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Tracy Crain: Selecting Dr. Mario Garita

I had one dentist for more than 15 years. During that time, I received an extensive list of procedures such as root canals, crowns, and bridge work, with costs of the crowns averaging $3,000-$5,000 per setting. In time, we found the majority of the work was not sustainable. A number of probable explanations were offered. During my last visit in 2012, I was told the existing bridgework had decay and that dentures would be the best option. For my age, it seemed an undesirable and unbelievable suggestion, especially when I had invested so much over the years to preserve my smile. I learned there were other options, such as implants, but those solutions exceeded the capabilities of my existing practitioner. I was also discouraged by my existing dentist in pursuing implants. I was told the story of a patient they compared as similar to me in dental issues. They said she had paid a lot of money for an implant and it failed.

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I live in the United States and I found Dr. Mario Garita’s office through online resources. I checked his background and did a general price comparison on the cost of services. From the information I gathered, he seemed to be one of the more qualified implant specialists. I liked that he had trained and taught in the United States and had an office in Miami listed. Ultimately, I decided to contact him because he was familiar with my culture and did implants on a regular basis. His experience was a significant advantage over many dentists in the United States who do not regularly do implants.

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In May of 2012, Dr. Garita and I started communicating via telephone and email on ways to preserve my smile long-term. A number of solutions were proposed. Although I was able to send an initial x-ray, it was difficult to determine the exact route without an actual visit to his office. Based on preliminary information, and without an in-person exam, a general recommendation was made on a treatment plan. We could not confirm this route completely until I arrived in Costa Rica. Since it is an international trip there, I was hoping the recommendation for treatment and cost estimates would not be that different from our initial discussions, as we were set to do dental work in that initial visit.

It is important to understand that it can be confusing in initial discussions and that there are unknowns. Upon arrival, some adjustments were needed. When a final treatment plan was reached, Dr. Garita and his staff went to work immediately. That was a little concerning at first, but I worked through it and gained trust in them throughout the months of ahead.

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It was decided that I would keep my natural teeth and that we would do five implants with crowns and bridges across problematic areas. There were also root canals and supplemental work. We began the implant process on the uppers. I went through the first half of the upper implant surgery. A temporary bridge and crowns were placed. I was there for about a week.

They have an impressive facility. It is much nicer than most offices in the United States. They were also very efficient in the use of my time. Dental visits were scheduled on most days that I was there. They were professional and knowledgeable. I was also impressed with their ability to speak to me in English about the details of the work. They were very kind and went out of their way to assist me in most every aspect of the procedures.

While the facility is top notch and the staff are very experienced, implant surgery is a bit painful, even with medications. I compare it to someone jack hammering the inside of your jaw. The worst part only last a short time during the actual surgery. The immediate healing process is also painful, but in a different way. During the first week, while there, my faced bruised. I had swelling and it was difficult to eat for the duration of the visit. I was alone. I stayed in one of the more recommended resort hotels, located close to the dental facility. My hotel room was exquisite and the resort was peaceful. It was somewhat remote, however, and there were only a few people I even came in contact with during my stay. While that was an advantage in some regards, there were times when I felt it would have helped to have the assistance of a nurse or some type of medical staff checking in with me.

I think Dr. Garita’s office really made an effort to care for me during my visits to the clinic. Members of the staff even called me at my hotel on some evenings to see how I was doing. They were all very nice, especially Ana. She was wonderful and seemed concerned.

I wasn’t sure what to expect in regard to pain management in Costa Rica. Like a lot of doctors, Dr. Garita is concerned over the use of medication and he does opt for what is probably the more safer routes of care. I have, perhaps, been more sheltered from pain in the United States through the use of pills, shots, and gas. Dr. Garita does not use gas. That was an element from my dental experience in the States that would have been comforting to have there. Dr. Garita makes healthy choices, but I did bring a few hydrocodone pills in case I needed them. That is a standard drug for dental care pain management in the U.S. In that initial visit, I was glad I had them. I found the hydrocodone to be very necessary.

I was concerned about flying right after major dental surgery. That first flight home was a little tough and I was still a bit swollen, but I didn’t have too many issues in flight following that first visit.

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When I got home, a few days after my arrival, I was mortified to find my temporary bridge did not hold. Since I was in the process of finding a dental implant professional to help me manage long term care of implants here, I did not quite have a dentist on hand that could assist. I had to find one and quick. It was a little odd because I was having work performed elsewhere and asking them to fix it in the interim. This brings up a lot of challenges, as they ask where you are having the work done. Because of the way he questioned, I felt uncomfortable explaining to my dentist here that I was traveling abroad. I was glad that Dr. Garita had the Miami office as I could reference that. Overall, my dentist here was able to fix the temporary bridge. My temporary bridge was in the front. While it was not the most attractive bridge, it did hold for the duration of my six month healing period. Further, my dentist here did not charge me to make that particular bridge, but there were other expenses I later incurred.

