A Guide to Dental Tourism IN COSTA RICA · • Dental Crowns • Dental Bridges • Porcelain...

C O S T A R I C A

A Guide to Dental Tourism IN COSTA RICA

TABLE OF CONTENTS

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 3

Costa Rica Entry Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 5

Finding a Reputable Costa Rica Dentist or Dental Clinic . . . . . . Page 6

Costa Rica Dental Procedure Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 7

Full Mouth Restoration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 9

All on 4 Dental Implants: Full Arch Replacement . . . . . . . . . . . . . . Page 9

Dental Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 12

Dental Crowns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 16

Dental Bridges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 18

Porcelain Veneers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .0

Dentures & Partial Dentures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Page 22

Sinus Lift Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Page 24

Root Canal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 27

Bone Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Page 29

Teeth Whitening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 31

C O S T A R I C A

INTRODUCTION

Costa Rica is home to highly trained dentists and oral surgeons that provide superior quality dental care at a

fraction of the cost compared to the United States. Every year, tens of thousands of patients visit the country to receive

dental and maxillofacial surgeries. As dental care costs continue to increase in the USA, choosing Costa Rica for high

quality, affordable dental care is an attractive option.

Costa Rica is an amazingly diverse and beautiful country. It boasts of mountains, forests, tropical beaches, and dormant

volcanoes. Combining a vacation with dental care is the main reason that dental tourism flourishes here.

www.GoodnessDental.com

Costa Rica’s brilliant reputation as a world-class dental destination is due to its internationally trained dentists and surgeons and cost effective, inexpensive oral

and dental surgical procedures.

Some of the best dentists, dental surgeons, and oral surgeons in the world can be found in Costa Rica. Patients from all over the world, come to Costa Rica for

its low prices on popular dental procedures, vastly skilled dentists, and high-tech facilities. An increasing number of patients are choosing

Costa Rica for All on 4 dental implants and full mouth restorations, finding that Costa Rica offers a high level of quality at prices that provide

remarkable savings for American and Canadian patients.

BENEFITS OF DENTAL TOURISM IN COSTA RICA

• Many dental clinics are world class, accredited facilities with leading specialists.

• These clinics offer quality health care at affordable rates.

• Dentists and dental surgeons are highly proficient in their fields of expertise.

• The equipment, facilities and surgical techniques used are highly advanced. The best clinics often exceed US standards.

• Dental Tourism helps patients save up to 70 % off U.S. rates for most dental procedures.

• Costa Rica is located at a convenient and short distance from the United States. Most direct flights are less than 5 hours. Costa Rica is only 2.5 hours by plane from Florida.

The goal of this E-book is to help you plan your dental vacation in Costa Rica and avoid the most common

pitfalls that may turn your dental vacation into a dental nightmare. This guide is not exhaustive, but we have tried to

be as thorough as possible.

https://goodnessdental.com/


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COSTA RICA ENTRY REQUIREMENTS

Below are the entry requirements when travelling to Costa Rica.

1. Your passport must be valid at least 1 calendar day beyond the date that you enter Costa Rica. However, it is preferable that the passport be valid for more than six months after entrance into the country.

2. You must have a pre-paid airline or bus ticket to exit Costa Rica within 90 days.

3. Passports must contain a blank visa stamp page.

4. Children under 18 may travel with a joint passport with their parents, legal guardians or travel companion.

This page will help you with your specific country requirements - http://costarica.com/visa/

Citizens holding valid passports from the following countries are permitted to stay in Costa Rica for 90 days without a visa:

Germany, Andorra, Argentina, Australia*, Austria, Bahamas, Barbados, Belgium, Brazil, Bulgaria, Canada, Croatia, Chile, Cyprus, Denmark*, Slovak Republic, Slovenia, Spain, United States*, Estonia, Finland, France*, Hungary, Ireland, Iceland, Israel, Italy, Japan,

Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, México, Montenegro, Norway*, New Zealand*, Netherlands*, Panama, Paraguay, Poland, Portugal, Principality Of Monaco, San Marino, Puerto Rico, Serbia, South Africa, United Kingdom Of Great

Britain And Northern Ireland **, Czech Republic, Republic Of South Korea, Hellenic Republic (Greece), Romania, Vatican City, Singapore, Sweden, Switzerland, Republic Of

China (Taiwan), Trinidad And Tobago and Uruguay.



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FINDING A REPUTABLE COSTA RICA DENTIST OR DENTAL CLINIC

The vast majority of dentists in Costa Rica are well-trained and reputable, but you’ll still want to do some research to find someone you feel safe and comfortable consulting.

Visit CostaRicaDentalGuide.com to learn about procedures and find the names of the most recommended dental clinics in Costa Rica. This guide offers a free service to help patients with referrals to the top clinics for their needs. Most patients fill out a form and then receive a referral to a recommended clinic. It’s reliable, fast and simple. Most patients find that this service was invaluable for navigating the many dental clinics in Costa Rica.

Visit GCR.org to see the ratings of the leading dental clinics in Costa Rica. Global Clinic Rating has compiled statistics and patient reviews from 126,000 dental clinics around the world. This is an authoritative site to help patients find the best dental clinics in Costa Rica.

Visit the Google Business Page for dental clinics in Costa Rica. If the clinic doesn’t have a Google business page, consider another clinic. The best clinics will have hundreds of patient reviews, not just a few. Clinics with scores of five-star Google reviews have proven their value and demonstrated their quality and reputation. It’s always best to choose the clinic that has high Google reviews and rankings.

Personal Recommendations - If you know someone who’s been to Costa Rica and was satisfied with the dental work, consider using that person’s dentist. If you don’t know anyone who’s had work done there, put the word out to friends and family and see if anyone volunteers a name or two. If you don’t know anyone that has received dental care in Costa Rica, check the leading clinic websites for patient referrals. The best dental clinics have a patient ambassador page that includes the name and contact information of satisfied patients. This allows you to contact patients directly to learn about their experience.

