Dental Tourism - La Cuenta Por Favor (Check Please)!

After much pondering and reflection on just what the hell to do about my teeth while I'm down here in Peru, I decided that I would utilize one of my remaining appointments to at least get the tooth that needed the onlay checked out, because my conclusion on that tooth wasn't totally confirmed yet. I know that my dentist in NY had said that the area around the existing (metal) filling on that tooth was turning gray. That sounded like a legitimate reason to have something fixed, because there was obviously something wrong.

So, I checked into my dentist here in Peru to talk about that tooth. He explained that over time, metal (almagam) fillings will eventually turn the area adjacent to it gray, since the filling itself is gray and, after reviewing the tooth again, could find no reason to have it fixed because the filling and the tooth were perfectly fine as is. Again, he didn't want to do work on me - that's a good sign!

So, five minutes after sitting down, I said "Great, that's all I needed to hear" and was basically ready to get up and leave. But he hadn't given me the "Thanks for coming in, maybe I'll see you again" look, message, etc. In fact, I heard a dental DRILL start and the assistant was suddenly standing next to me. And drilling on the aforementioned "root canal" tooth commenced. Okay, I'm not sure what the hell is happening here, but he had already started drilling so I just let it continue. I was thinking, what if he misunderstood and is starting the process to create the crown! And I'm leaving in a few days! Ack! It won't be done! What the hell have I gotten myself into! (De ja vu?). Then there was a pause and I could ask, unusually optimisticly, "Umm, are you just opening up the restoration to observe and confirm your earlier assessment?" Luckily, he was! He had told me during the first meeting that he was 80% sure that the tooth was fine, and that the only way to confirm it 100% was to open it up and take a look inside.

So I was totally cool with the fact he wanted to give me his 100% assessment, though it would have been nice to have a heads up! I guess that's a trade off when dealing with someone who's English is his second language. But I trust the guy, so I was cool with that. After probing him with questions after his drilling, he confirmed his earlier assessment that the four walls of the tooth are in great condition and no crown was needed!

So, he started the restoration (filling) for the tooth again and my mind was just thinking and analyzing the situation. First, I noticed that the tools (tooth picky things) were dark, not shiny stainless steel. Oh my god, they are RUSTY! Wait, can one of those tools be sanitized and still be rusty? I couldn't really think of a reason why not, and he was only touching tooth, afterall, not my gums. But I was mildly freaked out and kept trying to catch the angle of it to confirm the initial visual assessment. I just couldn't focus my eyes that close and figure it out. Finally, I did catch it and realized it was just dark colored - maybe tempered steel or something like that. NOT rusty.

As he continued the work and as I continued to analyze my situation, I noticed that he was pretty much usuing the same tools that my high-end orthodontist uses to zap the teeth with the infrared gun (or whatever it is) to harden the layers of the restoration. Big point for him on that. At two points of the restoration, he was talking on the cell phone that his assistant held to his ear without missing a beat in my mouth. This restoration was too easy for him! After all, his specialty is bite disorders, oral rehabilitation, and the mandible (lower jaw bone).

So after becoming comfortable with the restore, zap, restore, zap process of each layer, my mind drifted to the fact that I had only brought $40 with me that day and he accepts cash only. Crap! Would he let me come back later after visiting the bank? Crap! I didn't bring my insurance form! Maybe I could go to the bank and then print out the form at some nearby internet cafe. Yea, I'm pretty sure he would be cool with that.

Soon enough, he was finished. Previously, my tooth edge was sort of like a crater, where the outside edge was almost sharp and the restoration was more or less recessed a bit inside the tooth, which felt weird to me. And the tooth, due to the fact it was flat and didn't have the "cusp" (point to match the lower tooth). This guy not only restored it to the point it was before he drilled, he added the point to it to match my lower tooth! So now the tooth feels like a normal tooth, not an unusually flat, recessed tooth. Wow, sweet job!

So I was all done, now just to settle the bill. I asked him what the total was for this and he said $35. Holy scheisse! $35 to assess a tooth, drill out another, assess that tooth, and create an awesome restoration? I was amazing stoked and 100% sold on getting all future work done with this guy. It cost me over $200 (after insurance paid) to get a small restoration done a few weeks ago at my NY dentist. And, as I mentioned, insurance will pay for half of this bill, making the total cost $17.50 :o)

So as we walked around town, I thought about my NY dentist, in particular about whether their assessment jived with what this doctor told me and, as a result, whether or not I wanted to continue to get my teeth cleaned there. And I realized that their assessment wasn't necessarily wrong, they are just more aggressive about fixing the teeth and want to fix everything to the highest level to make sure there are no problems in the future. A crown would have definitely fixed my root canal pre-molar, no additional assessment or question necessary. An onlay would have gotten rid of the metal filling on my back tooth so that no discoloration would result. They weren't wrong, per se, but it would have been nice if they gave me the whole story rather than holding back alternatives and options. But in the future, I'm getting all serious work done here, and the doctor and my bank account are happy to hear that.

J. Riley, Erika's friend thought I paid too much for restoration :o) . I'll gladly "overpay" for the best dentist!