Dave's Faves: Costa Rica Dental Team

Costa Rica Dental Team

(Formerly, Smile 90210)

http://costaricadentalteam.com/

Financial disclosure information: I have no financial ties to this clinic or any of its dentists. I am not employed by them in any capacity, nor do I receive commissions or any other form of consideration for any referrals or anything else.

osta Rica Dental Team is an good choice for patients looking for high quality on a budget, especially those needing full-mouth restorations or lots of crowns. Prices for full-mouth restorations with 28 e.max crowns start at US $11,000 (cash price as of October 2014). A few Topix posters have reported on this clinic, always favorably, but I think it deserves an even higher profile on the Internet blogs.

    I visited this clinic and talked with its owner Mike Lomax in November 2010. Mike himself is not a dentist. Rather he is the owner of both this clinic and the dental lab next door. The clinic is nicely appointed, and American patients will feel at home in it. But what sticks in my mind is the lab next door. The lab is worth a tour in itself. Serving dentists in Costa Rica as well as the U.S., the lab is huge, and I can easily believe that it can turn out an entire full-mouth restoration—28 crowns that fit perfectly together—in just a few days. By comparison, one of my dentist's outside labs takes up to three weeks to do this.

   Mike currently has five full-time general dentists on staff, with specialists filling in for work like implants, gum surgeries or endodontics. The dentist most frequently discussed on Topix is Yelda Fernandez, who has been praised by several patients over the years. For example, see "Nicole's" posts #3948 and #3951. (Some of my comments are there, too. The post number is at the upper-left of each post: #xxxx. If you don't see the posts on that page, press the "Previous Page" or "Next Page" buttons to find them.) The clinic itself is very upscale, and American patients would feel comfortable there. I continue to follow Internet reports from its patients, and so far folks seem very pleased.

    I checked out a lot of references in Fall 2010 and heard no complaints. Of all the C.R. clinics I looked at, this clinic sent me the most names of patients with full-mouth restorations, which was my particular interest. One thrilled patient was cured from her long-standing TMJ with a full-mouth restoration. Another was a well-off gent who could have chosen any dentist for his work, but he chose CRDT and was very happy.

   I keep thinking that there must be hundreds—if not thousands—of US patients needing a mouthful of crowns but can't afford US prices. If only they heard about Costa Rica.

    Four years after my last contact with CRDT, I reached out to Costa Rica Dental Team and its president, Mike Lomax. Mike, an American who started out managing dental labs in the US, was supportive of my profiling CRDT (Why not? It's free publicity.) and graciously answered several of my emails. I've put our email conversation into the form of a Question and Answer dialog, with a little bit of editing, re-arranging and {annotating}.

I wasn't sure how Mike would take it after hearing from me for the first time in four years. But he took it well, even though he must have been a little miffed in 2010 when I chose another clinic. Here's his initial response:

David,

Wow such a long time since you were in our office you wouldn't recognize the place now. BTW we were recently certified.

I want to say again congratulations !! I also want to say thanks so much for including Costa Rica Dental Team in your blog.

{Now Mike starts spooling out some promotional boilerplate. I'm including it for those who might be interested in exploring its links.-dave}
Perhaps you might want to include the reviews that we have received on Costa Rica Dental Guide. Costa Rica Dental Team is the most reviewed dental clinic on this dental guide website with a perfect 5 Star rating with 7 perfect patient reviews.
http://costaricadentalguide.com/dental-directory/dentists-clinics-labs/costa-rica-dental-team

In the end, what really makes us stand out is our commitment to quality. Costa Rica Dental Team is the only American-owned and operated dental clinic in Costa Rica. We also are the only dental clinic in Costa Rica to offer a 10 year replacement guarantee. You can check out the video at http://www.youtube.com/watch?v=BID_AT3RVRg {Mike talks about CRDT in the video. When he says that that dentists he recruited to work for him had been his "customers," he means they were customers of his dental lab. -dave}

Over the past few years, Costa Rica Dental Team has become the national leader in full mouth restorations. We do more full mouth restorations for American and Canadian patients than any other clinic in Costa Rica.

Our patients stay in a beautiful new Hyatt hotel near our clinic and receive free transportation from our English speaking driver.

To see more patient testimonials...check out the video at
http://www.youtube.com/watch?v=uxvzoCvunws

Patients are encouraged to email me directly: mike (((at))) CostaRicaDentalTeam.com

You list five dentists on your website. Do they work directly for you? How did you select them?