Visit Clinic Websites - Check for accreditations, credentials, and other important details like awards and clinic photos. Look at news releases to gauge how much media attention they’ve received. Browse some message boards and forums to see what other people are saying about the practitioners you think you’d like to see.

Form a Relationship - Establish a relationship with one of more providers by e-mail and phone. Introduce yourself and explain who you are and what you need done. Ask for references from other patients, and discuss costs, post-op care, and anything else you’re concerned about. You’ll know soon whether the clinic is the real deal or not.


COSTA RICA DENTAL PROCEDURE COSTS Below is an average cost comparison for the most popular dental procedures that are being performed in Costa Rica . Each case is different and through your x-rays and initial consultation with the dental clinics, they will determine what specifically you need for your dental work .

Dental Procedure USA Average Cost Costa Rica Average Cost

All on 4 Dental Implants- Full Mouth (2 Arches) $59,200 - $78,600 $21,000- $30,000

All on 4 Dental Implants- Single Arch Replacement $34,200 - $41,800 $10,650 - $15,000

Titanium Dental Implants $2500 - $4000 $800 - $995

Dental Crown on Implant $1500 - $2000 $750 - $900

Dental Crown over Natural Tooth $1200 - $1500 $400 - $600

Porcelain Veneers $1200 - $2500 $400 - $500

Dentures $1500 - $2500 $700 - $1,200

Sinus Lift $3500 $1250 - $1800

Root Canal Treatment $900 - $1200 $350 - $500

Bone Grafting $3500 - $4500 $350 - $750

Teeth Whitening $600 - $750 $250 - $400

Cost savings for dental tourism procedures are typically anywhere from 50-80% over costs for the exact same treatment and materials as you

would find in the USA or Canada .


COSTA RICA DENTAL PROCEDURES: What to Expect?

Dental tourists should be in contact with the dental clinic of their choice and have a scheduled appointment before their plane touches down in Costa Rica. All clinics should walk you through the details of your procedure or

consultation process before arrival at the clinic.

The best clinics will take the time when you arrive to meet with you, conduct a clinical examination and discuss your treatment plan in detail, taking the necessary x-rays and CT scans to ensure that your treatment

proposal is accurate and thorough. Following is a summary of the patient experience for specific procedures in Costa Rica.

What to Expect with Each Dental Procedure?



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A full mouth restoration, also known as full mouth reconstruction, is an intensive cosmetic dental treatment implemented when an individual has a number of damaged, missing or worn teeth. The aim of full mouth restoration is to bring back the function to the mouth and improve the overall aesthetics.

The full mouth restoration process involves a series of dental treatments, typically including one or more of the following:

• Dental Implants (i.e. All on 4, All on 6 and All on 8)

• Dental Crowns

• Dental Bridges

• Porcelain Veneers

• Inlays

The extent and number of procedures will depend on the individual. Your dental clinic will help you choose the correct treatments to achieve your desired results. Several appointments and sessions will normally be required to complete a full mouth restoration.

If you need extractions, bone grafting and/or sinus lift augmentation; you will need to complete these procedures about 4 to 6 months prior to the final phase of the full mouth restoration.

Full mouth restorations allow the patient to receive a complete restoration of their teeth over several appointments. Typically the patient will have their mouth fitted with temporary crowns or a temporary removable or fixed denture. After the dental implants have healed over a period of six months, the patient will receive the final fixed dentures or bridges. It takes less time for patients to receive their permanent porcelain crowns which will replace the temporary crowns.

A full mouth restoration can be a life changing experience for anyone that has suffered from tooth decay, missing or broken teeth or a lifetime of dental problems.

If the thought of having your entire mouth worked on in one sitting is too much, consider allowing for more time to complete the procedures. Most dental tourism clinics

will work diligently to complete as much as possible to complete your work in a timely manner. If you can give them more time, they can space your appointments to give you more time in between your dental appointments.

Full Mouth Restoration Procedure

Pre-Full Mouth Restoration Preparation

• Professional review of your medical history.

• Impressions of your dentition are made after performing a cleaning and removal of tooth decay.

• The impressions are taken to the lab to fabricate your new teeth or full arch prosthesis. Some clinics in Costa Rica have on-site dental labs to expedite the process.

• Temporary crowns or prostheses will be placed until the permanent crowns/bridges/prostheses arrive.

• For dental implants, the surgeon will determine if the patient is a good candidate for implant placement.

• Dental implants are screwed into the jawbone and tested. Most implants are made from titanium.

• The implant then allows for a false tooth or set of teeth to be affixed permanently to the jawbone. There must be enough bone available to support the implants and the new teeth.

After the Procedure:

After the procedure, the mouth will remain sore for some time. Often the dentist will fit the replacement crowns to help correct problems with an over or under bite or with other bite problems. This may also cause some soreness as the body adjusts.

Alternately, the dentist may measure the jaw and recommend an orthotic appliance to help adjust the patient’s bite for several weeks or months. This can help restore a natural bite in

FULL MOUTH RESTORATION



conjunction with the new dental restorations. Some dentists will work with one tooth and restore it before moving to other teeth. This may help alleviate some of the pain associated with restorations and improve the patient’s overall experience.

After the Procedure – The First Day

You will find your teeth remain sore and sensitive to hot and cold for several hours to days following the procedure. There are many over-the-counter products that can help with this, although you can also ask your doctor for some products or prescription medications that may be more powerful or helpful in coping with this. Most patients recover well and are encouraged to eat a normal diet within a day or so following surgery. A diet of softer foods is always recommended for these first days following surgery.

