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How to find your perfect Costa Rican dentist

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Patient Report on Kriebel Dental

 Picked the wrong dentist in CR?  You're not necessarily doomed if you cut your losses in time and re-orient yourself.  Here's an example from a US dental patient who did just that.

She emailed me directly to discuss her adventures (or misadventures, rather).  But it all has a happy ending!

(She's given me permission to post her private email to me.  I've also posted her long review of Topix, a shorter version of which she posted #7662 earlier today on Topix.)

Thanks!  She found Dr. Kriebel on my blog (The Dentists==>Dave's Faves: The Specialists). It makes me feel good that my blog has rescued someone from a bad dental experience.

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Hi Dave,

I thought I would send you off a note, because, although I did not find your website early enough to avoid my initial dental catastrophe, I did find it in time to make a determination about which dentist to follow up with once I had to find someone to fix some problems.  Just an FYI-I was referred to your website by [name redacted by request]. I had a terrible dental experience.  I was not able to get in to Nova quickly enough given the severity of my situation, and my limited time in San Jose, but someone had recommended Kriebel Dental, and your review of them sealed the deal for me.  I am just dropping this note because I wrote a review of my experience and want you to know that you are not steering people wrongly to see Dr. Mariano Kriebel or his dad Dr. Ricardo Kriebel (or any other staff members at Kriebel Dental), for reasonably priced, top of the line dental work. 

I would be happy to answer any other questions you have…but just wanted to say thanks for spending the time and effort putting together such an intelligent and informed website (not driven by profit)…it really helped me.  

Again, thanks for hard work that really benefits people,
Best regards,

XXX XXXX,


Here is what happened to me-and how I wound up at Kriebel Dental: 

Without a doubt, Kriebel Dental is the BEST dental facility I have EVER been to ANYWHERE that I have lived, including six states in the US, Japan, The Netherlands and Mexico. 

Across the board, I have never encountered such a stellar combination of attributes in one dentist: Scholar-level education and training, polished, adept and PAINLESS clinical skills, experience borne from a 100-year lineage of dentists, and unparalleled, patient-centered treatment ethics.  Bar none, Kriebel Dental is in a league of their own.   The fact that I left Costa Rica raving about my dental experience says quite a bit about the provider.  This is especially true given the severity and complexity of dental problems I had developed by the time I finally (and fortunately) found my way to Kriebel Dental.  It’s difficult to articulate just how grateful I am that I wound up under the care of Dr. Mariano Kriebel, because I know the outcome would have been different had I not been directed to someone with his skills and experience.  The work that I required took a level of assessment and planning that most dentists are not trained for, and among those that are, few, if any, will actually invest the time to do the work correctly.  It simply does not maximize the profit margin, and, from what I have seen and experienced, many dental tourism clinics are focused on one thing: profit.  But, that was not my experience at Kriebel Dental at all. In fact, it was just the opposite: the treatment I received was patient centered and compassionate.  And, the final goal was excellence in dentistry-so my story ends well.  

 However, my dental tourism story did not begin well. While still in the US I had chosen a dental clinic based on poor criteria, and when I arrived to have the work done, it was a hellish experience and ended with me having work done that I was unsure of.  This was because I felt pressured and uncomfortable, and was so tired from flying overnight that I was not thinking clearly.  Thus, I allowed myself to be talked into something that I really should have taken time to think about.  By the time I got to Dr. Kriebel, my poor dental health was further complicated by questionable procedures, all adding to an already complex case.    

As background, I had decided to make the trip to San Jose because the condition of my teeth had deteriorated severely from patch-working dental problems for too long. The financial cost of the ‘quick fixes’ I had over the years had far exceeded a full mouth reconstruction, and without any of the benefit.  I have a severe grinding problem (Bruxism) and was at the point where my bite was so far off that I had worn through bonding, veneers and crowns, and was rapidly losing teeth.   

 For years, I had been hearing that Costa Rica was “The Dental Tourism Destination”  (even my US dentist admitted to this), so, once I made the decision to go, I decided to do my own research, believing that my experience as a “researcher” would ensure that I found a dentist qualified to deal with a situation as complex as mine.   This was a bad decision, in that not all dentists who appear to be “qualified” on the internet are equal.  So, although I followed very specific criteria in my search (eg. those listed with the US Embassy, mentioned on dental tourism referral sites, memberships in professional organizations, etc), in the end, I wound up choosing the Clinic whose name came up most frequently in my search.  I now understand that this simply means that they pay for more advertising than others, and says nothing about the dentists’ qualifications, or the quality of their work.  

