DDS Lister

If you’ve struggled with the discomfort and inconvenience of traditional dentures, you might be considering dental implants to replace removable dentures with permanent replacements for your teeth. With today’s advanced technology, mini implants can offer a less invasive alternative.

Narrow diameter dental implants, or mini implants, are similar to traditional implants, but can be placed in a single procedure. Traditional implants, by contrast, require a two-part procedure and a significant healing interval.

Traditional Dental Implants

Traditional implants are often used for:

• Replacing single teeth
• Replacing a bridge or full denture
• Holding removable dentures in place

If you’ve suffered bone loss in your jawbone, through aging or as a side effect of wearing traditional dentures, implants might not be the best option for you. If you’ve suffered bone loss, the jawbone can be augmented with bone grafts, or the implants can be placed to avoid the places where the loss is the greatest. Consult with a cosmetic dentist experienced with implants to determine if they’ll work for you.

When traditional implants are placed, the titanium screw section is implanted directly into the jawbone. After a healing period of a few weeks, the screw bonds to the bone. The top half of the implant can then be added, along with any attached appliances. Dentures attached to an implant can be permanent or removable.

Mini Dental Implants

Mini implants, by contrast, can be placed in a single visit. It’s not necessary to make incisions in the gums, nor are there any stitches to be removed later. The mini implants are fixed with a special attachment that fits into the bottoms of your dentures, holding them securely in place. The dentures can still be easily removed for cleaning, but they won’t shift while you’re chewing or talking, giving you new self-confidence and a more natural look.

Much like traditional implants, mini implants can also securely hold a single replacement tooth or a partial bridge, as well as full dentures.

Your particular situation will determine whether traditional implants or mini implants will work best for you. If you want to find out more about implants, a consultation with a certified cosmetic dentist who’s had experience with traditional and mini implants can help you decide if you’d like to pursue this procedure.

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• 24/7 Press Release

Although 72 percent of Americans have fillings, caps or crowns and one in six had a dental emergency during the past 12 months, most are not prepared to deal with a dental emergency, according to a recent survey conducted by Majestic Drug Company, a leading provider of oral care products.

Interestingly, in the national survey of 1,000 Americans, those with a lower income (less then $35,000) were more likely to have had a dental emergency in the past 12 months (vs. 14 percent of those who make $100,000 or more).

Of those who had a dental emergency, 23 percent involved a loose crown or cap, 10 percent involved a lost filling, while 72 percent said their dental emergency involved something else.

Among those who had a dental emergency involving a loose crown/cap or a lost filling, 67 percent immediately went to a dentist, and 14 percent looked for a temporary solution to purchase, while 19 percent did nothing at the time.

“You keep medical supplies on hand for cuts and bruises, but what about your teeth? It’s important to be prepared for a dental emergency in case one happens, especially if the emergency occurs on a weekend when your dentist just isn’t available or you are on the road and cannot seek immediate dental care,” according to Brian Gold, D.D.S., who practices in Monticello, NY.

Dental emergencies can range from a dislodged cap/crown or lost filling to a knocked out tooth to pain or a cracked denture. Majestic Drug Company explains some common dental emergencies and suggestions for treatment.

• Knocked out tooth. If a permanent tooth is dislodged from the socket, try gently replacing it into the tooth socket. Do not scrub the tooth clean–you can damage the fibers needed for reattachment. If that doesn’t work, place the tooth in a glass of milk to keep it moist. Get to a dentist immediately.
• Mouth pain. A throbbing pain from a toothache may indicate an infection and a dentist should be consulted as soon as possible. Tooth sensitivity can be combated by the use of desensitizing toothpaste such as Sensodyne. Irritation from mouth sores can be alleviated by the use of specialized oral pain relief products such as Orajel.
• Lost filling. Rinse out the cavity with warm water. Apply a temporary filling product such as Dentemp(R) O.S. which can be made into a ball and pressed firmly into the cavity.
• Cracked or broken denture. According to Dr. Gold, all denture wearers should have a spare pair to use until the other is repaired. If not, it is good to keep on hand an emergency denture repair kit such as D.O.C. Emergency Denture Repair Kit, available at your local pharmacy.
• Dislodged cap/crown. Apply a temporary dental holding product such as Dentemp(R) O.S. and gently replace the cap onto the tooth. Make sure you get a proper fit.
• Irritation from Braces. Sharp wires can be coated with special dental wax available at your local pharmacy.