Patients missing all or most of their teeth would benefit most from the All on 4 full arch replacement dental implant system that effectively provides the patient with a full set of teeth in the mouth. This is considered a permanent solution if you have lost all your teeth or if the remaining teeth are in poor condition and must be removed. The fixed dental implants provide patients with a long-term teeth replacement and allow for normal eating and smiling.

Benefits

• Let’s you eat and function like having natural teeth

• A solid, stable solution that will serve you for life

• Preserves your facial appearance and prevents bone loss

The Treatment Options Involve:

1) Installation of 4-6-8 dental implants per arch and restoration of the implants with a fixed porcelain bridge often replacing 12-14 teeth. This is a highly customized solution

requiring the individualized fabrication of each tooth from a highly skilled ceramist. However, many patients choose zirconia milled arches, which are a highly aesthetic and durable solution. The results are unmatched in terms of the appearance, feel, fit and long-term maintenance. For ideal results, this solution is often selected soon after tooth loss, where patients have the full volume of the jawbone. Patients that wait for years after losing their teeth may find that they have diminished bone quantity and may need bone grafts before placing the dental implants. It is not uncommon for long term denture wearers to select this option. However the quality and volume of the remaining bone will need to be determined prior to placement of the implants.

2) Installation of 4-6-8 dental implants per arch and restoration of the implants with a fixed acrylic hybrid bridge. This solution is often called a fixed hybrid bridge because it combines the use of acrylic denture teeth on a custom framework secured to the dental implants. This option represents

ALL ON 4: FULL ARCH REPLACEMENT

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a more economical solution in terms of materials but provides the same level of secure fit as a bridge. The specific solution to full arch dental implant tooth replacement depends on the patient’s desires and expectations. Often a detailed consultation will aid in the decision process. The dentist’s insight and knowledge will help the patient chose the correct solution that is best.

All on 4 Dental Implants: Full Arch Replacement Procedure

The course of treatment described here is one of several options available. Consult your dentist to find out what the best solution is for you, given your specific condition. This provides a general idea of what the procedure will involve. The patient experience will vary by clinic and by patient need.

The treatment procedure and number of visits is largely dependent on the specific conditions. However the entire surgical phase is completed in just one visit with the prosthetic teeth secured to the implants that day. Most patients report that they were much more comfortable following the procedure than they had anticipated.

1: Before the Procedure

The dentist determines what needs to be done and prepares both himself and the patient for the coming treatment procedure.

2: Installing the Implants

The first step is installing dental implants. In an All on 4, four dental implants are used. Temporary teeth are attached that enable you to eat and function like normal while waiting for the permanent bridge to be installed 6 months later.

3: Attaching the Bridge

The final bridge is securely installed on top of the implants. With a full jaw replacement like this, it normally takes 2-3 visits to have the bridge completely attached. It is important that the patient remains in Costa Rica long enough to ensure that the bridge is firmly attached, especially after the swelling is reduced following the dental implant surgery. Patients that return home too quickly after surgery often find that their bridge is loose-fitting.

4: End Result

Your new teeth should be hard to tell from natural teeth – both for you and others. People who have had traditional dentures before getting a fixed bridge often describe this as an overwhelming and very positive experience. For those who have lived many years without teeth, unable to eat properly or to smile, this moment of seeing your beautiful new smile can be overwhelming.


DENTAL IMPLANTS

Dental implants are meant to take the place

of missing, lost or broken teeth. Providing

a base for artificial or replacement teeth,

dental implants are a prosthetic that tend to

look a lot more natural and work far better

than other alternative replacements. In

most cases, a crown is placed on top of the

implants for a full replacement.

Dental implants are artificial roots and teeth

(usually titanium) that are surgically placed

into the upper or lower jawbone. The teeth

attached to implants are very natural

looking and often enhance or restore a

patient’s smile!

Dental implants are very strong, stable,

and durable and will last many years,

but on occasion, they will have to be re-

tightened or replaced due to normal wear.


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REASONS FOR DENTAL IMPLANTS• Replace one or more missing teeth without affecting adjacent teeth .

• Resolve joint pain or bite problems caused by teeth shifting into missing tooth space .

• Restore a patient’s confident smile .

• Restore chewing, speech, and digestion .

• Restore or enhance facial tissues .

• Support a bridge or denture, making them more secure and comfortable .

TWO PROCEDURES FOR DENTAL IMPLANTSYour dentist will direct you into which one of these procedures is optimal for you specifically. It is important to note that only two types of specialists are qualified to place dental implants. Specifically, only periodontists or oral/maxillofacial surgeons are qualified to place implants. Many clinics in Costa Rica offer dental implants, but very few have the proper specialists on staff to place your implants. Be certain that your chosen clinic employs a periodontist or oral or maxillofacial surgeon to place your dental implants. There is no such specification as a “dental implantologist”…so be wary of clinics that promote low-priced implants without the proper specialists.

Traditional Dental Implants This involves placing the implants and providing the tooth restorations after 6 months. This time is needed for the gums and bones to heal before the permanent bridges or dentures can be attached.

Same Day Dental Implants (IMMEDIATE LOAD DENTAL IMPLANTS)

This involves placing implants in patients and performing tooth restorations either on the same day or within a day or two. There is a minimum amount of bone that is required. The implant must also resist a minimum of 40 ncm of force. This procedure is often not recommended for dental tourists as is had a much higher failure rate when compared to traditional two stage dental implants.



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Before the surgery, your surgeon will review your medical history and talk with you about the different types of implants to see which will best suit your needs.

There are two main types of implants:

Endosteal: These dental implants are placed in the jawbone. Typically made of titanium and shaped like small screws, they are the most commonly used type of implant.

Subperiosteal: These dental implants are placed under the gum but on, or above, the jawbone. This type of implant may be used in patients who do not have enough healthy natural jawbone and cannot, or do not want to, undergo a bone augmentation procedure to rebuild it.

