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MESQUITE - Illegal dentistry performed by unlicensed dentists used tohappen in back rooms with makeshift equipment, where vulnerable customers gambled on low-quality care.

While the problems with quality are still there, what used to be an underground business is becoming an entrenched business.

Illegal dentistry is now an institution,with thriving permanentclinicspractically daring authorities to take action.

Just off Central Expressway in Richardson, a neon open sign blinks for new customers. Inside,a dentist from Coahuila, Mexico requires cash up front, even though she's not licensed to practice in Texas or the United States.

In Mesquite, smack inthe middle of aresidential neighborhood, a three-bedroom house has been anestablished clinic for fiveyears. It has security fencing, a parking lot and surveillance cameras - in part to insure the safety of the all-cash business.Inside, there are three dentist chairs and patients say at least one X-ray machine.

The property is owned by Rogelio Esparza. His brother, Arturo, said he is a dentist in Mexico, but does not practice here. That does not account for a bag of what appeared to be dental waste found in the parking lot.

A man we'll call Fred to protect his identity said he spent several thousand dollars in cash at the Esparza clinic and has suffered for it.

As soon as they did the root canal surgeries in this area, the pain began, he said. I was unable to sleep.

The pain hit up here in all this area and in all this area and up into my nose, he continued while pointing to his face.

Fred said a desk situated just inside the entrance to the home is nota receptionist desk.

That is a business to sell books, a book business, he said.

The business is owned by Esparza's brother, Fred said. He said he didn't know the name of the business.

Dr. Elba Garcia, a Dallas County commissioner who is also a dentist, said permanent offices for illegal dentistsare a new phenomenon, but the dangers are not.

You never know if they are sterilizing correctly, she said. You never know what are the techniques they are using. Twenty years ago, they didn't have X-ray machines.

Fred, the patient, said no one kept track of how many times he was X-rayed at the Mesquite office. Worse, after several visits, no one kept track of his teeth.

I cry it's so painful, he said I cannot chew anything; I cannot eat anything.

Fred said he was in the care of Esparza and another dentist named Martin, neither of whom have been licensed bythe Texas Dental Board.

Immigration attorneyMichelle Scoppolette said neither the lack of a license nor a lack of U.S. citizenship are barriers to someone who wants to set up an illegal practice.

They can come in on a B visa, that's a visitor's visa, she said. They can come in on a B1 visa and open a business here and not go back, or they can come in on a B2 visitor visa, stay here and not go back.

After weeks of pain, with numbness spreading into his face, Fred actually talked the Esparza clinic into giving him some money to get his dental problems repaired elsewhere. The clinic gave him $2,460 in cash, a notarized statement showed it was for Not Satisfied Dental Services. That is a fraction of what legal dentists say it will cost to fix his problems. .

Putting illegal clinics out of business can be difficult. It has to begin with a complaint.The Texas Dental Board then investigates them and hands them over to the district attorney.But, Texas Dental Board investigators are overworked.

Patientssay there are 18 illegal clinics acrossNorth Texas, but that is simply what patients say. The reality is an underground business with untold victims and tens of thousands of dollars of unpaid taxes is thriving, and nobody knows how big it is.

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