Remember, temporary dental solutions are just that–they are temporary. Make sure to seek professional assistance from your dentist as soon as possible.

Source:

• PR Newswire

Monica Gagnier skipped a checkup at a routine cleaning session to save money, but ended up with a $400 bill when the hygienist told her she needed antibiotic shots for a gum infection.

Many employer-sponsored health care plans do not include dental insurance, and those that do will typically offer only limited benefits. Individual private insurance is often too costly to be feasible. And Medicaid and Medicare offer only limited safety nets.

For most people, a toothache that turns into an expensive procedure like a crown or implant means thousands of dollars out of pocket. Routine checkups, cleanings and fillings can set you back hundreds. No wonder 35 percent of Americans have not visited a dentist in the last 12 months, according to a Gallup report in March.

Even if you’re fortunate enough to have some kind of coverage, you have probably discovered just how little it pays if you have big problems. Most dental policies pay for preventive care like twice-a-year checkups, but cover only a fraction of higher-cost procedures like root canals. Even fillings can get short-changed, if the insurer decides the tooth-colored filler the dentist used was too “cosmetic” for the pothole being patched.

At the same time, dental care costs are rising faster than inflation, just as the evidence mounts that taking care of your mouth can be a critical gateway to good overall health.

The health care bills circulating in the House and Senate include dental care provisions for children, which is good. But it also means that for most of us relief from dental bills is not likely to come soon. That leaves it up to consumers to find smart ways to reduce their dental care costs without sacrificing their oral health. So we asked experts and patients for advice.

PREVENTION Taking care of small problems keeps them from becoming big ones. Enough cannot be said about prevention, according to Dr. Matthew Messina, consumer adviser for the American Dental Association and a dentist in Cleveland.

Left unchecked, a small cavity that would cost about $100 to fill can easily turn into a $1,000 root canal. Skip those $80 cleanings each year, and you may be looking at $2,000 worth of gum disease treatments. An abscess that lands you in the emergency room will set you back hundreds of dollars for the visit, “and you’ll still have to go see a dentist, because emergency rooms don’t handle dental work,” said Dr. Messina.

Finally, your dentist also routinely looks for more serious problems, like oral cancer. More than 35,000 cases are diagnosed each year, according to the American Cancer Society. Early detection, usually during a dental checkup, is critical to successful treatment.

FULL DISCLOSURE It’s important to know the price before you agree to the procedure. Often patients sit down for a routine cleaning and checkup, only to find they have a problem. The dentist offers to take care of the situation on the spot, and the patient agrees — but then is socked with a surprising bill at the end of the visit.

That happened to Monica Gagnier of Beacon, N.Y., on a recent visit to her Manhattan dentist for a twice-yearly cleaning. Looking to save money, Ms. Gagnier was careful to tell the office when she made the appointment that she wasn’t due to get X-rays and didn’t need to see the dentist for a checkup. Without those two items, she figured she would save more than $100 on her bill.

During the cleaning, however, the hygienist told her that her gums were infected and she needed antibiotic shots. Her total bill was $400.

“The antibiotics may well have been necessary,” Ms. Gagnier said. “But what I hate is being hit by surprise costs and treatments when I’m lying on my back, my mouth is wide open, and I can’t talk about it.”

