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.