Molar City

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1:27Yes, one more time. So we shall see what the rest of the day holds. There are hundreds of videos online documenting this experience. Watch as many as I did, and they all start to meld together. That's 99PI producer, Basha Madon. Some people seem nervous in the videos. Others are more excited. Many will turn to their imagined audience behind the camera and speak in a reassuring tone. You see that American flag up there, y 'all? This is one of the safest crossings there is. And it's not scary, I promise you. It is not scary. Everyone here is headed to the same town in Mexico. It's called Los Algodones, and it's a place where, for decades, Americans have roamed the streets.

2:20They come here in desperate search of something they need, something that's almost impossible to find where they live. They're looking for a dentist, one that they can afford. Every day, thousands of people, mostly American, mostly white, and mostly retired, come to this town looking for relief from the turmoil in their mouths. Here, dental care costs up to 80 % less than what it might cost in the U.S. Dental tourism to Los Agudones is so common that many call this place Molar City. Today, there are nearly 1 ,000 dentists in this 7 ,000-person town. and 98 % of those in the patient's chair traveled here from outside Mexico.

3:07Vasha is going to take it from here. Watch any one of these YouTube videos, and you'll see how a trip to Molar City is made easy for an American. For decades, this crossing didn't even require a passport. In one video, a retired couple arrives at Arizona's edge. They do a 360, displaying the massive lot where they've just parked. We love Mexico, they say emphatically, talking to the camera. The camera then pans to show the rust-colored border wall in front of them, that corrugated monstrosity. They marvel. Then a U.S. Border Patrol vehicle starts driving past the screen, on guard, it seems, for anyone trying to cross in the opposite direction.

3:55To this, the camerawoman speaks again, as if she's talking directly to Border Patrol. Get him, boys, she says. Then they begin their walk into Mexico.

4:14In Los Algodones, there are dense clusters of medical offices and a canopy of billboards above them. Vendors are set up on sidewalks where they sell handmade goods and kitschy souvenirs, like this one graphic tee that says, Keep calm. You're on the fun side of Trump's wall. And then there are the street promoters, people who are stationed at almost every street corner, each of them competing for superlatives, the best deal, the quickest appointment, the most popular clinic in town. In Molar City, a street promoter is the first person a tourist will encounter.

4:57Some promoters try to lure people in with discounts. Others vie for attention in more creative ways, like dressing up in a full-body tooth costume and waving a sign. Then there's Alberto, a street promoter who takes a different approach altogether. He tries to attract customers with humor. I'm always trying to make stuff fun, you know? Make them laugh like a comedian almost. make them relax just for that second. Alberto is employed by a couple clinics in town. He's assigned to a specific street corner where he stands all day and tries to make his commissions. Since I'm like at a corner, I have a lot of people that pass by.

5:36So I talk to everybody. Eight hours out there, I'm over. From morning in the morning, I'm talking and talking. I don't stop talking all day. He told me that street promoters can also get a little territorial with each other because they're all vying for the attention of the same Americans who walk into town. You don't need appointment. My daughter's open right now. You get that service right away. We're not working with appointment.

6:02Good morning, buddy. What is it? You know what I did all day? I talked nonstop all day. And I still have the energy left. Alberto loves to talk. When I told him I wanted to talk about Molar City, he was like, how much time do you have? He told me how one time he was on the phone with a girlfriend for a whole 24 hours, standing at a payphone for an entire day, just talking. From this anecdote alone, I got the impression that Alberto was probably good at his job, or at least that he had the stamina to endure it. Well, maybe let's not aim for 24 hours, but I'd love to chat a little bit. Alberto grew up nearby, and over the course of his life, he's seen how Los Algodones transformed into Molar City.