You should always be given an opportunity to discuss any treatment, sitting up, without equipment in your mouth, says Dr. Messina. In addition, whenever you are facing an invasive dental procedure that is not an emergency, it makes sense to refuse treatment on the spot and get a second opinion, says Elizabeth Rogers, a spokeswoman for Oral Health America, a nonprofit advocacy and education group based in Chicago.

The range of prices on treatments like root canals, for instance, can easily differ by $1,000 or more.

SPREADING THE COST Patients can often space out treatments or negotiate payment plans with the dentist for extensive work. Working with the dentist on payments, says Dr. Mark Wolff, associate dean at the New York University College of Dentistry, is much better than putting the bill on your credit card and paying high interest.

Another way to negotiate, says Dr. Wolff, is to plan extensive treatments in phases. Say you need a crown. Your dentist may be able to put in a temporary filling for several months while you use that time to save for the permanent crown.

“It’s quite possible to phase in many dental procedures,” said Dr. Wolff. “And when it is, most dentists are willing to spread the work out over time.”

DENTAL SCHOOL CLINICS Almost every dental school offers affordable care provided by dental students and overseen by experienced, qualified teachers. You can expect to pay as little as a third of what a traditional dentist would charge and still receive excellent, well-supervised care, Dr. Wolff says.

That is what Julie Kingsley of Portland, Me., did after a checkup for her two young children at a pediatric dentist set her back a total of $375. “I realized that was as much as a car payment or a good chunk of our monthly food bill,” said Ms. Kingsley. “There had to be a better way.”

Ms. Kingsley started asking around for less expensive alternatives and found out about the University of New England’s dental college clinic, at the Westbrook campus in Portland. The bill for her children’s latest checkups: $100.

Ms. Kingsley was pleased with the quality of care her children received. But she did warn that patients may sacrifice time for money. “What was a 45-minute visit at the private dentist ended up taking three hours at the clinic,” she said.

If you have trouble finding a dental clinic in your area, you can seek help from Oral Health America (oralhealthamerica.org or 312-836-9900).

Many communities also subsidize low-cost dental clinics that offer free services to those who qualify, or charge fees on a sliding scale. To find a clinic in your area, you can check with your state’s dental director. A state-by-state list is on the Web site of the Association of State and Territorial Dental Directors, at bit.ly/kCCo7.

MUCH has been said and written about the tens of millions of Americans without health insurance. But often overlooked in these discussions is another vital medical statistic: more than 100 million Americans go without dental coverage.

DISCOUNT NETWORKS Alternatives to employer-provided dental insurance are often a bad deal, Dr. Wolff said. But for the uninsured, a discount network can make a difference.

Some networks like those on DentalPlans.com have formed to fill the void. Consumers pay roughly $100 to $200 a year in exchange for 15 to 50 percent discounts on service and treatments from participating dentists. “Be sure to compare plans carefully,” said Ms. Rogers of Oral Health America.

And, she added, make sure the discounts you are likely to use will be enough to cover the annual fee — and look carefully for any limits and restrictions.

Source:

• NY Times

Dental patients, accustomed to seeing sharp tools and paper bibs, should get used to seeing a computer nearby. The digital age has hit dentistry, and patients can see that change in the way crowns are built and X-rays are taken.

The new technology is radically reducing the amount of time it takes to create a crown, and it’s also giving dentists faster, more precise views inside their patients’ mouths.

In a classroom at Dallas’ Baylor College of Dentistry, a computer screen showed a 3-D digital image of a patient’s teeth taken by a wand with a laser sensor. A light green tint on the screen marked the soon-to-be crown to set it apart.

Dr. Paul Nelson moved the cursor around and suddenly, the crown on the screen became skinnier or fatter until it filled the gap between the teeth.

He clicked the mouse again. Then in the next room, a machine the size of a large printer came to life. In it, two diamond-studded drills carved into an enamel block. In about 20 minutes, the machine produced a crown that fits exactly into the patient’s mouth.

