How to choose a dentist in Baja California

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rana de la Bajaf

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.


dentist tijuana 1928

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 for

Good 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.

dental insurance and credit cards Tijuana

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.

one-stop medical tourism

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 expect

Many 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.

consultorio calle primera

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 believe

We 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.

entrance to tijuana

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.

24 comments:

Anonymous said...

I don't want a lot of words, I just want to know who the five best dentists are.

The Real Tijuana said...

We probably won’t be able to help you, anon, because we don’t believe there is such a thing. Medical professionals don’t compete for gold medals: the dentist who gives you what you need in a way that makes you comfortable is the best for you.

People who accept what someone else claims to be “the best” are often disappointed. Superlatives must be qualified if they are to be meaningful. The best at what? The best for whom? The dentist with the most awards? The dentist with the largest advertising budget? The dentist with the greatest number of patients who are culturally similar to yourself? The dentist with highest percentage of returning patients?

You get to pick the criteria that make sense to you; the best we can do is help you map out your search.

Anonymous said...

I already have a wonderful dentist in Tijuana, but last week it took me three hours standing in line on a weak leg to get back across the border.
Suggestions?

The Real Tijuana said...

A special traffic lane has been in operation for several years now that permits motorists who visited their doctor or dentist to return to the U.S. very quickly. But it sounds like you were crossing on foot. Although the pedestrian crossing at San Ysidro does not have an analogous Fast Pass, it has always given preference to the aged and infirm by allowing them to go straight to the head of the line.

Before all the WHTI paranoia, this preference was a simple matter of common courtesy: folks on canes and in wheelchairs went straight the front of the line. Nowadays two separate guards determine, case by case, who gets preference. The first guard is posted at the metal fence dividing the two countries, at the door to the right of the general line. You then enter the main building through the door on the left, marked "SENTRI", and proceed to the guard who checks for SENTRI cards. You don't need a SENTRI card, of course, but it couldn't hurt to have a note from your doctor. People accompanying the aged and infirm are no longer given the same preference unless the companion is medically necessary.

If you don't meet the guards' criteria for preference, you might try crossing during off-peak times. Three-hour waits are rare and occur usually because of long week-ends or the Christmas season.

Feel free to share your impressions of your dentist with us by writing directly to real.tijuana@gmail.com .

Anonymous said...

REVISED to clarify the last sentence:
This post seems like a promising start on a vital topic, but should be updated. For example, it says, "Outstanding dentists will receive entries of their own." Is there any timetable on that? The post also says unhappy patients can sue or file grievances with C.A.M.E.-B.C., but doesn't say how prospective patients can check for unusual complaint patterns; in the USA, it is possible to check the BBB and local court records. The suggestion to go for several exams, with multiple radiographies, might add up to a lot of unnecessary radiation. It would be very helpful to list some reputable dental practices that use modern digital radiography (to minimize radiation), American "universal precautions" (e.g. autoclave instead of just alcohol), speak English, use good supplies (for example, composite filling materials are still evolving, so 2011 materials may be better than 2009), etc. Otherwise I definitely agree that personal preference is a factor, some people want all the details and others don't, and personally I prefer the DIY type because I've seen bored support staff in the USA make obvious blunders (e.g. X-ray the wrong tooth), so categorizing dentists would also help.

The Real Tijuana said...

Addressing your issues in order:
• Our publication schedule has no timetable. We are an all-volunteer group that is not funded by the tourism industry. You can speed up the process by donating to the cause. Were our readers as generous with their contributions as we have been with our time, The Real Tijuana would be the publication we first envisioned it to be. There’s a Donate button at the bottom of “Useful Links”.
• The BBBs and the C.A.M.E.s have similar goals but their methods are much different. The Better Business Bureau is a commercial organization: businesses must pay to belong to it, so not all of them do. The comisiones de arbitraje médico, on the other hand, have oversight for all medical practice within their territory. Brent Emerson and Jay Scott Howard bought a sterling reputation in the BBB, which they used to authenticate “International Travel Brokers”, a telemarketing scam that bilked millions of dollars out of the poor and unemployed before landing Emerson in prison. Because of their discretion, the C.A.M.E.s could never assist such a fraud.
• Court records in Mexico can be checked at the Ministerio Público (criminal malpractice) and through the Procuraduría Federal del Consumidor (civil liability). Your first step, however, should be to see that your candidate belongs to the appropriate professional college – a quick e-mail in English to C.A.M.E.-B.C. will elicit that information. Details are in our article on C.A.M.E.-B.C.
• We do not suggest that a prospective patient submit him or herself to more radiography than necessary. Our recommendation is that you interview as many dentists from a “short list” of candidates as you are able and choose your dentist based on those interviews. Interviewing has nothing to do with X-rays.
• Dentistry in Mexico follows internationally recognized “best practices” as promulgated by the ADM, the ADA, and ISO; the professional colleges and the C.A.M.E.s are responsible for proper observance of these practices. Your suggestion that Mexican dentists are less reputable because they somehow don’t take proper precautions deserves to be referred to Gustavo Arellano (“¡Ask a Mexican!”), who finds more humor in such notions than we do.
• Unless you were born before 1920, dentists along the border have been speaking English longer than you have. No doubt there are a few nowadays who do not speak English but there’s no reason for them to show up in a blog written in English for an English-speaking readership. We can’t promise a similar bilingualism in the taquerías, though.
• As for the categorizing of dentists, we prefer to describe what we find so that our readers might draw their own conclusions. In that way, patients can be more active about their choices.

