American patients on a budget travel to Los Algodones, a dental paradise for the underinsured
Inches across the U.S. border there is a surreal oasis of tooth decay: Los Algodones, Baja, Mexico. Two-thirds of the town’s storefronts are dental clinics and approximately 85 percent of all employment is in the medical field. It is a mecca for American snowbirds and the uninsured. Los Algodones requires no appointment. Within 15 minutes of crossing the border, you can hear the screech of a drill and smell the enamel of your tooth as it vaporizes.
I have been blessed with fairly good health, excepting the occasional smash-up in my youth. But genetics failed me in the tooth department. Brushing doesn’t seem to cure the periodic breaking of teeth. My girlfriend Barbara and I once made a seven-minute 8mm horror film that we shot over several of my dental appointments. (When it screened at the San Francisco Art Institute’s student film festival, 10 people headed for the exit in the first 15 seconds.)
After I quit my job and lost my insurance, most of my dentistry was left to students. Their tentative hands convinced me I was in for trouble: the missed shot, the slipped drill, the likelihood of blood and pain. An extraction at a dental school in New York left me with an infection when, weeks later, I traveled to Phnom Penh, Cambodia. I walked into a threadbare pharmacy, pointed at my sore gum, and said the word infection. The owner returned with a sulfite that held the inflammation at bay for two weeks until I returned to the school and had them remove the sliver of bone poking through my gum.
In May 2008 a couple of my teeth started getting very sensitive. Unfortunately, they were molars: one above the other, and both in bridges. I knew I was in for some big bucks. My buddy Tommy, who lives in the desert in Southern California, mentioned a good dentist he’d been to in Mexico. I located the Clinica Integral Rubio online, booked an appointment, and burned up some frequent flyer miles for my ticket.
After I landed at the San Diego airport, the rental car agent attempted to upgrade my economy car to a midsized. “Are you crazy?” I asked. Gas prices were going up with every squeeze of the pump. My throbbing tooth kept me focused on my mission to save thousands of dollars by taking a medical holiday.
I picked up Tom and we headed southwest to the bottom of the Salton Sea, through an undulating landscape of sand and scrub, home to coyotes, desert tortoises, sidewinders, RVs,
and off-road vehicles. We listened to Radio Universidad Baja—an eclectic mix of heavy metal rockeros, reggae, and punk—for the next 60 miles, until we reached the Imperial Sand Dunes. Little vegetation turned into zero vegetation. Near the Arizona border, a small hill arose to the north with a tiny chapel on top. The exit sign said Felicity. Several miles west of Felicity we came upon the exit for the Quechan Indian Nation and the road leading to the Andrade border crossing, one of the smallest ports of entry in North America. We parked the rental in the paid lot and a few minutes later strolled into Mexico.
Los Algodones is located in a scorched geography of sand and dunes and pounding sun, a place only a lizard would choose to call home. The first dentist set up shop there about 30 years ago. Business began to grow as uninsured Americans looked for lower-priced alternatives to domestic dental care. Mexican dentists saw the dollar signs and changed a drinking hole into a drilling hole. The town, with a population of a little over 4,000, now has 160 clinics and about 350 dentists, all in a four-by-six-square-block area. Unfortunately, the typical rural Mexican family cannot afford the price of private dentistry and must rely on government clinics for all of their health care.
Hand-painted signs lure potential clients with depictions of giant molars and titanium implants. Hawkers on the streets approached to see what I needed—pills, dental, glasses? Shopkeepers were friendly and laid-back, quick to smile, even if you weren’t interested in their knock-off sunglasses. In the old days they would have been barking for the strip clubs and bars that used to clutter downtown streets, catering to American youth looking for a cheap party.
The Rubio clinic is a block and a half into town. I was given several forms, answered yes to the first question and no to all of the others, and two minutes later was led to a chair. My dentist, Dr. Alfredo, asked about my teeth, and I pointed out the most pressing problems. He gave me an estimate for the work and, before I knew it, he deftly slipped a needle into my gum. Minutes later, his drill was cutting a slot into my gold bridge. From my chair I scanned his framed diplomas and certificates, many from U.S. universities.
When he pried the bridge off, things looked dire. After 15 years of being covered, my rear molar was dust. The good doctor cut the tooth back to solid bone and shaped up the tooth in front. Off came the second bridge, and although these teeth were in better shape, I was in for four root canals, two bridges, and a crown. Dr. Alfredo’s steady hand assured me I was one among thousands of patients to have been in his chair. He scheduled me for a 2 p.m. appointment with the clinic’s endodontist, and Tom and I walked down the street in search of fish tacos.
The smoke and smell of an open grill is the best advertisement for street food. Three dollar bills quickly put three fish tacos on our plates. The currency is green in Los Algodones: The ATMs are American banks that spit out twenties, and the one cambio, or money exchange, looked permanently closed. I ate slowly, as only one side of my mouth could feel the food.
Back at the clinic the endodontist went to work on two of my root canals at record speed. He finished them both in a little over an hour and a half. Bad news: One of my teeth was infected. I was given a prescription for antibiotics and walked around the corner to the purple Farmacia Liqui’s—although it remained questionable whether a prescription was needed for any drug. Painkillers, Viagra, and hundreds of other drugs were on the menu in every pharmacy window.
Pills in hand, my jaw still throbbing, I walked back to the border crossing with Tom. Over the next 11 days I made four trips back and forth to Los Algodones to resolve my mouth problems. The only variables in the landscape were the numbers at the pump. Sitting in line at a gas station, I watched the attendant change the price to 10 cents more per gallon.
On each consecutive trip I wandered around Los Algodones looking for a piece of Mexico. The slightly garish facades reminded me of Disneyland. Downtown was a strange pop-up city erected for Americans in need of drugs and dentistry. Missing were the grocery stores, the banks, the clothing stores—all of the things that make a town a town. As I drifted to the edges of downtown, dirt roads replaced asphalt and the colors of the houses slowly turned to drab pastels.
On my last trip, I arrived at the Rubio clinic at noon and waited 15 minutes for a motorcycle messenger to deliver my newly cast bridges. When they arrived, Dr. Alfredo inspected the color against my teeth and decided they were too bright. I thought I was screwed: My flight departed San Diego the following day. But the doctor called his liaison at the lab and asked him to stain the porcelain down. An hour later my mouth was open; 30 minutes later I had teeth. Hallelujah—I could chew.
Dr. Alfredo was a perfectionist. Both he and his partner worked efficiently, providing me with quality work for less than half the money I would have paid back home. On top of that, they backed their work with a two-year guarantee. A few days ago an old filling popped out and once again I was in a dentist’s chair, this time in Brooklyn. My Greek American dentist checked out my teeth. “Nice bridges.”
“Got ’em in Mexico,” I replied.
Heart surgery in India. Rhinoplasty in Costa Rica. Sex changes in Thailand. New teeth in Mexico. The Los Algodones dentists are futurists: They are plugging the gaping holes in our crumbling health care system with an amalgam of professionalism and affordability.
Excerpted from Diner Journal (Summer 2009), a beautifully crafted, quarterly food journal, replete with recipes and narrative. www.thedinerjournal.com