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Another bad experience with Mexican dentistry

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Dr. Hall,
I have had dental work done at a dental clinic in Los Algodones Mexico over the past 10 years without any problems. Five years ago a local Arizona dentist that I went to have my teeth cleaned told me the x-ray showed inflammation around some of my 6 implants and the fixed bridged attached to the implants had to be replaced so the implants could be routinely cleaned or they would eventually fail and quoted $10,700 to replace the bridge. So I got at second opinion from two other Arizona dentists that the bridge should have been a screw on appliance instead of glued on.

So I decided to return to the dental clinic in Mexico that did the implants and bridge. They cut off the bridge and installed a snap on denture, but when I got back to Phoenix the next day I found it very difficult to remove and reinstall the denture. I had to use two hands to force the denture off and reinstall it. It also did not fit properly and made it hurt to chew and food got trapped between my denture and the roof of my mouth. The next morning I put it back in my mouth to eat breakfast and when I attempted to remove the snap on denture it broke. What recourse do I have to demand a refund I return to the Mexican dental clinic and demand a refund of the $1,900 I paid them for the broken denture. And, cut my losses and go to an Arizona dentist to remake the denture to attach to existing implants 6 implants? I am undecided what I should do and will appreciate any suggestions you can make.

Thank you.
Bill from Sun City, Arizona

(See Dr. Hall’s answer below.)


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Bill,
I’m not following the specifics of your treatment—particularly the transition from an implant bridge to a snap-on denture, but clearly the denture shouldn’t break when you were merely trying to remove it. And food shouldn’t be getting trapped under your denture. You knew that.

When you decide to get dental treatment in Mexico, you’re generally sacrificing a level of quality in exchange for paying a lower fee. Mexican treatment standards simply aren’t what they are in the United States. Part of the reason they are lower is that Mexican dentists can generally get away with sub-standard treatment. So I think you’re going to have to take your losses and move on.

There are some excellent dentists in Mexico, but they can be hard to find, because they generally don’t invest a lot in marketing. If you’re willing to travel for your care, I would recommend Dr. Gilberto Tostado in Agua Prieta, Mexico. Recognized by both the International College of Dentists and the Pierre Fauchard Academy as one of the best dentists in the world, I feel that he would be a safe choice for you.
– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

A horror story of dental tourism in Mexico

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I live in the Phoenix area but went to a dentist in Los Algodones, Mexico, as I had a broken tooth and also needed attention to the other side where this same dentist had worked three years previously. I was told I needed four crowns in all. Three days later one of the crowns came off. I returned to them and was told I needed a root canal before the crown could be cemented back on. I asked why I was not told about a root canal on the previous visit and was told that root canals are not always necessary and often times do not work. So I got the root canal and the crown was put back on.

Within a day or two I started having sensitivity to hot and cold, along with worse pain after eating. When the tooth was touched or lightly tapped with fingernail it hurt. I called and spoke to the receptionist who told me I would have to come in again. It’s 500 miles round trip to the office, so instead of going in, I started researching online.

Then I made an appointment with a local dentist. I simply told him that the tooth was giving me problems. I was told that there was a crack in the tooth and that it should be extracted and replaced with either a bridge or implant and that the existing crown could not be used.

I would appreciate advice as to the best way of handling this with the dentist in Los Algodones as I feel that I have had poor work. I feel that a reasonable proposal would be that they extract the tooth and do an implant and new crown, but that the credit the cost of the existing crown towards the new work.

– Dion from Arizona

(See Dr. Hall’s answer below.)


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Dion,
Yes, poor work for sure. I think you have pinned down the basic points where this dentist messed up. A permanent crown that comes off within a few days—that is definitely below the standard of care. A basic part of dental school training for doing dental crowns is doing them so that they don’t come off.

I also believe you were right to question whether or not you needed that root canal. The tooth wasn’t hurting. From what happened subsequently, it is clear that the tissue inside the tooth was alive, and if the tooth wasn’t hurting I seriously doubt that it needed a root canal. It sounds suspiciously like an excuse.

And then it doesn’t look like the root canal was done correctly. For the tooth to be sensitive to hot and cold and to touch there has to be some living tissue in it. But a root canal is supposed to remove all the tissue inside the tooth. So it was an incomplete root canal. And, of course, you have the other dentist telling you the tooth is cracked. But I will be honest with you, I don’t know that you’re getting the best advice there either. A crack in a tooth doesn’t make it unrestorable. You obviously have a failed root canal treatment. Why didn’t they tell you that?