Dentist Los Angeles said...

Outstanding post.

Anonymous said...

Very infornmative blog.

I am located in San Diego and chose my dentist based on the work I saw from a friend's mouth. The transformation in his mouth was amazing!

This dentist does not speak English, but I brought a friend who did. His office may not be fancy, but it is clean. Most of all, I was confortable with the dentist and did not feel pain during the extraction. PLIS a temporary denture type tooth was given to wear until the extraction healed and a bridge could be implanted.

I am very happy with my dentist. I think he should be included on your list and will email the name to you.

Anonymous said...

Where are these outstanding dentists? I have one and need one. I also have a "never use him" dentist. Others I have used are just ok for certain things. How do I find other people's recommendations here? Or anywhere? Your comments are great for beginners but I am looking for an information exchange about experiences. Suggestions?????

The Real Tijuana said...

Outstanding dentists can be found everywhere throughout the world. In this blog we would be concentrating our efforts on Tijuana, Ensenada, and Tecate.

If you have one and you need one, it sounds like we can't help you. If you would like to criticize the work of a dentist in our area, we would like to know about that. Please address your criticisms to our Reader Service address found in Useful Links.

Lillian Stuart said...

This is such a great resource that you are providing and you give it away free. I love seeing website that understands the value of providing a quality resource for free.
Regards
Endodontist Sterling

Dentist Indianapolis said...

Great resource. Thank you. This is indeed very helpful.

sheinpdx said...

Excellent post. No opinions on individual dentists yet? I'll be down in a couple of months so I'll be sure to send in information about my experience. You suggested crossing the border during non-peak hours. What would be a good time range for crossing the border without a lot of waiting? Also enjoyed the picture from 1950 - about the last time I was in TJ - as a small child (have a picture on a donkey wearing a sombrero.

Thanks - she

The Real Tijuana said...

Thanks for the compliments.

The blog has been on autopilot recently while members of our collective deal with personal crises. The preparation of publishable recommendations has been slow. We do have one that's almost ready to publish; we'll share that with you by writing us at Reader Service (in the Useful Links page).

As for crossing back into the U.S., non-peak hours are after 5:00pm on most days. Consider this a good excuse to get a nice dinner before returning home. During the work-week, the line calms down somewhat earlier.

If you're driving, the so-called Medical Pass gets you into a special lane that takes about ten minutes. Pedestrians, unfortunately, don't have that advantage yet.

Bruce Oglesby said...

This is an outstanding post. My wife would like to setup her practice in a nice area of Baja, any recommendations for a city that's good for raising children too? We are thinking about Loreto.

Many thanks!

The Real Tijuana said...

Loreto is not in our wheel-house, Bruce -- in fact, it's in a different state altogether. But you might consider Playas de Tijuana and Playas de Rosarito.

We've heard recently of a buyers' club being formed in our area that your wife might be interested in. It describes itself as the Costco of medical services, offering local doctors and dentists at their best prices to patients north of the border.

Shonya Smith said...

I did lot's of homework, got a referral from an organization I thought I could trust, and still ended up with a mouthful of fillings that started falling out within a few weeks of getting home. All work is having to be redone and two teeth now need crowns because decay was occurring under the fillings. I realize I'm only one case, but the dentist is blaming it on malabsorption. In a few weeks? What's the best way to warn others about such a provider?

The Real Tijuana said...

We had originally intended to publish patients' reports but then got bogged down in credibility problems. We are unable to substantiate the reports we have received. The dental industry in California has been slandering Tijuana dentistry with false negative stories since the 1960s and now search-engine marketers flood our mailbox with false positive reports as well.

Dental work ought to last for at least a year, so this "malabsorption" sound like the dentist's responsibility. Either your dentist should do the work correctly or give your money back.