All of those dentists are my employees. I hand pick them leaning on my 37 years in the dental industry to know skill and experience levels along with commitment to care. Even some of my assistants are dentists. That way we groom them for the future. It's kind of like a farm system in baseball.

We hire specialists to perform the implants, root canals and periodontal surgeries. They have all been with us for several years now and perform all treatments in house.

The full mouth reconstruction of 28 Emax metal free crowns starts at about $11K cash price.

Any other questions or suggestions let me know.

Are any of your five full-timers specialist dentists? And are any of your specialists full-time at CRDT?

No, all of our 5 full-time dentists are general dentists. Our specialists are in our offices every day but also serve other dentists. This is common in Costa Rica. Our specialists are listed on our web page though and do not have an issue being linked to CRDT.

By the way we use Zimmer brand implants. They are recognized around the world as a leader in the industry.

{Now I steered the conversation to one of my pet topics of interest, dental materials. -dave} I had 28 crowns made with Prettau "full-contour" (solid) zirconia back in 2010 (from another dental lab). I believe you were making crowns in that material, too, then. Do you still make them?

Yes. Prettau was a pioneer technique that in principle is still used everywhere in the world. Of course we make full-contour zirconia. We have equipment and technology to do so and make literally thousands of those crowns and bridges per month. You should stop by one day when you are in Costa Rica again. Nobody is as technologically strong as we are from a lab standpoint. 2nd place is a long way back. {I have no way of verifying Mike's claim to the title of Costa Rica's best lab, but I love the fact that he believes it.-dave}

We have been doing Prettau long before you were here in 2010. Enrico, the owner and inventor of Prettau, is a friend of mine. {Enrico Steger is the founder of the company Zirconzahn, which manufactures the Prettau-brand of full-contour zirconia. -dave} Started in 2007 making full arch and full contour zirconia. Prettau is not new. Full contour zirconia is not new. 7 years in this industry and technology market is a long time. I have personally been making porcelain to metal crowns since 1976. So 38 years. All ceramic crowns such as Coors crowns since mid 1980s. The evolution is non stop.

For full arch cases though, zirconia is considered too rigid and we are now making hybrid fixed dentures with resins that are lighter and have elasticity for long term survival of the implants themselves. {So not only does CRDT make crowns in solid zirconia, they also make more complicated appliances in that material and other materials too. -dave}

When it comes to full arch cases there is research that concludes there are more implant failures when using complete zirconia as opposed to resin materials due to the rigidity of the material. Therefore the Prettau technique and other similar 100% zirconia techniques, while their use is an excellent application in smaller spans (3-6 units) and individual crowns, there are genuine concerns about the long term survival of the implants that support them. Because of this many dentists and their laboratories are finding more flexible solutions such as hybrid fixed dentures and cad/cam milled resin materials as a better alternative. These cases are generally supported by only 4 implants. So especially on upper maxillary bone that is much more porous than lower mandibular bone more caution must be considered when placing a full arch restoration such as Prettau.
{Okay, dental patients! Not being a dentist nor the president of a dental lab, I have *no* idea whether any of the above technical esoterica is true, or more importantly, applies to your particular case! The state-of-the-art in dental appliances advances remarkably fast. That's why you need to find one or more good general dentists or specialist prosthodontists who keeps up with recent advances and can advise you on your particular options. -dave}

Wow, thanks. I know that there have been a lot of changes, for the better, in both materials and procedures in Costa Rica since I was there in 2010-11. At that time, crown lengthening was a rather exotic operation, but now it is being done regularly. I think a patient of yours posted on Topix she had crown lengthenings done at your clinic.

Another question. You're not a dentist yourself, and would-be patients are always asking, "Who's the dentist there at CRDT?" My blog itself also revolves around particular dentists.

What is your role at the clinic, and how do you interact with the dentists?

David we are a "team". The dentists, assistants, front desk, driver, laboratory personnel and myself as the owner and manager. I orchestrate and collaborate. The rest of the team has their role and knows what they need to do. I don't believe many patients that once they have been to see us have any doubt about who is their dentist or how we work together.

We do a lot of crown lengthenings and for different reasons. Its not always for the same reason. Sometimes it's esthetics and other times it's for retention and sometimes it to change the biological width of the tooth to avoid an extraction.

I appreciate all of your feedback by the way. It is always taken in a positive light.

Thanks so much, Mike!

Here's a review posted 3/16/2015 about them on TripAdvisor (post #342).

Erin's experience (post #7135) with Dr. Viola, 6/25/2015.

Comments welcome. Is the Costa Rica Dental Team your dentist? If so, consider "paying it forward" by telling us about your experience (hints for posting).

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