Nov 092015

Short Answer: In my humble opinion, no.

Long Answer: Yes, it’s true: dental work in the Unites States is expensive. There are good reasons for this and it’s not necessarily greedy dentists overcharging for what they do. It starts with the fact that cost-of-living in countries like the USA are much higher than in places like Costa Rica, Hungary, Mexico, etc.. In the USA, the cost of labor, insurance, real estate, taxes, etc is far higher than in any foreign country we are comparing to in this discussion. It also relates to the longer and more rigorous dental education USA-based dentists have to go through compared to most every other country (including advanced European ones) and the costs associated with that longer education. In almost every developed country, a dental education is 5 years after graduating high school, while in the USA, it is 8+ years. That’s a big difference, especially when considering a US-dental education costs about $60,000/yr in tuition! Costs are also higher due to materials used in the US requiring FDA approved and dental offices having to adhere to much more strict regulations and procedures than in more “lax” countries.

I see questions about foreign dental work come up when people need especially expensive treatment like dental implants, removal of many teeth, dentures or even a full mouth of crowns and bridges. The most expensive treatment a dentist in the United States can charge for is about $60,000, which is a ghastly sum for the majority of middle class Americans to afford. Mind you, $60,000 is for the most extreme and complex cases, while most larger cases fall more into the $15,000 range. Most insurance companies do not even scratch the surface on costs like that. But in a country like Mexico (a short flight for many Americans), any USA treatment costs about ONE THIRD. So a $15,000 USA treatment costs about $5,000 in Mexico. Most of these foreign clinics cater to “dental tourists”, speak English and take care of many travel arrangements to make it easier. But it’s not all roses.

Not to say that some of these foreign clinics do not have well-trained, experienced and talented dentists. The real problem lies with challenges involving follow up for complications and accountability if things “go bad”. There is also much less governmental oversight and the ability to accurately assess the quality of care you are receiving. I have many example of cases where this came up, but here is one:

My patient “John” had many dental problems and he required work totaling over $18,000. The work included 3 implants, 2 crowns and 2 root canals. He told me he could probably afford it all if he had to, but there was no way he would do that when it costs $6,000 in Mexico. So off he went and he came back quite happy. I saw him about 6 months later for a routine examination and took some x-rays. What I noted was that 2 out of the 3 implants had a condition called “peri-implantitis” which means they were failing. The root canals and crowns he had done seemed to be working fine, but they were not done to the standard mandated by the California Dental Board and I surmised they would ultimately need to be repaired as well. When I explained what I saw, it put John in a very difficult position. He had, indeed, gotten a lot done for a lot less somewhere else. But now there were problems and it was not practical for him to fly back to Mexico to have the problems evaluated and corrected in a timely manner. John had to be at work on Monday morning, he couldn’t just leave to Mexico for every follow up procedure and post-operative check that would be required to correct the issues he had. John ultimately required 2 moderately extensive surgeries to correct the problems and it ended up costing him close to $15,000 just to correct the issues with the two failing implants alone. In the end, he spent a total of $21,000 to get what he would have received in the USA for $18,000. That didn’t include the pain and suffering he endured while on “vacation” and when he got back home, the cost of traveling to Mexico and the time he had to take off work to deal with the corrective actions needed. It also didn’t include the repair of the substandard crowns and root canals he had done. John was understandably upset after all this happened. In fact, he even talked to me about suing the dental office that did the work for him, but alas, that was not possible. The laws in Mexico are not like in the USA, and it is far more difficult to sue a dentist in Mexico when you live thousands of miles away. Your potential award will also be significantly less than it would be in the USA, if you prevail at all.

The moral of the above story is not that all foreign dental work will end badly and require expensive corrections. I have no way to know what percentage of these cases fail or are done poorly. What I do know is that corrections are difficult and expensive. The more complicated the dental work, the more likely there will be problems (this is true anywhere including the USA). And what’s more, it is unlikely any of the implants placed in John’s mouth were FDA approved (as is mandated in the USA). It is exceedingly unlikely any official from OSHA inspected the clinic John was treated at to guarantee proper sterilization procedures were utilized. It is also not probable all of the clinic’s employees were licensed and certified to assist John’s dentists during the procedures he received. For that matter, it is not likely John’s dentists had to meet even a fraction of the ongoing requirements USA dentists have to adhere to in order to be licensed to practice.

Bottom line: It is not my opinion that patients should avoid all foreign clinics for dental work outright. However, if and when complications with treatment arise, patients tend to drastically underestimate the time, energy and money required to take care of any such complications back in the USA. It also becomes very frustrating for patients experiencing complications (sometimes due to gross negligence) to find out they essentially have no legal recourse at their disposal. What’s important is that one understands these trade-offs when receiving lower cost but complex dental care in a foreign country before committing to it.


[suffusion-the-author display='description']

 Leave a Reply

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>