If your work was performed in Baja California, CAME-BC, http://www.camebc.gob.mx/, can help you on that score. We ran an item on them a couple of years ago, http://realtijuana.blogspot.com/2010/10/bajas-medical-ombudsmen.html‎ CAME-BC is a medical arbitration board, so their mandate is to promote satisfactory resolutions as nonconfrontationally as possible: they don't like to publicize problems but they do try to weed out problematic medical practitioners.

Although it's too soon to know for sure, the best way to warn others might very well be Club Medico USA. We had been hunting them down when Bruce wrote and have since managed to meet with some of the organizers of this "buyers' club for medical services". Beyond negotiating the lowest prices for medical services and offering transportation to and from appointments, these guys said their business plan calls for a members' forum in which real people can share their experiences openly and freely. As of this writing, their website is still under construction, http://clubmedicousa.com/ We're still waiting to hear when this Club will be ready to accept members.

Anonymous said...

I went to White Smile Center in Tijuana 7 months ago. They told me I needed 3 root canals and 4 crowns. I spent over 5k. Now 3 of those teeth that they worked on are now infected, one of the crowns broke and the Dentist here in the US told me they did my root canals wrong and I need those 3 teeth pulled and implants put in! I'm devastated. I also had x-rays done in the US a couple months before going to TJ, witch my dentist here looked at and said they did 2 of the root canals unnecessarily. What can I do now? Can I sue a dentist in Mexico?

The Real Tijuana said...

Did you contact White Smile Center before writing to us? That should always be the first step whenever a consumer has a complaint. At least find out what WSC's "triple guarantee" means in your case.

Beyond that, all we can do is repeat the advice we have been giving all along.

(1) If you suffered malpractice as a patient of a dentist in Baja California, let CAME-BC know about it. Once this group is satisfied that you were really a patient of WSC and not someone using the anonymity of the Internet to slander the competition, it can arbitrate a satisfactory resolution for you.

(2) Check your healthcare provider's credentials. Doctors and dentists who have been certified by IBMS at their "gold" level or higher have pledged to indemnify their patients against adverse complications that arise after returning home. What this means in the present case is that you would not have to pay your dentist in Seattle for correcting any faulty work performed by a dentist anywhere in the world who has "gold", "ruby", or "emerald" certification from IBMS.

(3) Join Club Medico USA. This group, operating in northern Baja California, knows its healthcare providers personally and utilizes safeguards similar to those of CAME-BC and IBMS.

We don't like to run anonymous allegations of malpractice without investigating them, so we asked WSC to respond as well. Their answer will be posted as a follow-up. We are particularly interested in hearing how the dental work described in this complaint cost twice as much as WSC adverstises on its website.

Lisa De Leon said...

My brother also went to white smile center to have dentures. They list on their website the are us board certified & california board certified dentist & specialize so we felt confident with work would turn out well. He had his teeth removed on 12-23-13 and returned to have temporary dentures which they said could be used as permanent ones . They fitted him and sent him home with childsize teeth. My brother has a large round face so you can only imagine how ridiculous he looked. He was under a lot of medication and in pain. The older dentist of the group was very agitated with my brother because he would tell him it hurt when fitting and forcing dentures in. My brother complained and told them that teeth were too small. They brought in 3 dentist that were in office that day and a few staff members to reassure him they looked great. Sohe left with them after he shad already told them he didn't want them. The work is unacceptable & i have gone back with him to redo work. They state they are specialists in implants and denture work. The work looked like it came out of a bubblegum machine. They said it was ok he didn't need them & should wait to heal for temp or implants. It has been three months and he still has no dentures. The cost for removing teeth and 2 sets of dentures came out to $8,000. We are currently asking to be reimbursed as well as finding out who is board certified & who the specialists we have copies of receipts with work performed & both are different services. Would my best bet be to contact the cam-bc to help us ? My brother is depressed and out of money. We found out that this work coukd have been done cheaper in the us.

Craig said...

" 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 "

This is not entirely true. Generally all a dentist needs to do to belong to these organizations is pay the annual membership fees. There is no inspection, and no accountability attached to membership. The best way to vet for a dentist is through patient reviews and personal contact.

The Real Tijuana said...

Yes, Lisa, CAME-BC would be your logical next step. We can give you their e-mail address and any other details if you write to our Reader Service. Other points of contact are given in the article we've posted about them.

The Real Tijuana said...

We do agree with Craig that personal contact with your dentist is very important.

We tend to discount Internet reviews, however, because Yelp isn't the only portal to infested with shills and claqueurs. To correct this problem, Club Medico USA announced plans to offer patient reviews by actual patients.

As for Craig's opening allegation, the Reglamento de la Certificación y Recertificación de los Cirujanos Dentistas de la República Mexicana requires dentists to submit two hundred documented CME units every five years in order to maintain their certification. The passage Craig objected to contemplates Continuing Medical Education in particular.