The traditional process of creating a crown means forming a mold of the patient’s teeth and shipping it off to a lab that produces the crown, which could take weeks. Complicated crowns might require multiple visits, taking even more time from the dentist and patient.

“With something like this in a normal dental office if somebody knows how to use it, the patient would go home the same day,” said Nelson, an assistant professor.

The technology is pricey, part of the reason why in 2004 only 3.3 percent of dentists nationwide used digital impressions, according to the American Dental Association. The system used in the Baylor example costs more than $100,000, Nelson said.

Dr. Stan Ashworth, another assistant professor, admitted he was skeptical of the technology until he saw how accurate the final products were.

“With this technique, the first 50 of these that we did in here, 49 fit without any kind of adjustment at all, which is just amazing,” Ashworth said. “Dentists in private practice would love to have that level of success.”

That accuracy persuaded Dr. Mark Palmer, who has a private practice in North Dallas, to get digital impressions about five months ago. With his system, the images are sent to an outside lab that makes the crown and sends it back to him.

“The only reason that I got it is because it improves the quality of dentistry that I do,” Palmer said. “It’s an amazing technology.”

Patients are more familiar with digital X-rays, which have grown in popularity among dentists nationwide.

Rather than film, a digital sensor is placed inside a patient’s mouth to capture an image, which appears instantly.

Digital X-rays look similar to film, but they’re easier to transfer, and dentists can optimize the image to make a better diagnosis, said Dr. Byron Benson, who heads Baylor’s radiology division.

“If you were doing something where you needed high contrast or low contrast, you had to know that before you took the picture,” Benson said. “Now, you take a digital radiograph and, with the software, you can change the contrast.”

The ADA said about 16 percent of dentists used digital X-rays five years ago, but Benson figures that has grown to about 25 percent or 30 percent.

Palmer has used them in his practice for about five years and saved money on chemicals, film and processing.

“As far as I’m concerned, it’s a no-brainer,” he said. “There’s no reason not to be in digital X-rays.”

However, Benson points out to dentists who can’t afford the technology that film X-rays have the same quality as digital. He teaches his students both methods but makes clear that digital is the future.

“We teach them to a level of familiarity with film, but we teach to a level of competence with digital,” he said.

Chris Whitley is a Dallas freelance writer.

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• Dallas News

Cash, check or a cord of wood for that doctor visit? As health care costs climb, old-fashioned bartering has seen brisk growth since the economy soured.

Hillsborough, N.J.-resident Robert Josefs traded his Web site designing skills for nearly $1,000 in dental work last year when he had no insurance, and many other patients are learning that health care debts don’t always have to be settled with sometimes-precious cash.

Health care bartering has risen dramatically since the recession began, as people lose their health insurance and consumer spending drops, said Allen Zimmelman, a spokesman for the Bellevue, Wash.-based trade exchange ITEX Corp.

ITEX Corp. has seen its health care business rise 45 percent over the past year. The exchange, which has 24,000 members, now fosters about $1 million a month in health care bartering.

The Web site Craigslist says overall bartering posts have more than doubled over the past year as the recession took hold.

People who barter for health care say the practice allows them to stretch their resources or receive care they couldn’t afford. But bartering can be tricky, and not every health care provider will consider it.

Some doctors are open to bartering directly with patients. Others do their trading through an exchange like ITEX.

These exchanges allow people to trade goods and services with other exchange members generally for barter dollars. They can then use those dollars to pay a health care provider who also belongs to the exchange.

There are about 400 exchanges in the United States, Zimmelman said. The Web site barternews.com offers state-by-state listings.

These exchanges charge membership and transaction fees, and they also help members deal with tax implications of bartering. Hotel rooms, restaurant meals and services like plumbing are among the more popular items traded.

Direct bartering depends on the patient having a service or good the doctor needs. That’s a wide range at The Barter Clinic on the edge of the Blue Ridge Mountains in Floyd, Va.

