Cutting My Teeth in Mumbai

Thanks for your question @seancernow.  Yes, it has indeed been more than a year since I received my crowns at Dentzz. Amazing how the time flies! My crowns, and my teeth and gums in general, are still in perfect condition!  No complaints whatsoever.

The only negative I can think of is that the soft nightguard I was provided with, which I wear faithfully, gradually distended and discolored with time. I think this is the nature of these things and not Dentzz’s fault. However, last year they provided me with two, and I’ve started wearing the second one recently. I find that the new one aligns the teeth as they originally were (spacing), so I see the value of using a fresh one after a certain period of time, perhaps every 6 months?  I will be contacting Dentzz for a couple more, which I’m sure that they will be able to make for me since they have my digital records.

The following morning (last Thursday) I gave Dr Rahul my glowing report, with no negatives except for an area on a lower tooth that my tongue seemed to catch on. He would fix that later he said. Then he removed all the crowns in order to have the lab clean and sterilize them, in preparation for final gluing that same evening. Having had my new teeth for more than 12 hours, it was hard to go back to the ground teeth look. But it was just for an afternoon. After a few hours of sightseeing, we returned to Dentzz for what was essentially the last appointment. Dr Rahul did a thorough cleaning of my teeth and gums and then placed and glued the crowns. The glue was then set with a UV light. I asked how the glue inside could cure if it was obscured by the tooth. The answer was because the porcelain and zirconium were translucent, not opaque. And after a few more minutes of fine tuning my bite and cleaning up, it was over. I had 18 new crowns and a new smile! I would actually return the next day to have some final photos taken, pick up some night guards, and make a testimonial video for Dentzz. I had my new teeth! No doubt about it, this dental tourism trip to Mumbai turned out to be an incredible success. Everything went smoothly, work was performed beyond my expectations, and there were no cost overruns or last-minute unexpected charges. Dentzz Dental treated me well, with excellent communication throughout the process. Much of the credit for this goes to Nishikant, the customer liaison assigned to me since the very beginning, and who, I might add, vows to be only an email or SMS text message away whenever I have any issues or concerns about this work or any other dental issues. And of course, I have nothing but glowing praise for Dr Hussein, Dr Rahul, and Ash. Their work is is, as Arjana put it, “pure wizardry.” Friends are asking for some before and after pictures, so here they are. The before one is the one I sent to Dentzz a few months ago. I'm almost embarrassed to put it up at this point, but it should help make the case for why I needed work really well, to say nothing of making the before/after difference a drastic one!

And here’s the final, happy-guy smile!

It’s really hard to believe that we’ve been in India for 11 days already and that in all that time, I’ve found little opportunity to write about what we’ve been doing and what life is like here. At this moment we find ourselves on a completely packed train (the Tapovan Express), at the tail end of a long weekend’s journey to the incredible caves not far from the dusty, hot town of Aurangabad — the famous Ellora and Ajanta World Heritage sites. There are a couple of hours left of this 7-hour journey before we arrive back in Mumbai. Though officially first class with air conditioning, the railcar is ragged and worn, but functional and comfortable. The sound of kids playing and chattering is all around us, with families returning to Mumbai after a long weekend. The kids periodically focus on us with a playful “Hello Auntie” and “Hello Uncle.” My seat partner and new pen pal Reddy, a Hindu farmer dressed in traditional white garb, has just nodded off. Though we have only single English words in common, we’ve been able to communicate at a remarkable level, so much so that we’ve discovered that we were born only one month apart, creating an instant bond. I have a feeling it will last forever, with the exchanging of birthday cards every year from now on. This is the amazing, fantastic thing about traveling, especially by train. You never know when spirit I trans forming events will happen.

Reddy falling asleep and our conversation stopping for awhile seems like the perfect time to get started on a new blog entry. And transportation seems like the perfect subject.

