Episode Summary
In this episode of The Expat Files, Johnny Mueller dives into the world of dentistry in Latin America, providing an honest and unfiltered look at the challenges expats and locals face. He begins by discussing the state of dental care in the region, noting that while there are some high-quality dentists, they are rare and often cater to a small percentage of the population. Johnny explains that dental laboratories in Latin America often produce substandard crowns and bridges, resulting in unnatural-looking teeth due to poor quality control and inconsistent procedures. He references historical examples from the 1960s to the 1980s to illustrate the issue, comparing the unnatural appearance of crowns from that era to the current situation in Latin America. He also notes that Latin Americans are generally not inclined to complain about poor dental work, which contributes to the persistence of these issues. Finally, he concludes by observing that even among the wealthy in Latin America, the dental work is often mismatched and unnatural, reflecting the broader challenges of the region's dental care system.
Johnny also discusses the prevalence of poor dental hygiene and subpar dental care, even among the wealthy. He notes that missing teeth and bad dental work are common, and that this is due to a lack of dental education, non-confrontational dentists, and a focus on crisis management rather than prevention. He contrasts this with the first world, where dental hygiene is more proactive and enforced through regular checkups and hygienists.
In another segment, Johnny touches on the cultural and dental practices in Latin America, highlighting the contrast between the affluent and the poor. He mentions the prevalence of fluoride in dental products and the widespread use of silver amalgam fillings, which are common despite the lack of holistic dental practices. Johnny also highlights the issue of tooth decay, attributing it to sugar addiction and the lack of access to dental care among the poor. He contrasts the dental health of urban poor with that of rural poor, noting that the latter tend to have better dental health due to a more natural diet and less access to processed foods.
Johnny critiques the lack of continuing education for professionals in the third world, particularly dentists, and highlights how this leads to outdated and potentially harmful practices, such as the continued use of fluoride in water supplies. He contrasts this with the first world, where professionals are required to maintain their skills through continuing education. Additionally, he discusses the common stereotype of an elderly family member who practices self-dentistry, often pulling out his own teeth with pliers, which is common in middle and lower-class Latin American families.
In another segment, Johnny discusses the challenges and opportunities for first-world medical and dental professionals looking to relocate to Latin America. He highlights the appeal of moving due to lower costs, less regulation, and the status that first-worlders hold in the region. However, he also outlines the difficulties of obtaining a license to practice in Latin America, including the need to pass licensing exams and the language barrier. He explains that while third-world-trained professionals often struggle to pass these exams, first-world-trained professionals have an advantage. Additionally, he notes that reciprocity between Latin American countries is limited, and professionals may need to take exams in the specific country they wish to practice in.
Finally, Johnny discusses the phenomenon of gold and silver inlay teeth among lower-income populations in Latin America, particularly among indigenous communities and laborers. He explains that this practice is a cultural marker of class distinction, often associated with poverty and traditional customs. Johnny highlights the financial barriers to proper dental care, noting that even basic fillings are unaffordable for many. He also critiques the unhygienic and often dangerous conditions under which these procedures are performed, emphasizing the lack of regulation and oversight. Despite the health risks, Johnny acknowledges the deep-rooted cultural significance of this practice, which is often abandoned as individuals move into higher social classes.
Topics
Dentistry in Latin America, Quality of dental care, Cultural attitudes toward complaining, Historical context of dental work, Expat experiences in Latin America, Dental care in the region, Comparison to first world dental standards, Role of dental hygienists, Cultural attitudes toward dental health, Dental practices in Latin America, Fluoride debate, Tooth decay and sugar addiction
Chapters
00:00:00 Opening 00:00:34 Dentistry in the Third World Part 2: The Role of Dental Laboratories 00:01:08 The Evolution of Dental Work and Its Impact on Appearance 00:04:39 Mismatched Teeth and Picket Fences: A Comparison to the First World 00:05:17 Missing Back Teeth and the Wealthy Class 00:06:11 The Role of Dental Hygienists and Education 00:09:13 The Contrast Between Affluence and Poverty in Dental Health 00:09:53 The Fluoride Debate and Dental Practices in Latin America 00:13:21 Johnny's Personal Stance on Fluoride and Dental Health 00:13:48 Critique of Outdated Dental Practices and Lack of Continuing Education 00:16:43 The Stereotype of the Elderly Self-Dentist in Latin American Families 00:18:48 The Appeal of Relocating to Latin America for Medical Professionals 00:18:58 Challenges Faced by First-World Medical Professionals 00:20:03 Licensing and Exam Requirements for Practicing in Latin America 00:22:06 The Difficulty of Passing Licensing Exams for Third-World-Trained Professionals 00:23:00 Reciprocity and Language Barriers in Latin American Countries 00:23:31 Introduction to the dental practice among lower-income populations 00:23:54 Cultural significance of gold inlay teeth 00:26:44 Lack of regulation and enforcement in unregulated dental practices
Transcript
Automatically transcribed from the original recording; names and wording may contain errors.
