| CIUDAD JUAREZ, Mexico
CIUDAD JUAREZ, Mexico It was fear of the hefty bill as much as fear of the drill that kept American musician Don Clay away from U.S. dental clinics for 30 years.
When a sorely infected tooth eventually drove him to the dentist last month, it was to a clinic in a Mexican border city better known for violent crime and drug cartels.
Shrugging off concerns about hygiene and Mexico's brutal drug war, thousands of Americans are heading to Ciudad Juarez and other Mexican border cities for cheap dental treatment.
"I had to get my teeth fixed. I need a perfect smile to make a successful career in music. Treatment in the United States is so pricey," said Clay, a Texan trying to get a record deal as a hip-hop artist.
U.S. dental treatment costs up to four times as much as in Mexico, making it tough for uninsured Americans to treat common problems such as abscessed teeth or pay for dentures.
A dental crown in the United States costs upward of $600 per tooth, compared to $190 or less in Mexico.
Aspiring Mexican dentists are moving to border cities in droves and are luring American patients away from farther flung discount destinations such as Hungary and Thailand.
Americans have long crossed the border for cheap medicines, flu vaccines, eye surgery or specialist doctors, but dentists are now in highest demand.
Dental clinics are on almost every block in central Ciudad Juarez, ranging from dingy dives to clinics that look more like posh hair salons. Getting there involves dodging prostitutes, drug pushers and cowboy-boot sellers.
"We've gone from a handful of patients when we started 2-1/2 years ago to 150 new patients a month," said Joe Andel, an American who owns the Rio Dental clinic in Ciudad Juarez with his Mexican dentist wife, Jessica.
Rio Dental, which uses U.S. labs to make its crowns, picks patients up at the airport in El Paso, Texas, across the border and has treated people from as far away as Alaska and Hawaii.
"The Internet makes this possible. It allows patients to find us and research us and shows we can do dental work of equal or superior quality to the United States," Andel said.
Internet bloggers swap stories and compare notes about Mexican dentists, but it always comes down to money.
Dentistry in the United States has become prohibitively expensive for some patients, with bills that can run to tens of thousands of dollars. Malpractice insurance premiums, operating costs that are much higher than in Mexico and dentists seeking to claw back the rising cost of their tuition all weigh.
Even among Americans who have medical insurance, many find they are not covered for treatment other than the basics, and paying on credit means high interest payments.
"I did $4,000 of dental work in the United States and put it on my credit card. Because of the interest, I only paid off $400 in three years," said a U.S. teacher from New Mexico getting treatment in Ciudad Juarez who gave his name as Bill.
Cosmetic dentistry, which insurers do not cover and which can be paid in dollars in many Mexican border clinics, is also popular, Ciudad Juarez dentist Luis Garza said.
"If you want a perfect smile, you have to pay for it, and we can do it cheaper, that's all," he grinned.
(Editing by Catherine Bremer and Eric Beech)