Going to the dentist in Mexico.

Health and medicine explained.
Feb. 19 2007 10:40 AM

My Mexican Dentist

A medical tourist gets her teeth fixed in Nogales.

Twenty-three years ago, a bike crash landed me on my face, and over time the dental work meant to cover up the damage deteriorated right along with my teeth. Cracked porcelain veneers covering two front teeth trapped food and invited cavities. Another veneer fell off three times, and the one meant to disguise my dead, black tooth turned gray.

This winter I resolved to fix all of this, even though I had no dental insurance. I was too cheap for a friend's dentist in Philadelphia, who recommended gum surgery and four new veneers for $9,000, or the Manhattan dentist who wanted $6,000 just for veneers. I didn't trust the NYU dental school, where I'd experienced work I thought was botched, and in any case, the quote of $2,000 for four veneers came with "no guarantees."

I considered dental spas in Thailand or Costa Rica, where the price of a plane ticket and hotel offsets the extremely cheap rate of the work. Then my father told me about a co-worker who had taken his son to Mexico for a tooth extraction that cost all of $30. I had already paid for a plane ticket to visit my family in Sierra Vista, Arizona, so I started asking Arizona friends about Mexican dentists.

Everyone had a referral for me. A friend of a friend takes her daughter from Tucson to Nogales to have her braces tightened every month. My 86-year-old grandmother and her pals from an assisted-living community in Phoenix carpool to San Luis and make a day of it—teeth cleanings, crowns, prescriptions drugs, you name it. The going rate for a crown in Mexico? $300 apiece. I was sold.

To cross into Mexico, my mom and I parked the car on the Arizona side of Nogales and walked through some turnstiles into the Mexican city of the same name. There was no ID check. A 60-something man wearing a dark-blue uniform waved hello.

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"Come and Smile!"

We pushed our way through swap meet stalls crowded with blankets and silver jewelry and margarita pitchers. One out of every three shops was a pharmacy. For every 10 pharmacies there was a dentist. One sign showed a 3-foot-wide set of lips and teeth and read, "Come and Smile!" Little anthropomorphic teeth carried giant toothbrushes over their shoulders as they walked over the words "We Speak English!"

I stuck with my plan to go to the office of Dr. Ivan Gonzalez, based on a referral from a friend's co-worker, who'd been going to him for four years. The waiting room had a clean linoleum floor and the chairs were filled with senior citizens from the United States. "Medicare doesn't cover dental," one of them said. Marvin Jorgenson, a 70-year-old in a hiking hat, told me with a grin that he was getting two teeth pulled.

Dr. Gonzalez, a beefy guy with a receding hairline, promised me that my $300 crowns would look beautiful and last 30 years. The price for the consultation? Gonzalez smiled. "Free, of course."

Two days later, Gonzalez's assistant readied me for an X-ray by jamming the film between gum and teeth. As she swung the X-ray machine over to my head, I moaned and waved to let her know that she'd forgotten to cloak me in the usual lead vest. "It's okay," she said, positioned the barrel of the machine over my nose and mouth, and snapped the X-ray.

Gonzalez walked in, and I told him what had happened. He shrugged and asked me if I was pregnant. I said no. "Don't worry about it then," he said. He shot me up with Novocain and sawed away at my teeth. Toward the end of the procedure, I made the mistake of opening my eyes. Reflected in the lens of Gonzalez's glasses were my four front teeth, whittled down to nubs as narrow as golf tees. My God. I had trusted this man to virtually replace my teeth. I'd known what the procedure was—but the unfinished results terrified me.

Gonzalez fitted me with some "temporaries," pieces of hard plastic cast from a mold of my row of four teeth, and I walked out to the waiting room and right into Marvin, that happy man with the hiking hat I'd met during my last visit. This time, he wasn't smiling. "My plate didn't fit right," he said. "I've come back to get it fixed."

Since my crowns needed to be cast, I had a week to wait for my next and final appointment. I coped with my panicky buyer's remorse by phoning Gonzalez incessantly. Was the yellowish color of the temporaries to be the color of my new teeth? No, don't worry. Why do my teeth hurt when I drink something cold? That's normal sensitivity.

At the start of the capping appointment the following week, I lunged toward the dental tray to take yet another look at the crowns Gonzalez was going to put in. He had to pry me away and say, "Let me work here." When he took off the temporaries by tapping on them, hard, with a metal tool that looked like a nutcracker, I stopped him because I was worried about root damage.

"I could cut them out, but this way you don't need the Novocain shot," he explained. "It doesn't hurt, does it?" When I shook my head, he gave the final blow that cracked the temporaries loose. Blood came rushing out of my gums. Gonzalez stopped it up with a wad of gauze.

And then my Mexican dentist went from reckless to perfectionist. After testing the crowns in my mouth and sizing them up for five minutes, he decided that one was a little too short and would have to be recast. I thought I'd have to come back in a week or so for the new crown. But one of Gonzalez's many relatives working in the office took the crown to the lab next door and came back with the new one in a half-hour, a turn-around time unheard of in the United States.

As Gonzalez finally pressed the cemented crowns into place, their sharp edges bit into my gums, making me yelp and squirm. "I know. I know. It's okay," Gonzalez said calmly, and I tried to make that calm voice my painkiller.

When Gonzalez was finished, the crowns looked better than my teeth had looked for 23 years. Six weeks later, I have a mouthful of natural-looking, relatively comfortable crowns, and though I worry a bit over one tooth's slight sensitivity to heat and cold, it's not intense enough to merit even an aspirin.

Before I left Mexico with my parents and their friends, who'd come along for the trip this time, I watched them wheel and deal their way through the kids' candy store of Mexican health care. My dad stopped to pick up some cut-rate Prilosec. My mom's friend filled a new prescription for her eyeglasses. When we got to the border crossing, the customs agent asked, "What did you buy in Mexico?" I just smiled.

Molly McCloy is a writer in Queens, N.Y.