The Travel Chica

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My Biggest Fear: Dental Work in the Third World

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I am not one to publicize the things that scare me about traveling alone in Latin America, mainly because I don’t want to give my parents more things to worry about or discourage others from doing what I am doing.  Since I got the whole getting robbed thing out of the way the first day of my trip, the remaining fears were mostly medical-related.

A mere 6 weeks after getting robbed, it happened.

I was in the Quito, Ecuador airport chewing on a piece of gum (the real stuff, not the rubbery crap you buy in Latin America), and I felt a crunch in the back of my mouth.

Oh, shit!

I had broken off part of a tooth.

How exactly this could happen just from chewing a piece of soft gum, I do not know.  All I know is that I was terrified.  I could feel the panic starting to take over.

Then I realized that was all I could feel.   I did not feel any pain.

Panic attack averted.

I jumped on my next flight to Puerto Vallarta, Mexico where I would have a wonderful reunion with friends for a wedding.

Periodically, I would think about my broken tooth.  I would rub my tongue over the jagged edge, wondering if one day I would awaken in horrible pain.

Would it happen when I was in a small town in the mountains of El Salvador, where the only doctor is a 14-hour mule-ride away?  Would it happen when I was on an island without electricity or running water?

Maybe I should get this looked at.

But what if it’s bad?  What if they want to do a root canal?  What if they don’t have novocaine?  What if they want to put me under to extract the tooth?

I am all alone.  Who will hold my hand?  Who will take care of me while I am in pain and being whiny and demanding?

No.  Better to ignore the problem.

I considered going to a dentist when I was in Antigua, Guatemala.  I found out from a fellow traveler that she was actually getting dental work done during her stay in Antigua.  She informed me that Antigua is actually known as a “dental tourism” location.

I thought about it.  But I was still afraid.

Several months later, I settled in Buenos Aires for a while.  Although there was still no pain, I was constantly reminded when my tongue brushed against the broken part of my tooth.  I decided that this was probably the best place to get my tooth looked at.  Although there was some debate in the comments of a recent post regarding whether or not Argentina is a third world country, I figured Buenos Aires was probably one of the best cities I would pass through in terms of medical and dental care.  Plus, I knew expats that had regular dentists and could vouch for their ability to not inflict extreme pain.

So I did it.

I went to a friend’s dentist and got my tooth fixed.  And you know what?

I got my tooth fixed at a very affordable price.

The dentist I saw is fluent in English (and studied in the US), which made me feel more comfortable that there would not be any Spanish medical terms I was unfamiliar with.

She told me the tooth was broken in two places, and I also had a cavity in that same tooth (I assume related to my lack of attention to the broken tooth for the past 10 months).  Although the cavity was very large, she managed to save the tooth by drilling out the bad stuff, putting in a filling, and repairing the broken pieces.

The most surprising part about the visit?

She did NOTuse Novocaine or anything to numb the tooth or area surrounding it.

She simply explained to me that she would drill slowly, and if I felt pain to let her know.  She assured me that the pain would not be a sudden, excruciating pain but rather an uncomfortable feeling. 

I was nervous (read: terrified), but I decided to trust her.

She was right.

I felt a small amount of discomfort a few times as she drilled.  I raised my hand.  She stopped and came at it from a different angle.  After maybe 10 minutes (meaning it was probably only 3 minutes), she was finished.

I never had any extreme pain.

She told me that the cavity was much bigger once she started drilling into it, but she was able to save me from having a root canal.

Thank God!  And thank you, Awesome Dentist.

I only paid about US $35.

I have a feeling she didn’t use anything to numb the tooth because she knew it really would not be necessary, and it would just add to my bill.

So what did I learn from my experience?

 

  1. The things we fear may actually happen.  If they do, the outcome may not be as bad as expected.
  2. Although things may be done in a simpler and lower-cost way, the end result may be the same or even better.
  3. If you have to get dental work done in Latin America, hope you are near Antigua, Guatemala or Buenos Aires, Argentina  :-)

Have you had to seek medical attention while traveling?  Was your experience positive like mine?

Comments

  1. I had a pretty positive experience with doctors in Vietnam, especially when I contracted dengue fever when I was five month pregnant. It was a pretty stressful time, especially when my red blood cell count dropped down to the edge of the “hemorrhagic” range. I was in a isolation room in the three-room “hospital” above an expat medical clinic in Ho Chi Minh City. The GP, my (very attractive) French obstetrician and the Filipino and Vietnamese nurses were lovely. They didn’t mind my husband, who also had dengue, squeezing into bed next to me, or sharing my meals (delivered from local restaurants).