The Indian rail system is massive. It carries a staggering 23 million passengers per day, half of which are suburban travelers. By contrast, Amtrak in the US carries 86,000 per day, and China’s rail system carries 5.8 million. India’s population is 1.25 billion; US’ is 320 million; China’s is 1.36 billion. So, normalized for population, Indians ride the rails about 65 times more than Americans and 4 times more than the Chinese (my own calculation; data from WikiPedia, Amtrak, and Indian Rail websites).

When Becky and I were last here in 1976 for 6 weeks of traveling, there were a few times that we rode trains pulled by steam locomotives, with coal smoke and white embers flying into the open windows of passenger compartments, landing on our clothes. Got to admit that was exciting! Those are bygone days (ceased in 1980’s I think) except for a few locomotives that have been rebuilt and maintained for novelty and tourist purposes. The Tapovan Express (top speed 55mph) is pulled by diesel for part of its route and by electric locomotives the rest.

Booking a train ticket can be a real experience. Imagine the chaos of hundreds (thousands?) of people churning in the main hall of a station like Chhatrapati Shivaji (previously called Victoria Station) in Mumbai, in 95 degree heat and without air conditioning (I wish I could upload a video I took with Google Glass, but my internet connections are too slow; it’ll have to wait until I return). Ticket prices are incredibly cheap by US standards, so that people can afford them (per capita income of India is about $1500/yr), and the lines are long. Tickets can be bought online, but somehow having a tangible ticket at the end of a long wait feels more definite, especially since data connections can be very intermittent.

To get the feel of the train ticket process Arjana and I took the commuter train back from one of my first appointments at Dentzz, from Mumbai Central Station to Churchgate Station, a distance of about 4 miles. This wasn’t the same as the long-haul train system but a good practice session. The cost of the ticket was 5Rs (rupees), or about 8 cents US. The car was pretty empty because we were going in the opposite direction to rush hour traffic, into Mumbai rather than out of it. Not a bad deal. By comparison, a taxi would have cost about 100Rs ($1.60).

So last Friday evening, after a great afternoon in the upscale Bandra area after my 2pm Dentzz appointment, and then followed by happy hour drinks atop the Four Seasons Hotel where we decided to do this impromptu train trip to Aurangabad and the caves, we took a taxi to Mumbai Central Station to buy tickets. At the counter we were met with a “train all full” response. Oh no! But, said the attendant, we could stand in the line “over in the next building” to be put on a wait list. Hopes of this trip were sadly vanishing, but we were determined to make this happen and found the new line.

The slow-moving line of about 25 people felt like a Seinfeld episode. Remember the “close talkers” one? Well, this would have been called “close standers.” The man behind me was literally a quarter inch from me, so that I could constantly feel his breath on my back when he coughed. No sense asking him to move back a little, because the entire line was stacked like a line of dominos. The theory here is that if you don’t advance even a possible millimeter, someone will manage to jam in and shove his paperwork into the little opening in the glass window just before you, even if you are next in line. In fact, people occasionally yelled at some in the front who were brazenly trying to sidle into the front of the line by “just asking a quick question …,” demanding that they go to the back of the line.

This attendant confirmed that no seats were available for the trip out, and he couldn’t even sell us unreserved tickets. However, he could sell us a return ticket, 2nd class unreserved, for the trip back on Monday (yesterday); we might try going to the main station, CST, to buy the outgoing ones. “Isn’t this CST?” we asked (we assumed that CST meant Central Station, which is where we were). With the typical head wag, the attendant smiled and said “No … this is Mumbai Central … you need to go to CST.” This is how we learned that CST meant Chhatrapati Shivaji Terminus (Victoria Station), not Central Station.

The trip to CST took a good 20 minutes even though it was just a few kilometers. I’d like to say it was because everyone was out to have a good time on a Friday night, but Mumbai is like this pretty much all the time. The taxi ride was a typical one, in fact quite similar to the “close standing” of the ticket line. Maybe it should be called “close driving,” because the same principles apply: Take up any and all available space ahead of you or to the sides, allow no space for anyone to get ahead of you, swerve as needed and above all, drive aggressively. In the United States, this would be deemed chaotic and definitely result in accidents; in India, since everyone is expected to drive this way, traffic constantly flows about itself in all directions, like a river with many boulders and rapids … and the system magically works.

I forgot to include a vital component to this mix of driving requirements: It’s necessary to spend at least 50% of the time with your hand on the horn. In the US, the horn seems to be associated with anger. In India, it’s more than that. It’s used to announce to anyone that may be in the way that you’re blasting through, and that you’d better get out of the way as fast as possible. But if someone doesn’t get out of the way, no problem … just swerve to avoid them at the last instant. As long as you have a quarter inch between your side mirrors and those of the car next to you, you’re OK.

From a pedestrian’s point of view, it can be scary as anything trying to cross a street because cars, mostly taxis, keep coming at you at high speed. Fortunately, many crossings have walk/don’t walk indicators with countdown displays which make it easier. But even then you have to remain vigilant for cars running red lights, which happens a lot. Sometimes you just have to step out into traffic and place your faith in the drivers’ well-practiced swerving ability.

We arrived at the real CST and stood in another line for 20 minutes. Again, we could only get 2nd class non-reserved tickets. The price was great: 250Rs for the two of us. That made the roundtrip to Aurangabad, a travel time of 7 hrs each way, only 500Rs total, about $8. The bad part of it was that the tickets were 2nd class unreserved, which meant jam-packed, probably without a seat and standing in the space between cars, with no air conditioning. We didn’t look forward to that. I don’t enjoy ordeals as much as I used to. Our hope was that we could somehow upgrade to first class reserved once on the train by talking to the ticket collector. In the worst case, we would have 7 long, hot hours each way. But it would be worth it in the end!

In the old days, the Indian rail system had three classes: first, second, and third. Third was bare-bones without cushioned seats. Second added cushioned seats. First was upgraded second with the addition of air conditioning. Unfortunately, as the story goes, people would take the 2nd class cushions home with them, turning the seats into third class. Eventually second class was done away with entirely. So back in 1976, there were only two classes offered: first and third. Becky and I would always go third, loving the open windows more than any A/C. Today, there are still two classes, first and second, with a few variations of each.

We arrived at CST at 5:30am on Saturday morning after only 4 hrs of sleep and asked a policeman for the platform of the Aurangabad-bound train. Platform 1. 2nd class non-reserved were restricted to the first two cars, and they were already jam-packed. Things looked extremely bad. So we asked two armed guards standing on the platform about the possibilities of upgrading our tickets. They told us to just find a first class car with some empty seats and sit in them until the TC (ticket collector) came, and then just pay him an upgrade fee. That’s what we did, finding a virtually empty first-class A/C car marked “wait-list passengers.” The TC came and collected an extra 500Rs for the trip. We would find out later that this kind of upgrading is technically illegal, and the extra payment goes directly into the TC’s pocket. Whatever. It was great to have a reserved seat, especially since we’d been told there were absolutely none available!

One great thing about train travel in India is the stream of vendors that pass by your seat with all kinds of things to eat, drink, and amuse yourself with. In the course of the 7-hr trip, hot breakfast and lunch boxes were served, and samovars of coffee and tea (chai) passed by constantly. Toward the end of the trip we were entertained by a person hawking a toy that looked like a horizontal Rubik’s Cube. He did such a good job that I had to buy one for myself. I found myself thinking back to 1976, when the entertainment included children that would jump on the train at local stops and perform musical acts for money until the next station, where they would hop back off and catch the return direction home. I didn’t see that this time. Maybe they’ve cracked down on that … maybe it’s because we weren’t in the 2nd class car.

There’s another type of taxi that’s common in some parts of Mumbai and pretty much everywhere else in India (and the rest of Asia for that matter): the autorickshaw, or tuk-tuk. This is a light little three-wheeled vehicle with a two-stroke engine, like a three-wheeled motorcycle with a cabin on top. We made sure we took one to the hotel when we arrived in Aurangabad. As you would expect, the tuk-tuk doesn’t provide much protection in case of a collision.