[00:03] Hi everybody, I'm Johnny Mueller and you're listening to The Expat Files, living in Latin America. The show that tells you what it's really like to live, work, play and or retire in Latin America. I tell it just like it is, not the version they give you in those glossy travel magazines, or the picture they paint for you in those international traveler websites, where they're only trying to sell you something. What's it really like for expats living in Latin America? Well, it's time to take off those rose-colored glasses and find out. So let's get started. Now today, like I promised, we're talking about dentistry in the third world part 2. Now the last time I talked about dentistry, I spoke a lot about dentists on the higher end. That 5% of dentists that do almost first world style work when it comes to less complicated
[00:49] procedures depending on the circumstances. And I mentioned that even though these guys look almost first world in appearance and in equipment, there are certain critical procedures you should never let them do in your mouth. Like reconstruction work in multiple crowns and bridges, because the dental laboratories that these guys use are really substandard. Now I'd like to say just one more thing about dental labs down here. If you're old enough, you might remember yourself. Back in the 60s and 70s and even in the 80s, a lot of times you'd know someone up in the first world who'd had a lot of crowns and bridges done in his or her mouth. And when they smiled, you'd see that these crowns and bridges did not look natural because they were just too white. There was something wrong about them. They looked kind of one dimensional and didn't have that nice deep range of colors that you're
[01:35] used to seeing in natural teeth. Because teeth, you know, aren't just one solid color. If you look at the edge, a tooth is kind of translucent there. You can almost see through it in some people. And as you look down the center of the tooth to the part near the gum, it gets thicker and the color of the tooth becomes more substantial and dense. Especially when you're looking at the front teeth in the mouth. Now like I said in the last show about dentistry, there's a real art to making a tooth look lifelike. And the guy in the laboratory doesn't just form a bunch of porcelain goop together and burn it in an oven and then polish it. And send it up to the dentist so he can glue it in your mouth. What he's taught to do is add layer upon layer of different colored porcelains until he gets that natural tooth effect. And if you remember back in the 50s, 60s, 70s and 80s, up in the first world that is, it was often really easy to spot a person who'd had recent porcelain work done in the
[02:23] front of his mouth because it was so oddly unnatural and flat looking. Almost like a white picket fence. Especially if a person had for example just one odd front tooth done from a car accident or a misplaced hockey puck let's say. I mean back then when the art wasn't quite perfected yet by laboratory technicians, your eye went right to that tooth when the person smiled and you knew it was closed but no cigar. And that's why in a lot of Hollywood movies of the period, if you check the close ups, you could spot a lot of unnatural white picket fence smiles. A dead giveaway to the bad porcelain work of that era. But that's all changed up in the first world now. Nearly all the laboratories in the United States use techniques that allow them to make beautiful natural looking teeth that have that translucence that natural teeth have. And these days up in the United States, if you've had porcelain dental work done in the
[03:11] 21st century in the last 10 years, it's rarely pretty difficult for the average man to spot. Because the standards are so high. But down here in the third world, though there are some real artists working in the dental laboratories and the porcelain looks nice, the problem is the quality control stinks and sometimes the colors are just way off. And there's an obvious mismatch. I mean if you're firing up porcelain in an oven and the power goes out for 10 or 15 minutes, which is quite common down here in the third world, the temperature in that oven will drop a bit, that'll change the porcelain color slightly and the crown will come out just a little bit off. And guess what, the laboratory will send it off to the dentist anyway and the dentist will cement it in the patient's mouth and 99 times out of 100, the person won't say a thing, he'll accept exactly what the dentist puts in because Latin Americans are not a
[03:59] culture of complainers. And they almost never complain to authority figures like dentists and physicians. And that's why if you walk around Latin America and take notice of people when they smile, you'll see an awful lot of badly matched dentistry in the front teeth. But to the patients I guess it's better than nothing. I suppose they figure it's that or not have a tooth at all. And in fact I can't tell you how many times I've been to one of these embassy parties where the highest class of movers and shakers and professional politicians and thieves gather to show off their bodyguards and Rolexes and Range Rovers. And these guys have all the money in the world. When they go to the dentist, they're not looking for a deal. But being of a third world mentality, they're not discriminating at all. And when these guys smile, you'll see just as many mismatched teeth and picket fence jobs as you saw commonly up in the first world in the 50s, 60s and 70s.
[04:48] And that's just the kind of less than mediocre dentistry that a first world person would never accept in his mouth these days. But the upper middle classes and the very wealthy down here are a walking testament to the bad dentistry that exists even when price is no object. And another odd thing that you'll notice down here, even with the wealthier classes, so often when a person smiles, he or she will be missing some back teeth. It seems like as long as the front ones are intact and reasonably white, to them it doesn't matter how many back teeth are missing. And of course, that's a far cry from what you see up in the first world. The fact is, up there, if you happen to see someone smile and you notice some gaping holes in the molar and bicuspid areas where teeth used to be, we first worlders almost always jumped at the conclusion that the guy's either a lowlife, has seen some hard times, or is
[05:35] on the skids, or he's a roadie for Willie Nelson. I'm sorry to say it, but it's true now, isn't it? Anyway, down here, even when you're dealing with the wealthy and the upper middle classes, the bigger the smile, the more you're likely to see an obvious black hole here and there where there should be teeth. And what that says to me is that the dental profession itself is not doing a good job at all, teaching the public about dentistry and dental hygiene. Because if you can't motivate your rich people, that small 5 or 10% of your population, that can actually afford to get a modern standard of dentistry, then how are you going to educate the other 80 to 90% of the population that could never afford a root canal or a crown if they needed one? Now, I myself have been to the dentist down here quite a few times, and it looks to me like it's a matter of attitude, and of course, culture. The dentists, like the rest of the population, are very non-confrontational.
[06:23] They're not at all likely to sit you down, point all the bad spots out in your mouth, and give you a lecture about how you're not taking care of yourself and what you should do about it. Instead, they're completely non-confrontational and as nice as can be, and just get down to work. They're so used to patient non-compliance that they're just interested in fixing what problem the patient has at the moment. I've been to so-called high-end dentists down here, and I've never once seen them pull out a periope probe either. You know, the little probe with markings on it, that the hygienist sticks along your gum line to check to see if you have any pockets or gum disease. So there's another big huge flaw in the system down here, because they don't have hygienists, there's just not much dental education. Because up in the first world, the hygienist usually is the one that scolds you for your bad habits.
[07:08] She's the one that reads you the riot act when you're lax. So by the time the dentist walks in, you're apologizing all over the place for being a bad boy, and you gladly take responsibility for what's wrong with your mouth. But down here it's much more raw and basic. The vast majority of Latins, rich or poor, do not go to the dentist on a regular scheduled basis. Normally, dental offices do not schedule routine cleanings and checkups six months ahead, like in the US, Europe and in the rest of the first world. Because they know the people just don't show up unless something's wrong or it hurts. The whole dental business down here is crisis management, not prevention. So naturally, dentists double and triple book their appointments, because they know, if a person calls when his tooth hurts, if you give him an appointment for tomorrow, and when tomorrow comes it doesn't hurt anymore, that person's not going to show up.
[07:56] Anyway, that's usually how it happens. And that's exactly the way dentistry used to be up in the first world, pre-1970s, dentistry by crisis. Back then you only went to the dentist when something broke or it hurt, and dentists and their office managers knew that a good percent of the patients would never make their six month checkup appointment. But by the 1970s and 80s, dental hygienists became a fixture in almost every dental office up north. And it didn't take long before they had us all whipped into shape, and had us coming in for a visit every six months. And it's a good thing too. But down here, bad teeth, even in the rich and upper classes, is one of the first things an expat notices, especially when you get up close and personal with these people. Like at one of those embassy parties I talk so much about. And that's when you see a mix of high-end wealthy people with some very bad dental problems.
[08:44] And they don't even seem to care. And in the back of your mind you're thinking, what's wrong with that guy? Why does he have so many missing teeth when he smiles? What's wrong with his wife? Why doesn't she tell him? Well, the fact is, she's got the same problem. Then, my old pal expat Eddie gave me a good line. He said, when he first came down here, he hadn't seen such bad dentistry since he'd been at a block party at a Texas trailer court. And I know exactly what he means. Because often times when I'm at a party or out to lunch with some of these power brokers, when these guys smile, sometimes I think I'm looking at the front row of a Willie Nelson concert. Only, these guys have bodyguards, Rolexes, and they're wearing Armani suits. Go figure. And when I discussed this with expat Eddie, who's had a lot of dental work down here, by the way, he told me he had a porcelain front tooth made and he didn't like the color,
[09:31] and he made the big mistake of complaining to his dentist. And the dentist spent the next 20 minutes trying to convince Eddie that the tooth looked just fine and nobody would notice. And that his tooth was as good as it gets. And Eddie caved in. Luckily, Eddie has a big mustache and he doesn't smile much, so it's really hard to notice. And more importantly, his girlfriend doesn't seem to mind either. But anyway, those are the kind of things you run into down here. And I have to mention a little bit about the fluoride debate, because I know all of you who listen to PRN know that there's a big debate about putting fluoride in the water and using fluoride trays to give kids treatments in dental offices, and fluoride toothpastes and mouthwashes. Well, let me just mention that in the 20 years I've been down here, I've never met a dentist or in fact a Latin person that ever had a negative thing to say about fluoride, or for that matter, silver amalgam fillings with mercury.
[10:18] Not only that, I've yet to meet a person who's ever gone to a holistic dentist. In fact, Latins don't even know what a holistic dentist is. And even though in the supermarkets they have lots of brands of toothpastes and mouthwashes, the problem is, all of them, and I mean all of them, have fluoride in them. So if you don't want fluoride in your mouth, you either brush with water or baking soda. Those are your options and that's about it. And dentists down here are always pushing fluoride treatments on kids. And you can see their point because they think fluoride really helps. And that's because all the kids down here are addicted to sugar and have such rampant tooth decay, that that's about the only option that a dentist has. But the problem is, the dentist down here tow the party line. If up in the first world, the American Dental Association approves fluoride, and it does. They're all for it down here.
[11:05] Because once again, the first world experts are always right. And I've asked more than one so-called high-end dentist down here about your common silver mercury fillings. Everybody and I mean everybody has them in their mouths down here. It's the standard treatment. And though all dentists offer white plastic resin fillings too, which by the way are a little more expensive than the silver mercury fillings, anyway they offer those plastic resin fillings, not as a replacement for the silver mercury fillings. The fact is, that argument is not even on the radar for dentists down here. Now since half the population of Latin America, that's 250 million people by the way, live on less than $3 a day, it's not hard to imagine why these folks don't go to the dentist or medical doctor unless they're absolutely in dire straits. And it's a funny thing, because these poor people, when you encounter them in the cities,
[11:52] nearly always seem to have some dark stained, obviously decayed, and in fact, pretty much terrible teeth in general. However, the very same class of poor people living out in the boonies, on farms and such, and in the tiny little villages of 500 to 1000 people, well, their teeth generally seem to be pretty good, considering they don't even know what dental floss is. And at 3 to 5 bucks a roll, that's about a day's wages. And when they smile, you rarely see empty holes in dark pockets of decay, except in the very old people. And the reason for that, the dentist will tell you, is that the kids in the cities are absolutely addicted to sugar and suck on cheap sugar candies and cheap sugar flavored artificial drinks all day long, basically a Kool-Aid and cookie diet. Whereas out in the boonies, where everybody lives or works on a farm, where most families
[12:40] have some crops growing in their own backyard, the kids out in the hinterlands don't have much access to processed foods and sugar, and because of where they live, they're on a much more natural, wholesome, whole food diet. Their parents don't have spare change to give them every day, because their farmer is not working a regular kind of job, unlike poor folks in the city who get weekly or daily pay even if it's only 5 or 10 bucks a day, it's still cash money. So they always have a few pennies to give to their kids when they get restless. And of course, the kids go out and buy more sweets. So unlike the first world, tooth decay is epidemic down here, and none of the towns have fluoride in their municipal water. Which I think is a good thing, even though tooth decay is rampant down here. Now personally, I don't believe in putting fluoride in the water because of all the problems
[13:25] with it. It is a toxin. And the dentist down here point to the fact, erroneously I think, that one of the reasons the kids have so much decay here in the third world, is because they don't have fluoride in their water like up in the first world. Again, the party line of the first world American Dental Association. Which to me is just another case of misplaced logic, which reflects the incomplete education of dental professionals down here. It's as if none of them have ever read a single piece of scientific literature since they graduated from dental school, who knows how many years ago. I mean, what do you think about dentists who think the cure-all is adding fluoride to the water supply, when the rest of the world is coming to realize that it's nothing but a poison, and they're either legislating its removal, or banning it all together. Take for example Europe, where fluoridated water is not permitted in almost every country.
[14:13] But that's the mentality of the dentist down here. And unfortunately, one of the reasons for that kind of close-minded antique way of thinking, is because there are no continuing education requirements down here for professionals. And that goes for professionals of any kind, including lawyers, architects, engineers and medical doctors too. And I don't know how many of you first-worlders know this, but your own medical doctors and professionals up in the first world have to obtain a certain minimum amount of continuing education credits by law. That is, they have to go to classes to maintain their proficiency, and these course hours are registered with each state board, and if a doctor falls short in class time, he's put on probation and eventually can lose his license. Which is a good thing, no matter how imperfect that system might be. I mean we've all heard that some continuing education jaunts are nothing more than disguised
[15:03] golfing trips to Maui. But most doctors are pretty serious about it, because it prods professionals into maintaining certain standards. But no continuing education requirements exist for professionals down here in the third world. In fact, a physician or a dentist could graduate from professional school and never ever read a book or a pamphlet in their chosen field again. Because there's no oversight, no one's checking, and no one in government who are supposed to be involved in setting up some kind of standards on these things, well, they could care less. And that's why I always suggest that expats, when you're down here, look for those diplomas and certificates, and if they've been taking continuing education courses, which is good, you'll see those diplomas and certificates up on those walls too. And they're also proud to list that kind of stuff on their websites, in those bloated
[15:49] resumes, so you can check that out too. And believe it or not, many physicians and dentists down here do have their own websites. But let me get back to that 50% of the population that lives on about $3 a day or less. Now it's often been said about Latin American families, especially in that 50% of the population, considered very poor and living on $3 a day, and even in that 20 or 30% of what you'd call the middle class down here, making $300 to $1,000 a month, well, in those two big groups, it's often been said that in each extended family, there's at least one family member who's a thief, one gang member or drug dealer, one alcoholic, one wife beater, and one member that's a child abuser. Now as pessimistic as that sounds, if you ask any expat who's lived down here for quite
[16:36] a while, he'll tell you that with some exceptions, that analysis is basically true. Well, I'd like to add just one more stereotype to that list. And that's the old timer in the family, grandpa or uncle Julio, who's never been to the dentist at all, except to have false teeth made. And what that guy's been doing all his life is when his teeth finally get so rotten and bad that there's not much left to him and they're causing him a lot of grief, he ends up pulling him out one by one with the pliers himself. Now however crude and gross this might sound to you, there's one old timer like that in every Latin family down here. Of course, not in the upper classes, but that's only 10% of the population. The rest of the folks, that 80 or 90%, who are middle class or lower, well, there's an own hands living under everyone's roof.
[17:22] And I've personally met more than a handful of guys like that myself. And it's true, nobody's broadcasting the fact that the old guy's been practicing dentistry on himself. That doesn't come up in your normal after dinner conversation, that's for sure. But I've heard it come up in casual conversation when some younger person in the family just got back from the dentist or is complaining out loud at a get together about the price of something he had done at the dentist. That's when the old guy spills the beans. And that's when he brags how much money he's saved over the years by doing his own dentistry. And sometimes it's not the old guy at all who tells you about his dental experience. Sometimes another young person in the family will say something like, why don't you just take up pliers and pull them out like Uncle Julio does? And the first time I heard that, I thought it was a joke, but believe me, it's not.