I have seen my new dental implant dentist here several times throughout my experience with Dr. Garita. First for the temporary bridge. Then, later, for various check-ups and for work in the lower jaw that became an emergency necessary during my six month healing period for the uppers. While we had planned to work on the lowers, we had started with the top. Perhaps if we would have started on the bottom, I would have avoided the extra expenses of lower work here that was only done as a temporary measure until Dr. Garita started on the lower section. I’m not sure if the decision to do the uppers was more critical than the lower or if that was something that could even be determined. If it could have been, then I would have saved time and money from work done here.

There were times when I felt like the decision to get implants abroad, truly required an international agreement with a dentist here. Dr. Garita had to consult with my new dental implant specialist and it was awkward for me. I was asking someone here to fix something I was paying someone else to do.
I was taking his business away and then asking him to fix the broken parts. My new dental implant specialist here cooperated, but it was strange to have to go to him so many times during the work for help with the work. I think it reflected poorly on Dr. Garita’s office and I think it was kind of rude on my part, although my dentist here did gain some business throughout the process of it. That gain was, however, an unexpected additional expense for me that perhaps could have been avoided.

My dentist here also indicated to me that the stitches had not been done right and that the bite work was off on my temporaries.

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Overall, my dental work in Costa Rica spanned from November 2013 through January of 2015. My first trip required about a week. My second trip required a 10 day stay. My third trip required about a week. To have this done, I had to have at least 20 working days away from my job. That meant I gave up vacation time for two years in order to get the medical procedures. It also left me with little time that I could be away from the job throughout that process. If an emergency would have come up, I would have been at a loss as to how I would get the time away from work. There were challenges.

I no longer work at that particular company, which I am not allowed to name. While people did provide support in a variety of ways, I can tell you that throughout my experience, I found those same people to be quite judgmental. My privacy was compromised. If you are familiar with American movies, I will say, at times, I felt a bit like Edward Scissorhands.

It is important to note that having the work done made me quite vulnerable and the object of a lot of gossip. It was not easy to endure. To be the joke or topic of people’s conversations. People in the states can be perfectionist and the slightest imperfections can cause damage to your reputation or well being. Having the work placed risk on my job, as it required so much healing time and additional time to fix the work here.

Throughout the healing process, I went through several temporary sets of crowns and bridges. At times, this made it challenging to speak. I also had to adapt to a changing appearance. For a year and a half, I had different kinds of teeth coming and going, with people openly discussing the elements of those teeth. This was hard on my confidence, my ability to speak, and at times, to eat. It was also concerning as I had to do so much public speaking in my position. Because the first temporary failed, I was afraid that the work might not hold during important presentations.

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When the final dental work was placed in Costa Rica, I had to adapt to a new kind of smile. It looked different. Felt different. I was taken back by the fact that shading seemed different than I expected and that exact color matches were not possible. While I was told much of that has to do with the lighting, an adjustment period was necessary.

Two months later, I am still concerned about how I look from different perspectives and about whether or not the work will hold, though my confidence grows more with each day. My prayers are that it will, as the cost was significant to me.

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Traveling to Costa Rica was pleasant. Of course, I have traveled to Mexico. I did study Spanish for a couple of years in school and my brother married into a Hispanic family. As a result, I have family that speak Spanish and I have had exposure to environments where Spanish is the only language utilized.

Because of those experiences, I was not too concerned about making my way around the country. If it were not for those things, I’m not sure I would have had the confidence to travel there alone. Upon arrival, I was pleasantly surprised to find how many people in the country speak English. Dr. Garita has wonderful English skills. So do his staff members.

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I have read several things about travel to Costa Rica that warns of a variety of things. Thankfully, I did not experience any of those in my time there. I stayed in a very small circle of people and the details of my stay were planned on the recommendations of the dental facility. I pretty much had the same taxi driver throughout my trips and I became close with the people at my hotel. They went out of their way at times to really help me. For instance, when I couldn’t eat, they brought me ice cream. I was concerned about drinking the water, as someone on my initial flight into the country, who was working with the water systems, told me that I should drink bottled water and be cautious. I did try to bring bottled water from the states. I supplemented that with drinks from the grocery stores made by brands I have purchased in the states.

I did catch a bug on my second trip home and was quite sick for a couple of weeks. It is difficult to say if that was attributed to something I had in Costa Rica or something I picked up in transit.

While some people do speak English in Costa Rica, the culture is a bit different. The landscape is colorful. There are some of the most beautiful buildings located next to some of what looks like the poorest little shacks and tin huts. It gives the impression that the country has a two class system. Those who are very rich and those who are very poor, with the majority seemingly very poor. Because of that, I recommend dressing in casual clothing. I went with casual and business casual and felt comfortable in my surroundings. It is a bit alarming to find the facility gated and with security guards. That is something, however, that you grow to appreciate in the surroundings.

