December 22, 2007

Cheap Lima Dentist
Lima, Peru

What has to be one of the strangest trips to the dentist in my life occurred here in Lima, Peru.

I was raised to believe that visits to the dentist are something that should be done twice a year. I had my first dental experience abroad in Nicaragua, in 2006, and it went quite well. It's hard to get around to visiting a dentist every six months, but I've generally been able to do it about every nine or so.

A few days after I arrived in Lima Tatiana and I swung by proper dental clinic that was just a stone's throw from where she had her first ultrasound in town. We asked how much a cleaning was, to which the receptionist replied: "Well, that depends… You're teeth must be inspected first."

We promptly walked out.

Cleanings are typically a fixed price, and the fact that they wanted me to spend my time in a chair just to hear that they were going to overcharge me wasn't something I was interested in doing.

You have to be very careful in these parts of the world. If it looks like you can get screwed over, someone's typically going to try it—especially if you look like a foreigner. It's just the way it works out here.

I told Tatiana: "All I want is a cleaning. No x-rays, no special this or extra that—just a cleaning. And I don't want to pay more than US$20 for it. What happened back there was B.S."

A month passed without much progress. Tatiana recommended a visit to the dental school that was near the house, but I didn't want dentists in training working on me for cheap—I wanted the legitimate thing at an affordable price.

Then, a few days ago, Tatiana ran into a woman while she was looking at supplies for her belly cast. It turned out she was a dentist—a professor at the school down the street—and that she accepts patients when she's not otherwise occupied. She gave an up-front price range that was within limits, so Tatiana made the call and setup the appointment.

This is the Place?

I'm sure most reading this share similar mental images of what a visit to the dentist looks like: A small building or rooms in an office complex, a waiting room with old magazines, and two or three of those reclining chairs with autopsy lights overhead. I have vivid memories of wearing a lead vest as a small child during x-rays.

We arrived at the address, just a 15-minute walk from Tatiana's home. I looked at Tatiana, and furrowed my brow. It was just a worn house, with no markings to indicate a business of any kind. We rang the bell, waited, and were eventually received by the woman that Tatiana had met earlier.

Much like the setup with Tatiana's obstetrician, this simple practice is run out of a room in a typical neighborhood home. The setup was generally complete, but it was quite a bizarre experience to be getting worked on in such a place.

One of the scariest things for me about visiting dentists in developing countries is their lack experience or knowledge with permanent retainers—also known as a "bonded retainer" or even a "bonded mandibular lingual retainer". Twice now I've had my teeth cleaned in Latin America, and on both instances the dentist has looked into my mouth, pointed, and said: "What is that?"

I had braces in my mid-teens, and it turned out that my gums didn't like to keep the teeth in place after the hardware was removed. I was faced with either wearing a retainer at night for the rest of my days, or getting a small wire glued behind some teeth and forgetting about it. It was sort of a no-brainer to take the lazy joy of option two. I've had it for over a decade.

The downfall comes when the thing breaks—as mine did from stress about five years ago. I worry about it happening again (by my own fault, or perhaps because of the actions of a dentist cleaning my teeth), and where I'll be in the world when it does. It doesn't instill confidence that twice I've had dentists who've never seen such a common solution in the United States.

It was quite nice having Tatiana there to translate. I lack the (dental) vocabulary to express important details in Spanish, and even more so when I have a suction tube lodged in my mouth.

The woman did a nice job. I received the typical inspection, ultrasonic-pick cleaning, polishing, and inspection routine, but then she finished up by coating my teeth with a clear, sour syrup, which I was told was fluoride.

Much like the lead vest, I have memories of fluoride treatments at the end of my dental sessions as a child. I thought I'd toss in some fun USA trivia at the end of our session by telling the two how these treatments are typically not done with adults, and as a kid, I was able to choose a flavored gel (like bubblegum or cotton candy) that was squeezed into a mouthpiece, and worn for a few minutes.

I think I was the only one entertained by the remark.

The cleaning cost 30 Peruvian nuevos soles (US$10).

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