Some things have changed at the U.S.-Mexico border. In January, the Trump administration stopped processing asylum claims there, initiating a long-promised immigration crackdown. Since then, U.S. Customs and Border Protection reported a 93 percent decrease in migrant encounters at the Southwest border. Shopkeepers in Nogales, Sonora, south of the border, described seeing the usual throngs of tourists replaced by buses of deportees coming from the United States. Mexico began enforcing a permit requirement for foreign travelers in some areas.
In short, much is uncertain at the border, though much is still the same: people go to work, people come home, and Americans go to the dentist.
For decades, Americans have been traveling to Mexico for cheap dental work. Nogales, Sonora, is one of the most popular spots to visit the dentist across the border: only 70 miles from Tucson, the Mexican city boasts dozens of dental clinics advertising braces, implants and whitening in English at a third of the price in the United States.
The staff at Arizona Dental, a Mexican clinic less than 500 feet from the Nogales border crossing, estimated around 99 percent of their patients are from the United States. On a Friday afternoon in April, the waiting room there was full of people, presumably American, wearing University of Arizona hoodies and speaking English.
Oral surgeon Dr. Gibran Adrián Rivera Prado said he usually sees around five patients a day, but lately that number is falling.
“Many patients are telling us that they are afraid because they hear things that the line is too long to get into Mexico and they need permission,” Rivera Prado said. “It’s a big concern, to be honest.”
Rivera Prado said patients are concerned about encountering a situation similar to the one across the border from Yuma in Los Algodones, one of Mexico’s biggest dental tourism destinations, where Mexican officials began requiring a travel permit for Americans at the beginning of March, creating long lines at the border.
Former dentist Mark McMahon runs Coyote Dental, a Tucson-based company that helps facilitate dental appointments for Americans across the border. McMahon maintains the line to get across in Nogales isn’t any longer than before, and that the Mexican government isn’t asking for any sort of permit or visa from Americans there, which is true — on the morning McMahon crossed the border in Nogales on foot, the Mexican immigration officials at the port of entry didn’t look up at him from their phones.
McMahon said since January, he’s heard from some patients who are hesitant to cross the border, though the number of new patients at Coyote Dental is rising. If the Mexican government does end up asking for permits to enter Nogales, McMahon said he’ll just help his clients through the extra paperwork.
“From my understanding, it’s not that big of a deal to fill out some forms online before you cross,” he said. “We’ll all get through it.”
McMahon, who calls himself the “Tooth Truth Ambassador,” got into the international dental concierge business when his dental license lapsed after a trip across South America.
“I came across the border thinking, well, maybe I could work down here,” McMahon said. “And then I came in as a patient. I went to four different offices as a patient just to check things out and see, you know, if I really wanted to do it. And that’s when I found out about the technology and the prices, and I was like, I’m not going to make money here because prices are so cheap. But then I realized, wow, this is a great thing that people should hear about.”
Around 60 patients a month book appointments through Coyote Dental — which does not charge for this service, instead taking a cut from the providers.
Prices are 70 percent lower in Mexico than in the U.S., McMahon said. A crown that would be $2,000 in Tucson is $450 in Mexico. In Nogales, a cleaning can cost as little as $45.
Dental work is so much cheaper in Mexico because “everything is cheaper” in Mexico, McMahon said, namely the rent and the labor. Unlike in the U.S., dentists in Mexico don’t have to pay for costly malpractice insurance.
“America is based on, if you can find some way to rip people off and it’s legal, it’s good on you,” McMahon said. “There’s nobody there who has set up their office to be patient-centric. That’s all operator-centric, it’s based on the dentist in his little kingdom, or it’s based on the insurance model which is based on making money, not serving patients.”
More than a third of Americans have not seen a dentist in the past year, according to the Centers for Disease Control.
Arthur, an American from Tucson, came to the Nogales office of Dr. Sergio Gálvez to fix an emergency situation with a root canal that he says is “old enough to vote.”
When his face swelled up and he started running a fever, he knew it was time to get to the dentist.
“The problem is that, in the States, all the dental work I’m getting is at least five figures,” he said, “and that ain’t in the fucking wallet right now.”