6:55Being at the border, we have America. America is very influential. America really affects everything that happens to the people right here. Los Algodones has built itself up to serve the dental needs of Americans and Canadians. And the town has become wildly successful in this goal. But Algodones went through many reinventions before it became Molar City. And I wanted to understand how it all happened and why. Los Algodones means cotton in plural. And that's because commercial cotton farming is what this land was once known for. back when it was still vibrant and green. Then a series of policy changes depleted the soil and dammed the flow of the Colorado River into Mexico.

7:47By the 60s, riverbeds were drying up and crops were struggling. But many Mexican border towns have long had another thriving business, booze. And after the farming industry crumbled, that's what Los Algodones relied on. At one point, the town had 48 bars. American soldiers living on military bases in Yuma, Arizona, were regulars. Alberto spent his childhood in Yuma, too. Yeah, we go to Aguadones to get drunk. But yeah, that's what Aguadones has been to me from the beginning. It was a little town. Aguadones was a very small town with lots of cantinas. And used to come people from Yuma to dance in the cantinas or drink.

8:32This is Dr. Jesus Medina. He moved to town fresh out of med school in 1973, and he's been working here as a doctor ever since, although he seems to be perpetually on the brink of retirement. I think when they have to retire, and my sons tell me, when are you going to retire? Why? I'm too young to retire. Dr. Medina first learned about Los Algodones from his brother-in-law, Dr. Bernardo Magana, who's often described as the godfather of Molar City. He was the first dentist from this town, you know. Magana's now in his 80s. He is retired and didn't want to be interviewed. But Medina told me about how his brother-in-law, Magana, first had this vision to transform the town into a dental mecca.

9:22Back in the 60s, Magana and Medina were living together in a city about 25 miles from Algodones. Magaña was a young dentist looking for a place to set up his private practice. At the time, he was working for someone who already had a few American patients, patients who likely lived in the South and would cross into Mexico to take advantage of lower prices. Lots of them start to tell about algodones. Why you don't move to algodones? Because algodones is four minutes from Yuma. If you go there, you're going to have a lot more patients. At first, Magana was skeptical. He paid Los Algodones a visit, and it was a lot like he expected.

10:04A sleepy little place with a lot of mostly drunk people. But many of those drunk people were Americans. Its proximity to the border meant there was already a culture of coming and going. He saw the Americans spending their money at the bars and thought, maybe they'd spend money on dentistry too. Magana knew he could offer them a price lower than what they could get in America. And my brother-in-law, he got the idea. He says, I'm going to put an office in Nagalana. And he put the office, and he grows so fast. And he has so many patients, so many patients. Magana set up his clinic right across the street from the border crossing.

10:43On his first day, he saw nine patients. And for the first three years, he was the town's only dentist, sometimes working from 6 in the morning until 11 at night. The demand for health services ended up being so much more than he could handle on his own. So he started asking others to come set up shop, including Dr. Medina. And then I have the idea to come and practice right here. Magana helped Medina acquire a small office for his practice. He gave me a key. He says, take this. What? Go to my office and see. And then I come and I see he made me a very small office, you know, two rooms, waiting room in the office to give attention, a table, a desk.

11:31And that was my first practice office I have, you know. Medina remembers those early days with amazement. Once, he stepped out of his office to see a line of people, Americans, all waiting for an appointment with him. He wasn't even taking appointments. He says the demand was immediate. And I start to work and I start to see American people, you know, hard time because I don't speak too much English, but I don't kill nobodies, you know. Magaña and Medina were treating patients who would talk about their struggles with health care in America. For most Americans, dental care has always been out of reach.

12:13Early dentistry was considered more of a craftsman's trade. Dental work was performed by barbers and blacksmiths, people who were considered quacks by the larger medical field. And ever since then, dentistry and general medicine have fought hard to keep themselves separate. Cut to today, and dental and healthcare are still separated. They have separate insurances, separate teaching schools, separate medical records even. It's as if matters of the mouth are separate from the body. But of course, they're not. Every year, hundreds of thousands of Americans end up in emergency rooms for something like a toothache, something that could have been treated in a dental office.

