All posts by David Hall

David Hall founded this website as a vehicle for selling dental books in 2002. In 2009, he also founded Infinity Dental Web, an Internet marketing company for dentists. He was a practicing dentist for many years and is an accredited member of the American Academy of Cosmetic Dentistry.

Another story of problems with dental work in Costa Rica

It’s a different mentality, these dental bargain-hunters, who seek to save money by getting dental work done in Mexico or Costa Rica. I can’t relate to this degree of risk-taking. They must not understand all the things that can go wrong in dental treatment.

With dental implants, especially. Even done in this country, dental implants treatment is poorly regulated. Providing dental implants should be a specialty, but the entrenched powers in the dental profession don’t see it in their interest to make it so. Independent regulatory bodies have arisen: the American Academy of Implant Dentistry and the International Congress of Oral Implantologists. Dentists can pursue certification with either of these organizations. But those certifications are not recognized by the American Dental Association or dental boards, and so any dentist can legally provide dental implant treatment without any extra training at all. As a result, there is a high rate of dental malpractice in dental implantology.

But when people go to foreign countries in search of a bargain, they are on even shakier ground. I get e-mails from these people occasionally, wondering what they can do when they have run into trouble with their treatment. The answer is that they really have no recourse.

I have one e-mail I received a week ago from a woman from Chicago who went down to Costa Rica for dental implants work. She ended up with twelve teeth on the upper jaw, but only eight on the lower jaw. The back four teeth on her upper jaw have no opposing teeth and are therefore useless. What can she do now? Nothing, really. She says she keeps e-mailing the dentist for an explanation and he is ignoring her.

What will she do next year when the dental implants begin getting loose? If that happens, that will make her present complaints pale in comparison.

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A Clear Choice complaint

I get regular e-mail complaints about Clear Choice Dental Implants Centers through one of my websites. Clear Choice operates a chain of dental implants centers around the country. I thought I would share this one that came through yesterday, about an experience someone had at the Las Vegas Clear Choice:

“After my initial visit to this place all they seem concerned about is the damn money. Well we’ll need so much before we can do this or that is always their answer. I was to go in for my second consultation and exam prior to surgery today. I cancelled the appointment. I spoke with the sales person last night and after our talk I started having reservations about this company. Still the emphasis on their damn money prior to me coming in. Then in our discussion it came out that these people have only been around for a little more than 5 years and only have a little over 10,000 customers. That is nationwide. After I hung up I thought hard and long about the conversation. The fact that concerns me the most is they are nationwide and only have 10,000 patients to account for. The second concern is only a little over 5 years in the business. Putting implants in people’s mouths needs highly skilled and trained people. The person I work with is starting to sound like a used car salesman and doesn’t give a damn about you or your health. Even the brief talk with the actual doctor at this site seemed cold and uncaring. I have cancelled today’s appointment and am now back to searching for a solution for my problem.”

– Dennis from Nevada

My comment:
While I do believe that Clear Choice tries to recruit dentists with strong expertise in both dental surgery and implant prosthodontics, their sales tactics are what come under repeated criticism. They conduct aggressive marketing campaigns that draw in a lot of prospective patients to their presentations. They offer them a free CT scan. Then they present an exorbitantly high fee for a one-day procedure – in the neighborhood of $40 to $50,000. And what I hear from people is that they will offer a significant discount if the patient signs today, a high pressure sales tactic that people aren’t used to seeing in the health care industry. All of these dealings happen before they see the dentist, so that the time is spent by sales personnel and clerks who are at a lower pay rate. So while there is only a small percentage of those who come who sign on to their program, there is a handsome profit on those who do, enabling them to pay their dentists salaries and bonuses in the high six figures to seven figure area.
– Dr. Hall

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Don’t become a cosmetic dentistry horror story

Here’s an ad that I spotted over the holidays in our Mesa Tribune:

North Scottsdale Family & Cosmetic Dentistry
A cheap smile makeover offer from Steven Poulos DDS and Sid Stevens DDS of North Scottsdale Family & Cosmetic Dentistry

I would skip this smile makeover offer – there are a couple of serious red flags here that, as an accredited cosmetic dentist, I can help you with.

The first problem is the fee of $695. This is a cheap porcelain veneer. You can easily pay triple that here in the Phoenix valley. It’s way below the minimum for which you can get a quality smile makeover. You need to pay at least $1000 or $1100 per tooth for a smile makeover.

Don’t try to cut corners here. Once the dentist grinds on your teeth and replaces your natural tooth enamel with porcelain, there is no going back. But if you get a cheap smile makeover, there is no going back, even though you may wish to. And I have corresponded with many patients who have wished they could have their natural teeth back after getting a mediocre smile makeover.

If money is an issue, try this cheaper alternative: do nothing. But if you want a smile makeover, go for beautiful and be willing to pay for it.

Wondering what your smile would look like with one of these cheap smile makeovers, I decided to check out their website.  When I did, I found this smile gallery:

bogus smile gallery
Bogus smile gallery from North Scottsdale Family & Cosmetic Dentistry

I was immediately suspicious, because nowhere on the page did it claim that this was the work of Dr. Steven Poulos or Dr. Sid Stevens, the two dentists at this office. So I decided to call. And I was fortunate to get Dr. Poulos himself on the phone. I mentioned the smile portfolio and asked, “Who did this work? Is this by one of your dentists, or is this just an illustration of the procedures?” He confessed that these were what he called “canned” photos. He said that they do good work but they’re not very good photographers.


My advice: Skip this smile makeover offer. Go ahead and take them up on their teeth whitening, but if you want a beautiful smile of porcelain veneers, you need to be willing to pay in the neighborhood of $1000 to $2000 per tooth. Avoid cheap smile makeovers as you would avoid cheap parachutes.

This blog is sponsored by America’s Dental Bookstore.

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You don’t need to change your toothbrush after being sick

I was in a Walmart yesterday after work, and ran into this display:

Change your toothbrush after a cold or flu

Give me a break, Colgate! I’m disappointed in you for this marketing gimmick. There is absolutely no need to change your toothbrush after a cold. The idea that invisible nasties are lurking in your toothbrush sounds gross, but have you ever heard of anyone re-infecting themselves after a cold or flu? No. Neither have I. Basic biology teaches us that we fight off disease by creating antibodies to the disease. Once you’ve built up the antibodies and cleared the disease from your system, you’re not going to be able to re-infect yourself. And research shows that there is no need for a new toothbrush after being sick.

Even if it were possible to catch the same virus twice, you have an excellent household method for sterilizing any toothbrush – simply dip it in Clorox or any similar household bleach for about a minute. That will kill everything.

Bleach is so good at sterilizing, you could take your friend’s toothbrush, and even if he has tuberculosis, pneumonia, or hepatitis, a one-minute soak in bleach straight from the bottle will kill all the nasties. We would have used Clorox to sterilize our dental instruments, but it is extremely corrosive to metals. For plastics, however, it works great.

Change your toothbrush when it wears out. When the bristles start to splay out, change it. If the bristles look good, keep using it. It’s as simple as that.

When to replace a toothbrush
There is no need to replace a toothbrush until it is worn out. The bottom toothbrush should have been replaced long ago. The top toothbrush is fine, no matter how long it has been used.

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