Specialist Dental Group’s resident Oral Maxillofacial Surgeon, Dr Ho Kok Sen, was profiled in the December 17 issue of Mind Your Body (Straits Times) today. For those of you who are unable to access the paper, read on below to have an idea of what the story was about.

I decided to specialise in oral-maxillofacial surgery because…

I get to disassemble and reassemble stuff which is something I’ve enjoyed since I was a small kid. I remember spending hours on my airfix models and WWII toy soldier models. When i did not have the funds to purchase new models, I would take the existing models apart and put them back together again.

Similarly, in the oral cavity, I get to take out broken or decayed teeth and replace them with dental implants. In the facial region, I get to move the jaws around and put them together to give new form and function. I also get to fix the various jaw segments together when patients fracture them during a road traffic accident or traumatic fall.

The jaws are fascinating because…

It is such an integral part of the body. It gives form (and function!) to the face. People in the fashion industry talk about jaw lines. People in the food industry talk about jaw strength! But remember, jaws without teeth on them neither give you any form nor function. So maintaining a good set of teeth sets the stage for a fabulous smile and nice jaw line.

If I were to give an analogy for what I do, I’d be a…

Handyman. I piece together things and fix people’s teeth so that they can function again.  I also make sure things are working as they should be.

I have come across all types of cases…

…ranging from a little child engaged in child’s play getting a thumbtack stuck in his tongue to big jaw cysts requiring removal and reconstruction. I have also had cases where patients have come in straight from the airport to be admitted into the hospital due to airway obstruction caused by the swelling of an infected tooth. In between, I take care of impacted wisdom teeth, place dental implants and perform jaw surgery.

A typical day for me would be…

I wake up at 7am to play with my 2.5 year old daughter before she heads to playschool. I then spend some time with my 5 month old son before I leave and reach Specialist Dental Group at 830am.

The rest of the day is divided between consultations and surgeries. General anaesthesia procedures are done in the hospital operating theatre while sedation procedures are performed in the clinic.

I hold a teaching appointment as an adjunct senior lecturer at NUS and I spend one morning or afternoon a week teaching dental undergraduates and graduate dentists.

My day usually ends around 6pm and I head home to spend time with my 2 kids and wife who is an obstetrician and gynaecologist at KK Hospital. I may be called upon some nights to attend to emergency cases at the A&E of the Parkway Group Hospitals.

I love patients who are…

Appreciative of what I am trying to do for them. Many of them have become friends. The doctor-patient relationship has no hierarchical levels. It is one forged on mutual respect and understanding.

Patients who get my goat are…

Patients who have genuine dental needs but choose to listen to “overly concerned” relatives and friends who convinced them otherwise. In doing so, they are not giving themselves the opportunity to have treatment that would improve their lifestyle and health.

One little known fact about wisdom tooth surgery is…

It can be a painless procedure. With proper management, the procedure and post-surgery recovery can be smooth and pain-free. And yes, you can eat after surgery, in fact, ice cream and other cold desserts are encouraged …..

Things that put a smile on my face are…

When a patient’s smile is restored successfully and you can see the change in their confidence level and attitude to life at subsequent visits. Another thing that makes me smile is the relief on anxious patients’ faces when their surgical experience was more positive than they had initially expected.

It breaks my heart when…

Patients do not know that there are solutions available now for virtually any debilitating dental conditions that they may have. As a result they experience a less-than-optimal quality of life or suffer pain in silence.

We live now in a highly advanced and high tech society and this has allowed scientists and researchers to come up with new techniques and solutions that our forefathers had no access to.

I wouldn’t trade places for the world because…

This career gives me the satisfaction of taking out what is not salvageable and replacing them with state of the art artificial teeth while seeing the tremendous positive impact it can have on a person’s life.

I also enjoy working together with the multi-specialty team at Specialist Dental Group because we are able to take a comprehensive approach based on our different areas of training and experience. This not only enables cutting edge dental treatment to be done, which is fulfilling on a professional level, but also enables the patient to access comprehensive treatment in one place.

My best tip…

Remove your wisdom teeth before they start to give you problems. Prevention is better than cure. Take care of your teeth well and they will be with you longer.

It’s that time of the year again…  Orchard Road in Singapore is beautifully decked out, the Christmas carols are playing at all the shopping malls and crowds can be seen by everyone.

Even as we try to figure out the perfect gift to give our loved ones and friends, there are many options for giving meaningful gifts that can change lives this Christmas season.

Teddy Bear Drive

As part of our Corporate Social Responsibility (CSR) efforts, Specialist Dental Group was proud to be a Corporate Donor for the Annual Teddy Bear Drive earlier this month, organized by the Canadian Association of Singapore. The beneficiary of this year’s event was the Spastic Children’s Association of Singapore.

We were delighted to hear that $20,000 and many boxes of toys and bears were collected. Our staff enthusiastically made cash and bear/toy donations as well. The funds raised will be used to acquire a multi-media early education learning programme, for food vouchers for families of needy students,  wheelchairs and diapers.

Virtual Tree of Life

Our clinic is also pleased to be a sponsor of World Vision’s Tree of Life Project. Those of you who have been to our clinic will know that space is a premium. Although we would love to have a Christmas tree in the clinic, it just is not possible.  Thus, we did the next best thing – we have a Virtual Tree of Life where visitors to the Specialist Dental Group tree can learn more about being a Child Sponsor – this is a wonderful way to make a difference in a child’s life. You can view our Virtual Tree by clicking here.

In addition, if you have run out of ideas on what to get the person who has it all, do consider making a life changing gift by clicking here where you can buy food for several families in a community, fund the digging of a well, or buy mosquito nets or blankets for those who need them.

Thank you for your support throughout the year. We wish you and your loved ones a Blessed Christmas and a very Happy and Healthy New Year !!

Dentist ≠ Pain

Many people associate a trip to the dentist with pain and they continue to do so without realising that nowadays there is no pain. With the advancement in dental diagnostic and therapeutic techniques, dental procedures now can be performed with precision, much faster and with minimal downtime for the patient.

Dentistry has evolved to a point where pain is no longer a factor in the overall management equation. With trouble free post-treatment recovery possible, patients no longer have lingering “bad” memories or experiences at their dentists’ office.

Why Pain Arises

Dental pain is one of the most intolerable body pains one can withstand. It has been said that dental pain from a broken tooth can bring the bravest of men to his knees.

• Lack of good oral hygiene contributes to development of gum diseases and dental cavities.
• Lack of good oral health education and dental awareness also deters patients from regular visit to their dentists. The dental problems then snowballs to bigger and more severe ones as time goes by.

By visiting the dentist on a regular basis, problems can be spotted early and resolved before any pain or infection occurs.

Dealing with Anxiety

Possible reasons for anxiety:

• Extreme anxiety in dental patients can often be passed on by their family or friends. