Friday, December 3, 2010

One Night in Bangkok, One Afternoon at ... the Dentist?

No, I didn't take singing lessons from Murray Head, but my first night in Bangkok is behind me now, albeit a day late due to the vagaries of modern air travel.  The primary purpose of my trip is a visit to the dentist.

That's right, the dentist.  Back in 2006, I had the shock of a $7500+ dental bill for a few onlays; fast-forward to this year, and my current dentist (different guy, obviously!) gave me the bad news that those platinum-priced onlays were failing and needed to be replaced with crowns.  After a $1800 dentist bill for just two crowns at that dentist (and mind you, that's after my insurance paid $900), I wasn't quite ready to fork out another $3600 for four new crowns!  Factor in that I'd used up my dental insurance for the year already, and we're talking a $4500 expense.

Rewind to 2006 for a moment, when after hearing of the ridiculous cost of those onlays, several friends suggested my money would have been better spent on a trip to Thailand--one of the world's premier "medical tourism" destinations thanks to the quality of their medical system plus the exchange rate between the baht and dollar--where I could have paid for the same work, a flight, and a week at a five-star beach resort to recuperate and still have had several thousand dollars left over.  I kind of laughed at the idea then, but the frequent traveler in me coupled with sticker shock over necessary dental work had me seriously thinking about going to the kingdom of Siam.

As for the costs of a trip, hotels in Thailand are cheap by US standards.  Bought at the advance-purchase rate, a night at a five-star resort hotel like the Millennium Hilton is around $100 (and I've paid nearly double that for a Hampton Inn stateside this year).  Dining can be had for $10 or less per meal for some tasty cuisine.  And airfare isn't ridiculous; I paid a bit over $1000 for my ticket, but that was to get an upgradeable fare which would let me fly in business class instead of economy.  So add up airfare, hotel, meals, and the dentist, and it's still less than what I'd be paying stateside.

Needless to say, weighing the cost of those crowns in the US vs. a trip abroad came down on the side of travel.

After doing much research on clinics, I settled on Thantakit, who despite having a somewhat cheesy Web site (though you should see a few of their competitors--definitely seems like the Thai medical industry hires Web developers who studied site design circa 1995), came highly recommended by both personal experiences of frequent travelers I know as well as with good online reviews.  They are a bit pricier than several of the ubiquitous dental clinics in Thailand--on par with the top-line hospitals in Bangkok--but even at that and a worsened exchange rate with the baht, cost less than half what my out-of-pocket would have been even if I hadn't used up my dental insurance for the year.

Thantakit sent a shuttle van to pick me up at the hotel, and after a 40 minute ride--traffic being atrocious in Bangkok--I arrived at their very classy, clean offices.  Now, no ding on my current US-based dentist, but I'm so used to dental facilities which look like they were build in 1970 that this was quite a pleasant change.

On to the consultation and initial appointment itself: the dentist spoke very good English and took a quick look  at my teeth, took several photos, and then sent me over for x-rays.  The x-ray equipment was the same state-of-the-art computerized system I'd used at the $7500-onlay clinic in Washington, D.C., though to save on my final bill, the dentist only took bitewings and not a full panoramic set.  The clinic took them digitally, instead of on film (this is a nice plus), and rather than having to bite down on an awkward film cartridge holder, one of the technicians positioned the sensor and held it in place during the x-ray--the only strange bit of the procedure, as she's taking a bit much radiation to her hands in the process.

Back to the exam to go over with the x-rays with the dentist.  Now, I'd expected a pressure-sell technique where the dentist would try to get me to go in for pricier options or for more services than I needed; I've had that happen in the US before, and was certain I'd experience it at a clinic whose primary business is dental tourism.  But I was honestly and pleasantly surprised to have the dentist argue for a more conservative, less-expensive treatment plan.  The remaining two one-surface inlays didn't need crowns, he explained, pointing out on the photos and the x-ray that most of their problem was in their surfaces having worn badly.  They simply weren't large enough fillings or in teeth used heavily in chewing to require a crown.

Chalk one up to the good guys.  Here I was willing to fork out a lot more money, and the dentist talked me out of it.

He also explained that for a molar and pre-molar crown, a noble metal covered with ceramic crown was a better option than all-ceramic for strength, and that though all-ceramic looked better, for teeth that far back in the mouth, he didn't see the need.  Yes, I agreed entirely.

On to the treatment.  The dentist went over everything ahead of time which he would be doing (that's more than any dentist I've gone to in the US has done), and explained if I was ever uncomfortable, to raise my hand (as opposed to the instruction to "tell us"--yes, that's what I hear in the US all the time from dentists: "tell us" when you've got a mouthful of dental probes, drills, retractors, and the associated paraphernalia off some sadist's confession-extraction kit in use).

"I'll give you the injection to numb the tooth now," he explained, and there wasn't even a pinch from it.  This may be a strange observation, but in the US, Novocaine injections frequently hurt quite a bit (the exception being the $7500-onlay dentist, who used an automated metering system to deliver the anesthetic--though the added cost was not worth it in his case).  I don't mean the needle itself so much, although that "pinch" the dentist warns of does often hurt.  No, I mean the anesthetic itself, which can send quite a burst of pain down the nearest nerves during the injection.  But this didn't hurt at all; I can only chalk it up to the dentist having a really careful hand and taking his time with the injection (it took a good minute to fully deliver the Novocaine).

Then came that most dreaded of dental implements, the drill.  Beth has described our current American dentist as being "quite fond of his drill," and indeed, I've spent a long afternoon or two in the chair wondering when the heck he'd be finished.  But another pleasant surprise awaited me: the drilling itself took a bit less than an hour for the two crowns plus some work on my inlays, and a filling for a cavity between two of my teeth.  It wasn't painful.  I can't ever describe dental excavation as pleasant, but it certainly wasn't an awful experience, either.

Finally, after taking some molds (downgrading to the noble metal + ceramic crowns necessitated molds vs. the photo-aided CAD/CAM milling I'd had for the past several dental procedures), the dentist put in place a temporary crown--explaining up front and apologizing that the process would smell like hot plastic for a few minutes--and sent me on my way, to come back in a few days and get the final crowns installed.

I'm due back to get those crowns in a couple of days--time needed for the lab to fabricate them to spec--and will report back once I've completed my dental tourism experience.  But so far, I have to say: this was the best dentist I've ever gone to.  Wish I could justify going to Thailand every six months for basic dental care instead of only the big-ticket stuff!

No comments: