I had a $12k quote in California, $9k in rural southern Illinois...and I ended up going to Costa Rica and getting it done at a fantastic office (clean, modern, upscale, English-speaking, and very friendly) for just a bit over $3k. I got in on Saturday, did a city tour on Sunday, dental work Monday/Tuesday, rainforest excursion Wednesday, final dental work and adjustments Thursday/Friday, flew home on Saturday. Hotel + airfare + food + tours came out to about $1200-1300, and the dental office drove me to and from the airport and all dental appointments.
Perhaps the best and most unexpected thing about it was that the dentist only worked on my teeth during each appointment - none of the patient-hopping my dentists here in the US always did.
Every time I've ever had work done here in the US, they would do something on my teeth, then switch rooms and work on someone else for a bit, then come back, etc. Sometimes they'd have a hygienist doing something else, but other times I'd just be sitting there waiting. It seems fairly common.
I did research on WhatClinic, TripAdvisor, and a number of random blog posts people made about their experiences abroad. I found several that sounded good, talked to all of them, and went with the one that just felt right.
The dentists there had been trained at UCLA, and their coordinator was a Johns Hopkins alumni, so I felt really comfortable with both their level of education and their command of English (to minimize potential for misunderstandings, since my Spanish is barely enough to understand telenovelas).
Several acquaintances of mine living in first world countries resort to going back to their 3rd world countries of origin when serious dental work is needed. So much that it has become a trend and a very common piece of advice.
If this is not a sign of the health care system failing, I do not know what is.
On the other hand, this is also a sign of a better functioning market than the rest of health care.
You can actually get a good estimate on the cost of dental work, before it's completed, so you can compare prices. It seems like many procedures have a basic standard, so I would expect similar results from dentists of similar experience with similar facilities. Many dental procedures may be somewhat postponed, so you can shop around, and possibly plan a trip to a different locale. There are no import/export duties or other means of enforcing market segmentation.
I'm not surprised that dental procedures in the US are more expensive -- skilled labor is more expensive, some procedures take several hour and require the dentist, maybe a second dentist, and one or two assistants.
> resort to going back to their 3rd world countries of origin when serious dental work is needed
They also probably wouldn't have to spend money on hotels and have their family to help them with everything, so it's even cheaper
I guess a lot of people are scared to do this because they can't evaluate quality/get good referrals, and of course you're going to get the "low cost clinics" as well as the high level ones.
But in the end the quality of care in 3rd world countries is usually good, especially in major centers
I had a fantastic experience in Costa Rica. I researched on WhatClinic, TripAdvisor discussions, and various blogs where people talked about their experiences, then contacted a couple places to get a feel for what they were like. I ended up going with one of the most expensive ones there, but it was still a better deal than what my little sister paid for her root canals and crowns after insurance here in the US (she has great benefits as a teacher) - and of course, there was no annual benefit cap to contend with.
I'd definitely recommend going during their rainy season, since hotels and flights are cheaper and you'll spend a ton of time at their office and in your hotel room anyway. If your work won't be too painful and you can afford it, plan the trip to be longer than you actually need so you can build in a little more fun time. Most of the better places have coordinators who are happy to help you figure out where to stay and how best to schedule the trip.
You can send your xrays down ahead of time to get a rough estimate of what's needed, but they'll do a new evaluation when you get there. In my case, they told me that some of what my US-based dentists had recommended was completely unnecessary (and that the treatment plans had likely been more about making money). I needed a few root canals and crowns, but not as many as was recommended here in the US. Similarly, the CR dentist said there was no reason I couldn't keep my 2 remaining wisdom teeth.
I'd recommend staying really, really close to the office you choose. Traffic is pretty awful and the driving down there can be a little scary to those of us who are used to orderly driving. I stayed at the Radisson and went to Meza Dental and it was no more than 5 minutes back and forth, even during rush hour. When your face is numb and you're miserable after a long day at the dentist, that's really nice.
The only thing I think I would have done differently is to pack more of my own food, as hotel food started to get really old and food there can be surprisingly expensive, even at the local Walmart. The hotel employees repeatedly advised against going out after dark (about 5:30-6pm in June) without a large group or local guide, so I ate a lot of room service (which, weirdly enough, was the same price as walking to the hotel restaurants to eat).
That's a pretty rare and extreme example you're using though. 1% of dental patients need to or do spend more than $2,000 in a given year on dental work. The average person spends less than $500 per year out of pocket on total dental care.
