You might be disappointed. Our advice is going to be pretty much the same as that for choosing a dentist in Outer Mongolia. On the bright side, our dentists are more plentiful and better trained than what you might encounter in Outer Mongolia.
The first step in both places is to overcome the cultural discomfort of traveling for professional services beyond one’s neighborhood. “What if I pick a bad dentist?” is the greatest fear when you’re in a different town. Well, relax. Bad is very rare these days because of all the quality controls in place. The worst we’ve heard of so far has been an average dentist who charged like he was the best.
After that, we recommend you research your options thoughtfully, whittle your candidates down to a short list of four to six dentists, interview them, and make your decision based on who made the most sense to you.
“My dentist in Los Angeles thought he was a Mercedes mechanic” writes one of our correspondents. “I left him fifteen years ago and have been going to a dentist in Tijuana ever since. Now I’m not afraid to sit in the chair and, even better, my teeth stay fixed.”
Our correspondent is not alone. Because the dentistry in Mexico is of world-class quality while also being relatively inexpensive, you’ll find concentrations of dentists along the border from Tijuana all the way to Matamoros. The Asociación Dental Mexicana counts more than five thousand members in the central part of Tijuana alone.
The ADM didn’t count the many dentists who are not members. Nor does that number include the thousands of ADM members in Tijuana who practice outside of downtown and the Zona Río. It does not include any of the hundreds of ADM dentists in Ensenada, Rosarito or Los Algodones, nor the large numbers in Mexicali and Tecate. Dentistry along this border is very serious business and has been so for some while now.
People from southern California crossed the border for dentistry in the 1930s. Patients have jet-setted in for their annual check-ups from as far away as Canada and New York since the 1980s. Such loyalty stands as an eloquent recommendation of Baja’s quality. But how can someone who lives so far away possibly choose from among so many dentists?
For that matter, how do those of us who live in Baja California manage to choose from among them all?
We asked a few patients and a few dentists about this. Those patients said they’ve stayed with a dentist longer when the dentist had been recommended to them. The dentists reported that their regular patients are those who agree with the particular dentist’s approach – patients who don’t want to be bothered with the technical details returned to dentists who just get the job done, those who want take part in treatment decisions stayed with dentists who discuss the options, and do-it-yourselfers have been most comfortable with the dentists who handle everything personally.
What to look forGood dentists, according to the ever-cautious doctors Stephen Barrett and Robert Baratz, are those who “take a personal interest in patients and their health. They are prevention-oriented.” How would Barrett and Baratz recognize a poor dentist before it’s too late? “Be wary of flamboyant advertising,” they say, “because it is likely to signify an emphasis on mass production rather than quality care.” They make a good point, that there can be no economy of scale with professional services. Mass production should be avoided. An axiom of mass marketing, popularized in the 1970s, holds that more than a third of the price of your toothpaste is spent on the advertising that convinced you to buy that toothpaste.
Payment terms also figure into patient satisfaction: typically, the easier the terms, the longer the patient stays. Every dentist accepts cash – most even prefer dollars to pesos – and almost all accept bank cards. Patients with U.S. dental insurance have traditionally paid their dentists out-of-pocket, either cash or card, and then had their insurance company reimburse them.
Ever since the late 1980s we have seen a growing trend among dentists in Tijuana to accept U.S. dental insurance. This has allowed insured patients to ignore the whole question of payment. “My rates are so much less than what U.S. dental insurance companies are expecting,” said one such dentist, “that I can almost always take care of everything my patients need to have done and they don’t even get charged their deductible. A lot of my patients have come to me just because of that.”
The range of services offered by a dental office is another factor that medical tourists need to consider. Between the cultural differences and today’s welter of dental specializations, patients from north of the border might feel bewildered when selecting a dentist. In response to their prospective patients’ discomfort, our dentists have been offering “one-stop shopping” of one sort or another.
There’s a well-known dentist, for example, who is certified in periodontics, endodontics, and as a lab technician – he’ll clean your teeth, give you a root canal, and make your crown right there in his office. Other dentists have clustered into medical-tourism hospitals where a patient can get a tummy-tuck, Botox injections, and porcelain veneers all at the same time. Most recent are the large U.S.-style dental clinics, the kind that are run by accountants, promise the moon, and attract their customers by the sheer force of marketing.
The great majority, however, follow the tradition of offering general dentistry, root canals, and basic cosmetic services from small practices, one to three dentists. Although this Pareto approach may not be too reassuring for foreign patients who haven’t yet found their dentist, it tends to be the simplest and most cost-effective. Most patients’ problems are addressed skillfully by the dentists of a traditional practice. A patient with an unusual problem is introduced to a specialist whom the patient’s dentist knows and trusts.
There are many specialists to choose from. Because the local campus of the state university is one of the top dental schools in the country, Tijuana now offers services such as pediatric and geriatric odontology, maxillofacial reconstruction, several styles of dental implantation, Hollywood-style cosmetic dentistry, and even esoteric approaches – described as “holistic” and “biological” – that include chelation and nutrition among their protocols.
Dentists along the border will also perform services that are not related to their profession. In order to accommodate the needs of their northern patients, they speak fluent English and are happy to suggest reliable cabbies, hotels, and restaurants. Some will handle their patients’ transportation to and from the border. A few maintain apartments to lodge longer-term cases. For patients who drive their own cars across the border, some dentists now offer the Fast Track medical pass, which cuts down the return border-crossing wait to about ten minutes by giving the patient access to a restricted lane at the San Ysidro port of entry.