Protection against collisions isn’t something high on the list of Indian priorities though. Tuk-tuks may offer little protection, but motorcycles offer none at all, especially when helmets aren’t used. Motorcycles are everywhere, and it’s not uncommon to see entire entire families of four on a single one - the driver holding a child in front, his wife sitting sidesaddle on the back, and anoter child in between. All without helmets, with heavy traffic passing within inches, and with the driver constantly trying to swerve around a multitude of potholes. For us Americans, it’s a terrifying sight.

Our trip back from the Ajanta caves to Aurangabad, about two and a half hours, was a memorable one. It was a Sunday night, with families returning from outings. The highways were packed with all the modes of transportation I’ve described except trains - motorcycles packed to the gills, tuk-tuks, taxis, private automobiles (these were in the minority), and even bicycles. There were also a great number of heavy trucks. Imagine them all skillfully swerving around each other at 30-50mph, with little clearance, with the constant honking of horns. Then imagine looking up and seeing two heavy trucks barreling toward you, one passing the other, taking up the entire road. You think this is the end, but you know it’s India so the chances will be good that you will somehow come out of it alive. And sure enough, at the last millisecond, the passing truck swerves past the other and back into its lane, while your driver has swerved just far enough the other direction to give him clearance. It’s a constant thrill ride.

But all this being said, India is one of my favorite places in the world to travel. There’s always some kind of transportation available, and it’s cheap. What you’re guaranteed to see out of your window is every manifestation of human activity, and it’s always unforgettable.

On Wednesday afternoon (April 15) I came in for a very brief session to make another 2 molds. That was it.

My second appointment was Monday morning. First Dr Rahul took a set of "before" pictures of my smile, and then we were free for a couple of hours before coming back after lunch for an intense tooth grinding session with Dr Hussein.

I'm tempted to branch off here to say something about what Mumbai itself has been like, to describe Kemps Corner where Dentzz is located, but I think I'll resist that to keep these appointment updates just about my teeth. I'll do the life coverage in later posts after I catch up with where the tooth work stands.

After lunch Dr Hussein began with a briefing of what to expect. He was going to go methodically from tooth to tooth and grind it down considerably on all sides, to an optimum amount so that the zirconia crown would completely encapsulate it. In some cases, where the enamel was really thin,the grinding would get close to the nerve and might give me some pain, but not so much that any local anesthesia would be needed. In one case an old crown would be pulled out and the tooth ground down.

He went to work, grinding for about 2 hours while an assistant handled a suction tube to remove cooling water for the grinder from my mouth (along with ground enamel), before it ran down my throat. I'm sure this helped, but I nevertheless felt a constant trickle in the back of my throat that was pretty irritating, and over the course of the 2 hours I swallowed quite a bit of water. It wasn't very comfortable to say the least. But then the grinding was done with really high speed, requiring a lot of water to cool the grinder. I doubt this procedure could ever be done in total comfort. Dr Hussein exhibited a good sense of humor as we joked about how he must love to inflict pain to do this kind of work. At one point I even said it probably felt like waterboarding. He didn't quite get that. I guess it betrayed my American familiarity with certain buzzwords that others wouldn't have. Probably bad form on my part. You say weird things under torture!

The grinding itself was bearable, although there were areas close to the gums of some teeth where the enamel was particularly thin that the nerves fired and I had to clench my fists. But it passed, and Dr Hussein would go on to the next tooth. There was definitely no babying on his part. He did it quickly and expertly.

At one point, Dr Hussein performed a gum retraction at center of the lower jaw, to give me a good looking, straight gum line instead of the jagged mess I had lived with before. Looking at the photos, I had no argument that this would be a worthwhile improvement. Am I beginning to slide down the slippery slope of narcissism?

18 teeth later the grinding was over. After taking quick mold impressions of the resulting upper and lower teeth, he asked me whether I wanted to stop for the day or continue to the next procedure ... which might be even more uncomfortable. Since the grinding was over and I felt great by comparison, I told him "No problem - keep going!"

OK OK ... I’ll show the grinding results (excuse the wild eyebrows please!) ... 

