A bit of background. After years of neglect, I finally decided to do something about my teeth earlier this year. I visited 2 dentists in the Washington DC area; the costs for implants were staggering to say the least. The costs pretty much ruled out implants and left me with the option of dentures. After a bit of research, it seemed that going to Costa Rica might offer an alternative – affordable implants.
I brought the topic up with my wife (who by the way used to be a nurse). Her first response was that I must have lost my mind even considering going out of the country! However, after discussing the U.S. options, she agreed that we should at least investigate Costa Rica more.
I established minimum criteria for dental clinics in Costa Rica (member of American College of Prosthodontics, specialized training in the U.S., active participation in training in the U.S., and recent training (to ensure they were up to date on latest research and techniques).
My wife and I made appointments at several clinics in Costa Rica, making it clear that our goal was to meet the staff, evaluate my condition and discuss possible treatment options. To be honest, my wife fully intended to find an issue with each clinic – but she was getting a vacation trip to Costa Rica.
We visited three clinics in San José, and while each were very modern and up to date, the treatment options varied greatly. In one, the proposal was the “all on four” method. Having read up on the various treatments, I was concerned that if an implant failed, the result was a 25% lose of the foundation! The second took the approach of temporary dentures after extractions and implants (while cautioning that “your jaw might get broken!”). And the third clinic visit was with Dr. Brenes.
While each of the dentists were willing to talk with us about treatment options, Dr Brenes seemed to be the most concerned about ensuring a positive long-term outcome. He also spent the most time examining me and took additional X-Rays to help develop a plan. Both my wife and I commented that we felt most comfortable with Dr. Brenes; his attitude and general demeanor made us feel comfortable. Also (and very important from my personal perspective – he was very careful and gentle in his exam!). His proposed treatment plan was not the fastest, but built a good foundation for implants.
I must also mention that knowing that if any complications developed, Dr Brenes’ office was literally steps away from a very modern full hospital was reassuring.
Even before getting the estimate from Dr. Brenes, my wife and I talked about the various clinics – and we agreed that Dr. Brenes was our first choice by far (and that included the U.S. options). He simply seemed to be the most concerned with my well-being. My wife, the skeptic, was very impressed with the facilities and staff. I had not planned to start any treatments on the first trip, but we decided to move forward with 4 extractions and a fixed provisional while on meds to address infections. Even feeling confident in Dr. Brenes, I was nervous going into that first procedure. He put me at ease and introduced me to the staff (in addition to Dr. Brenes, Dr. Retana). They answered any questions my wife or I had, and explained what they would be doing. The first procedure went very well (i.e., painless!) and I came back to the U.S. for a month.
My second trip involved more extractions, 12 implants, and upper and lower fixed provisionals. Other than spending a lot of time in the chair with my mouth wide open, the procedures were not bad. Yes, there was a little discomfort – but the doctors and assistants were very attentive and would stop to check to see if they could reduce the discomfort level. Yes, there was pressure – but again, very attentive to my comfort. What I was very pleased – I had no pain (ample Novocaine, but no pain). Numerous extractions, 12 implants, fitting upper and lower provisionals – I really am glad that it was spread of several days and not the “all on 4 approach” of everything in one day. Yes, there was some minor swelling and minor bruising – but I still felt well enough to go out the day after each procedure. Within a few days, the swelling and bruising was gone and my gums were not tender and I could enjoy eating. The fixed provisionals took a little time to get used to – learning to chew on one side, what foods I was ready for, etc. Within a few days I was enjoying eating and feeling more confident in my smile. While the implants were being placed by Dr. Retana, Dr Brenes made sure that my wife was kept up to date on the procedures.
It’s been about 2 months since getting the upper and lower provisionals. I have found very little that I can’t eat. In fact, my wife and I recently enjoyed grilled steaks and corn on the cob (and I do mean I enjoyed both!). The biggest adjustment has been that I would have avoided certain foods in the past, I’m having to remind myself that I can enjoy them again. I’m still careful in what I eat since the provisionals are only anchored in 4 places in the upper, 3 in the lower. The next trip, there will be 12 or 13 anchor points! I’m very pleased with the treatment plan and very glad that we chose Dr. Brenes. Having the fixed provisionals means that I don’t have to worry about dentures popping out, foods that I have to avoid, and the inconvenience of dentures.
I also can’t say enough good things about the staff – if I had questions, they were always very responsive and helpful. I’ve also never had a dentist that followed up after a procedure the way Dr. Brenes does – he’s called a couple of times just to see if I’ve had any problems since getting the provisionals. You don’t find that level of patient care in the U.S. anymore. Please feel free to contact me if you have any questions –