Most Americans I know have never heard of medical tourism or, more specifically, dental tourism. What is it? Why do people do it? It seems stupid or crazy to go to a less developed country for medical care, right? When I tell people that we travel abroad to places like Thailand, India, Costa Rica, or Mexico for medical treatment, people imagine dirty exam rooms, primitive and substandard equipment. The reality is the opposite. Bumrungrad Hospital in Bangkok, Thailand is like a five-star hotel and when you leave, after you receive treatment there, they ring up your bill on a cash register and you pay for it (because it’s affordable enough that you can to do that). Mexico offers a lot of futuristic treatments that the U.S. isn’t ready to embrace yet because of our jacked up healthcare system. Most doctors in big U.S. cities send patient x-rays overseas to Indian radiologists NOT because it’s much cheaper (though it is), but because the Indian radiologists do a better job [1]. We travel abroad for medical treatments for two very simple reasons: the medical care is better and the cost is reasonable.
Medical tourism is a Life Hack…it’s a loophole in the broken healthcare system that plagues the U.S. The only catch is that to get the great healthcare at an affordable price, you have to travel. Some people love this aspect of medical tourism, other people recoil from it. Our family travels even when we aren’t sick and go try different treatments just for the hell of it…just to get to talk to people who are sick and looking for alternative cures. But this time, on this trip, when we went to Tijuana, we actually had a dental problem: we needed our mercury fillings removed.
We’ve seen and done some crazy things health-wise. The Ayahuasca ceremony that we watched in the Amazon rainforest was probably the most amazing thing I’d ever seen or experienced in my life and we didn’t even take the brew. We just watched as someone else puked their guts out. And yes, puke and all, it was an experience that I have not yet been able to put into words. It was that amazing. We went to an Arabic pagan-type-of-trance event at a place called Al Makan in Cairo. And, of course, there was the temazcal in Mexico. But none of these “treatments” involved pain or discomfort, per se. Unfortunately though, dentistry always promises to include just a little bit of pain and terror. And when I booked our appointments at the American BioDental facility in Tijuana, Mexico, I knew that it wasn’t going to be a happy little ride down the Amazon. Nope. Nope. Nope.
We arrived in the morning at the dental clinic, which is located in the spectacular Grand Hotel in Tijuana. We got X-rays, and spoke with “Alex”, the owner’s son who goes over treatment plans for patients. Right before I went in to get my amalgam fillings removed in the dental office, John, Lydi, and I went over to the American Holistic Care side of the business to start our heavy metal chelation therapy, which is basically just an IV drip that lasts about 4 hours. The nurse installed an IV in my arm and I remained mostly optimistic about the day ahead of me.
When it was my turn to go in and take my seat in the dental chair for my mercury filling removal, I rolled my little IV holder with me to room number 5. The dental treatment room looked exactly like every dental treatment room I’d ever seen in the U.S. sans the “Hang in There” kitten poster that’s usually stuck on the ceiling (the ceiling in Tijuana was totally bare). It was clean, the dentist and his assistant wore blue uniforms, and it was fully equipped with everything, like I said, except the poster.
One thing that was different about the dental office and my overall experience in Tijuana in comparison with the U.S. was that the dentist never left my side while I was in the chair, even during my teeth cleaning. This is one of the things that people who do medical tourism rave about: the doctors (and dentists) in other countries take the time to actually talk to and work with patients. That’s partly because in the U.S., there are about half as many doctors as there are in other countries that rank higher than the U.S. in quality of healthcare (and there are a lot of them). Several years ago, for example, in Kathmandu, we went to the CIWEC clinic for rabies vaccinations because they were only $38 per person versus $1000 in the U.S. On our last visit, when I got my final vaccination in the series, I mentioned a small insect bite on my abdomen to a nurse. She looked at it and then went and got a doctor. The doctor spent 30 minutes with me looking closely at the bite with a magnifying glass. I’d been riding elephants and he took me to another room and explained the problem of elephant ticks and then, he gave me a couple of doxycycline from the back office to prevent an infection from developing. It reminded me of the days when the “Old Doctor” in the small town where I grew up used to dispense his own medications for patients in little paper packets. The dentists in Tijuana were like this too. They hardly ever left the room while John, Lydi, and I got our dental work done, sometimes for hours at a time. They took the time to do the work carefully and properly. And as they worked, they explained what they were doing to us and to the dental assistants. They were constantly educating, educating, educating…
But still, it was dental work. So, what can I say? It was… (heavy sigh) unpleasant.
The dentist began my procedure by numbing my entire face except for my eyes. You see, one of the cool things about dental tourism in Tijuana is that they get the work done fast. Dental work that would normally be done over the course of months or even a year is done all at once, over several day’s time here. So the dentist numbed each quadrant of my mouth in one sitting, a new experience for me. Slowly, my upper left lip disappeared. Then my lower left jaw. Next, he numbed the right side of my face. I lifted my hand to feel the numbed out areas and the dentist chuckled, “You have no face now.” I chuckled with him, not knowing what was coming next.