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Even in the best areas of Costa Rica, however, there are differences in quality. For instance, I was staying at a very expensive hotel, that was very nice. My ceiling, however, did leak and my air conditioner was non-functioning during my first trip there. Considering the amount of healing I was undergoing, it was an inconvenience that was tough. The hotel, however, went out of their way to get things fixed. They even reduced my costs. It was a beautiful place. If something went wrong, they did try very hard to address it. The climate is different. One night there was a spider I could not identify in my room one and a variety of little “rain forest” like things you might not expect during a trip. I’m not sure how wise it is to be in recovery, on medication, and to have unidentified spiders in your room, but I survived. For the most part, it was a pleasant and beautiful recovery experience.

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I’m not sure being alone is the best thing when having procedures like mine. There were times when I was concerned for myself and wondering if I did not need more of a hospital like setting. Those moments, though, were short-lived.

There are some beautiful places in Costa Rica and I felt blessed to have the opportunity to visit some of them through the careful planning of my hotel staff. For instance, I did get to see the rain forest and some of the coffee plantations. I also got to see the ocean and a variety of neat things that you don’t find in the states. There was ample entertainment options if I wanted, though I primarily stayed in my room and focused on work or healing.

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When I arrived in Costa Rica on my different trips, I was already partly exhausted from an everyday hectic schedule. With that said, time to rest was needed, though I may have been a bit run down for such extensive work.

Cost savings
I may have saved roughly $10 to $15 thousand dollars by having the work performed in Costa Rica. I felt Dr. Garita was more of a specialist than anyone I could have found in the states in the time frame I had and on the budget I had to work with, and I did feel confident in his work as a dentist.

Dr. Garita did go out of his way to assist me. He was always available when I had emergencies and he was patient as I asked numerous questions and worked through a variety of trust issues. Another very nice thing about Dr. Garita….I ended up having dental surgery on my birthday and Dr. Garita’s office went out of their way to buy me flowers, a gesture I did not expect, but certainly appreciated, as I was there alone. It was kind.

Some of the primary reasons I had for having these procedures involves the ability to speak and to help preserve bone structure. While it was challenging throughout the process, I find I have very little difficulty, if any at all, with any pronunciations. I find that I can still sing, without any issues. I remember asking Dr. Garita if I would be able to eat an apple with my implants. He told me that I would. I wasn’t quite sure if I believed him. With everything said and done, I find I have been able to eat an apple without difficulty, though I still peel it and chop it with a knife beforehand, primarily because I’m still building confidence in my ability to bite.

There are a few differences in my bite and in chewing, but those differences are minimal. I am still in an adaptation period, but I find I like my new smile more each day. At the end of my procedures, I took a picture of me smiling and posted it to Facebook. It got more likes than any picture I have ever posted on social media. People say I have a nice smile. I’m not quite sure how I look yet. I know it looks better than the temporary bridge I had.

In comparison…I did have a nice smile before I started my procedures, though their were decay issues. I no longer have decay issues and I feel there are many things that have improved besides that. Evenso, there are, at times, some things I do miss about my former smile.

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The implants are way more functional than a partial or dentures ever could be. As I was telling a member of Dr. Garita’s staff, if these hold, Dr. Garita and his staff, will be my heroes.

Getting implants is a lifestyle change. Traveling internationally can also be risky. It was a bit frightening, but I faced little if any difficulty. I even went to a pharmacy that did not speak English and was able to pick up a prescription. I enjoyed that experience, but I could see where that might be a serious safety issue for someone who was not familiar with the language.

I don’t think the work performed was easy to do and I think Dr. Garita and his staff did the majority of the work exceptionally well. His office was so much better than the dental offices here. His staff was wonderful and there were few if any challenges during procedures.

A few mistakes were made, not necessarily made by Dr. Garita, that I think could have been avoided. I think the difficulty level for my work, however, was more significant. And where some things initially failed or hurt, many things that were hard to do, were done brilliantly. I think the work done on the lower jaw has made my smile and bite much more functional. I can eat without difficulty. Speak without any major issues. I don’t have to worry about taking them out. There are a lot of great things about the work performed. I do think, cosmetically, the partial was prettier. While it might have been pretty, it was difficult to speak, painful to wear, and an inconvenience.

Overall, there are different types of healing that must occur during these kind of procedures. It is not just a dental experience. I do wish I would have had more privacy.

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I have to say I like my new smile. I am thankful and hoping this investment proves worthwhile. Like I said, if it holds, you and your staff will be my heroes.

I’m not sure I have truly expressed how wonderful some of the staff members were at times or how terrific Dr. Garita is in so many areas, but I think they know I appreciate their time and talents.

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