12:56But most ERs don't have on-call dentists, so often these patients are sent home with painkillers and are told to go visit their dentist. But a lot of these people don't have dentists. Or if they do, the cost for a visit is impossibly high. And yet, people are held personally accountable for the state of their teeth in ways that they're not held accountable for many other health conditions. Poor dental care can be both life-threatening and humiliating, as if unhealthy teeth are a failure of individual responsibility rather than the symptom of a broken system. In Algodones, Dr. Magania saw the state of dental care in America as an opportunity to turn this small Mexican border town into a place full of dental services catered to desperate Americans and Canadians looking for deep discounts.

13:49But the town was still mostly strip clubs and bars. And he felt like that was holding them back. So in 1980, Magaña became mayor, although the technically accurate term is municipal delegate. As municipal delegate, Magaña shuttered most of the cantinas. It was his first major step in transforming Algodones into Molar City. Year after year, the same buildings that housed those cantinas gave way to more clinics and pharmacies. In cantinas, I don't have there no more. Only one or two in Algodones, you know. But they disappear almost, you know. If we drink, we drink at home. All cantinas are dental offices now.

14:37Magana helped transform the town in other ways, too. He opened a middle school, a high school, and a dental school. And Dr. Medina, like his brother-in-law, also got involved in town leadership. He coached the local sports teams. And he became the town's first official delegate of tourism. And when I come, we make the revolution right here, you know? More and more health care professionals were migrating to Algodones. and among Americans, knowledge of the town's services was spreading, although mostly by word of mouth. Still, Dr. Medina was looking for a way to take Al-Gadonis to the next level.

15:15And so he decided to attract people to their reformed party town by throwing a giant party. A party specifically for snowbirds, a term for retired Americans and Canadians who migrate south every year following the sun. Come on over, Medina advertised. We'll have free margaritas, free Viagra, discounted root canals. When kind of did you start this? Wait a minute because I took it. Right here is when they gave me the position, you know, in the newspaper of Mexicali. Dr. Medina is sitting in his office, flipping through an old photo album that he's holding up to our Zoom screen. It's full of newspaper clippings and pictures of all the parties he threw over the years.

16:04His first one was in 1987. 7 ,000 tourists showed up. In the photos, they're all crammed into the town's four square blocks. Many are holding red Solo cups. This was my first party. Look at American people, how I do it. Just in the street, you know, I don't have places to do it. Medina flips through the book fondly, as if he's cooing at baby photos. And that's the way Algodones start, you know, with that. And like this, you can see all my book is full of parties, you know, tell to I go and everything, you know. Well, it's all my life in this book, you know. It's clear that Medina put his heart into these parties, into making the town grow the way it did.

16:54He convinced his neighbors to cook enough food to feed thousands for free. He hired a mariachi band and converted an old boxing ring into a stage. And the Americans had a great time. Medina made sure the margaritas were strong. And they was drunk like crazy, you know. The American customs told me, Dr. Medina, what do you give to those guys? Why? They cross right here. They don't want to show the papers. They tell a son of a bitch. They was very drunk. Year after year, Los Algodones would continue to throw parties like that first one. Americans would return home, talk of the tacos, the town, their teeth.

17:34What was once a town of about 750 when Magana first arrived is now crammed with clinics, hotels, restaurants, and pharmacies. Today, young dentists and souvenir vendors from all over Mexico continue to migrate to town in hopes of finding stable work. and the tourists keep coming in droves. In winter, it's too much people, and they make lines, and that's uncomfortable for them, but they don't care. They make the lines, you know, and they're still coming because they find dental services good, a good price and everything, and very handsome doctors.

18:15We live from the tourists, you know. We live from the tourists. It's a sentiment I heard from everyone in town. Teenagers will run to the border after school to sell trinkets to people waiting in line to go home. Women will walk up and down the line selling handmade sweaters and hot meals. And on the American side, the Kwitsan tribe manages a casino resort. It's a popular spot for dental tourists who try their hand at the slot machines in between appointments. I think Agadones is a good town. It's become a better town than it was before. You know, we really don't have a lot of, like, serenic views or, like, anything touristic.