So, I’ve never had a rubber dam installed in my mouth. I guess I’m lucky. One fellow I spoke to at the clinic had always had a rubber dam installed in his mouth whenever he got dental work done as a kid (his mom always took him to a nearby dental college where the dental students used him as a guinea pig to learn new skills). I was cool as the dentist took the green rubber and stretched it back over the first molar to clamp it into my mouth with a pair of pliers. I wondered briefly if the numbness would somehow affect my ability to breathe and swallow properly, but chided myself for such dark thoughts. Just breathe, I told myself…You’ll be okay. Then, the assistant put an oxygen cannula on my nose and wrapped the tubing behind my ears. I asked what the nasal cannula was for…
“Es oxigeno.” The dental assistant said quietly as she readied her gear for the procedure. I wondered why I would need extra oxygen. A little red flag went up in my brain. I saw it in my mind’s eye, waving in the distance as the dentist installed the rest of the dam on the other side of my mouth, pushing hard with the pliers, stretching the rubber out over my tongue and the other molar on the other side of my mouth. I couldn’t really feel what was going on in my mouth (because my mouth was numb) except that suddenly, I couldn’t breathe out of my mouth. My eyes got wide. The red flag was still waving, but now it was accompanied by a loud voice inside my head that said, (quietly at first), “sedation…tell him you need SEDATIONSEDATIONSEDATION!!!” I had opted out of sedation (what was I thinking?!?). I lay there, the dentist stretching the rubber wide so that it covered my nose and I felt that surge of adrenaline that happens when you get nervous and unconsciously start holding your breath. The voice inside my head said it again, this time with urgency and terror, “SEDATION…YOU NEED SEDATION! TELLHIMTELLHIMTELLHIM…” So I sat up in the dental chair to proclaim my need. This was when I discovered that I couldn’t speak. When I tried to speak, no sounds came out. . I felt like Keanu Reeves in that movie The Matrix when he gets taken in by the police and suddenly discovers he has no mouth. The dentist sat back on his little rolling swivel chair and looked at me, a little shocked and concerned that I’d sat bolt upright from the chair.
Officially, I panicked. I have never had a panic attack before, but this was something on par with what, to me, would cause PTSD and a lifelong fear of dentists. I grabbed at the armrest. I looked at the dental assistant who didn’t speak any English at all and frantically mimed my urgent and immediate need for a pen.
“Necessitas boligrapho?” She asked, nervously, and I nodded vigorously. She hurriedly opened a drawer behind her and searched for one. I could hear the objects in the drawers being pushed out of the way, the drawers left open. Finally, eons later, she handed me a pen and I wrote the word “SEDATION” as fast as I could on the palm of my hand. I turned and pushed my hand into the dentist’s face.
He looked back at me, scared. “It’s too late,” he said. “We have to order that ahead of time. You can’t have sedation”
“OHMYGODOHMYGODOHMYGOD…” I looked down at the floor and reminded myself to breathe through my nose. I swung my legs over the side of the dental chair so that I was sitting fully upright so I could work toward a semblance of calm. I sat there for a while, gathering myself. Some other people peered in through the square window and opened the door to see the drama. I reminded myself that I had wanted this procedure done. This was what I wanted. I breathed through my nose…breathed through my nose…until that feeling like I was going to suffocate subsided. I wrote a new question on my hand, “How long does this part take?”
He told me that he’d work fast and that it would be done within 10 to 15 minutes. “Easy.” He said. The other people who had come into the room at that point were staring at me, wondering if I would try to rip the rubber dam out of my mouth, pass out, or both. I decided as I sat there, that the inability to talk…to even make a sound, was where my panic was coming from. I could breathe, but I couldn’t speak. So I kept the pen for a sense of security (at least I could still communicate) and eventually laid back in the chair to have the mercury fillings pryed out of my mouth. Throughout the procedure, I had a few revelations about how awful it would be to have a stroke and be unable to speak. I considered the problem of puking and how I could die if I barfed…the more I thought about barfing, the more I felt like barfing. But that the assistant had a suction thingy…I might survive it, I thought. None of my thoughts were calming. Mostly I quelled my nerves by reminding myself over and over again that if I forgot to breathe and passed out, I’d probably start breathing again when I lost consciousness and the voices in my head stopped panicking.
All told, over 4 days, I spent around 9 hours in the dental chair after this incident. By the third day, I had come up with a calming mantra, similar to the round-about thoughts I had about puking, and I recited them over and over and over again:
“The more relaxed I am, the more relaxed I become.” (as opposed to the more I think about vomiting, the more I feel like vomiting…)
Sometimes, when I’d feel the dentist getting dangerously close to something that seemed to my numbed out mouth like it might be momentarily excruciating should he move one micromillimeter to the left, I’d say to myself, “It doesn’t matter until it matters.” And then I would breathe deeply. And this worked too for the most part.
For all of you readers out there who have had lots of rubber dam experiences, I’m sorry…I had no idea what you’ve been through. For all of you who are considering getting your amalgam fillings removed using the Huggins Protocol, think very carefully about getting sedation for the rubber dam part. Having a totally numb face and a rubber dam is an edgy experience. If I had to do it again, I’d definitely get sedation.
It’s been about two weeks since John and I finished our dental journey at American BioDental and my teeth are still sore (which is not uncommon given the amount of work done over such a short time). I had the same cavities drilled out twice in four days. Once to remove the mercury and reshape the fillings and again to remove the temporary cement that they’d installed overnight to make it possible for me to go home that first night and drink soup.
Of all the medical tourism and health tourism things we’ve ever done, this was definitely the most terrifying, but I’d do it again in a heartbeat. The dentists were superb, the place was clean, and the work got done for about 1/12 (that’s right ONE-TWELFTH) what we were quoted in the U.S. There was nothing scary about the dentists or the clinic itself, just the usual awfulness of extreme dental work that’s done without sedation.
American BioDental does all kinds of dental work including x-rays and diagnostics, root canals, wisdom teeth removal, dental cleanings, fillings, and more and they do it for a fraction of what you’d pay in the United States. Dental tourism in Mexico is booming because they provide better care for a much lower price…I’ve been there myself and I wouldn’t hesitate to recommend American BioDental to my family and friends.
References:
[1] Bookman, M. (2007). Medical Tourism in Developing Countries. Palgrave MacMillan.
