My mother suggested I get my implant in Costa Rica as she had
As I sat in my dentist’s chair last August and received the news that I would need a dental implant —a titanium root that’s drilled into the bone and attached to an artifcial tooth— I didn’t even finch about the prospect of having oral surgery. What caused me anguish was the estimated cost: at least $5,000. For one tooth. I prayed that my dental benefits would pay for it, but it was not to be.
My insurance did not cover an implant —it’s considered a “restorative” procedure— and, after a consultation with the oral surgeon, I discovered that the grand total would be above $7,000. My dentist quoted me $650 for a temporary tooth and $1,700 for the permanent one, installed once the bone where the implant is placed has had time to heal.
When it comes to your teeth, what choice does anybody have? It’s wince, gulp and hand over the credit card —something a friend of mine will have to do when her son turns 19, to pay the $39,000 she’s been quoted for his four implants.
I booked in with the oral surgeon and resigned myself to debt —until my mother sugested I get my implant in Costa Rica as she had, because the prices are signifcantly lower.
Immediately I had visions of Romancing the stone, slashing my way through brush with a machete to reach the dentist’s office.
But once I started looking into it, it became apparent that medical-dental tourism is a legitimate and increasingly popular option. In 2000, Costa Rica’s health-care system was rated #36 in the world by the World Health Organization —higher than the U.S.’s— and #1 in Central America.
Dentistry has always been excluded from publicly funded care in Canada
Of course, dental tourism is something the Canadian dental industry is guarded about. “I don’t know if we oficially discourage it, but we certainly caution people about it,” says Dr. Euan Swan, manager of dental programs at the Canadian Dental Association. The argument is twofold: In Canada, dentists are certifed and registered by regulatory authorities (not that that isn’t true in Costa Rica); and if you have complications after surgery abroad, your legal options are limited and you’ll have to deal with them back home.
A closer look at the system reveals why dental tourism is appealing. While there are provisions made for children and people with low incomes, dentistry has always been excluded from publicly funded care in Canada, despite the fact that oral health ties directly to overall health. And yes, many Canadians have access to care through their employee health benefts, but these plans vary. If you end up requiring something major that insurance doesn’t cover, it’s coming out of your pocket.
Education, training, equipment, materials, lab fees, staff salaries and malpractice insurance explain the staggering dental fees in this country. But, as Vancouver dentist Dr. James Armstrong theorizes, we’re outraged at the bill because we’re used to universal health care. “Canadians don’t see the cost of medical care,” he says. “Just the chair and the swivel thing that the dental assistant uses can be $50,000.” Each province issues a fee guide, with the exception of Alberta, but dentists are free to charge above or below them.
Feeling gouged by the (dental) Man, I cancelled my surgery in Toronto and contacted Dr. Mario Garita in San José, Costa Rica, the dentist my mom had visited. I was comforted by the fact that he was trained in Miami and has over 20 years of experience, and that everyone in his practice speaks English. An emailed X-ray later, he got on the phone and recommended doing the procedure in two phases. I would get the implant and return, afer properly healing, to get the permanent tooth in three or four months. He said the price would be at least 60 per cent less than in Toronto. I could fly on points, and many hotels offer discounts to patients. (One, Wyndham Garden, helped me set up daytrips to see the ocean — crocodile sighting included! — as well as, oh, an active volcano.) I even confirmed that the brand of implant he would use was North American. There was nothing lef to do but book it and hope for the best.
A patient from New York was quoted $120,000 at home; in Costa Rica, he paid $35,000
From the moment I met Garita, I felt like I was in great hands. Instead of IV sedation, he used a local anaesthetic, which took $500 of the bill. As for the surgery, I could not have hoped for a better experience. And I’m not alone. Garita estimates that 80 per cent of his patients are from North America. Most are seeking implants, and many are extreme cases: A patient from New York was quoted $120,000 at home; in Costa Rica, he paid $35,000. When I ask Garita how he can offer these prices, he says the reason is primarily sheer volume. He does about 1,000 implants a year, and as many as 22 in one day. And his overhead is lower—though he pays for North American equipment and materials. Of course, not all Costa Rican dentists are equal; doing your research is crucial, and it’s very much buyer beware. But unless dental care becomes more afordable in Canada, dentists like Garita will likely continue to see patients like me.
That may change one day; aware of the fact that many Canadians don’t even go to the dentist, the Canadian Dental Association met in Ottawa in February to discuss a national oral health action plan. Obviously, money was a topic of huge importance. “We’d love to see more funding,” says Armstrong, one of the board members. “We’re dreaming big.” I’ll dream with them. Until then, I’ll be hopping back on the plane this spring.