Mark Bolzern traveled 3,700 miles to go to the dentist. The 56-year-old Anchorage, Alaska, native left home this spring, made a pit stop in Las Vegas to pick up a friend, and kept heading south, all the way to Los Algodones, Mexico, a small border town teeming with dental offices.
About 60 percent of Americans have dental insurance coverage, the highest it has been in decades. But even so, the nation's older population has been largely left behind. Nearly 70 percent of seniors are not insured, according to a study compiled by Oral Health America. A major reason is because dental care is not covered by Medicare and many employers no longer offer post-retirement health benefits. What's more, the Affordable Care Act allows enrollees to get dental coverage only if they purchase general health coverage first, which many seniors don't need. At the same time, seniors often require the most costly dental work, like crowns, implants and false teeth.
As a result, many are seeking cheaper care in places like Los Algodones, where Mexican dentists who speak English and sometimes accept U.S. insurance offer rock-bottom prices for everything from a cleaning to implants. Dentists in Los Algodones say a large portion of their clients are seniors.
In the desert outpost near the border of California and Arizona, men in white shirts stand outside of offices with signs advertising root canals and teeth cleanings. Other signs advertise prescription drugs like muscle relaxers at low rates - no prescription needed.
For Bolzern, seeing a dentist in Los Algodones meant a savings of up to $62,000. He was told the extensive dental work he needed - his teeth needed to be raised and he needed a crown on every molar - would cost $65,000 at a private dentist. He looked for lower rates, finding a dental school where the work was less expensive because it was performed by students. But it still cost $35,000.
He paid $3,000 in Mexico and has been back several times.
The cost of dental care has surged in the last two decades and continues to increase at a rate of 5 percent annually. Many dental plans have high deductibles and don't offer extensive coverage. Many people opt out.
Mexico has lower costs because of cheaper labor and fewer regulatory requirements. Residents in border towns like El Paso, Texas and Nogales, Sonora, often make the short drive to the Mexican side for basic medical needs and prescription medications that are much costlier in the U.S. Some businesses even offer shuttle services from the Phoenix area to Los Algodones, a nearly 200-mile ride.
Going abroad for cheaper health care is nothing new. Americans have been doing it for years, for everything from elective, cosmetic procedures to major, life-saving surgery.
Matthew Messina, a practicing dentist and consumer adviser on behalf of the American Dental Association, said Americans who visit dentists in foreign countries should do a lot of research before they go.
Different countries use different types of equipment, and some items, such as implants, may not have warranties. Malpractice lawsuits may not be an option.
Dentists in Los Algodones say they attend less school than their counterparts in U.S. but spend more time practicing clinical work. They say they practice the same safety standards as American dentists and have offices that are just as clean.
José Obed Zuñiga has been a dentist in Los Algodones for a decade and found business was so good he opened his own shop about two years ago.
"Everything, the quality, is very similar to the United States," Zuñiga said. "We see the work from the United States, and it's very competitive."
Aiti Gutierrez left her home in the state of Tamaulipas, Mexico, 1,400 miles away, to practice in a Los Algodones office that has four patient rooms and a lobby with a water-stacked mini-fridge. In the busy season, she sees about a dozen patients a day, and 12-hour work days aren't unusual.
"They like to feel comfortable and that they're safe," Gutierrez said of her clients.