The next procedure was to take thread, much like dental floss but with little markers on it, and weave it around each of the 18 teeth, while pushing the thread up under each gum line. It sounded awful but really wasn't that bad. Maybe someone with more sensitivity issues would hate it, but for me it was OK. The reason this was done was to create a clear demarkation of the gum line on the next two molds. These molds would be 3D scanned, and the marker positions (from the string) would control the exact length needed for each finished crown. The intent was for each crown to extend up and under each gum line, leaving no gap and forming a perfect seal once the gum closed around the installed crown. Makes total sense to my engineer mind! And apparently there's little if any chance that I will ever have a cavity in these 18 teeth, for the rest of my life. Even better!

Dr Hussein cautioned me that I would probably have a great deal of soreness in the gums that night and the following days and suggested a pain reliever. In fact, I had absolutely no pain whatsoever.

It’s Wednesday afternoon in Mumbai, and I’ve already had my third appointment at Dentzz Dental (this morning). Since the dental work is supposed to be the subject of these blogs, I’d better start bringing you up to date on what happened at these three visits. I’ll try to do an update righafter each appointment; this is the first.

My initial visit to Dentzz was Saturday morning at 11am. Arjana and I were feeling the jetlag (and still are to some extent!), but we managed to get things together and depart our hotel in Colaba by 10am for what was supposed to be a 20min cab ride to Kemps Corner, not far from the famous Chowpatty Beach. As it turned out, Google Maps was right on the money (yes, we were able to purchase data plans for our phones for very little money from Vodaphone the day before) and we arrived in plenty of time, for a cab fare of only about 100 rupees ($1.60).

The first impression was a really good one, exactly as I had pictured from the internet promos. The office has a really modern feel and is aesthetically pleasing. I noticed there were about 5 foreigners waiting for their appointments (mostly Australian). We were welcomed by Nishikant, the facilitator who has been in constant touch with me since the beginning. It was good to finally put a face with the name. The receptionist was equally pleasant, and we were offered tea and coffee. An excellent first impression.

After a short wait, we were ushered into an equally modern examination room (and asked to leave our shoes at the entrance … a sanitation measure that really makes sense!) and were greeted by Dr Rahul, one of their “smile makeover” specialists. Dr Rahul asked me to explain what exactly I was seeking by being there, to which I answered that I had been told I needed 8 crowns on my front upper teeth … and didn’t like the idea of spending $15-20K for them back in the USA. I expressed my concerns that the 8 would just be the tip of the iceberg, since it seemed that new teeth on the top would have to be accompanied by new ones on the bottom too - otherwise how would the bite be right, etc.

Dr Rahul then outlined the approach that Dentzz would take to assess the complete condition of my teeth, the mechanics of my jaw alignment, and the process of making everything right along with giving me new teeth and a good smile. We spent about an hour in an extensive Q and A that Arjana participated in. We were both extremely impressed by Dr Rahul’s knowledge and apparent commitment to achieving a top-notch result. He put my mind at ease that I had not made a mistake by coming to India.

After lunch, Dr Rahul took me into a room housing a 3D scanner that totally mapped my teeth and jaws from all angles, producing computerized images. Knowing that they had this capability, I had already asked for this service beforehand.

Then, Dr Rahul left and Dr Aakanksha Chandak (Ash for short) came in. Ash is their aesthetic dentist. She would perform the initial dental exam, make recommendations for the course of treatment and give me a fixed-cost quotation, all in a few hours time, the same day. She would also be in charge of handling all issues I might have during the course of treatment. We were impressed by her personality, her apparent expertise, and her positive attitude. 

The examination started right after a lunch break. Let me tell you, I’ve had quite a few dentists in my life, and not one has ever given me as comprehensive an examination as did Ash. 

Nor has anyone used photographic tools to do it. Maybe it’s common for others, but I had never experienced it. She moved a camera around inside my mouth and created a series of high resolution pictures that showed each tooth and the gums surrounding it in amazing detail. She was able to pinpoint a couple of areas of gum inflammation that explained some pain I had been having, one of which was next to a new crown that I had done just a few months ago. She said the other one would not have been detected in any regular checkup … it would only show up with this kind of imaging. I was impressed.