But if I were in your shoes, I wouldn’t want this dentist in Los Algodones to touch my teeth any more. He screwed up your crown, then he told you that you needed a root canal when there is good reason to believe you didn’t. Then he screwed up the root canal. You have a true dental horror story here that keeps getting worse with every subsequent step. I’m starting to wonder if this dentist can do anything right. Implantology is one of the most demanding areas of dentistry. If you have him place the implant he could end up drilling into your nerve, your sinus, or some other serious place. From what I know of him so far, I wouldn’t be surprised if he were to place one of these cheap knock-off dental implant fixtures that will maybe breed infection and come loose in a couple of years. What you need to do is find a competent dentist to start fixing you right. If you want to go to Mexico to save some money, I know of two excellent dentists just across the border.

I don’t know enough about the legal system in Mexico to know what recourse you have against this dentist who has committed malpractice on you. If there is any hope for justice there, you could try that. But you may just have to swallow hard, cut your losses, and move forward. Maybe a quality Mexican dentist could help you recover something from your dentist.

I have a question for you. How do you know that you needed these four crowns that he did for you? Do you have any suspicions that he wasn’t honest with you about that? If this dentist was willing to sell you a root canal that you didn’t need, would he also be willing to try to sell you crowns you didn’t need?

Bottom line, dental tourism is a risky business. Just going across the border to save money can end up being a very expensive choice, as it has in your case. The standards of dental care in Mexico are not what they are in the United States. As I said, I know of two excellent Mexican dentists who operate practices in border towns and can legitimately save a patient considerable money, if they are willing to travel. But I would advise strongly against picking any dentist in Mexico at random or because they have good marketing. Dentistry isn’t cheap if it doesn’t last, if you’re sold treatment that you don’t need, or if it causes problems that later have to be fixed.

– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Should I get my crowns done in Costa Rica?

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Dr. Hall,
I am debating on going to Costa Rica to get my 12 crowns replaced. I have 6 on the top and 6 on the bottom. In Costa Rica they do everything in a lab and it takes two weeks ( So I have to stay 2 weeks, which isn’t a bad thing except the time I can go it will be raining). I am just curious what my options are here in Arizona since I just moved here. I am looking for natural-looking teeth and would like a dentist that doesn’t make my teeth look like they came from a cookie cutter so to speak. In Costa Rica I can get all of my teeth done for around $6000. Not including the travel and hotels etc. Is there anything comparable to that here in Arizona that you know of?
– Tanya from Arizona
dentistry in Costa Rica
Tanya,
I have a question for you before you go to Costa Rica to have your crowns done. Do you think there is any possibility that anything could go wrong in the process of getting twelve crowns?

I’ll give you the answer to that question–yes, there are any number of things that could go wrong. Let me list some of them for you, off the top of my head:

These are the first twelve things that came to mind, of problems I have either seen or patients have told me about when they had multiple crowns done. It isn’t an exhaustive list.

And then here is a link to an earlier blog post I wrote about dentistry in Costa Rica. A woman wrote to me about crown and porcelain veneer work she had done there. She ended up having four of these things on the list go wrong, and some things that aren’t on my list. Another dentist told her that what was done to her by this Costa Rica dentist was criminal negligence. But when she tried to get satisfaction, SHE ended up being the person in legal trouble, because of the corrupt legal system in Costa Rica. She has an estimate of $35,000 to fix the damage this dentist caused.

Even with excellent dental care, with that many crowns there is often something that will go wrong during the treatment. It appears that if that happens to you in Costa Rica, you’ll end up stuck.

If you want to save some money and you’re in Arizona, one option could be to go to Dr. Isaías Íñiguez. He is actually AACD accredited and has a practice in Los Algodones, Mexico, just across the border from Yuma, Arizona. He charges Mexican fees for what I believe is high quality cosmetic dentistry. Check him out.