    The only real problem I had was later, when dealing with the insurance company. I ended up quite a bit out of pocket because the GP sent me home when I first went to the clinic. If he’d admitted me straight away I would have been totally covered.

    I think I would have also been fine if I’d gone to a local hospital. But, like you, I was a bit scared. Thankfully the baby is OK and has grown into an energetic talkative toddler.
    Barbara – The Dropout Diaries recently posted..Magical Floating Lanterns

  2. Great post! It’s so true, everyone is terrified about going to a doctor in a foreign doctor. You are out of your comfort zone and have no idea what to expect, but I’ve found in my experience that doctors abroad are often just as good as the ones back home. When I was living in Sri Lanka I had to go to the doctor’s multiple times, and I found that actually a lot of them were trained in the UK and then came back to Sri Lanka to work. This being said, however, I think it is important to do your homework on which doctors are better to go to. In Cambodia for example I was warned by many NGOs that more people go into hopsitals there than come out. Cambodia’s proximity to Thailand makes this less of a problem though. A quick flight to Bangkok and you can get some fantastic medical care at a fraction of the price you would at home. If you do your research right, you can almost always find the right place to go for medical attention, and if you are in a real dire situation make use of your travel insurance and get flown out to the nearest country offering the kind of medical care you need. Just don’t ever put off going to a doctor because you are worried that they won’t be as good as the ones back home – it is better to have something treated immediately than leave it until it is too late.
    Natalie Lyall-Grant recently posted..the world’s weirdest seafood

    • Very true. I got lucky with my tooth that I did not need a root canal or wake up one day in agony and need an emergency procedure.

      I was in San Juan del Sur, Nicaragua, and a guy staying at my hostel had to have emergency surgery. The nearest hospital is in Rivas, and his friend told us how horrible the conditions were. His friend even had to come to the hostel to get clean sheets to put on the hospital bed. They ended up saving his life but things could have very easily gone bad, especially if his friend was not with him to make sure he was receiving car and medication during his recovery.

      You make a very good point about doing your research and knowing the best place to go.
      The Travel Chica recently posted..Buenos Aires Odd Jobs: Old Lady Walkers

  3. I had positive experiences in Australia. While living in Brisbane my teeth exploded because I ate something hot. It was in the middle of the night and with extreme pain I opened a bottle of Whiskey and waited for the next day. The dentist was great and managed to reconstruct the teeth. Luckily my insurance covered it afterwards as it wasn’t that cheap.

    I was also very lucky in Sydney where some idiots spiked my drink and robbed me. I later was hit by a car and had to spend one and a half weeks in the hospital there. I was feeling very safe from the first minute. I’m just happy this happened in the big cities and not in the outback!
    Sebastian recently posted..Best Pictures of Norway

  5. I got nervous right away when you said that the dentist didn’t use Novocaine. If I were that I will no longer stay there. I’d probably go home. I’m a little uncomfortable about drilling the tooth without Novocaine. I guess the dentist have soft hands or you have a high tolerance on pain, which makes it less painful during the operation. Either way, I’m glad that you can take it. You’re strong.
    Candice Michelle recently posted..pevonia skin care reviews

  9. Good story! I just recently broke a tooth eating soft bread. My dentist told me I had most likely broken it a little earlier, but things like gum and bread will pull the broken part off. Interesting, no?

    I saw someone get hurt in a traffic accident while in the non-tourist part of Cozumel a few years ago. The ambulance that showed up was a pick-up truck with hay in the back. Scary!
    Curt recently posted..Four Bean Salsa & Sausage Soup

  11. I found an excellent dentist in Medellin when I broke a tooth. Bilingual, US trained, state of the art full service clinic. In fact he was so good, I stayed an extra two weeks and had a couple other things taken care of that I had put off. He did not try and sell me a crown for everything as US dentists do. His prices were about a fourth of what I would have paid in the US. I wil never have significan dental work done in the states again, it’s all about upselling here. Hopping on a plain to Colombia is so much cheaper and more pleasant. Glad you had a positive experience too.
    Philip recently posted..The Great American Road Trip–Part III

  12. Ugh. I HATE going to the dentist! I’ve been once here in Chile and it wasn’t horrible, but it also wasn’t cheap either. $35 is a super good deal. I did have major surgery in September though, and spent four days in a private hospital. With my Chilean health insurance, my total out of pocket was less than US $500.00, which I think is quite a great deal! And the care I received was the same or better than what I would have received in the States.
    Abby recently posted..Crazy Gringa Cat Lady

  13. My travel experience so far has been limited to travelling within Australia, mainly between Melbourne and Sydney by plane. In 2004 I flew up to Sydney for New Years Eve to watch the fireworks there which are some of the best in the world.

