Monday, December 29, 2008

DECEMBER 28-THE DENTIST'S OFFICE..it's not Portland

One of my primary reasons for this trip is dental work.  Sad but true..I simply can't afford to go to the dentist in the US of A.  At 65, I need some major work...and I need it bad.  After getting a price at home that was just about the cost of a new Mustang, i checked out options.

I'd heard about people coming to Costa Rica for cosmetic surgery and weight loss surgery and while I was here on my last trip, I met a woman who had gone to the dentist and raved about her work.  So I googled Costa Rica Dentists and wrote about 15 of them for prices and estimates.

Meanwhile at home, I had some preliminary work done with the $1800.00 a year that my insurance will cover which isn't much.  I've had 2 root canals, but declined the crowns which would have run me $2000.00 since by then I had no insurance to cover them.  I had a terribly broken molar pulled as well as a tooth that was crooked and had become decayed right in the front of my bottom jaw.  So yeah, since October I've been running around with jack-o-lantern gaps in my teeth...but at least it's a seasonal look.

After taking 6 weeks to heal all the oral surgery up, I'm ready to have things fixed.  

I grew up in the era just before orthodontics for teens plus my parents were middlin' poor so it wouldn't have been an option in any case.  As a result, I've suffered with very crooked bottom teeth.  I did get ortho for my kids but never for myself.  Just couldn't afford it as a single parent.  As a result, my bottom teeth are a mess.  So one of the things I really wanted was veneers on my lower teeth-but they were just too crooked for it.  So I'm getting caps on 5 and 2 implants where I had a decayed tooth pulled and a canine never grew in. plus an implant on the molar on the bottom and a couple of crowns for the root canals..like I said..the cost of a 2006 Mustang in the states.

Dr Marco Munoz Cvallini


I scheduled an appointment at Aesthetic Dentistry with Dr Marco and his son Dr Marco.   A couple of real charmers both of them.  I'd communicated at length with them via email and found them to be very forthcoming and willing to give me an almost firm price for all the work I wanted to have done.  It was $3500.00  Which was less than the cost of 2 implants in the states.  Amazing.

  Dr. Marco A. Muñoz Peralta


Arriving at my first appointment, I found a full waiting room all of who had 10 am appointments.  The TV was going like mad with a game show in spanish and people were chatting and reading, working on their computers and listening to their iPods and generally just patiently waiting for their turn.



Occasionally Dr Marco the Elder would come out and kiss and hug a patient and send him or her on their way and Dr Marco the Junior would bring someone in to his office, while one of the many assistants were bringing people to and from x-ray and fittings and color matching and so on.  It's a busy friendly place and absolutely nothing like a dentist in the US.

At noon, still not having seen anyone, we were all herded out of the office for lunch and told to return at 1:30...so I wandered around, found a soda ( a usually small coffee shop/restaurant that serves inexpensive meals) and grabbed an excellent empanada pollo.  At 1:30 I returned to discover I was the last person back, which made me last on the list to be seen.  I finally got in about 3PM after waiting all day...but say..it's Costa Rica and time doesn't mean the same thing there.  I'm glad I had a book and had met a couple of people from the US to talk to.

Dr Marco Jr had x-rays taken of my mouth and soon was telling me exactly what he could do for me, applauding that I'd had prep work done in the US and scheduling me for another 11AM appointment the next day to begin the implant process.

Now understanding exactly how 'appointments' here work, I wised up and grabbed an early bus, arriving at 9AM, first one in the door and first one to be seen---so remember appointment times are just suggestions in Costa Rica.  Get there early!

Soon Dr Marco senior was singing to me in spanish as he drilled holes for the implant pegs.  He is a total charmer and kept calling me Shirley as I look sort of like Shirley McLaine.  He called me His Little Shirley for over 2 weeks, which was pretty funny as at 5'9" I am anything but little!   I was prepped for implants over a 2 day period, given temps at night and on the 3rd day I was prepped for the caps on my lower teeth and the crowns.  Molds for the first of the permanent teeth were taken and fited to me, adjusted for correct fit and the permanent ceramic teeth designed, including a consultant for exact color match with the lab artiste'.

 The lab work takes several days but it's ok because by now your mouth is pretty sore and it's a relief to have free time that isn't spent in the dentists office.  I scheduled some tourist things, such as a white water rafting trip and a long weekend at Volcan Arenal in the company of a couple of other dental patients from the US.  Took a nice hike with a guy from New Jersey, who had kindly let me borrow his room for half a day when my mouth was uber sore and I didn't want to get right on the bus..theres a rather dingy hotel next door to the dental clinic where he was staying for something like $35.00 a night.

Come monday morning I again arrived at 9 and had 2 crowns put on and was sent on my way by 10:30 and told to return in a couple of days for the lower caps to be cemented in place. 

And so it went...a couple of hours one day, nothing for 2 days then an all day session...interrupted by my bout with e coli which took almost a whole week off my dentist time.  Nobody cares, really, what time you arrive..when you walk in the door the receptionist signs you in and thats the order you're called, usually, except if you need x-rays or are getting a cleaning for fitting for crowns or caps.

I had lots of time to sight see and vacation, the temporary teeth I got every day were fine to eat with and generally I fell into the flow of wait and wait and wait....glad I'd brought a book and my iPod.

My last week was a bit of a rush, due to my lost time, but the Drs Marco went all out to make sure I got finished early on Wednesday the day before my flight, which was at 3PM on Thursday.  I went out to dinner with Dr Marco the elder to test run the fitting of everything and came back in dragging luggage for a final fitting and cementing the morning of my flight, then Dr Marco called his friend the gypsy cab driver who took me to the aeropuerto for $15, which is $10 less than anyone else quoted me.

My work is fully under guarantee, something I am taking advantage of as after a year and a half the lower molar has loosened for some reason.  Again I am having it removed in the US and getting a bone  graft in my jaw, but the replacement of the implant and the crown is free to me.  Try and get that from a dentist in the US.

Aesthetic Dentistry uses immediate load implant pegs which means they can place your new tooth within a few days.  They use a much smaller peg when compared to that used in the US dentists office when I first looked at implants.  The drill a quite small hole into your jawbone, then use a torque wrench for fairies..a tiny tiny thing, to ratchet it into place after applying glue.  

I have nothing but praise for the office staff and the doctors and dental techs.  Though it took a long time, that was because I had a lot of work done and didn't rush things, making sure I had plenty of free time.

Finally, if someone talks about Costa Rica being a third world country and very dangerous I have to disagree.  I'm a senior citizen and did plenty of walking thru the main city as well as hiking in the cloud and rain forests by myself and hanging out in the smaller town of Grecia..I never met with anything but politeness and interest.  My spanish is minimal and many of the people I dealt with spoke more passable english than I did spanish

I highly recommend them for inexpensive but excellent dental care in a wonderful country.

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