Dental care south of the border

JERREY ROBERTS David Weinberg of Williamsburg sits with his atlas open to Mexico. He has traveled there for dental work which he says is comparable in quality but far less expenive than in the U.S.

Weinberg, a frequent traveler, recently had such a dental emergency. In November, while vacationing with his wife, Deborah Jacobson, and their 10-year old son, Max Weinberg, in Puerto Vallarta, Mexico, a temporary filling in his mouth "began to disintegrate." The situation led him to visit a Mexican dentist, where he received a successful crown for the tooth, and resulted in a second, return visit to Mexico in December to have more dental work done.

Weinberg, who says he is far from alone as an American heading to Mexico for dental work, said he is very satisfied with the dental work he had done both in Puerto Vallarta and later in Tijuana.

In all, he said, in Tijuana, he spent just $1,100 for his dental care. Add to that his airfare and hotel costs, his grand total came to $1,559. He said the dental work alone would have cost him at least $3,365 in the U.S.

While vacationing in November, Weinberg said he was hesitant to wait until his return home to have the tooth fixed because the filling was over a recent root canal, so he decided to do something about it right away. He set out walking, in search of dental help.

He spotted a sign that said 'dentista,' he said, and soon ended up with a perfectly good crown that cost him just $300.

Weinberg said he thought the price was a real bargain.

A price list at Hampshire Mall Dental Center, where Weinberg has gone locally for dental work, indicates that a crown there costs $670. A check of several other area dentists found charges for crowns run as high as $900. Weinberg said some local dentists charge as much as $1,000.

Weinberg said he is sure that the work could have been done in Puerto Vallarta for even less, but said he "didn't take the time to negotiate or look around."

Based on his satisfaction with the work done in Puerto Vallarta, when Weinberg returned home from his vacation, he began to make plans to have more dental work done in Mexico.

Using the Internet, he checked out the availability of dentists south of the border by searching, generally, under "dentists in Mexico." Among the sites he found was one for Dental World in Tijuana, Mexico, owned by dentist Luis Manuel Rodriguez.

When Weinberg e-mailed the Mexican clinic to find out the costs of procedures, he was impressed with the prices, he said. "It's like going to a store and buying services," Weinberg said of searching for dental care in Mexico.

According to the World Health Organization, there were, in 1999 - the last year for which statistics were available - more than 83,000 dentists practicing in Mexico, with 60,000 of those in private practice throughout the country.

"If you look in a Tijuana phone book, you'll see page after page of advertisements for dentists - many with price lists," said Weinberg. "On every block there are dentist, after dentist, after dentist ... and, everything is set up for Americans - they all speak English."

Weinberg said he was thrilled with what he found out - Rodriguez would charge $200 for a crown, "...and I needed two," said Weinberg. In fact, he said, he needed quite a bit of dental work done - a root canal, two crowns, 10 teeth bonded and a deep cleaning - and with the promise of major savings spurring him on, he quickly made plans to go to Tijuana.

However, Weinberg said, before deciding to go he checked with his local dentist at the Hampshire Mall, Dr. William Grass, to ask his opinion.

"He said he has seen some good work from Mexico and said it was OK to go there," Weinberg said.

Efforts to reach Grass for comment for this story were unsuccessful.

Other area dentists contacted about this story declined to comment, saying they were unfamiliar with the practice of U.S. patients heading to Mexico for dental treatment.

A spokesman for the American Dental Association, with headquarters in Chicago, said in a phone interview that the association does not have a position on American patients receiving dental care in Mexico. And, a spokeswoman for the California Dental Association in Sacramento said she is unfamiliar with the practice of Americans going to Mexico for dental care and declined to comment.

Armed with the OK from his own dentist, Weinberg, who said he does not have dental insurance, made plans to travel to Tijuana in mid-December.

Weinberg owns his own business manufacturing motorcycle saddle bags and has traveled extensively, often to meet with suppliers. And, in the past, he said, he has had to see doctors in other countries at times of medical emergencies. Traveling in India several years ago, for instance, Weinberg, who has asthma, was treated by an Indian physician for breathing problems. "He charged me $10," Weinberg said. Another time, a second Indian doctor charged him just $3 for treatment ("He wasn't as renowned as the first doctor," Weinberg said.)

Given that history, going to Mexico to get dental care, he said, didn't seem all that unusual.