    At the time I was being treated with a mood stabilizer called Benzodiazepine. What I wasn’t told by the doctor who prescribed it to me was that I shouldn’t stop taking it abruptly.

    What did I do? I left my medication at home. So what happened was I was traveling home from Sydney and sitting in the terminal waiting for the last flight back to Melbourne to come in and I felt this weird trepidation that I’ve never felt before and never felt since. I considered staying an extra night in Sydney and seeing a doctor in the morning but that would have costs associated with it. So I decided to travel on to Melbourne. I made it back to Melbourne and was picking up my one suitcase from the carousel when I had one mother of an epileptic seizure.

    Luckily this was at the domestic terminal at Tullamarine Airport. Luckily there were hundreds of people there. Luckily there was an ambulance stationed right out the front door when this happened. From what I was later told I was out cold for about 60 seconds thrashing about uncontrollably on the floor.

    When I woke up there were ambulances guys there but initially I couldn’t see. Then my eyesight came back and then put me in the back of the ambulance. Then I suffered temporary respiratory problems. The ambulance guys put a respirator on me and were panicking almost telling me to breath with everything I had.

    They transferred me to hospital where they thought I could have sustained some sort of brain damage as a result of what I went through and were going to keep me there for three days for observation. But after a CT scan and my blood pressure restoring to normal they discharged me in the morning and I caught a bus and a train home.

    I didn’t have any ambulance insurance at the time. $750 later I learned an important lesson. Always take my medication with me if I’m not coming home that night. Also to interrogate the doctor that I now see about all of my medications, what they do, how they react with the other medications I take. I even know the chemical structures of some of them now. And have either ambulance insurance if you’re an Aussie traveling within Australia or have travel insurance if you’re traveling internationally.

    Because of my vigilance or better put; common sense, I’ve never had a repeat of that situation even through I’ve been back to Sydney since that trip.

      • Australia unfortunately has a two tiered public/private health system.

        If you’ve got the money the private system is first class treatment all the way but it’s very expensive. The public system is our version of universal health care called “Medicare”.

        Don’t confuse it with the Medicare of the United States. This one applies to all citizens regardless of their means and also to visiting citizens of a number of European countries plus Canada whom Australia have a reciprocal health care agreement with. Unfortunately because you don’t have a universal read single payer health care system yet in the States you’ve got nothing to reciprocate with hence no agreement and the fact that you need travel insurance if you’re coming down here.

        The public system is better than nothing and service levels are patchy. Some hospitals say the Royal Melbourne in Melbourne are much better than others like Box Hill Hospital or Maroondah as I’ve learned from experience. Ambulances times vary from a few minutes in Melbourne to more than half an hour or more out bush in places like Maryborough a two hour drive from Melbourne where my mother lives. This delay is life threatening in some cases and every now and then in the media you hear of somebody who died because they didn’t get an ambulance quickly enough. Fortunately it doesn’t happen in Melbourne but if you’re out in the middle of nowhere one it takes ages for an ambulance to reach you and two it becomes very expensive, into the thousands of dollars in some cases if you’re not insured. An if they have to helicopter back to Melbourne you’re looking at five digits as the expense.

        Medicines here though are much cheaper than in the United States or Canada because the government buys them in bulk and then on sells them to the pharmacies. The cheapest pharmacy and the biggest by size is called Chemist Warehouse. They’re practically everywhere now and they’ll save you tonnes of money especially if you’re paying full price like you would if you got sick here.

        As for doctors here experiences vary. If you find a good doctor like I have stick with him or her. I’ve had a few bad experiences with GPs so I can understand the comments of a few other people on your blog. Expect to pay between $70 and $120 to see a doctor. I believe that’s what my doctor charges people without a Medicare card so use that as a rough guide. Pathology tests like a simple blood test are about $40 a pop. Ultrasounds are over $100. If you were in Melbourne and sick I’d try and get you in to see my doctor. He’s really good and I’ve seen him for over 15 years. He’s also located across the road from the Royal Melbourne Hospital so if you were seriously sick you wouldn’t have to go far for hospital treatment.

        Dentists though aren’t covered by Medicare here, not yet anyway. One of the political parties here; The Greens wants to bring in a medicare dental scheme but in the meantime dental care here is very expensive. Expect to pay American prices here. Most people on a low to middle income tend to go without unless they absolutely have to have it.

