Dental Tourism

I arrived in Peru last week with grand expections: we could kill three birds with one stone by fitting in my friends' Ryan and Lili's wedding, Erika's mom's surgery, and of course the completing the latest chapter in my storied dental history all in the course of a week or four. Although I'm only five days into it, it looks like I might have introduced another bird to the story.

I had a dentist appointment on Wednesday night to attend right after I got off of my flight in order to ascertain the possibilities of getting my crown and onlay started by a highly respected dentist in Lima. It is a little bit unfair to expect that I could arrive at 10:00pm at night and have a dentist who doesn't even know what I (or my X-rays) look like to come to a quick conclusion on what needs to be done and, at the same time, for me to determine if it is indeed a dentist that I would trust with doing this work on . But I was pretty impressed already by the fact that he was willing to wait around until that hour to see me, even though he had a 3:15am flight the next day to Northern Peru to participate in a meeting or teach a course at the esteemed university there.

To preface this appointment, there were some reasons (other than financial, the primary reason) that I was exploring this option. I've started to question the integrity of my dentist after they told me that I needed to have a crown done because I had a tooth that had a root canal - two years ago. This same dentist is the one that told me that I needed the root canal done in the first place and was actually the dentist that had put the restoration on that tooth after the root canal. Why would it take them two years to tell me that I suddenly need a crown on a tooth that has been in the same condition since that time? Their excuse was that "teeth that have had root canals can be brittle and can break if you bite something hard". So why didn't they tell me that two years ago? I queried the other dentist in the office who usually does the work on my teeth and her synopsis was "Well, it's not really required since there is not impact with the tooth on the bottom, it's just recommended." Differing opinions in the same office make me want to get another opinion.

So the dentist in Lima spent a lot of time reviewing my x-rays that I brought along and poked around my mouth a little bit checking out the teeth that needed to be worked on. He was a younger guy than I had pictured and he was pretty quiet for most of the time, studying the various pictures of my jaw. But after about fifteen minutes, he sat in front of me and gave me his opinion of the situation. He said that the four walls of the tooth that had the root canal were healthy and strong and that very little of the tooth had been removed when the root canal was done, so he was 80% sure that nothing else was needed on that tooth. He could tell 100% by removing the restoration that covered that tooth, but he basically confirmed what my initial opinion was - that it wasn't needed. He said that having a root canal alone does not make a tooth brittle. What makes the tooth brittle is when a tooth has a lot of decay - or something along those lines. But he was very clear that a root canal alone does not require a tooth to have a crown and that my tooth was healthy and strong.

The second tooth he didn't talk to me much about, but just said that there was nothing that needed to be done other than the restoration that had already been performed. I was confused about that because I was supposed to get an onlay done on that tooth. Was he looking at the right tooth? What about the "gray" area around the existing (metal) filling that my dentist mentioned? He said that anything that needed to be done about that filling would be cosmetic only, but that there was no other problem. After the appointment, I was reading through my dentist's notes and they mentioned the tooth number, so I will go back to the dentist in Lima on Tuesday to just make sure I'm on the same page as he is.

So this was not the results I was expecting, but is that a bad thing? The dentist in Lima himself mentioned that he is used to seeing people with serious issues (if you've been to Peru and seen people's teeth, you'll understand), so does that mean he is accustomed to only looking for serious problems, wheras my dentist in NY is looking for little problems and fixing them before they become bigger problems? It seems like there are more questions now than there were before, so I will likely go back to NY and get a second opinion there as well before deciding what to do...

J. Riley, sigh.....