Johanna Nichols barters produce from her organic vegetable farm with Susan Osborne, an osteopathic physician. Nichols, a Floyd resident, said she barters less than $600 in care every growing season to help offset a high-deductible insurance plan that covers her family.

“We still are paying our health insurance premiums every month,” she said. “It’s just kind of an extra way to stretch our dollars.”

Osborne’s Barter Clinic also accepts clothing, firewood and has counted violin lessons and child care among other unorthodox forms of payment. About 10 percent of her patients pay by alternative means from time to time. People will suggest a trade, and her office does research to figure the local prices for the proposed barter before deciding whether to accept it.

Josefs, the Web site designer, found quick acceptance for his services. A dentist about an hour from his New Jersey home responded a few days after he posted a notice last year on Craigslist, the popular online classifieds site. He had chipped a dental veneer, but he had no insurance at the time.

“There’s a lot of out-of-pocket expenses that I was really just hoping not to pay,” he said.

Josefs had bartered successfully once before — by doing some Web design work for a sushi restaurant he and his wife frequent — and decided to try again. After calling an insurer to make sure his barter partner was an actual dentist, Josefs got about $900 in work in return for designing a Web site for the dental practice.

He and the dentist hashed out a price after Josefs showed some sample Web sites and explained their cost.

Web design is a popular bartering tool, but sometimes a specific skill isn’t necessary.

New Sharon, Maine, resident Anita Allen is spending part of her summer volunteering at nearby Franklin Memorial Hospital to help trim her uninsured grandson’s medical debt. Allen, 72, works in the hospital’s kitchen and gift shop under its Contract for Care program, which pays her by reducing the debt, which she figures may be around $8,000.

She said her grandson took two trips to the emergency room for car and snowmobile accidents. He suffered no serious injuries, but the ambulance rides and exams that followed were pricey.

“It sure helps to give time and pay off a bill because those bills run up quite fast,” she said.

Sarasota, Fla. resident Steve Armstrong said his wife is getting a $6,000 dental implant paid by barter dollars he piled up through his business, Steve’s Termite & Pest Control.

Armstrong earns barter dollars by doing a few days of work each month for fellow members of International Barter Exchange.

“Then the word of mouth from them goes to cash-buying customers too,” he said. “It’s like free advertising.”

Bartering to pay health care bills is generally limited to specialties like dentistry or smaller doctor practices that are less bureaucratic, said Andrew Whinston, a University of Texas at Austin professor who has studied bartering.

But it never hurts to ask whether bartering is possible. Osborne recommends writing a letter — not making a phone call — to ask if bartering for a bill is possible, either before or after a visit. She has request forms her patients can fill out.

If a care provider agrees to barter, patients should comparison shop to get a sense of fair prices before agreeing to a deal. Zimmelman said some providers will charge a different price for barter customers.

He also said patients should clarify how much bartering can be done. Providers rarely accept bartering as the only form of payment for expensive procedures.

Check on the quality of a potential barter partner’s work before agreeing to trade. Patients who want to barter for their health care are already shrinking the pool of providers they can chose from because not every doctor is willing to do it. That can limit quality, Whinston noted.

No matter what is bartered, the transaction must be reported to the Internal Revenue Service. The fair market value of property or services received should be included as income on tax returns (For more information see http://www.irs.gov/taxtopics/tc420.html).

Failing to do so can lead to headaches. Osborne said state officials once audited her barter accounts to make sure proper taxes were being paid.

“Several people … had not realized that they had to report it on their taxes, and so they ended up having to redo their taxes and were angry with us,” she said.

Source:

• Associated Press

In the slowdown, even dentists are feeling the pinch. David Wong, who runs a private practice with his wife in Tulsa, Okla., has seen his business slip 10% since the beginning of this year. That has him spending more time marketing and less time cleaning or pulling teeth.

