It was time to see the dentist…
Last October when we were in Porto I managed to chip a previously repaired front tooth. I didn’t even realize it at the time (and neither did Won, which makes me wonder if he’s ever really looking at me, but that would pull me off topic). In fairness, it wasn’t terribly obvious; it was the edge of my tooth, but still…!
I had originally broken it while on a bike ride in Germany in July of 2019. Literally two minutes before the end of the ride I hit a curb which pitched the front tire of my bike violently to the left causing me to lose control. I fell mouth first onto the granite walkway. (Won attempted to put an amusing spin on this by describing it as “flying off my bike and kissing the pavement”. Very amusing, honey.) In addition to a lot of nasty wounds and bruises on my legs, knees, lips, nose, chin, arms and chest, I broke two of my front teeth and pushed a third toward the back of my mouth. To this day, I still can’t believe my good fortune because a dentist also happened to be on the ride (a complete stranger to me!). He rushed over, immediately assessed the damage and was able to pull my tooth back into alignment (after he asked my permission). The accident happened on a Thursday afternoon and by Monday of the following week I was in the chair of my local dentist in Chester, New Jersey to deal with the rest of the damage.
Back to present time. Since the new break wasn’t glaringly obvious, I dragged my feet when it came to getting it fixed. Up to this point we had not identified a dentist for our oral care needs. We have no excuses for that other than moving to another country, navigating the process of getting settled, coping with COVID-19 restrictions, galivanting all over the country to see as much as we could, and spending the rest of the time trying to get our car legalized and registered. Finally, just before the end of the year, I decided it was time to get past this irrational procrastination. Besides, we both needed to get back to regularly scheduled cleanings.
Won and I had driven past a local dental practice called Alinea Premium Oral Care for months and while out walking one day, I decided it was time to deal with my snaggle tooth. We stopped in and were instantly pleased; the office was light, airy, and modern. The two young women at the front desk both spoke perfect English (and French and Portuguese and Danish!).
I scheduled an appointment to get my tooth repaired and we both scheduled dental hygiene appointments.
I was able to see Dr. Gabriela within a few days for the repair work. Dr. Gabriela received her degree from Columbia University in New York City and spoke perfect English. She did an amazing job at fixing that front tooth. You would never know it had been broken. Yay! I returned to the clinic the following week for my regular cleaning. In between my appointments, Won went in for his cleaning and, after a separate consultation appointment to discuss a missing molar, decided to get a dental implant done. The reason I’m sharing all of this is because I want to compare and contrast the experience we had, quality of care, techniques and technology used, and cost to what we have encountered in the US.
NOTE: While writing this post, I finally decided to check and see where the Euro symbol should be placed when referring to currency. Not surprisingly, I made a classic American-centric assumption that it should be placed in front of the number where the dollar symbol typically goes. The euro symbol typically follows the number. (And here I was feeling really good that I was using the correct decimal formatting when I was blowing the currency symbol placement all along…groan.) I’m going to immediately begin using the right format and will correct all my earlier posts as I go back and re-read them over time. Back to the story…
Alinea utilizes modern and sophisticated tools and technology. X-rays for example; instead of the old method of shoving an uncomfortable plastic form full of right angles into the back of your mouth and up against the soft tissue of your palate, aiming a big “x-ray gun” at your jaw, and having the technician run outside the room to click the button before running back in to remove it, Alinea uses a panoramic x-ray machine that circles around your head while you stand still biting (very comfortably) on a small piece of plastic placed between your front teeth that is a part of the equipment itself. So much better!!
I was also delightfully surprised at the dental cleaning process. Instead of jumping right in with metal scraping tools, my hygienist, Ana (who also spoke great English), used an ultrasonic cleaning tool that shot a high powered stream of warm water mixed with a solution that dissolved and removed the plaque (aka calculus or tartar) on my teeth. She followed that up with a machine called an Aquacut Quarttro that also uses a jet of pressurized warm water mixed with a special powder that gently removed any staining I had revealing whiter teeth. She completed the cleaning with about 20 seconds of teeth scraping and the requisite flossing (apparently Won didn’t even need the scraping). I nearly fell out of the chair it was so easy and fast – albeit a bit moist with the water spray, but I didn’t care. She finished up with a tray of fluoride. She explained that Portugal doesn’t add fluoride to the water so they administer it at the dental clinics. I had a choice of mint, strawberry or orange flavors – I picked mint.
In addition to those services, she and her assistant took a variety of digital photographs of the inside of my mouth (roof, tongue, under the tongue, bite, etc.), along with external photographs of my face full on, profile, and 3/4 (smiling and unsmiling). She explained that all of these would go into my digital file as reference points should anything happen requiring reconstruction or repair and as a baseline for my oral health. And, finally – this is the one that was really amazing – after she cleaned my teeth she used a space-age looking hand held camera that took hundreds of images of my teeth in about one minute that instantly created a 3-D, rotatable image of my upper and lower teeth and gums! She pulled up a mobile touch-screen monitor and spun the image all around. I could even see the backs of my molars! Impressive. Ana said I was in good shape and used it to show me what she will be monitoring going forward. As if all that wasn’t super dooper spectacular, the exam room had a stunning view of the ocean. Honestly? I can’t wait to go back.
OK…so what did we pay for all this? The dental hygiene appointment was 73,14€ which included a 6% tax. The breakdown of the charges were 39,00€ for plaque removal, 20,00€ for teeth whitening, and 10,00€ for the fluoride treatment (they didn’t charge for the panoramic x-ray, which is normally 20,00€). All of their services and associated costs are posted on their website. The clinic does not accept insurance and we learned after the fact that our coverage doesn’t include dental hygiene appointments, which we also learned is typical here. However, because these services are so affordable we can easily cover the cost. For all other dental services our insurance covers 80% up to 300,00€ per person per year (no co-pay). The repair of my front tooth was 127,20€, therefore, we should receive a reimbursement for at least 96,00€ (not sure if they include reimbursement for a portion of the 6% tax – we haven’t received it yet).
And, what about Won’s dental implant? How does that compare to what it might cost in the US? I had a dental implant when we were still living in New Jersey. Because we had exceptional dental coverage due to my job at J&J, we backed into the total cost of my implant by including the amount covered by insurance in order to compare apples to apples. The total cost for my implant and crown was $6,195.00 (5.078,00€). Insurance covered $3,717.00 (3.046,00€), which means we paid $2,478.00 (2.031,00€) out of pocket. Won’s implant and crown in Portugal will cost 1.970,00€ ($2,403.00) minus the 300,00€ insurance reimbursement for a total out of pocket cost of 1.670,00€ ($2,037.00). That’s about 60% less than the US when you compare the total cost of these procedures and an out of pocket difference of $440.00 for us.
Once again, we are gleefully surprised and so pleased with the quality and cost of care here. I wasn’t kidding when I said I’m actually looking forward to my next appointment.
Let me know your thoughts and reactions. In the meantime, please stay safe, stay healthy, keep smiling, and stay in touch!
From Portugal with love,