18:58But the people are really, like, they're really, like, hardworking people. And they're also, they like to party, you know. They like to have good times also. Street promoter Alberto moved back to the area eight years ago, in part to be closer to his family after a road accident in Cancun made it difficult for him to walk. He told me he gets discounted dental care from the clinics that employ him, but he's been putting off amputating his leg for years because of the cost of surgery. For mortars, we vary anywhere from$120 to some of us. Some of us are making like$500 or$800 a week. I asked Alberto what he thought about the town's transformation into Molar City.

19:41I think dental has helped algodones a lot, But I think people just make their money and they go somewhere else, you know? They go live it up somewhere else. Because a lot of doctors have become millionaires. Many of those original dentists live in mansions, complete with indoor courtyards and pools. In addition to their dental practice, certain families in town own many of the hotels, restaurants, and pharmacies here. But zoom out of the town center, and you'll see mostly unpaved roads and humble homes.

20:23There's this 18th century paleontologist, Georges Cuvier. He has this famous quote about teeth. Show me your teeth, he said, and I will tell you who you are. It's true that from teeth alone, a dental anthropologist can gather all sorts of information. They can decipher migration patterns and cultural norms. They can tell if you ate with your fingers or if you endured famine. Our teeth are biographies. They hold facts about ourselves, facts we may not even recognize while we're alive. I'm curious how you would describe your relationship to your teeth. You know, my relationship with my teeth was, you know, I didn't really take the time on a daily basis to have good dental care.

21:16I haven't truly smiled in probably 10 years. This is Jeff Jackson. He's a retired veteran in his 60s. Jeff and his wife live in their RV, which is parked in Nevada for most of the year. Over the last couple years, Jeff started losing more and more teeth. By the time he made the decision for implants, he had 13 teeth left. My wife and I are both waiting to get those permanent teeth in. Yeah, it's just, it's going to be a fun time. Go down there and get them in and be able to enjoy it. I spoke to Jeff after his second trip to Molar City. He was planning to go back a third time to complete what's called a full mouth restoration, which is one of the more popular treatments in town.

22:01You understand why people go through it. I was like, you know, I'm just going to be an ugly old dude anyway. But the confidence booster. And not having to sell my house to do it. Jeff isn't eligible for Medicare. He makes too much money for Medicaid, and he couldn't find a private insurance plan with a premium he could afford. A dentist in Nevada put together a price tag of about$50 ,000. In Los Algodones, he found the same treatment for less than$20 ,000. On top of the implants themselves, that price included getting his remaining teeth pulled, the cost of his pain medication, and his hotel stay.

22:45Mexican dental work is less expensive for a couple reasons. Labor and real estate in Mexico costs a lot less than in the U.S. And dental school is heavily subsidized, meaning fewer dentists graduate school with the kind of colossal debt that's rampant in the U.S. And in Mexico, dentists don't need to get malpractice insurance. Still, it's not as though Mexican dentistry is affordable to all Mexicans. Only 48 % of Mexicans nationwide who are in need of oral health care are able to receive it. But to the average American, it's a discount worth traveling for. And this trend might increase. By 2060, the number of Americans over 65 will practically double.

23:30And the U.S. will see an exploding need for all kinds of health care services in a system that won't be able to support all of its people. People like Jeff. I'm just curious if you have any thoughts or opinions on health care, access to health care in the U.S., you know, from your perspective. I mean, there's clearly a problem, right? I am a dive-in-the-wool capitalist kind of guy. And so I don't really buy off on socialized medicine. But we have to bring down costs. You have millions of people who can't afford health insurance. To Jeff, Molar City might be a solution. But dental tourism is also a measurement of the problem.

24:28It shows us the lengths people must go to seek an end to their pain.

24:40More with Lasha after the break. Thank you.

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