[18:08] And as usual, when these old timers finally get their dentures, whether they're 60, 70, 80 or 90 years old, they usually end up wearing the top ones and leave the bottom set in a dresser drawer because it's just too much of a mouthful for a guy who's basically been without nearly all of his teeth for years and years. So he just doesn't wear them. So expats and expat wannabes out there get used to the fact that if you get invited to dinner at a middle or lower class Latin American family get together, I guarantee you there's going to be an old timer at the table chomping away at his food with no teeth at all. And if that kind of thing drives you up the wall, which it does me, by the way, just try not to sit across the table from him unless you're on a diet. And now I'd like to talk to all you physicians and dentists up there in the first world who are thinking about relocating down here to start a practice because you're so sick of
[18:56] what's happening up in the first world. What with the huge expense of malpractice insurance, the threat of lawsuits, overregulation and big brother and insurance companies trying to tell you what to do and how to practice, low Medicaid and Medicare fees, insurance company rejections and long waits for payments, high rents and climbing office overhead, well, you know what I'm talking about. Coming down here to work as a physician or a dentist does seem like a great idea and even if your income drops to only about a half or a third of what it was up in the first world because your prices will have to stay competitive with everyone else. Though because you're a first worlder, word would get around and you'd be busy in no time. Just by virtue of the status first worlders automatically get in the minds of Latins. And think about that instant stress reduction you get when you come down here.
[19:43] You automatically slip into low gear though it's still a much higher gear than everyone else is in down here. But that's part of what gives you that first world advantage. So anyway, some of you expat wannabes up there who are medical and dental professionals, some of you guys have been sending emails asking me just what the process is to come down here and work in the third world. And the big question is how do you get licensed? Well the truth is, as you know by now, things are pretty loose down here including licensing requirements. But they still have licensing boards and board exams that career professionals have to take before they're able to get a license and practice down here. And even though every Latin American just loves and admires everything about the first world it seems, and every practicing Latin physician and dentist would've loved to have
[20:29] gotten his degree from a school up in the first world, instead of a third rate backwater Latin American university, that 95% of these guys end up getting their degrees from, because any Latin that comes back done after he's gone to a first world university is a prince in his own profession. And with a first world degree under his belt, he's always in big demand, especially in the higher classes with the money. Well the fact is, the reciprocity thing in the professions doesn't work down here. A dentist or physician down in Latin America cannot go up to the United States and practice. However if they have a medical or dental degree from a Latin American medical or dental school, they can go up to the United States and take the board and licensing exams, the same ones that first world dentists and physicians take, and if they pass all the sections and qualify,
[21:16] and the school they went to was accredited, then they do get a license to practice up there. And since those board exams have a written and practical part, a good 95% of those Latin physicians and dentists that come to the first world to take that board exam never pass. First of all the written exam goes on for quite a few days, and it's in English, so if your written English isn't perfect, you're out of luck. And secondly, in dentistry, you have to take the practical board exam on regular patients and your work is graded by the test superiors in a dental school clinical setting. And since third world dental schools are vastly substandard in almost every respect, dentists who've graduated down there almost never pass that one either. So in the end, third world trained dentists and physicians almost never get to practice
[22:02] up in the first world because they just can't pass the oral and the written exam. And the ones that do practice up in the first world almost always got their dental or medical specialty up in a first world school, which means they've spent a few extra years in a first world program. So they're well prepared to take that board exam. Now in reverse, when a first world physician or dentist wants to practice down here in the third world, he's required to take the Latin American version of the board exam. Now of course it's easier because it's not up the first world standards. And there's also a written, a practical, and even an oral portion of the test too. So if you don't know your Spanish and know it really well, you're almost guaranteed to fail the written and the oral part no matter how easy it would be if it was translated into English. So that's the main obstacle for all you professionals that might want to come down here and practice.
