Third-Market Dentistry

To say Theresa Rosa is afraid of the dentist would be putting it mildly. Long before her derriere touches dental chair plastic she begins squirming and covering her mouth as though shielding her teeth from unseen attackers.

Recently, Rosa was in for the second part of a root canal at Greengos Dental in Matamoros. She’ll make several more visits before it’s complete, an unpleasant thought considering her distaste for the profession.

Nevertheless after a series of bad experiences with other dentists in Matamoros, Rosa said she has finally landed in the right chair at Greengos.

“Its kind of hard telling somebody working in your mouth that its hurting, especially when they don’t understand you,” she said. “As much as I hate the dentist I can handle coming back here.”

Rosa found Greengos through her boyfriend, Rick Doddington. The uninsured couple from Port Isabel has been crossing the border for dental work for years.

Rosa and Doddington are not alone.

The couple is among the estimated 45 million uninsured Americans, or those otherwise priced out of healthcare in the United States. Unable to pay for a procedure domestically, many find it simply cheaper to walk, drive or fly across the border for medical care.

In 2006, The Henry J. Kaiser Family Foundation reported that employer health insurance premiums increased by 7.7 percent while the average family of four paid nearly $11,500 in premiums.

The unfavorable healthcare climate has forced many to seek medical procedures outside the country, and the U.S.-Mexico border has become one of the preferred destinations.

“The border culture is unique,” said Charlie Kingston, co-owner of Greengos Dental. “People in Mexico come (to the U.S.) to buy their televisions, for example. Well, Americans cross the border to get their cheap stuff too. In this case healthcare.”

In Matamoros, there are literally dozens of dental offices within walking distance of the Gateway International Bridge.

Greengos’ whitewashed office is on the same street as pharmacies, doctors’ offices and nightclubs.

But, as Kingston is quick to point out, his is not just another Matamoros dental office.

“We’re not here to compete with the Matamoros dentists,” he said. “For that matter we’re not competing with American dentists either. What we’ve done is actually create a third category.”

A quick lesson on business theory suggests that location and price point largely determine success. Although location is important when competing head to head for clients, price plays an equal if not bigger role in determining where customers spend their money.

Nestled between location and price point is Greengos, according to Kingston.

“We can’t compete with American dentists on location, and we can’t beat Matamoros dentists on price point because we’re more expensive,” he said. “What we did was cross a single line on a map to provide an American quality product for people who can’t afford American dentistry.”

Intent on capturing that so-called third market, Greengos Dental opened for business in February, but the seeds had been planted years before.

Kingston and his wife, Lucia, were living in Austin at the time. Lucia is a dental surgeon, but as a Mexican national she faced the daunting task of earning U.S. equivalency licenses before she could practice in Texas.

The solution to their situation was waiting in an El Paso restaurant.

Kingston, a pilot, had flown into town and by chance met a woman planing to have Lasik eye surgery across the border in Ciudad Juarez.

At first stunned at the woman’s brazen approach to her well-being, Kingston had unwittingly stumbled on the answer to his own conundrum.

On the border his wife could open her own practice, and if they did it right make a bundle of money.

He quickly scribbled notes on a napkin, he remembered — the first draft of his business plan.

Over the next two years the Kingstons visited towns up and down the Texas-Mexico border, eventually settling on Brownsville and Matamoros.

“It had the best combination of market, accessibility and safety,” Kingston said.

Still, Kingston asked that his real name not be used out of fear of being targeted by local gangs.

During that same period the Kingston’s added several partners, including Lucia’s sister and her husband, and two couples.

In addition to financial support, each had a functional role.

Kingston developed the business model, Lucia took charge of actual dental work, her sister navigated the Mexican legal system and her husband Marco managed daily operations of the business.

“In Mexico, being an employee is ok, but it’s not good for a life plan,” Marco said. “When my wife and I saw the plans we realized that Greengos could be the start of a very good business.”

In all, the Greengos team invested $1.5 million on the front end.

They bought a building and had it remodeled to American dental standards. They invested in the latest dental technology, including a Sirona Cerec 3, which is used to make crowns, and a DENTX digital x-ray machine.

Over the months Lucia and the three other staff dentists have slowly been building their client base, now at nearly 1,000. By December, the company expects to reach profitability.

The American Dental Association cautions U.S. citizens about businesses like Greengos, which offer what the association calls dental tourism.

Matthew Messina, a dentist and consumer spokesman for the ADA, admitted that as long as patients are receiving good dental work it doesn’t matter where it happens.

“People need to be aware that some things they take for granted (in the United States) are not necessarily true in other countries,” Messina explained. “There is a reason they are able to offer reduced rates, but you have to look at the reasons they cost less and the potential risk for patients.”

To be sure, Greengos offers dental work at a significant discount. Braces run $2,499 there, compared to $8,500 in the U.S. Teeth cleaning and an oral exam cost $29.99 compared to the average $160 in the U.S.

Its dentists earn less too, just $18,000, well short of the six-figure salary dentists in the U.S. earn.

Taxes, regulations, and insurance are much lower also, and that makes the practice inherently riskier than anything stateside.

“Those people were going to take the risk anyway,” argued Kingston, “but, if you’re going to go to a place where you have no recourse, go to one with something to lose.”

Matamoros dentists have been impressed. At least two dentists who had their own practice have joined the Greengos team. All of its dental assistants, like Ricardo Viveros, are dentists in training.

Viveros is studying at the Instituto Odontolgico de Matamoros and is about 3½ years into his five-year program.

“Everybody wants to work there,” he said. “It’s the best clinic in town.”

Kingston said the partners expect client traffic to spike when the winter Texans return, and later this year they have designs on developing a more defined dental tourism trade for markets in Houston and Dallas.

Eventually they hope to expand into other cities along the border.

“We’ve established the model,” Kingston said. “And we’ve got the team too. From here we can slap another building and another building and another, just like McDonald’s.”

If you go: Greengos is located at Ave. De Las Rosas 53, Matamoros. Phone: (800) 664-4814

EDITOR’S NOTE: Charlie Kingston and his wife Lucia asked that their real names not be used.