 The good news is that I WAS directed to Kriebel Dental and I am inordinately grateful.  Everything about the experience can be rated as outstanding.  Upon entering the clinic I noticed that the office reception is immaculately clean, tastefully decorated, quiet and peaceful, and it is staffed with gracious, welcoming people. I immediately felt comfortable and experienced a huge sense of relief.  The rest of the clinic was equally pristine-every room that I saw was spotless, organized and clearly sanitary.  The dental chairs face huge glass windows with a view of Sabana Park, with mountains as backdrop. Thus, the environment itself is recipe for relaxation.   When Dr. Kriebel came in, I explained my situation to him, chatting on, probably way longer than I should have.  He sat and listened calmly, and (I felt) non-judgmentally, as I babbled on about my deplorable condition and horrendous experience.  There was something about his demeanor that just calmed me down.  He took x-rays, did an exam and asked a number of sensible questions that no-one had ever asked me before.  It was clear that he was listening with a high attention to detail.  At the end, he explained that I did have a complicated situation but it certainly was manageable, and in fact, it was his specialization.  It was at this point that I learned that he had done a four-year specialization at Ohio State University-and this was above and beyond his DDS.  Being an academic myself, I know that Ohio is an excellent school and getting in as an international student is no easy feat.   I asked if he could start immediately, thinking he would jump at the chance given the amount of work that was going to be involved.  He said no.  He wanted to spend time reviewing the x-rays and considering options, and then he would draw up a plan and go over it with me.  I was disappointed because I wanted it all fixed immediately, but internally, I knew I was in the right hands.   

In the end, I had two dental implants and some temporary crowns on the uppers, and all of my lower teeth crowned. Dr. Sergio Ortiz performed the implant surgery and was equally professional.  The procedure was seamless and they took care to ensure I understood every aspect of what was happening.   I am absolutely thrilled with the outcome and will be going back to finish the uppers in the Spring.   Everyone I have shown agrees that my new crowns are beautiful and very natural looking.   

 But, in addition to the appearance of the final product, the process itself was extraordinary, and is testimony to the fact that Dr. Kriebel is a consummate professional.  He is a very rare combination of new-school dentistry and old-school work/professional ethics.  He spent an inordinate amount of time attending to details, including consideration of any possible factor that could affect my bite, and then working to perfect each factor.  Meanwhile, he would regularly check in with me to be sure I wasn’t feeling any pain.  At some point I found out that he was using children’s anesthesia on me and that was why he was asking about pain so frequently.  When I asked why not use regular anesthesia, he explained that he remembered me mentioning high blood pressure when he took my medical history, and apparently regular anesthesia can complicate that.   All of this equated to him spending more of his time-a place where other dentists cut corners in the name of money.   In summary, every single aspect about my experience with Kriebel Dental was excellent.  I recommend them to everyone-family, friends, colleagues, etc.  At a time where the state of medicine in the US is questionable, this was a breath of fresh air and really has renewed my faith that there are health care professionals who take pride in their work, and truly care about their patients. For these professionals patient well-being IS THE BOTTOM LINE.   

 XXX XXXX, February 2016, New York, U.S.A.


Note added 5/8/2016:  I just put up a new post with an email interview with Dr. Mariano Kriebel. (Click on the "Dr.Kriebel" label to find it.) It gives some more background on this clinic. 

Kriebel Dental-New report from US patient

By CometGlare → Sunday, March 6, 2016
I promised to update this blog when my dental condition changed, even in a minor way, so here's my latest adventure in dentistry.

A first molar came unstuck during vigorous flossing right before New Year's.  These things always seem to happen on major holidays.  The following week, my local dentist removed it with a special tool; apparently some of the glue still held the crown firmly in place.   He examined the crown and the prep (tooth stub) and said both were fine.  He recemented it, and the dental assistant had a time removing the stray cement.  The dentist said that the molar had a short prep, but my teeth were short to begin with.

Since the crown was never loose even after it got unstuck, I'm not too worried about it now.  I've changed my flossing habits so now I floss with only one strand of floss rather than the two strands together I had been using.  End of adventure.  Will update as needed.

Happy 2016 to you, dear reader!