Some of these services are announced in the dentists’ signage. All of these services can be discussed when interviewing the dentists or their office managers.
What to expectMany medical tourists have commented on how much more human their Mexican dentists have seemed in comparison to the dentists they knew back home. Although such comments are too broad a generalization for us to endorse categorically, we can say that compassion is more highly valued in the Mexican culture than in Anglo-Saxon cultures. It is very likely that your Mexican dentist will spend more time with you, answering your questions and putting you at ease, and will take extra pride in the painlessness of their work.
On the other hand, there is less squeamishness here than there is north of the border. This difference can cause a mild culture clash. Every Hallowe’en, for example, one of the most successful practices in Tijuana decorates its waiting room in north-of-the-border macabre, going so far as to play sound effects of women being tortured over the sound system. Only gringos might think that the screams were coming from patients inside. Nor are people in Mexico put off by realistic anatomical images or by cartoon drawings of teeth in pain: on the contrary, as they walk between the roots of a molar in order to enter a building, they are reassured that they’ve come to the right place.
Regardless of the cultural differences, you should expect highly competent work at one third to one quarter of what you’d pay in the United States. Most of the dentists you’re likely to meet belong to both the American Dental Association and the Asociación Dental Mexicana; many either have studied in the United States or are currently teaching there.
You can expect a greater efficiency than back at home. A number of patients have noted how quickly their treatments progressed. Because border dentists know you’re coming from out of the area, they try to get more done in each visit.
You can expect your dentists to stand behind their work. If you’re not happy with that work, ask your dentists about it directly. They need the opportunity to fix it or to explain to you why they did it that way. If you’re still not happy, you could always sue for malpractice – but lawsuits are just as cumbersome here as they are north of the border. On this side of the border, you have the much more practical recourse of C.A.M.E.-B.C., the state watchdog organization, where you can file a grievance informally, quickly, and for free.
Whom to believeWe have found the recommendations of friends and family to be about as reliable as their suggestions for clothes, books, and blind dates: sometimes yes, sometimes no. Selecting a dentist is a very personal decision, after all. But at least these recommendations can go straight on to your short list of candidates because they’ve already received one credible vote in their favor.
Those of us on this blog with backgrounds in journalism and psychology have had the best luck by looking beyond the simple recommendation into the reasons why the particular dentist is being recommended. Says Roberto, our psychologist, “We all err when we believe any opinion without first looking into its underlying facts.” So consider asking such follow-up questions as:
- How easy was it to make an appointment?
- How long did you sit in the waiting room?
- Did you understand your treatment options?
- Were you comfortable asking your dentist questions?
- How did your dentist handle emergencies (your own or others’)?
- Does your bite feel the same as before?
- Do you feel pain when drinking hot or cold liquids?
- How did you pay for your treatments?
- How long did your treated teeth stay fixed?
Advertising is the usual way people learn about professional services. It can be useful so long as you respect its limitations.
For one thing, a number of our best dentists can’t be found through advertising because they rely on word-of-mouth. Some don’t even use e-mail. But you might see their signs while walking near their offices … anywhere between First and Eighth streets downtown, from Revolución to Avenida G, and anywhere in the Zona Río along Paseo de los Héroes and Sánchez Taboada and all cross-streets.
Visitors to Tijuana are greeted with billboards offering bright smiles. Southern California newspapers publish ads promoting dentists who are “only steps away from the border”. Websites promise to be the complete directory for our area but display only a couple dozen dentists, all of whom highly recommended because all of them pay monthly fees to be listed in the directory. Internet advertising agencies follow your click patterns in order to offer you their clients’ dental services. And, most insidiously, there are now the Internet claqueurs – phantom blogs written in stilted English that pretend to be authoritative on the subject of Tijuana dentistry and fictitious patients who post reviews, either ecstatic or libelous (depending on who paid them) in online directories, forums, and other social media.
All of this is offered in the spirit of helping you choose your dentist but, since it’s biased in favor of the dentist who paid for the advertising, it can only complicate your decision.
You don’t have to believe us, either, but no one pays to appear in The Real Tijuana. We want to describe the Baja California that we know from living in it, not one that commercial interests want you to believe in. We prefer to work from personal experience, so we’ll be adding a page detailing specific dentists in whose chairs we have sat. You will be welcome to contribute to this page. (Your contribution will be published anonymously so long as you allow our editors to confirm that you are a real patient and not a claqueur.) Outstanding dentists will receive entries of their own.
Choosing a dentist is simply a matter of researching your alternatives and selecting the one you like best. Here are a few specifics for that research:
- Don’t take Internet opinions and advertorials at face value, not even if someone’s name is attached. The Internet is home to some truly amazing nonsense. Contact the author to see if they’re for real.
- If you have dental insurance, check with your provider to find out how they handle out-of-network claims. Then bring your insurance information with you when you come to Baja California.
- Select a short list of candidates and interview them all. The last one just might be the one you like best.
- Ask your short list about the professional groups they belong to. In order to maintain one’s membership in these organizations, the dentist needs to demonstrate to his or her peers that he or she has kept up with the advancements in the profession and any specialization.
- Ask for an estimate, especially if you don’t have dental insurance. Prices and treatment plans vary the world over and from one door to the next.
- Ask your short list to let you speak with some of their existing patients.