If your jawbone is not able to support dental implants, several techniques can be used to rebuild bone, restore your natural jawline and provide a sturdy foundation for implant-supported teeth. These include:

Bone augmentation: This involves restoring or regenerating bone in your jaw when it is not able to support implants otherwise. Research shows that using bone additives and growth factors to fortify the bone generally achieves the best results.

Sinus lift: Also called sinus augmentation or sinus elevation, this involves adding bone below the sinus in cases where natural bone has deteriorated due to missing upper back teeth.

Ridge expansion: If your jaw isn’t wide enough to support dental implants, bone graft material can be added to a small ridge, or space, created along the top of your jaw.

THE PROCEDURE:

• The dental surgeon will place you under anesthesia. Today, many patients are choosing IV Conscious Sedation, which results in little or no pain for the patient.

• The process begins with the surgical placement of the dental implant(s) into the bone.

• After surgery, there is a healing period of approximately four to six months. During this time, the implants fuse to the bone and become permanent…just like real teeth.

• The dentist attaches the post to the implant. The post supports one tooth or a set of teeth.

• The prosthodontist will take impressions and make a new tooth that will attach to the post.

• When completed, you’ll have a mouth full of beautiful, functional new teeth!

POSSIBLE COMPLICATIONS

As with all surgeries, dental implants surgery does come with some possible complications. You could have a reaction from the anesthesia. You could go into surgery only to discover later that the implant does not work properly with your jaw. Your dentist may decide you are not the best candidate for surgery. It is far better to discover these things before you go to surgery than when you are in the middle of surgery. Fortunately most complications including bacterial infections can be cleared easily with an antibiotic, some talk therapy and a little TLC.

There are cases where implant surgery does not work because the body rejects the implants. This happens rarely, in approximately 1-5% of cases.

TRADITIONAL DENTAL IMPLANTS PROCEDURE



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SAME DAY DENTAL IMPLANTS PROCEDURE(Immediate Load Dental Implants)Same day implants (also known as immediate load dental implants) are not complex procedures but they do involve fulfilling certain criteria. There is a minimum amount of bone that is required and the placed implant has to be in a position to resist a minimum of 40 ncm of force. The dentist has to adjust the temporary crown in a manner to avoid any kinds of forces on it during function. Fulfilling these criteria helps the bone to develop around the implant.

A crucial success factor in immediate load implants is removing the tooth effectively but without removing any bone in the process. A thin instrument called a periotome, is employed to separate the root from the bone. The socket for the implants will be prepared with sequentially sized bone drills designed for perfect placement of the implant. The implant is placed and tested for fragility by applying suitable force with the help of a torque wrench.

This is followed by an immediate abutment and temporary crown. This process is called Osseo Integration. In the previous stage, the dentists make sure that the implant size and the bone surrounding the area provide enough anchorage for these items.

An X-ray is usually taken to confirm the successful implant. The entire process takes about 15 to 20 minutes (for 1 tooth) and in 30 days patients can have their permanent crown fixed.

Not everyone is a candidate for same day dental implants. It is more important to get the operation done correctly than quickly. Your dentist will help you decide if you fit the criteria for Same Day Dental Implants (Immediate Load Dental Implants). Most patients that come to Costa Rica for dental care are advised not to seek same day dental implants as they come with increased risk of failure.

Questions about treatments?

Call Toll-Free: (866) 406-2744

[email protected]


DENTAL CROWNSA dental crown covers a single tooth and lend stability and support to an

otherwise weakened tooth. There are lots of reasons teeth become weak.

Tooth decay can for example, cause teeth to become weakened.

Often dentists will have to remove decay to leave a tooth much smaller

than it was prior to the decay. A crown is put in place to help stabilize

and support the tooth.


Dental crowns are used when there is a need to:

• Protect a weak tooth or to fix a broken tooth

• Restore a broken or a worn out tooth

• Cover and support a tooth with a large filling when there isn’t much tooth left

• Keep a dental bridge in place

• Cover misshaped or severely discolored teeth

• Cover a dental implant

TYPES OF CROWNS(Different Dental Clinics Offer Different Options)

• PFM: Porcelain Fused to Metal Crowns: Porcelain is fused to metal crowns to achieve a more natural-looking crown. With time, these metal crowns form a silver line at the gum as it recedes from the tooth.

• Porcelain Crowns: These crowns can be fully porcelain, which maintain a natural, lustrous-looking appearance.

• Zirconia Crowns: Zirconia crowns are very durable and long-lasting. They also have a very natural appearance.

DENTAL CROWNS PROCEDURELittle if any preparation is needed prior to surgery. Your dentist will let you know if you need to stop taking any medications prior to the procedure, but do not do so without your doctor’s advice.

The Dental Crown Procedure:The procedure starts by stripping off the enamel of the tooth where the crown is going to be placed. This process cannot be reversed; once the tooth is destroyed permanently there is no going back.

Depending on the type of crown to be used, the dentist may do one of several things. If a gold crown or cap is to be used, a dentist will take a mold and send it to the laboratory for manufacturing. In these cases once the mold returns, then it will be fitted. Some dental clinics have the ability to do this on site to reduce the amount of time.

In other cases the dentist will make a mold during surgery and fit it during surgery. This is often the case when a dentist decides to use a porcelain crown. In this case just one porcelain mold may be necessary.

After the Procedure:Many people will notice their new crown is sensitive to hot and cold sensations during the first few days. This is normal and will diminish in the first few hours and days after treatment. If you continue to feel pain one week following your dental crown placement you should talk to your dentist immediately.

Possible Complications:Some people find their new dental crowns feel sensitive following treatment. There are many desensitizing agents available over-the-counter or that your dentist can apply. Some prescription medications are also available that can help.