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Update: 1/2016 Loose crown, recemented without problem

By CometGlare → Sunday, January 17, 2016
Here's a list of holidays in 2016 when one dental clinic in Costa Rica is closed.  I thought it would be of interest when scheduling visits. It's obvious that ticos observe different holidays than us norteamericanos.  In particular, it seems that they observe only a single day for Christmas, but take a whole week off for Easter.

Be sure to contact your own dentist: His holiday schedule might well be different than the one below.

List of Observed Holidays in 2016

·         March 21st to 25th (Holy week)
·         April 11th
·         May 1st
·         July 25th
·         August 2nd
·         August 15th
·         September 15th
·         October 12th
·         December 25th
·         2017:  January 1st
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Typical Schedule of Holidays in Costa Rica

By CometGlare → Monday, January 4, 2016
Just an update about my dental work after about 4 years and 4 months.

Things are going well, which I'm grateful for.  The dental hygenist says I have the cleanest gums of any of her patients, probably due to clean living...and seeing her four times a year.  I also love my Sonicare toothbrush (the model with the selectable settings so I can brush on "sensitive"), which I use twice a day.  And, oh yeah, I also sip bottled water all the time and swish it around in my mouth.  I'm not going to complain about success.

I also saw a local periodontist for complete periapical x-rays and to see how the work is holding up.   I was concerned about my upper right teeth which have a long history of feeling funny, but there are sinus issues too.  He said the teeth and gums were fine.  My upper left lateral incisor still feels unnaturally numb after the root canal; but there is no pain.  He said that the root looked fine, echoing what my Costa Rica dentists had told me a couple months back.

The periodontist found two small issues with how the crowns fit the gums. As he didn't notice these four years ago when he first examined me, these must reflect changes in my gum tissue since then.  The defects are quite small now, and my general dentist never even mentioned them.  However, if they continue to get worse, the time may come many years from now when I might need a couple of new crowns. There is also a small (1 mm) recession in my gum on the back side of my upper front teeth.  This actually seems much less of a problem than it did when my general dentist commented on it a year ago.  Specialists are excellent in finding irregularities.

So, my 28 crowned teeth are no longer perfect. Oh, well. But I still have 23 or 24 crowns and gums that are as good now as they were in April 2011.

I'll continue to provide updates.


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My dental work at 4+ years (20 September 2015)

By CometGlare → Saturday, September 19, 2015
I have dental x-rays taken once a year, typically in the summer, and last week was the chosen week.  My usual local dentist did the honors.  After an uneventful teeth cleaning and exam ("Wow, those are great margins," he semi-whispered to no one in particular), he looked at the x-rays.  His hygienist pointed him to my #10 tooth, which is the upper lateral incisor that I had so much trouble with in 2013.  (It couldn't hold a crown, so DDS's Dr. Carranza did a root canal and Dr. Prada inserted a metal post. I've already written about how I'm not thrilled with the general idea of root canals.)

Anyway, the dentist and hygienist were in agreement:  The tooth was fractured.  I was pretty distressed, because it had been only two years since the root canal, and because I've been extremely busy lately and didn't want to spend time or money on dental stuff.  As much as I've enjoyed reading about OTHER people's experiences with implants, I wouldn't feel deprived in the slightest at not having one.

Nevertheless, I bit the bullet and sent a semi-frantic email off to Dr. P.  He responded fairly promptly, and asked to see the x-ray.  I was chagrined to admit that I didn't have anything to send him; my local dentist still uses his 30-year-old machine from deep in the pre-digital era.  Dr. Gonzalez (who rarely attends to email) also chimed in and stressed that fractured roots could impair implants because when the body tries to seal off the infection, the underlying bone shrinks.  That makes the implant precarious. Was there pain or swelling?, they wanted to know.  No, just a telltale x-ray.

More worried than ever, I promised to find a dentist with a digital x-ray machine as soon as possible.  Of course, this happened on a Thursday afternoon, which is basically Friday for dentists here in North Carolina since they usually take Fridays off.  After a worrisome weekend, I located a dentist willing to take a pic.  It was taken Tuesday morning (for $44).  An hour later it was on its way to Costa Rica on wings of electrons.  Dr. Prada, Dr. Carranza and Dr. Gonzalez all looked at it and said it looked fine: no sign of fracture or bone shrinkage or anything else.

Whew! What a relief.