  14. Yay! It took me a looong time to trust the dentists, etc in Costa Rica. But when I found out I was moving, I hurried to get into everyone one more time, because they were so great and cheap. I still use my Tico contacts!
    Abby recently posted..This is why I travel

  15. I’m glad you are ok. I went to the dentist last week (here in Valencia) and the experience wasn’t all that glorious. The anesthetic she gave me was so strong I couldn’t feel my face for over 3 hours. And my mouth still feels funny after so many days. I so miss my dentist from Costa Blanca…
    Laura recently posted..10 Weirdest Bridges In The World

  17. Pretty sure I have either a fractured rib or torn chest muscle from coughing so much after a recent bout of flu but I refuse to go to the emergency room – Dr. Google says they can’t do anything for me so hey…why pay for expensive x-rays. But I digress…I don’t even want to see the doctors in Australia or the US because of bad experiences so I think I would happily take my chances in a foreign country (if I absolutely had to) – great to read your story and second that instinct!
    Andrea recently posted..How Could This Have Happened?

  20. Great post Steph. I would rather see the gynecologist than go to the dentist. I admire your will to overcome your fear. You didn’t mention….do the locals even have insurance????

    • I am not completely sure how it works here. My understanding is that there is public health care. However, I have heard there are long lines and waits to get appointments. Better than nothing though.

      Then there are many “official” jobs that offer insurance to their employees. And I assume that is much better, easier care.

      Then the people that can afford it buy private insurance. Don’t know the costs, but I am guessing it is much lower than private insurance in the US.

      Another point of interest…. insurance here covers one cosmetic surgery a year. Maybe that’s why you see so many boob jobs and plump lips :-)
      The Travel Chica recently posted..Foto of the Week from …. Buenos Aires

  24. I’ve heard stories from both sides… I think it really depends on your luck and the city you are in! So glad you had a positive experience! As for me, I’d probably wait till I get home if it can wait! You’re very brave!

  28. A co-worker of mine years ago told me that she was going on a dental vacation to Costa Rica. I thought, why in the world would she opt to go to a dentist in a third-world country when we have perfectly good dental insurance in the USA? Apparently, its big business in CR, especially the cosmetic type because supposedly they have excellent dentist. And because so, there are such things as dental vacation packages to CR. Strange, but it really does make me want to go there for some cheap, but quality dental work, too. Your experience only makes the idea seem better.
    Sherry recently posted..“Playing with Endangered Sea Turtles”

  29. What an interesting experience and I am amazed at all the challenges that people have in other countries. However, I think these same concerns exist even when you travel to different states. If you do have a compromised tooth which you may not even know exists, it can become very problematic upon flying due to the altitude changes. It happened to me on the way to a dentistry conference in Las Vegas several years ago. There was terrible pain as the plane descended very rapidly. I had not had any previous problem with the tooth. Fortunately, I was able to get a root canal done at the office of the dentist that was the keynote speaker.

    If I had a problem in a foreign country, I would definitely try and find an American or Canadian trained dentist. Costa Rica was mentioned and I think there are a lot of American trained dentists in that country. I have been to San Jose, Costa Rica, and it seems that I recall seeing dentists advertisements that said they were trained or got their dental degrees in the United States. Keep in mind that dental training is not uniform throughout all countries and in fact it varies to some degree here in the USA.

    I also should point out that many American dentists visit other countries and offer free or low cost dentistry to the people in those countries. My brother-in-law, who has taught at the University of Florida Dental School for many years and has a private dental practice, has been maintaining a free clinic in Chiapas Mexico for about 30 years–he spends about 4 months each year in that Chiapas clinic. All work is free to the people that live there and we send him money every year to help buy supplies such as material for fillings and pain medication.
    Dr Pauley recently posted..ORAL HEALTH HAS POTENTIAL LINK TO BREAST CANCER

  30. I had some real fears getting my teeth worked on in Germany. They did a good job and the cost was so reasonable but the pain of having my wisdom teeth out was phenomenal and the German dental system is all about giving LITTLE pain medication. Suffice it to say I had to call my regular German Dr and he gave me the additional necessary pain medication. All my other medical experiences in Germany were outstanding! I have learned that care outside the US can equal or surpass the care in the US and the cost is a fraction.

