My work with Dr. Prada and Dr. Gonzalez

By CometGlare Sunday, September 7, 2014

My Experience with Dr. Prada and Dr. Gonzales 

Six months after completion of dental work

[These two posts marked my debut on the Topix forum.  I had been mulling them over for some time, and when a poster asked for information about a Dr. Prada, I was glad to oblige.  The posts review my treatment with Dr. Prada from the perspective of about six months following completion.  I reprint them below as they appeared in Topix, with only minor emendations and comments.]

[DISCLOSURE Updated 5/26/2019:  Since I originally wrote this post in August 2011, I heard third-hand that this clinic is offering fees to former patients who refer new patients.  I have never taken advantage of any such referral fees, though I cannot rule out doing so in the future.  In any case, such fees played no part in my motivation for starting this blog or reviewing this dentist.  When I talk with prospective Costa Rica dental travelers--as I do once or twice a year--I typically give them several dentists that I think might suit them. I never leave them with just one name to research.]

p.104, 2138 and 2139:
 Chicago Dave#2138
Aug 29, 2011
Dentists Reviewed:

Hi Stargazer!

I know a lot about Dr. Prada and Dr. Gonzalez and will be happy to share. I had a full-mouth restoration completed in May 2011, and I am happy how it's turned out. I have no financial interest in this; I'm just a recent patient. Not every dentist is right for every patient, so let me explain briefly why I chose Dr. Prada over several other Costa Rican and American dentists.

First, after investigating dentists, I became biased in favor of specialists, by which I mean already-licensed dentists who went on to complete 2- to 3- year post-graduate training programs at American dental schools. Dr. Prada's advanced training is in prosthodontics (crowns, veneers, etc.), and I think that his skill and judgment show through in his work. Some examples: He had an instinct about how much to “open the bite,” that is, how tall the new crowns should be. This is a crucial consideration in full-mouth restoration. General dentists had a problem with this question, and typically tried to sidestep it. Dr. Prada knew in a glance that my bite needed to be opened--which he proceeded to do. He easily answered scores of questions of mine, some very technical. He even answers emails now, three months after delivery of the crowns. Well, I could go on and on.

Second, I was impressed with the level of cooperation between the specialists at DDS Dental. There wasn't enough tooth structure above the gum line of my teeth, and I needed to get a procedure called "crown lengthening" on my teeth. Dr. Prada coordinated with his colleague Dr. Gonzalez, the periodontist who actually did the gum lengthenings. At one point during the operation, Dr. Prada actually came in the room, examined the progress, and suggested a different approach to Dr. Gonzalez. As another example of inter-specialty cooperation, twice Dr. Prada brought in DDS's endodontist, Dr. Caranza, to consult on my case. [Note added later:  Dr. Caranza would later give me my first root canal, in July 2013.]  This was done on short notice, at a time when my teeth could easily be examined. Having all these specialists under one roof proved to be very convenient.

Lastly, I wanted the most "conservative" approach I could get. By "conservative" I mean doing one step at a time and not taking shortcuts. (Dentists love to take shortcuts.) My case needed two separate "preparation" (grinding) phases. Dr. Prada insisted on doing both phases as the best approach to my case. He shut down his clinic for me two days in December to remove my old crowns (and to allow Dr. Gonzalez to do the crown lengthenings). Three months later, he again shut down his clinic to work on me for two full days. He did not charge me extra to do this, even though it was a big investment of his time.  (A local U.S. dentist wanted up to $20,000 just for the second prep.)

I have nothing against American dentists. In fact, my first full-mouth restoration was performed by a very well-regarded North Carolina prosthodontist in 1995. But the difference between Dr. Prada and my former prosthodontist is day-and-night. And the difference between the dental lab I used (Lorenzo Favini’s) and the in-house lab my former prosthodontist used is also day-and-night.

I feel grateful for my new teeth, and want to encourage others to seek out the best possible dental care, wherever it might be found. Lest you think that I am totally blinded by gratitude, let me offer up a criticism to show my objectivity. Among the dozens of tasks and snap judgments that Dr. Prada made flawlessly, one decision I would have done differently would be to choose a lighter color.  (My crowns are B1, but if I had to do it again I would do A1 or "A0" or even into the "bleached" shades that all dentists and medical doctors disdain as unnaturally white.)  [Note added later:  But RJ faced the same decision in early 2014 and chose a darker, more natural color than A0.  Everyone is different.]

Readers of this board often want to know about costs. My crowns were $600 each, plus an additional $75 each for the services of Lorenzo Favini's dental lab.  (I highly recommend this lab, which also did LadyBoss's crowns.) A clear and fashionable night guard was $300.  These were Dr. Prada’s standard prices in November 2010 when I began working with him. He stuck to his original quote, despite all the trouble I was to him. Dr. Gonzalez's crown lengthening work was less than half of what I would have paid in the U.S. More importantly, he did an excellent job with a procedure that few Costa Rican periodontists would have been able to do. An outside anesthesiologist gave me IV sedation during Dr. Gonzalez's work (about $300 or $400); it was well worth it. Finally, I took advantage of a cash discount off the above credit-card prices by wiring funds directly to Dr. Prada’s bank in Florida.

I’ll mention in passing, for whoever might be interested in implants, that Dr. Gonzalez places implants and Dr. Prada fits the crowns for a large discount over U.S. prices. I don’t have any implants so I can’t give a first-hand account of this, but I did meet one of his very satisfied American patients in the office one day who had implants.

Anyone wanting more information can contact me at [this blog].  I have a 2,000-word description of my dental “adventures” for anyone so interested, as well as before-and-after photos and x-rays.  [Note added later:  I lost my long description when my computer crashed in 2012.  Sorry!]

May I make one final appeal to readers of this blog? Please pick your dentist, whether American or overseas, with care. Dentists differ enormously in skill, clinical and aesthetic judgment and just plain competence! DDS Dental is not the only good clinic in Costa Rica. For crowns and full-mouth restoration, I also like the Cavallinis, 90210, and the specialists in general. (However, I don’t like Costa Rican General Dentists in general, especially for complex procedures like a lot of crowns, or implants.)

Best wishes and good hunting!

Dave Gardner
(now in North Carolina despite my username)
[NOTE:  I'm still in the Triangle area of North Carolina as of September 2014.]

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