Then she explained the reality of just how much my teeth had been ground down over the years. The images showed how much of the enamel had been worn down, and how bad things would become if I didn’t have some work done. She also explained how my bite had changed over the years because of this, and how it had contributed to the TMJ that I’ve always suffered. Basically, my jaw position had to be corrected during this course of treatment; otherwise, I was asking for problems by just fixing 8 top teeth. And if it was corrected, the TMJ would probably reduce with time.

Two more issues were the crookedness of my bottom teeth and the variation of the gum line. These needed work in order to correctly oppose the new top teeth. I asked how this could be done without an extensive straightening process beforehand (ie braces). She said that they easily could. As in the process for the top teeth, where each tooth would be ground down from all sides in order to provide what essentially would be a post for a completely new tooth, the bottom teeth would also be ground down. But the bottoms would be ground to different degrees front and back, to give the illusion that the new teeth were close to straight. For someone of my age, whose gums were not so pliant as a younger person’s, this was the preferred method of "straightening.“ 

Again, we had about a one-hour Q and A in which all our questions were addressed. It all made total sense. I found myself wondering why noone had ever explained things so clearly, and so comprehensively, back home in the US. 

The answer to that was probably contained in the answer Ash gave to a question I asked her: "How can Dentzz do all this for such drastic cost differences from USA prices?” She answered that it’s for 3 main reasons. First, they are able to buy materials (the same ones used by US and European dentists) for far less money than in the US or Europe, driven by the drastic difference in per capita income in India. Second, dentists in India have only a small fraction of the educational costs as counterparts in the US. India is always in dire need of more dentists and makes the education of promising individuals virtually free. In other words, for dentists in the US, billable time is more important than in India. Lastly, labor costs (and cost of living) in India are only a fraction of those in the US.

Asha then took some time to analyze the images from the 3D scanner and called us in to discuss the proposed course of treatment and costs. The proposal was as follows:

Full Zirconia crowns, computer generated, completely encapsulating each existing tooth from all sides, extending to just inside each gum line

9 crowns on top (one to replace the existing crown with the gum infection)

9 crowns on the bottom (to create a full “smile” of new teeth)

1 root canal for the existing (new) crown that was giving me pain

Gum retraction for the lower teeth, to make an attractive gum line

Opportunities to tailor the final look through the next 2 weeks

25-year warranty for the Zirconia crowns

Total cost for all work and materials: $10,100

This was pretty much what I expected the work in India to cost. I can only imagine what it would be in the US. I’m sure it would involve a number of specialists and countless dollars above my simple $2000/crown calculation, which doesn’t include Zirconia (the best material available). The 3D scan alone would be $500-700. $50-60K for a total would probably be in the right ballpark.

Tuesday is already here, with no postings yet about how we're doing in Mumbai, and in particular, what's happened with my teeth at Dentzz. I think any of you who have ventured out 9 time zones (actually 9.5 here in India) will give me a pass on my tardiness, understanding that the realities of jetlag can make even the simplest things a huge chore. Also, finding and placing oneself within a wifi zone for long enough to make a blog entry happen is a difficult task in a place like Mumbai. And who wants to sit and write anyway, with so much going on outside?

Having just spent 5 hours today on an epic adventure walking the tiny, fascinating, congested alleys from Chor Bazaar to Crawford Market, Arjana and I had finally reached the senses-saturation point and took a quick cab back to Colaba, where we're staying at Bentley's Hotel. Bentley's is just down the street from Cafe Leopold, a site of the terrorist attacks of 2008. Before the attacks, Arjana and friends had made plans to meet there on Nov 27th. This turned out to be the night after the attack occurred. Shudder.

In need of cold beers and A/C, we decided to go to this still-popular tourist spot that dates back to 1871. Our table in the A/C section upstairs was just under two windows that had been left bullet-ridden from terrorist machine gun spray. Arjana's Aussie acquaintance Steve saved 30 people's lives that night by barricading the stairs with the very tables we were sitting at. It was difficult to be there, so we clicked our glasses of Kingfisher beer in a silent, almost reverent moment.