  31. One reason that you can have tooth problems in other countries is that when you fly the changes in altitude and pressure that the plane makes can cause otherwise dormant conditions to flare up and be real problems. They may occur very quickly while in the airplane or flare up later after you have landed. I once had such a problem as we were going into the airport in Las Vegas for a dental convention. It was a very rapid decent and the pain began just as we were touching down. I was lucky to be able to have the major conference speaker treat me with a root canal that evening. So the problems with dental concerns can happen in the states as well as in foreign countries. The level of training varies somewhat even in the US. The US and Canada have the highest level of training for dentists in the world. Many dentist trained here do go to live in other countries, such as Costa Rica as one commenter mentioned. So if you have a problem in another country and you have time to check around, and you may be able to get a US trained dentist as you did when you were in Argentina.
    Dr Pauley recently posted..ORAL HEALTH HAS POTENTIAL LINK TO BREAST CANCER

  32. I have also feared these things, like the time I was on a train China, a 24 hour train ride and my wisdom teeth started to hurt worse then they ever had in my entire life. (I had no health insurance then, so I just had to deal with these things). So bad, that I was sure my next stop would be the Chinese dentist, where I envisioned all sorts of horrible things happening to me. Thankfully, the pain subsided, but I went through a few more years of that before they finally got removed FOREVER! woohoo. And I have NEVER heard of exploding teeth! That post made me chuckle, but I am glad that person is ok. And you are my new hero for doing that without anesthesia!!!!!!
    Claire recently posted..Sometimes, Travel Rears Back and Slaps you in the Face

  34. Like you and most commenters, I am not fond of going to the dentist and have been avoiding going to mine for many months. But that is about ME, not about my Filipina dentist, who is totally terrific. Most of the medical care I’ve had here has been as good as any I would get in a “First World Country” (and I chuckled at the reports from Australia, Germany, Spain, etc… when did those become
    “Third World”?) The only exception was a time when I was in a bad car accident on the mountain roads of Ifugao, Philippines; there the local clinic was sorely lacking in medication and equipment to deal with us, but the next day we were flown out to Manila and we were well taken care of. I think travelers can bear in mind that everywhere 50% of medical staff graduate in the bottom half of their class. The trick, as Natalie has already pointed out, is to do your homework, at least for non-emergency cases.
    Francisca recently posted..R is for Road

  35. I am currently undergoing three root canals on my teeth while in Turkey. Surprising my dentist has a better grasp of the English language then I do. Also has all the modern machines and while it is taking a lot out of me, it is going rather smoothly. All this considering I hate dentists worse than bankers! :)
    Natalie recently posted..A Guide to Tasty Turkish Street Food

  36. I think the thought of being sick in an unknown place is terrifying. Even going to the drugstore can be stressful! I have spent a good share of hours in foreign drugstores trying to determine what is that I need to get. I remember being sick here in the US –many years ago-. Although I knew the best was available, with a broken English and limited budget, I did the same you did: Ignore the problem. The thought of trusting my whole self to an unknown person in an unknown place, when I was at my weakest, was horrible! Luckily, I recovered with some rest and homemade remedies.
    I have to add that my experiences with dental and medical work in Colombia have been excellent. Although I have an excellent doctor here, I have traveled to have medical testing and/or dental work done in Colombia. It is more affordable, and the doctors and staff at medical facilities are more personable than they are here.
    Natalia recently posted..Don’t Ride the Train!

    • The only other problem I have had while traveling was a bad case of food poisoning that kept me in my hostel bed and unable to eat more than popsicles for 3 days. The good thing was that my hostel was very nice, and both the staff and guests were concerned and offered me any help they could.

      Good to know about Colombia. I’ll definitely contact you for referrals if I ever need something done :-)
      The Travel Chica recently posted..Foto of the Week from …. Buenos Aires

      • Food poisoning! Yikes! I experienced it once, and it is noooottt fun!! I can help with recommendations any time. :-)

  37. Glad that worked out for you and $35 for that work is a good deal for sure. Definitely a good thing avoiding a root canal.

    We went for teeth cleaning in Honduras and it cost us around $10 each compared to the $300-$400 we would have paid back in Canada. And it felt no different afterwards in terms in job quality.
    Pete recently posted..Roman Ruins and Satellites

  38. I lived 10 years in Argentina, 2 in Brazil. Its all about our fears. Argentina and Brazil have medical and dental schools since the 19th century. Third world or not, they have a long tradition in public health care and you can expect the same kind of work but cheaper since you dont have to deal with health insurances in their public health systems which are free for everyone who need it wether you’re a local or a traveler. In the US you probably will spend a lot because its all a big bussiness, but the professional quality is almost the same. Believe me.

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  48. Hey Stephanie, Great Post! Thanks for sharing your great experience with us and I really appreciate your efforts on this post. Keep up the good work!

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