– Dr. Hall

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Dentistry in Costa Rica

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I’ve written before warning about getting dental work done in Costa Rica. But I just became aware of an incident that truly highlights the risks. Because I am only able to partially confirm this patient’s claims, I am not publishing the name of the dentist, which she had provided, only her story because it illustrates the risks in dental tourism.

dental tourism in Costa Rica

(see the full story below)


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Dr. Hall,
I went to Doctor [name withheld] at [name withheld] Dental Clinic just outside of San Jose Costa Rica for some dental work and to have porcelain veneers placed. The dentist broke one tooth and caused me to need three root canals. He left me with ten open margins, I had crowns pop off, and he screwed up my bite so badly that I now suffer from severe TMJ, constant pain, can’t eat or speak properly etc… I have an estimate of $35,000 to fix my bite (which I don’t have) which doesn’t include the root canals. He refuses to refund the small fortune that I paid him and refuses to pay to have my teeth fixed.

But the story gets worse.

After my follow-up with an American dentist who said that I was the victim of criminal negligence, I hired a Costa Rican attorney. We were able to get three Costa Rican dentists to concur with the American dentist. We met at the Dental Colegio. But all that mattered at the Colegio board meeting was the fact that I complained publicly about Doctor [name withheld]. It was explained to me that it is a felony to speak against the reputation of a Costa Rican citizen unless or until that person has first been found guilty of a crime in a Costa Rican court of law. It did not matter that I filed those complaints online about the dentist from my own home in America. I had to flee Costa Rica immediately to avoid being arrested.

As far as filing criminal charges or a lawsuit, my attorney told me that the dentist would just bribe an official and make the case go away. My only hope was with the Costa Rican dental Colegio and they cared nothing about justice. Their legal system in Costa Rica is very corrupt. There is no justice there for Americans.

I also learned that this dentist didn’t graduate from a dental school in Miami as it claims on his website. He only took a class there.

– Kimberly from Florida

I thought I would just pass on Kimberly’s experience here, as there isn’t much I can do to help other than to help publicize her plight. I did look up the dentist she mentioned, and the website looks very inviting and gives you the feeling that you’re going to get wonderful care. The credentials presented look legitimate. However, as a dentist, I noticed some red flags that I think would escape the normal patient. For example, this dentist claims to have had a minor in implant dentistry from Miami University, as Kimberly mentioned. But there is no such thing as a minor or major or any organized course of study in implant dentistry at any American school—it isn’t a recognized specialty. He also claims to have a minor in Orthodontics and Prosthodontics from the DaVinci Institute. Besides the fact that this makes no sense—there are no “minors” in any dental field in the United States, only majors. And the combination of those two specialty areas in dentistry is made up. If minors did exist, he would have two separate minors—one in Orthodontics and one in Prosthodontics. Besides this, the DaVinci Institute is a think tank in Colorado. It may sound dental because of the famous DaVinci Dental Studio in California (a renowned dental laboratory that makes porcelain veneers), but there is nothing dental about the DaVinci Institute. Then, googling the dentist’s name and the name of his clinic, I discovered that the name of the clinic had been recently changed, a tactic used to escape a bad reputation. Also, there are no Google reviews for this dentist or his clinic, under either of its names, which is very strange. These are all red flags. But they would escape the typical dental patient.

I also found another serious complaint filed against this dentist on the website ripoffreport.com.

Bottom line: Beware! Just don’t do it. Both implant dentistry and beautiful cosmetic dentistry are risky enough in the United States. Don’t compound it by going to a place where you have poor standards of care and absolutely no legal recourse in case something goes wrong.
– Dr. Hall

Do you have a comment? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

How long after cosmetic dental work should I feel pain?

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One month ago, I went to Mexico for cosmetic dentistry. The dentist completed 12 lower crowns and 6 veneers on the front upper teeth. Since getting the work completed (2 1/2 weeks ago now), my lower jaw has been extremely painful. It’s not in the gums, but my jaw itself. One tooth hurts to chew anything (even something soft, like bread). I asked the dentist about it and she said to take ibuprofen for a few weeks because so much work was done in such a short amount of time; and that the crown on the tooth that’s sensitive to chewing may have high contact, or need a root canal. That tooth does not touch any of the top teeth when I clench. I’m concerned that I’m having to take so much ibuprofen, and that it’s not really helping the real issue. Should I still be experiencing pain at this point? I take 800mg of Ibuprofen every 4-6 hrs – that can’t be good!!
– Julie from Iowa

Julie,
This doesn’t sound good.

The dentist told you to take ibuprofen for a FEW WEEKS??? Are you serious? So much ibuprofen over that long a period of time can damage your liver or your kidneys. You are taking 3200 to 4000 milligrams a day. I think the maximum recommended dose is about 2400 mg per day over short periods.

