First Experience With A Dentist

Before I came to Ecuador I had noticed some minor discomfort in my teeth. So, I thought I would take advantage of the cheaper costs, that I had read about, once I arrived.

As I was busy with a lot of other activities I just never managed to find the time until the pain started to get a lot worse.

Nieve recommended a dentist that her family had been using and whom they all thought highly of and that he spoke english.

The first visit involved an x-ray which cost $15. On the second visit, the dentist told me he could not see anything wrong in the x-ray.  So at his suggestion he added a coating to three of my teeth as I was experiencing hot and cold sensitivity. This cost was $45. This seemed to help. But there was still this overall dull pain. 

So in the next week and I went back to see him again. He took another x-ray and still could not see anything. I told him there was pain in the gum below the tooth. So he hummed and hawed as if he did not know what to do next. Then suggested it might require a root canal or tooth removal. Since he could not determine what to do he did not charge me anything for this visit. As I had heard of another dentist via the gringo Internet I decided to get a second opinion. I was able to get an appointment the same day.

Her name is Dr. Grace Ordoñez. As soon as I had described the symptoms, Grace immediately prescribed a pain killer (800mg tablets of Ibuprofin), a course of antibiotics (Ciproflaxin) and made an appointment for the next day with a dentist who specializes in root canals. She said these things can get very painful. Grace charged me $10 for the consultation.

The next day at 9:30am, I had my first session with Dr. Jorge Espinosa which would be the first of three sessions. I wanted him to give me gas as I hate needles but apparently they do not use gas in Ecuador.

The first session went with very little problem. However, the second session, two days later, involved a fair amount of pain despite the Novicaine. He then prescribed a heavy duty pain killer (called Ketoralac Trometamina) which I read about on the Internet. Apparently this drug has some severe side-effects and has been banned in a number of countries. Despite this I gave it a try but fortunately observed no negative symptoms.

Now it is two days after the second session and I no longer have to take any pain killers and no longer feel any pain.

I do not know what he has in mind for the last session. Perhaps all he needs to do is install a more permanent filling. My next appointment is next Wednesday (Sept 24th). I will add an update when that session is complete.

The total cost of the three sessions on the one molar will be $330. As I have never had a root canal before I do not know what the cost would have been in Canada.

I was visiting a couple of Canadians who are in the process of moving here and one of them had been to visit the same dentist. He has two teeth that need to be cut down and then capped. Apparently this is going to cost him $800 per tooth.

If I had been able to acquire the Social Security Hospital insurance soon enough this would not have cost me anything more than my monthly medical insurance cost of $70 per month. Unfortunately, it takes three months after you acquire your Cedula (National Identification card) before you can take advantage of the system or so I have been told.

UPDATE: The root canal is finished and the pain is all gone. For some reason the Orthodontist that did the root canal does not do fillings so I had to go back to the other dentist (Ruth Ordoñez). Upon visiting her she stated that since the molar has 3 fractures and not a lot of structure (which I can confirm from feeling it) that I need to return to the Orthodontist and have him put in a "base" which then Grace can install a post and crown. The estimate was $320.

The "base" has now been put in and feels just like a filling. However, two days after getting the "base" installed, part of it fell out.

My next visit to Grace is scheduled for this Monday (Oct 6th) and I am sure she is going to say that it is not good enough for the crown and I will have to return to the Orthodontist to get the problem corrected. I will post the next part of this commentary as "Update 2".

UPDATE 2:  Even though some of the "base" had fallen out Grace said that it would be OK for the addition of the "post". However, upon starting to work on the tooth, Grace mentioned that it smelled bad. I also have noticed a small amount of pain when applying pressure to the tooth. So, Grace made another appointment for me to go back to Jorge Espinoza.

Jorge examined the tooth and determined that the tissue was just inflamed. He prescribed a 5-day course of an anti-inflammatory called "Arcoxia" (120mg) to be taken once every 24 hours. He gave me 2 free tablets and did not charge me anything for the visit. The other 3 tablets cost $11.43 including tax.

I am to complete the course of anti-inflammatory and then make another appointment with Grace to have the "post" and crown installed.

In addition to the work Grace was doing she examined my other teeth and reported that there were two molars on the left upper side of my mouth where the fillings needed to be replaced. I hadn't had any dental work done in about 25 years so I guess it was due. She replaced the fillings for $125. There were 5 fillings in 2 teeth. It took roughly 3/4 of an hour.

Stay tuned for UPDATE 3!

UPDATE 3:   I re-visited Grace and she mentioned that the smell is still present. I am not surprised as an anti-inflammatory drug is hardly going to get rid of a problem like this. She thinks that the tooth has a fracture which is allowing blood to come up into the tooth where bacteria can get at it thus causing the smell. She showed me some black material she extracted from my tooth which could have been blood. Given that this is the case she says the tooth needs to be removed. So, unfortunately, all the money I have spent on this tooth has been wasted.

Since the bad taste and smell have only been present for the last 4 or 5 days, I suspect that during the root canal Jorge may have created the fracture. But, there is no way to prove this.

Grace also said that when the tooth is removed that a bridge should be installed to prevent the bottom tooth from growing up into the hole where the old tooth had been. The bridge would cost roughly $800. Hmmm!!!

Nieve's daughter says that the cost of installing a bridge is way overpriced. She is going to ask her dentist what the cost would be.

UPDATE 4:   I had the tooth removed today - Oct 28th ($42.80) and I am now taking antibiotics (Amoxicilinia 500mg - $3.24 for 21 caps) and a pain killer (Motrin 600mg - $7.49 for 14 tablets).

The tooth definitely had a fracture. You could see it once it had been removed. You could also see black spots along the fracture area.

Grace also said that because the fracture was vertical in orientation that is why it did not show up in the X-rays.