[22:49] If you're really serious about doing it, start taking some fast track Spanish courses and really learn that Spanish. Because unfortunately that's the only way you have a chance of getting your license down here. And the other thing, most countries in Latin America don't even have reciprocity between Spanish speaking countries. Even neighboring countries prohibit some professionals from crossing the border and practicing. In other words, you could get your dental or medical license in Costa Rica for example, and right next door in Panama and Nicaragua you can't practice. And the same is true for lawyers and with some of the other professions. And in that case you'd have to go to Panama or Nicaragua and take the medical or dental or law exams there, all over again. And now I want to get back to that segment of the population that 50% or more who almost
[23:35] never go to the dentist unless they're absolutely in dire straits. And of course it's all about the money. If you're living on three bucks a day, even at 15 or 20 bucks a filling, dentistry is not in the budget. Believe me. And by the way, some dentists do charge 15 or 20 bucks a filling. Truly 1960s prices if you're from the first world. But when talking about those hundreds of millions of people who live on three dollars a day or less, there happens to be a strange dental custom that I just can't get used to. And I don't think first worlders will ever understand. Now it seems to be a rite of passage with this group of people that when a guy or a gal gets to be about 16 years old, they somehow save up a little bit of extra money. And they go to some backroom dentist's hack and get some gold inlaid front teeth. I'm not talking about solid gold teeth now, rapper style.
[24:23] Or a full metal rack like an alien robot. But I'm talking about a fine gold square border glued around the outside edge of a front tooth. Or more than one tooth. For them, the more the merrier. You know what I mean. The center of the tooth still being white like a tooth with a thin gold border framing it. And you see that down here all the time. And it shows an obvious cultural and class distinction between people because you never ever see that kind of thing with the upper middle classes or with the wealthy. But it's very very popular within the poor classes and especially the indigenous people. The ones that claim to have Mayan, Toltec, Aztec and Inca blood in the family. And often when you're out in the boonies, you'll run into a whole family of indigenous people in indigenous clothing and every single one of them has at least one tooth like that.
[25:09] But it's not just the indigenous tribes that like this kind of stuff. Bad ugly dental work like that is very popular with cleaning ladies, gardeners and construction workers down here. So any expat that rents or owns a house gets to experience a dose of that kind of bad dentistry right away. And the funny thing is if one of these lower income indigenous folks works his way up in school and gets a college education or ends up later in life owning a thriving business and somehow works his way out of poverty and into the middle or even upper middle classes, one of the first things they do is get those gold border teeth restored to the natural white condition before they had the work done. It seems that after they mingle a bit with higher class wealthier folks, they want to ditch that old tradition. Even though within their own class of people, it's a mark of pride and distinction.
[25:58] Which is exactly why I don't get it. And by the way, when indigenous people like that can't afford a gold border tooth, they'll often get a silver bordered one or even two, which of course is cheaper than the gold. But just as ugly. To us first worlders that is. And you might wonder about the dentists that do this kind of work on these people. Well, those are the lowest of the three kind of dentists that I mentioned that exist down here. And in fact, most of the guys that do that kind of work aren't really dentists at all and are nothing more than glorified lab technicians and pretty terrible ones at that. And though these kind of procedures are done in a very unsanitary kind of way, in a garage like setting with no gloves and no autoclave to sterilize instruments, because these fifth rate dentists are working on the poorest of the poor down here, the government doesn't
[26:44] regulate them at all. And though the governments are aware that these guys are breaking all kinds of rules when doing these procedures, there's no enforcement agency to go after them. So nothing happens and it probably never will. And when I commented on this phenomena to my own dentist down here, he told me that those gold and silver inlay borders like that are done so poorly, are so bulky and are such food traps and such great plaque accumulators that most of these teeth end up getting cavities or gum infections and have to be extracted some years later. But he also said traditional decorative dentistry like that has a few hundred year tradition behind it. So he doesn't think it's ever going to change, even though it's totally unhygienic and bad for the person's health in general. And that's why I just don't get it. But I'm not much on tongue or nipple piercings either.
[27:37] You've been listening to The Expat Files, living in Latin America. And don't forget you can email me on anything at all about Latin America. The Expat Files at gmail.com. That's theexpatfiles at gmail.com. See you next time. Nos vemos.