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DENTAL BRIDGES

As the word implies, a “bridge” literally bridges the gap created by one or more missing teeth. A bridge is comprised of two crowns on either side of the gap and a false tooth (or teeth) in between. These false teeth are called pontics and

can be made from gold, alloys, porcelain or a combination of these materials. The resulting dental bridge is supported by

natural teeth or implants.

The dental bridge helps replace the gap left between missing teeth, usually one or more missing teeth. Dental bridges

are not the same as dentures because the dentist will permanently place a dental bridge in the mouth, so you can’t

remove the bridge.


REASONS FOR DENTAL BRIDGES• Tooth loss due to disease

• Tooth loss due to decay

• Tooth loss because of injury

• To help correct eating and speaking functions

TYPES OF DENTAL BRIDGESTraditional Bridges: These are the most common. A crown is made for the tooth (or implant) on either side of the missing tooth, with a pontic (false tooth) in between. Material used is either porcelain fused to metal or ceramic.

Cantilever Bridges: These are used when there are adjacent teeth on only one side of the missing tooth (or teeth). The process and materials are similar to those used in traditional bridges.

Maryland Bonded Bridges: These are made of plastic teeth and gums supported by a metal framework, Metal wings on each side of the bridge are bonded to the existing teeth on either side.

Zirconia Bridges: These are made from Zirconium oxide, an extremely tough dental ceramic. Compared to conventional bridges, there is less tooth sensitivity, no gray coloration around the edge of the gums, and no problems with allergic reactions.

DENTAL BRIDGES PROCEDUREPre-Bridge Preparation

• Your dentist will provide you with any specific requirements about preparation before you receive treatment.

• Please follow basic oral hygiene and need to tell your dentist about any health conditions or medications you currently take that may interfere with preparation or require you to take special health precautions before undergoing any medical procedure no matter how minimally invasive.

The Procedure:

• The dentist will first remove all traces of decay or damage from your mouth.

• The dentist will give anesthesia to numb the site of the bridge.

• The adjacent teeth need to be prepared for the correct taper and accommodate the thickness of the crown. If the adjacent teeth already have fillings, the filling may serve as a foundation for the crown.

• An impression will be then prepared, which becomes the mold from which the bridge, false tooth and crowns will be prepared.

• A temporary bridge is put in place until the permanent one is ready. This temporary bridge helps protect your teeth and gums.

• Once the bridge is created, you will then return to have it placed in your mouth and bonded.

After the Procedure:

At home, it will be important that the patient follows all prescribed steps for a better chance of few to any complications.

Possible Complications

If you fail to take care of your teeth with proper hygiene, cavities could grow around the areas where the bridge bonds, growing deeply into the sides of teeth before they are noted.

This could result in loss of teeth or the need for additional expensive dentistry including full replacement of teeth with implants, crowns, additional bridges or other expensive

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PORCELAIN VENEERSPorcelain veneers are custom-designed thin, artificial shells or

transparent sheets of porcelain or composite resin. These films or shells are created by dentists to fit over the surface of your teeth and

bonded to help create a beautiful, shiny and uniform smile.

Used in restorative dentistry and cosmetic dentistry, customized porcelain veneers or composite tooth veneers are crafted of composite

resin or porcelain to restore the surface look of teeth that are damaged, destroyed or ruined by plaque, disease or trauma.


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Reasons for Porcelain Veneers:• Stained or discolored teeth.• Unsightly gaps between front teeth.• Chipped teeth.• Rough or jagged edges on front teeth• Teeth that are too small or large in

proportion to rest of the mouth.• Crooked or worn teeth.

Advantages of Porcelain Veneers:• Provide a natural tooth appearance.• Gum tissue tolerates porcelain well.• Stain resistant.• The color of a porcelain veneer can be

selected such that it makes dark teeth appear whiter.

• Offer a conservative approach to changing a tooth’s color and shape; veneers generally don’t require the extensive shaping prior to the procedure that crowns do, yet offer a stronger, more aesthetic alternative.

PORCELAIN VENEERS PROCEDUREPre-Veneer Preparation

• Have a thorough discussion with your cosmetic dentist. They will want to know what kind of an image or appearance you want and how much you want to spend on the procedure, etc.

THE PROCEDURE1st Visit

• Your teeth will be prepared by removing a small amount of the front surface of the tooth (about 0.3 to 0.5 millimeter) to make space for the veneer.

• The dentist will take an impression of your teeth which will be used to create your veneers.

2nd Visit• You will try the veneer out. The dentist

will check if the porcelain veneer meets your esthetic and functional needs. If it doesn’t, other try-ins will be arranged until it looks perfect.

• If the try-ins are approved during this visit bonding is done. The tooth is cleansed with some chemicals to achieve a bond. Special cement is sandwiched between the veneer and tooth and a light beam initiates the release of a catalyst to harden the cement.

POSSIBLE COMPLICATIONS• Some people will find their veneers

chip and they require maintenance . Composite dental veneers will erode or become porous with time and may require replacement every five to ten years . Porcelain veneers generally last longer, up to 10 years or more in some patients.

• A porcelain veneer is highly stain-resistant, but coffee, tea, wine, tobacco products, and other chromogenic products can over time stain the cement that is used to bond the veneer and the tooth.

• Porcelain veneers are durable and strong, but they are not designed to withstand sharp impacts. Biting fingernails, etc., and striking them with hard objects may cause them to break.

The fundamental difference between porcelain veneers and other dental restorations is that very little tooth reduction is needed. Also,

porcelain veneers are used only when it’s just the outside of your

teeth (the side that shows when you smile) that needs repair.



There are two types of dentures – complete and partial dentures. Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain. A partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.

FULL DENTURESConventional Dentures: These are made after any existing decayed or damaged teeth have been removed and the gum tissue has begun to heal. These dentures are placed in the mouth about 8 to 12 weeks following removal of the teeth.