So back at the hotel, I finally have a little time to catch up. Here's what's happened so far (if I don't finish, I'll do some more in the next post):

The flights to Mumbai via Munich on Lufthansa were really pleasant, as I wrote before. It really didn't seem like a 17hr trip. During the airport approach, I started thinking about the last time I arrived in Mumbai, with Becky in 1976, at the age of 28 on the tail end of our 2 years of adventures in Asia. It was called Bombay then, and we were a little apprehensive on arrival.

It was late at night, like this arrival, and I remember feeling very vulnerable. First we had to exchange money with travelers checks (we must have bought those in Japan or Hong Kong) and then quickly learn rupee denominations and the conversion rate, while jetlagged, before approaching the taxis waiting in the unknown outside. We had no reserved hotel room and had to rely (as I recall) on recommendations from a guidebook written in Japanese. This destination had to be communicated to the taxi driver, with no sense of how much it should cost, and with no guarantee of a room once we got there. The road into town was quite dark, but it was possible to see cows wandering close to the traffic. I remember lots of beeping of car horns and aggressive driving. We had no idea whether the driver was even going in the right direction.

Almost 40 years later the experience was very different. Both Arjana and I already knew India and were ready to jump in and enjoy it from Day One. We couldn't wait for the food, the markets, the smells, the congestion and the craziness. India is a love/hate place at an extreme. We had definitely been reset to the love end by years of absence. We couldn't wait to get started.

The airport is totally new (a year old said our driver) and expansive. Beautiful works of art from the National Museum line the walls of the long corridors and people movers. I hoped that our online "visa on arrival" visas would in fact be waiting for us at immigration. My experiences with Indian bureaucracy 40 years ago gave me a tinge of doubt, but it was misplaced. The system worked, and we got our 30 day visas with no problem.

While Arjana visited the bathroom, One of the female immigration officials started a conversation with "Is that your daughter? She's so tall and beautiful!" From there it went into a discussion of the average age of marriage for Indian women (according to her, 24-27). The official was quick to say that she herself was not married, at the age of 31, and that developing self-sufficiency by marrying much later was a good thing for Indian women. I wholeheartedly agreed with her. It was a great first conversation in (the new) India.

Memories of money exchanging flooded my brain but the Arjana saw the ATM sign. Popped the card in ... and 6,000 rupees came out in crisp 1000's and 500's. What a welcome change from 1976! We made our way to the exit through a huge arrival hall patrolled by machine-gun-armed guards and scanned the waiting crowd for someone holding our names on a placard. And there he was! What a relief, and impressed that things were rolling along so easily. Of course everything had been prearranged via email and WhatsApp texts, so different from the stone-age communication methods of 1976.

The trip from the airport into the Colaba district took about 1 hour. Much better roads, and no cows. But the glimpses of life that we saw through the streetlights looked very similar to what we saw back then. The light of day would show more.

Arriving at Bentley's Hotel around 1am, we awoke the guard at the front gate who sleepily ushered us into the lobby. Not a usual hotel lobby; rather more like a government office with a few chairs. This wasn't a surprise to Arjana, who had stayed here before (as I mentioned). As for me, I was ... I am ... ready to throw away the material "softness" that I've undoubtedly acquired through staying in more expensive hotels the last few decades, dialing my body and soul clock back 38 years to my late 20's, when more spartan accommodations were my (our) norm. Not that Bentley's is spartan. At $45/night, it's not down in the backpacker range. But it is a hotel run in Indian style.