"I'm more adventuresome than probably a lot of people," Weinberg admitted. "I like to travel, so why not? What have you got to lose? You just have to have confidence."

His dentist's credentials

The dentist Weinberg chose to visit, Dr. Rodriguez, was interviewed by the Gazette via e-mail. He graduated from the School of Dentistry at Universidad Autonoma de Baja California, and by now, has more than 15 years of experience as a dentist, he said.

According to information provided by the American Dental Association, requirements for a dental license in Mexico include five years of post-high school education plus one year of community service. Rodriguez said dentists must then pass an examination in order to obtain a license to practice. Continuing-education credits are required for re-certification every five years, he said.

While malpractice insurance is not required of dentists in Mexico, Rodriguez said that because he accepts American insurance, he is required to carry malpractice, and is covered for $1 million.

Two Mexican government agencies - the Comision de Arbitraje Medico and PROFECO - monitor related complaints. Rodriguez said it is mandatory that all dentists post the agencies' telephone numbers in a visible spot in their offices.

"If a dentist is found guilty of malpractice, he/she loses the license," Rodriguez said.

Rodriguez, a member of the national college of dental surgeons and a past president of the Dental Association of Tijuana, has geared his practice to patients from the United States who travel to Mexico for the much lower prices. Rodriguez said health care prices, in general, run about 40 percent of costs for comparable services in the U.S., and his own prices run even lower than that.

Most of his patients - about 25 a day, or 80 percent - are from the U.S. Of those, he said, only 25 percent are Hispanic and Spanish-speaking, so it is important for him to know English.

Most pay by credit card or travelers checks, however, some have dental insurance with U.S. companies, many of which will cover dental care in Mexico, according to Rodriguez.

When he started his clinic, Rodriguez said he initially thought that, in addition to his local patients, he would get patients primarily from San Diego, which borders Tijuana, and Los Angeles just to the north. Much to his surprise, since launching his Web site, www.dentalworldtijuana.com, two years ago, patients have been coming from all over the U.S., including as far away as Alaska and Hawaii.

"We have a girl from Boston who comes every month to her monthly orthodontic checkup," Rodriguez said.

When potential U.S. patients first call Rodriguez, "they ask me about my credentials and experience, my prices and how to get here," the dentist said.

Weinberg shopped around

For Weinberg, getting there in a fashion that suited his wallet was part of the challenge. On Priceline.com, he found a round-trip fare to San Diego for $309. Because he would arrive in California late at night, he made a reservation, also with Priceline.com, with a downtown hotel that was close to the trolley he said he planned to take into Tijuana the next morning. That hotel cost him $60.

Workers at the dental office in Mexico recommended a local hotel, a short walk from the clinic, that was inexpensive - $45 a day - and was "clean and safe," according to Weinberg.

Tijuana is about a 30-minute drive from downtown San Diego and is also accessible by a trolley that runs every day.

"Most patients come to do a lot of work so they save a lot of money," Rodriguez said. Many also plan to have the work done on weekends, when they have time off from work - and to accommodate them, Rodriguez' practice is open on weekends.

Rodriguez said his patients "usually stay the weekend and we do all they need."

The dental clinic's waiting room, complete with Christmas decorations at the time of Weinberg's visit, was small but serviceable, said Weinberg. He said he was joined there by a number of American patients waiting to be seen by the dentist.

Weinberg said the clinic was "impeccably clean," the instruments were all "sterilized and wrapped," and that Rodriguez "explained everything he did."

Rodriguez said the infection-control requirements to which he must adhere are the same as in the U.S. and, because he accepts many U.S. dental insurance policies, he has had to pass all the same inspections as a U.S. dental office.

While many Mexican dentists catering to U.S. patients adhere to standards of care similar to those in this country, the Internet is littered with cautionary tales and advisories to be careful in choosing a dentist there.

Weinberg said standard precautions should be taken when looking for dental care, including a check of the dentist's license and references which he said can be had in advance by e-mailing the dentist before a trip to Mexico.

Rodriguez advises that prospective patients check if a dentist has been in business in the same location for at least three years, ask about infection-control practices, and if the dentist speaks English. Also, it is advisable, he said, to get a guarantee for treatment in writing and to ask for receipts for all work done.

As for Weinberg, he says he knows a similar adventure might not be for everyone, but, "if you're willing to travel," dental care in Mexico makes perfect sense.

Kathleen Mellen can be reached at kmellen@gazettenet.com.