Immediate Dentures: These are made in advance and can be positioned in your mouth as soon as the teeth are removed, so you’re not without teeth during the healing period. However, since bones and gums shrink over time (and especially during the healing period after tooth removal), immediate dentures require follow-up adjustments to ensure a proper fit. For this reason, they’re considered a temporary solution until conventional dentures can be fitted.

PARTIAL DENTURESPartial dentures consist of replacement teeth attached to a plastic base that resembles your gums. These replacement teeth are connected by a metal framework that holds the denture in place. Partial dentures are used when one or more of your natural teeth remain in your upper or lower jaw. A permanent bridge replaces the teeth in between, with the denture filling the space. Besides filling the gap, the partial denture prevents existing teeth from changing position. The partial denture is removable, and since the attachments are internal the appearance is considerably more natural.

Reasons for Dentures:

• Complete Denture – Loss of all teeth in an arch.• Partial Denture – Loss of several teeth in

an arch.• Enhancing smile and facial tissues.• Improving chewing, speech, and digestion.

DENTURES & PARTIAL DENTURES PROCEDURE

Pre-Denture Preparation

The dentist will review your medical history and take an impression of your teeth. The dentist may also perform an extraction or two to ensure the denture will fit right, prior to taking a mold of your teeth.

The Procedure:

• The loose teeth will have to be extracted or you may need treatment to get your gums in good health before the denture procedure.

• The dentist will create a mold or impression of your mouth so the dentist can take exact measurements of your mouth size and shape.

• The dentist will create wax forms or plastic patterns in the exact shape and position of the final denture. You may need to try this model many times.

• The denture will be checked for color, shape, and fit before it is finalized.

• Your dentures will be crafted in a dental laboratory and then placed in the clinic.

POSSIBLE COMPLICATIONS

• Pain - first time denture wearers as well as seasoned denture wearers will find themselves suffering sore gums from time to time for various reasons.

• Loose Fitting - over time the shape of the gums may change and dentures may no longer conform to the new shape. Dentures may become loose and ill-fitting and rub against the guns causing pain.

• Swollen gums - ill-fitting dentures can lead to friction against the gums and eventually swollen or bleeding gums.

• Gagging - this may be due to the thick dentures or over extended dentures. This can be solved by reducing the thickness and the overextended part of

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the denture. Sometimes the gagging is because of psychological reasons that may restrict the patient from wearing the denture. It is difficult to overcome that. In such cases palate less dentures with denture implants are recommended.

• Increased Salivation - after dentures are first fitted, the wearer may have increased salivation. This is a short-term problem.


SINUS LIFT SURGERY

Sinus lift surgery is a bone graft procedure.

It is performed in order to prepare a site for a dental implant in the upper jaw. Sometimes, when a patient has elected to have a dental implant, it may be necessary to have a sinus

graft performed prior to insertion of the implant.


REASONS FOR SINUS LIFT SURGERY

• People who have lost teeth in their upper jaw — particularly the back teeth, or molars — do not have enough bone for implants to be placed. Because of the anatomy of the skull, the back of the upper jaw has less bone than the lower jaw .

• Bone may have been lost because of periodontal (gum) disease .

• Tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be resorbed (absorbed back into the body). If teeth have been missing for a long time, there often is not enough bone left to place implants.

• The maxillary sinus may be too close to the upper jaw for implants to be placed. The shape and the size of this sinus vary from person to person. The sinus also can get larger as you age.

ADVANTAGES OF SINUS LIFT SURGERY

• For patients with anatomical structures that do not provide enough space for dental implants, sinus lift surgery will certainly be advantageous. Also, patients with bone loss, either as a result of gum disease or as a result of certain cancer treatments, will also benefit from a bone graft procedure and dental implants. Obviously, if a patient wants to have dental implants, a firm, supportive base is necessary to support the implants, and the only way of achieving this satisfactorily for some patients is a sinus lift.

DISADVANTAGES OF SINUS LIFT SURGERY

• One of the biggest problems in sinus lift procedures is the time factor. Post-surgery it may take at least 6 months, and sometimes longer, before implant surgery can take place. The repeated surgical processes involved - at least three - is time-consuming and also adds greatly to the cost. Any surgical procedure involves risk, including damage to the sinus membrane, infection to the bone graft and non-integration of the bone graft with the natural bone.

SINUS LIFT SURGERY PROCEDUREPre-Sinus Lift Preparation

• The bone used in a sinus lift may come from your own body (autogenous bone) or from a cadaver (allogeneic bone).

• If your own bone will be used in the sinus lift, it will be taken from other areas of your mouth or body. In some cases, the surgeon removes bone from your hip or tibia (the bone beneath the knee).

• You may need X-rays taken before your sinus lift so the dentist can study the anatomy of your jaw and sinus. You also may need a special type of computed tomography (CT) scan. This scan will allow the dentist to accurately measure the height and width of your existing bone and to evaluate the health of your sinus.

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The Procedure

• Your surgeon will cut the gum tissue where your back teeth used to be.

• The tissue is raised, exposing the bone.• A small, oval window is opened in the bone.• The membrane lining the sinus on the other

side of the window separates your sinus from your jaw.

• This membrane is gently pushed up and away from your jaw.

• Granules of bone-graft material are then packed into the space where the sinus was. The amount of bone used will vary, but usually several millimeters of bone is added above the jaw.

• Once the bone is in place, the tissue is stitched closed.


• The main risk of a sinus lift is that the sinus membrane could be punctured or torn. If the membrane is torn during the procedure, the surgeon will either stitch the sinus tear or place a patch over it. If the repair is not successful, your surgeon may stop the procedure and give the hole time to heal.

