sir, would you prefer we do this while you lie on the floor or would you prefer the Chair Package?" "Care for our Adequate Lighting Option?"
Worse: This was just the beginning. The dentist said I needed at least four crowns -- at about $1,500 each. While that's about the average cost of crowns around our home in Maryland, according to our insurer, that would probably be about $5,000 more than our insurance would cover.
I was moaning about this to my brother-in-law who lives in Norway, and he said people there fly to Hungary for good, affordable dentistry. A little Googling about dental tourism had me sold. The savings from crossing the border can appear remarkable. Crowns that cost $1,500 would run just $300 to $600 apiece in Mexico or Costa Rica, I found. No wonder medical and dental tourism is a booming business. The U.S. Bureau of Economic Analysis says Americans spent $2.6 billion on medical and dental tourism in 2018. That's up from just $757 million in 2008. While there are no reliable counts of how many people leave the U.S. for discount foreign dentistry, officials in Costa Rica, a hub for dental tourism, estimate that tourists spent more than $200 million on implants, crowns, veneers and other tooth care there in 2017.
Of course, a cheap but bad dentist is no bargain. Traveling to a foreign country for discount dentistry certainly has additional hassles and risks. The federal Centers for Disease Control and Prevention warns that local standards of facilities and training may be lower than in the U.S. and that mistakes in translation or communication can result in mistreatment. Also of concern for anyone having major work done: Flying shortly after any kind of surgery heightens the risk of deadly blood clots.
But putting off needed dental care also has risks. So, I was determined to try it.
First, to find that good and affordable overseas dentist. I opted for Costa Rica because I'd never been there, it had a good reputation for dental tourism, and I'd heard it was a great place to vacation. Why not offset the pain with a little pleasure? Googling for Costa Rican dentists returns almost 1.8 million results. To narrow my choices, I used a facilitator, or broker. I figured that was safer, since the dentists are beholden to him for repeat business.
While it's difficult to suss out legitimate online reviews of anything anymore, I chose a broker who seemed to get real-sounding praise on sites like TripAdvisor. I sent him my X-rays and my American dentist's treatment proposal. He distributed those to several Costa Rican dentists, who sent back bids. I chose one who passed my wife's online investigation. The facilitator also handled travel, arranging for a hotel ($75 a night), airport pickup and transportation to the dentist's office. He didn't charge me for this service. He collects commissions from the dentist and hotel.
I arrived in San Jose, Costa Rica, on a Tuesday, and the next day a driver whisked me to the clinic, where I was reassured. I saw state-of-the-art equipment and learned that several of the dentists had trained at American dental schools. My dentist had done some training at Baylor College of Dentistry in Texas, now Texas A&M College of Dentistry. The staff was fluent in English.