I talked with the dentist's office about why they thought it was fractured, since I was curious to know.  Apparently the old x-ray equipment doesn't have the resolution of the new digital ones, and movement might affect how it looks, and...okay.  Not sure what to make of all this, but I now realize that I need to find a local dentist with up-to-date equipment to monitor my teeth.  Once again, I've learned to not take anything for granted regarding dentists.

So that's it.  I thought I'd update you on my latest faux dental adventure.  Now I have to get back to work.

-dave
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False alarm! (19 June 2015)

By CometGlare → Friday, June 19, 2015
2015 May Updates!

Well, it's that time of year again... Time for the May Updates on the Topix forum.

This will be the second annual May Updates. Last year was the inauguration of this tradition.  I had this idea back in late 2013, when the Topix forum was going through one of its periods.  There were a lot of off-topic posts back then and some back-and-forth arguments going on.  My idea was to have a lot of dentist reviews posted at one time in the year, allowing interested newbiews to just read a few days or weeks of posts to get the general flavor of things.  Furthermore, I thought it would be an interesting idea to have folks look back on dental work that had been completed months or years earlier and tell us what they thought.  Most dental patients give their dentists glowing reviews immediately after the work is completed, but problems usually don't become apparent for weeks or months.  So that was the idea behind the May Update tradition.

For the May 2014 Jamboree Update, I emailed dozens of old posters and tried to convince them to post.  Many did, but many ignored me.  This year I emailed just three people (who all ignored me).  So the eight people or so who have posted so far have done so spontaneously, for which I am grateful!

Some thoughts about the posts this year...

>>> I posted an update on my dental work from Dr. Prada.  It was a belated admission that I don't like root canals, which is what I always thought.  I'm still happy with the work, but I wish I had a time-machine so I could have had it all done by Dr. Prada back in 1995 when the first set of 28 crowns were placed.  He fixed a lot of the problems stemming from the 1995 crowns when he worked on me in 2010/2011.  But it is just so much easier (and less expensive) to have dental work done right the first time.

>>> I see a sour note regarding Dr. Castro by one of the posters.  I appreciate honest posts like this.  (And in my opinion, asking folks to contact him privately is the best way to handle cases like this.)  I posted a reminder to him to "Register" so that folks would be able to Private Message him if they wanted to follow up.  I remember seeing another post from a patient of Dr. Castro's (maybe by the same poster, I don't remember) in last year's May Updates (sometime in May 2014, obviously).

>>> I don't understand Infoseek's comment (#6996).  Is this directed to me or to someone else?   I don't know.  It's very easy in a public forum to write a post that seems perfectly clear to the original poster, but leaves some readers scratching their heads.  I've written many such posts.  This is another reason why I recommend that people with complaints reserve their hardest-hitting shots for private discussions, where the criticism is less likely to be misunderstood.

>>> As usual, my posts get flagged.  There are one or two guys who hold a grudge against me and flag my posts routinely.  Eventually, they will get bored and go away.  But until they do, the ratings no longer make any sense because of people like that.

Enjoy!



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2015 May Updates!

By CometGlare → Saturday, May 9, 2015
A
lex Wideman runs a web site for people needing implants.  He gives general information about implants and crowns, and advises prospective patients about their options in choosing a dentist.  I've looked at the site, and it seems to fill an unmet need.  Implants are a huge expense for patients, and it's good to see a site that tries to provide unbiased information about them.  I'm always leery that dental-oriented web sites might have some hidden agenda, so I scrutinized the site looking for any telltale signs that Alex has "sold out" to some commercial interest. I'm glad to report that I didn't find any.  Whew!

He sent me a list of questions, which I dutifully answered and sent back.  My answers are now posted as an "Interview" in the "Costa Rica" section of the "Dental Tourism" page.  If you've read the other posts on this blog, I don't think you'd find many surprises in my interview.  I provided my standard list of encouragements and warnings.  You can read the full interview here.

Why did I give advice about implants even though I don't actually have any implants?  Well, I have procedures just as complicated as implants.  Furthermore, I know folks with implants--some of whom used dentists I recommended.  Even if I couldn't tell you the technical details of their work, things turned out well, so I felt both vindicated and gratified.  So when Alex knocked, I answered.

Buena suerte and pura vida!


My Interview on Alex Wideman's Implant Site

By CometGlare → Sunday, March 8, 2015