• Infection is a risk of any surgical procedure. However, this rarely occurs after sinus lifts.

• On rare occasions, the existing bone does not integrate with the bony graft material, and the grafted area does not develop a blood supply. If this happens, any implants placed in this area will fail because there is no live bone for them to attach to. If this happens, you can have the sinus lift procedure repeated.

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SIGNS THAT YOU NEED ROOT CANAL SURGERY

• You have a severe toothache and it intensifies upon chewing or application of pressure.

• You have had prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed).

• You have tooth discoloration or darkening.• You have tenderness and swelling in the

nearby gums.• You have recurring or persistent pimple on the

gums.

ROOT CANAL SURGERY MYTHS

• Root Canal Therapy Is Painful - Root canal therapy is used to alleviate pain. Most people who have root canal therapy admit they did not experience any pain during the appointment and felt better afterward.

• Completing a Root Canal Requires Several Appointments - Root canal therapy may be completed in one to two appointments.

• Root Canal Therapy Causes Illness - The idea that bacteria trapped inside an endodontically-treated tooth will cause illness, such as heart disease, kidney disease, or arthritis, stems from research conducted by Dr. Weston Price from 1910 to 1930 -- almost 100 years ago. Recent attempts to confirm Dr. Price’s research has been unsuccessful in proving that root canal treatment causes illness.

• Teeth Need to Hurt Before Root Canal Therapy Becomes Necessary - Teeth that require root canal therapy are not always painful. In fact, teeth that are already dead may require root canal therapy to prevent the tooth from becoming infected.

• The Benefits of Root Canal Therapy Don’t Last Very Long - This myth originated after patients experienced their tooth breaking months after a root canal was performed on their tooth. Technically, it is not the root canal that has failed; it is the restoration on the tooth that has failed.

ROOT CANAL PROCEDUREPre-Root Canal Preparation

Get rest. If you are not feeling well or running any kind of temperature be careful as you don’t want to have a weakened immune system when undergoing this type of procedure. You will need your immune system strong to help combat or fight any infection.

The Procedure:

• An X-ray is taken to see the shape of the root canals and see if the infection has spread to the surrounding bone. Local anesthesia will then be given to numb the area surrounding the tooth. Anesthesia in most cases is not required, because the nerve is dead, but is still given to put the patient at ease.

ROOT CANAL SURGERYA root canal is the main canal within the tooth. The root canal contains the pulp chamber,

filled with dental pulp. This pulp is susceptible to decay or inflammations because of various factors like caries, bacterial attack, etc. The process of removing this infected tissue

is known as root canal treatment.

Root canal therapy, or endodontic treatment, is required when the pulp inside your tooth becomes inflamed or infected. There are many reasons why this can happen —

deep decay, repeated dental procedures on a tooth, or a crack or chip in the tooth that leads to damage to the pulp inside.



• The area to be treated should be kept dry. A rubber sheet is placed around the tooth to prevent saliva from making the area moist.

• An access hole is then drilled into the tooth. The dental pulp along with the infected and decayed nerve tissue and other debris is removed from this hole, using root canal files. A series of these files of increasing diameter are put through the access hole to clean the sides of the root canals. The debris is flushed with water or sodium hypochlorite.

• After the tooth is completely clean, it is sealed. If the root canal cannot be finished on the same day, a temporary filling is placed in the exterior hole in the tooth to keep contaminants out between appointments.

• A sealer paste and a rubber compound is placed in the root canal, and the tooth is filled.

• A tooth that needs a root canal also usually needs further restoration like a crown or a post. This is now done to protect the tooth and restore it to a healthy state.


If a root does become infected or an abscess does grow because the infection spreads past the roots of the tooth, several severe side effects can occur including:

• Swelling that can occur in the head, face and neck.

• Bone loss especially at the tip of the root.

• Holes in the side of the tooth or problems with drainage into the gums.

• The seal of the root canal breaks down over time, and this can allow bad bacterial to re-contaminate the tooth resulting in further decay.

Call or email to book an

appointment today:

Toll-Free: (866) 406-2744

[email protected]

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BONE GRAFTING

Bone grafting replaces missing bone lost from previous dental extractions, injuries, accidents, cysts, periodontal

disease, infections along with many other causes. Although these

procedures increase the cost of dental implants, they also help create more

cosmetic and often more durable restorations.

A bone graft replaces the bone that has been lost with material from the

patient’s own body (autogenous bone) or with a natural, artificial, or synthetic

substitute. In most cases the goal of the dentist is to generate new healthy

and natural bone in the area of the procedure.


POSSIBLE REASONS FOR NEEDING BONE GRAFTING:

• Missing teeth: If the patient has been edentulous (toothless) for a long time, bone absorption accrues gradually.

• Trauma: Any accident that causes bone loss.

• Periodontal Disease: Infection may affect bone mass.

• Genetics: Inheriting a specific jawbone anatomy.

TYPES OF BONE GRAFTS MATERIAL:

• Autogenous Grafts: The patient’s own bone is taken from other areas in the mouth. Rarely, bone may be taken from areas outside the mouth like the hip or the shin bone. Bone from the hip is considered the best because the hip bone has a lot of marrow (soft tissue within the bone), which contains bone-forming cells.

• Allografts: An allograft is a graft between genetically dissimilar members of the same species. An allograft may be obtained from living donors who are having bone removed during surgery or cadaveric donors. Allograft material has been used for more than 30 years in periodontal therapy. There are several types of allografts: (i) Fresh; fresh-frozen allograft (ii) Freeze-dried bone allograft (FDBA) (iii) Demineralized freeze-dried bone allograft (DFDBA)

• Xenografts: The bone is taken from another species, usually from a cow. The bovine bone is specially processed to make it biocompatible and sterile.