Dr. Wong has upped his advertising, taking advantage of low newspaper and broadcast rates, and now sends email reminders to customers on top of traditional mailed postcards. He is even on Twitter, aiming to connect with customers as “not just the guy in a white coat with a drill in his hand.”

“It’s a lot more work,” he admits. “You can’t go to the office and just be a dentist anymore; you have to go to the office and be a dentist and a CEO.”

Like many dentists, Dr. Wong has noticed a trend in the last year: As more patients lose jobs and employer-sponsored insurance, fewer come in for major treatments or even routine cleanings. A little more than half of 1,275 dentists surveyed in July by the American Dental Associaton said their net incomes have decreased and their unbooked appointment times have increased from the first quarter. That means more dentists see the need to step up the marketing of their services.

“Dentists are taking a good look at their systems, trying to figure out what they can do internally that won’t cost them anything but will keep people coming,” says Gene Werner of Mercer Advisors, a company that does financial planning and practice management for about 4,000 dental practices across the nation.

There are more than 120,000 dental practices in the U.S., according to the dental association’s last count in 2002; more than 60% of them are solo practices.

In dental school, most dentists learn that good location and personal service will earn referrals to new patients. But these days, the old ways alone aren’t enough to cut it and dentists with slumping business want to know what to do differently, Ms. Werner says.

“For four years in dental school, they learn damn well how to take care of teeth but they don’t know anything about business,” says Ms. Werner. “I see that more in dentistry than any other business.”

Dentists like Ken Peters of Highlands Ranch, Colo., noticed twice as many patients were cancelling appointments and putting off expensive treatment in mid-2008 from the year before. “They figure they can’t afford it so they wait,” says Dr. Peters, who estimates between 20% and 30% of his patients have put off dental treatment, hoping to find another job in time to cover them. “They’d rather feed their family than spend the money on a crown.”

Hesitant about the effectiveness of marketing for dentists, Dr. Peters says he and his small staff haven’t modified their strategies much besides contacting patients more often.

Other dentists have significantly upped their personal connection with patients by sending newsletters in the mail, offering phased payment schedules for the recently uninsured, or calling patients directly to book routine cleanings.

Scott Scharf’s office in Plymouth, Minn., has rolled back prices on crowns while his office staff hand-write between 150 and 200 letters to patients a week. The office started seeing a slew of cancellations in February. The receptionists began jotting notes in the margins of patients’ charts on their last visits before insurance ran out: “Losing job soon.” For the time being, the schedule is still full of patients, “but it’s trouble to keep them there,” says Pam Kent, Dr. Scharf’s clinic manager.

To be sure, some dentists have received a business boost as the soon-to-be unemployed seek health care before their benefits run out. But turning those patients into regular customers is tricky unless they are in pain.

Meanwhile, Dr. Wong in Oklahoma uses Twitter to reach patients with marketing messages. One recent tweet: “Check out our latest implant surgery video to stabilize loose dentures.”

Source:

• Wall Street Journal

According to a recent article in Popular Mechanics, researchers at Tufts University are making headway on developments that will could completely revolutionize the way dentists go about repairing tooth decay. The new procedure implements stem cells, those miracle working “blank slates,” by placing them in a biodegradable polymer scaffolding that has been specially designed for tissue engineering. The scaffold is then implanted into the affected area where it can grow into enamel, dentin, or pulp.

Although this all appears to be very promising the technology will likely not be ready for use in humans for several years.

Researchers at Tufts University are working on a way to use stem cells to repair tooth decay. How it works: Tooth-growing cells are seeded into polymer scaffolds. The scaffolds are then implanted into the jaw, where they regenerate tooth enamel, dentin and pulp. The operation has been successfully tested in pigs and rats.
Availablility: Could be available for humans within seven years.