So here’s the deal on why I’m getting ready to depart for Mumbai this coming Wednesday with my daughter Arjana, for a 3 week stay:

For the last decade, I’ve been dealing with steadily accelerating dental costs,  Some of this is probably normal for a 66 year-old guy, but I have an additional factor that is bringing things to a head: I grind my teeth.  Or so the dentist has kept nagging me.  Yes, I’ve worn a nightguard faithfully for the last decade, even though part of it broke off a couple of years ago (I’m just too cheap to spend $300-400 for a new one, and heck, it still works).  Still, my top front teeth have gotten shorter and thinner at the bottom edges, and they’ve started to get little chipped sections.  Until now I’ve managed to convince myself that because my teeth have always been short and not that visible, I could care less about “how they look” because this is me, and I’m 66, and ... (blah blah).  

But now, crunch time has come.  Last summer, my dentist told me I need 6 crowns ... no, make that 8 ... in the top front.  They had all worn down so much, and developed some dark spots by the gums, that something had to be done before costs increased dramatically more because of additional problems.  Sounded bad.  Having had 3 crowns already at about $1800 each, all I could think about was the dollar signs, so I pushed all thoughts of this to the back of my brain, as I can do so well when it suits me.  Besides, my wife had finally gotten me to be excited about a new kitchen earlier in the year, and I was in the midst of writing giant contractor checks.  Noooo room for the crowns problem!  So when I showed up for my January checkup, and the dentist asked “So Andy, are we going to start on those crowns soon?”, my brain was desperately scrambling for a way out, much like a cornered cat.

I found myself asking the dentist, “So ... what would you say if I said I was considering having this work done abroad, like in Hungary or India or somewhere like that, to save a good deal of cash?”  I admit I half dreaded her probable response.  But it was an incredibly cool one:  “You know, I’ve seen work that my friends have had done abroad and it’s been first class.  It’s certainly an option.” (or something like that).  My question had been somewhat rehearsed beforehand, because when told about the situation, my 31-year old daughter Arjana had responded with “Pop, you’ve gotta be nuts if you spend $2000 apiece for crowns here when you can do it so much cheaper abroad, and have a great trip to boot!”

In fact, having been in Budapest a number of years ago, I had seen one of the main streets lined with 24/7 dental offices serving tourists.  It was evidently a huge and profitable business.  I had also heard somewhere (no doubt the internet) that Mumbai offered world-class dental services as well, largely due to the demand from Bollywood (which makes Hollywood pale by comparison).  So for the last couple of months, I’ve done lots of research into the best places to have this work done.  At the same time, I’ve gotten estimates from my dentist’s office for the total “expected” expenditures:  $15000 for 8 crowns, excluding any root canals and other unexpected costs.

By far, the best deal of all seems to be India, and Mumbai in particular.  I’ve found what seems to be a high quality clinic, Dentzz Dental, and have been in constant touch with them for a few weeks now.  My initial quotes, based on sending them my x-rays, a few selfies, some phone calls and lots of emails/texts, are about $370 each for top-of-the-line zirconia crowns, computer generated, with the best materials, and around $130 for root canals where needed.  The cost difference would be immense.  Let’s say $500/tooth in the worst case, times 8.  That’s $4000.  At home it would be $15,000 without root canals, maybe $20,000 with, and for lesser quality materials (non-zirconia).  At Dentzz, all work can be done within a couple of weeks since everything is done in-house.  Also, the place is ISO certified, meaning that it conforms to European standards for quality control.  

I made my decision to move forward quite easily.   Did I drink the Kool-Aid too readily?  Perhaps.  But somehow, I don’t think so.

As soon as she found out Mumbai was in the cards, my word-traveler daughter Arjana made it clear that I wasn’t going without her, and that therefore, I had to plan it for April, when she was in town (Newton MA) for a couple of months break from her Carnival Cruise Lines singer-with-a-band job.   My wife Becky is green with envy because she has to work (teacher).  Couldn’t we do it in the summer, with her?  No ... it gets too hot and rainy then ... she admits it wouldn’t be a pleasant time.  So April it is, with Arjana at my side as my cosmetic consultant and traveling buddy.  Nice!

And April is now here, with departure from Boston only a few days away.  We almost snagged round-trip tickets to Mumbai, via Istanbul, for only $750 ... but still paid only $900 each.  Cheap enough to be a drop in the bucket.  This is gonna be fun!