• Alloplastic Grafts: These grafts are man-made from synthetic materials, normally a type of calcium phosphate as this mimics natural bone. Grafts of this kind can be replaced, over time with natural bone as they are resorbed into the body and encourage natural bone growth. Some alloplastic grafts are made from material which cannot be resorbed by the body and instead these will act as a scaffold on top of which natural bone can be built.

BONE GRAFTING PROCEDUREPre-Bone Graft Preparation

X-rays will be made of your jaw and teeth to ensure that a bone graft is the right treatment for you. Bone grafting will only take place after your dentist has assessed the quality and quantity of the bone in your jaw and found that there is not enough to continue with a dental implant. Your dentist will then discuss the different types of bone graft with you and you will decide which will be the most suitable.

The Procedure:

• A local anesthetic will be applied to both areas being affected, the recipient site, (where the bone will be grafted onto), and the donor site, (where the bone will be taken from).

• Incisions will be made into the gum in order to determine the amount of bone necessary.

• The gums will be cut under your lower front teeth, if it has been decided that this is where the donor bone will be taken from, and a section of bone removed with the marrow. The bone is usually replaced with a synthetic material, and then stitched over.

• A membrane will be placed over the area where the bone was in order to protect against the soft tissue invading the site.

• Small holes will be made in the bone along the recipient site to produce bleeding, so allowing blood to make contact with the new bone and start the healing process.

• The new bit of bone is secured into place with screws and then bone marrow and other materials are placed around the edges of the new piece of bone.

• The area will be stitched up.

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• Infection is a risk of any procedure that punctures the skin. If caught early an infection can be easily treated with antibiotics but otherwise can cause serious health problems.

• The bone will be rejected by your body. This isn’t as common as having organs rejected and usually only occurs due to an infection or because the bone is loose. If this happens you can have another graft put in place at a later date.

• Bone grafting sometimes requires a general anesthetic and an overnight stay in hospital, if the graft is particularly large. This runs its own risks, as a general anesthetic can prove problematic for some people.

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TEETH WHITENINGTeeth Whitening or the whitening of teeth is a procedure often performed for patients that want to improve the brightness of their smiles. Tooth whitening can be performed for several reasons. It often helps reduce discoloration and staining that occurs from

years of drinking too much coffee or tea, or from smoking cigarettes. Some patients also experience discoloration because of medications they took as children or as adults.

• Extrinsic: Theses appear on the surface of the teeth. They are caused by exposure to dark-colored beverages, foods, and tobacco.

• Intrinsic: These stains are those that form on the interior of teeth as a result of trauma, aging, exposure to minerals (like tetracycline) or excessive ingestion of fluoride. Earlier, intrinsic stains were proving too stubborn to be removed by whitening. But, thanks to the advances in cosmetic dentistry, now even the intrinsic stains can be removed.

But the results of teeth whitening are not permanent. They last for a maximum of three years, depending on the method of teeth whitening and your dental hygiene.

Most dental practices offer two types of whitening:

• Surgery Teeth Whitening• Professional Home Whitening Kits

Both procedures are based on a bleaching process that uses a peroxide-based bleaching gel of varying strength (3%-6% peroxide). The higher the concentration of peroxide in the gel, the more powerful it is. While a higher concentration gel is more effective at whitening the teeth, it also has greater potential to cause side effects such as sensitivity and damage to the surrounding gum tissue and your lips.

TWO TYPES OF TEETH STAINS:

Questions about

treatments?

Call Toll-Free:

(866) 406-2744

[email protected]



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PROFESSIONAL HOME WHITENING KITS

To make a professional home whitening kit, your dentist will take an impression (mold) of your teeth using a special dental putty. Your dentist’s technician will then use this to cast a model of your teeth from plaster and make your custom teeth whitening trays from this. Once these trays have been made (usually takes 5-10 days) you use them in combination with professional whitening gel (provided by your dentist) until you are happy with the results.

LASER TEETH WHITENING PROCEDURE

Pre-Teeth Whitening Preparation

Prior to carrying out the procedure you would have a consultation with your dentist to make sure that you are suitable for teeth whitening and to explain possible risks and side effects of the procedure.

The Procedure:

• The dentist will thoroughly clean the teeth, removing any surface stains and tartar. This procedure is commonly referred to as a scale and polish.

• The dentist will make a record of the shade/color of the teeth before the procedure. This is either recorded using a tooth colored shade guide/chart or by taking a digital photograph of your teeth.

• The area is then prepared for the procedure. The bleaching compound usually contains a high concentration of peroxide (up to 6%) and so the dentist will usually place some form of protection around the gums so that only the teeth are exposed to the compound. This involves covering the gums with rolls of cotton and a protective gel material that hardens once applied to the gums. A cheek retractor is used to keep the lips and cheeks away from the teeth.

• The dentist isolates your gums and lips with a protective material in order to avoid any potential damage or burning.

• Eye protection (goggles) is also provided to prevent any damage to the eyes from the laser used or any accidental splashes of the peroxide.

• The whitening gel is then applied to the surface of the teeth and exposed to a light or laser, which activates it. After approximately 15 minutes the gel is removed and the process repeated another 2 times. During the procedure some people may feel sensitivity in their teeth, which are described as short-lived shooting pains.

• The dentist will finally wash off the whitening gel and remove any gum protection before evaluating the final result by taking a photograph or using a shade chart. The results are usually quite dramatic and can often be up to 10 shades lighter.


The biggest risk many associate with tooth whitening procedures is the sensitivity associated with using cosmetic dental products. Fortunately there are several over-the-counter products that can help with this.

What are you waiting for?

Call Toll-Free: (866) 406-2744

[email protected]


3rd Floor – Habitat Empresar ia lEscazú, San Jose

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A Guide to Dental Tourism IN COSTA RICA · • Dental Crowns • Dental Bridges • Porcelain...

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