Source:

• Popular Mechanics
  

PALOMAS, Mexico — Before the police chief here sought political asylum in the United States, after all his deputies had run away because of the kidnappings and killings, this was a nice little town to get your teeth cleaned.
This Story

People drove the 360 miles from Phoenix for some periodontal attention. Looking for a good deal on a new crown? As the signs all say (in English): No appointment necessary! Palomas was the Mexican border town that discount dentistry built.

Palomas is like Vegas, except people don’t come to gamble, they come for root canals.

The one main street is lined with storefront clinics, some empty and open, others empty and closed. Before the violence from the drug war exploded here last year, 50 dentists were keeping their chairs warm morning, noon and night, serving an almost exclusively American clientele only too happy to get their wisdom teeth extracted for a song.

“It’s a pity, really. Our patients are afraid to come back,” said Oscar Quiñones, one of the lonely dentists, dressed in his crisp white smock, his drills idled by the brutal realities crushing Mexico’s border economy into dust.

Quiñones went down the list. “There was the influenza,” he said. “Very difficult for us.” People suddenly didn’t want somebody else’s hands in their mouths. Especially someone from Mexico, where the global swine flu pandemic first emerged in April.

“Before that, there was the economic crisis,” Quiñones said. “Then the government made everybody get papers.”

On June 1, the U.S. Customs and Border Protection agency began to require travelers entering the United States from Mexico or Canada to have passports or special high-tech driver’s licenses. A U.S. passport costs $100. Traditionally, dental tourists were in Palomas to save money — on new dentures perhaps — not to spend it, especially for a passport they were going to use to drive only three blocks into Mexico to hear that they should floss more often.
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Noting this, the clinic where Quiñones works is offering clients with a new passport a $100 rebate on any dental work of equal or greater value.

Overlaying all this is the spasm of shocking drug violence that has swept the borderlands. A year ago, when it started to get bad here, the mayor of Columbus, a town just across the border in New Mexico, was sitting in a dentist chair getting a root canal when two pistoleros burst in demanding money.

There were bodies dumped at the edge of town, kidnappings and strange men driving fancy pickup trucks with expensive rims. In a story that ran in the Deming Headlight, a New Mexico newspaper, a popular dentist assured his clients that he was not dead, as rumored, just not in Palomas at the moment.

The violence has settled down. In the evenings now, the locals again cruise the main drag in their pickups, bouncing along to norteño ballads on their stereos, waving to friends. The brand new Mexican army post outside town might have helped.

On a recent weekday morning, dentist Jesús Jasso Salazar sat in his waiting room waiting. He was reading a dentistry textbook.
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“I used to see five patients every day, and for a dentist around here, that’s a good number,” he said. “Now it can be a week without a patient. In my case, I had just two last week.” He made $35, after he paid his dental assistant.

Jasso said dentists are closing shop. “Two left just now,” he said, pointing at the San Jose Pharmacy across the street. Ten dentists worked alongside Quiñones in the town’s biggest clinic, which now employs three.

Jasso, who sports two gold caps on his front teeth and runs a simple two-chair operation, came here from Monterrey, Mexico, 10 years ago. Sure, there was a lot of competition, he said, but there were plenty of cavities to fill. Life was sweet for the dentists of Palomas, as it was for the pharmacists, opticians and general practice physicians who also worked in the medical tourism trade.

Although there have been dentists in Palomas for more than 40 years, business boomed as health insurers in the United States demanded ever higher co-payments. Suddenly it made sense to drive four hours from Tucson to get a crown for $125 or a cavity filled for $60.

Alma Sainz sat in the waiting room after Jasso fixed her porcelain crown, her cheeks a little swollen from the Novocain. She paid $130. Sainz lived in Palomas when she was a child and said the town was once a fun, lively place filled with tourists. Now she resides across the border in Deming.

“I work for the public schools, and my insurance is pretty good,” she said. “But a crown in Deming would cost $700 or $800, and my insurance only covers $200.”
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Sainz smiled. “So here I am,” she said.

Source:

• Washington Post