No, this kind of pain after getting crowns or porcelain veneers is not normal. Something is wrong. Some tenderness or soreness for a couple of days maybe could be expected. And your teeth should all be touching evenly.

You need a second opinion from a reputable American dentist. You have two excellent cosmetic dentists near you. [Names not included in this post]. Have one of them look you over and see what is wrong before this gets out of control and so you can get off this ibuprofen immediately. It does sound like you may need a root canal treatment. Don’t have that done in Mexico, please.

Only about one out of every fifty dentists in the United States is capable of doing a beautiful smile makeover. However, most of our dentists are fairly competent in general dentistry. If you go to Mexico, your chances of getting in trouble with even basic general dentistry are high, and there are probably only a handful of good cosmetic dentists in the entire country. I know of a couple, so it is possible to get quality work there. But clearly you didn’t end up with one of the good ones.

Dr. Hall

Links: Read more about cosmetic dentistry costs.
Read more about the quality of dental care outside the US.

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About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Should I go to Clear Choice or Costa Rica for my dental implants?

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Your website only discusses Clear Choice as a provider of the all-on-4 implant procedures. I went in for a 3d x-ray and initial eval at both Clear Choice (CC) and EON. My experience with CC was consistent with the experiences of others reflected on your website. EON seemed much better. In particular, the head of the EON clinic spoke with me. Apparently he used to be associated or partnered with CC. He stated that he left CC because he did not like the practice of abandoning the patients once they had the procedure done. Also according the the “evaluation done at CC and reported to me by the sales rep, I was a fine candidate for the procedure. The dentist from EON referred to the x-ray and mentioned several consideration that needed to be evaluated. Ultimately he stated that they could make the necessary modifications to allow insertion of the implants without bone grafting. If any of this seems odd or false, please let me know. I figured you might benefit from my description of the initial meetings with the 2 local competitors in Chicago area. Thank you. Mike Burke My next step, in addition to scouring the internet for justification and knowledge is to consider going out of the country to have the implants put in. Costa Rica?

Mike from Chicago

Mike,
I don’t understand. You are unhappy with the idea that you would go to Clear Choice and get dental implants and they wouldn’t have any follow-up. And for THAT you are going to Costa Rica? What kind of follow-up do you think they have in Costa Rica? Do you think THEY will call you for a checkup and a cleaning?

Having dental implants placed, even in the United States, is a risky procedure. We are seeing so much malpractice in this area. Dentists are getting into it without adequate training, and the standards of care are not well established because it isn’t a recognized specialty and is fairly unregulated.

But take the worst dentists you have in the United States, and remove ALL quality control standards that even they have, and that’s what you’ll have when you go to Costa Rica. If you are a brave soul, you could try getting crowns or bridgework done in Costa Rica, because you could always have those re-done if something goes wrong. But when something goes wrong with implant dentistry, you could end up a dental cripple, maybe with practically no jawbone. They could accidentally place implants in your nerve canal, in your nasal sinuses, they could perforate the bone. Infection could set in. The implants could be too short or too thin. They could be placed under load prematurely. They could come loose. If they place cheap fixtures, they could lack precise tolerances, which would leave openings for infection and coming loose. The fixtures could corrode. You could get peri-implantitis. There are so many things that could go wrong with dental implants. At least in the United States you might have some legal recourse if things go bad.

I am not a fan of Clear Choice. As you were told, they do not have any follow-up contact with you. We have numerous reports of high-pressure sales tactics. And the all-on-4 procedure has some risks – if anything goes wrong later with any one of the four implants they place, the entire case will have to be re-done. But you are far better off having this done by Clear Choice than going down to Costa Rica. If you want the best care, my recommendation would be to find a solo practitioner with expertise in dental implants. Look for credentials from either the International Congress of Oral Implantologists or from the American Academy of Implant Dentistry.

There are other dentists who do the all-on-4 procedure in the Chicago area. Dr. Anthony LaVacca in Naperville is one. He is a board-certified prosthodontist and is also implant surgery trained. Another option could be to get a second opinion from Dr. William Cohen in Glenview, who used to be my dentist when I lived in Iowa.

But please, please, don’t go down to Costa Rica for dental implants, not if your quality of life is important to you.

Dr. Hall

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About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

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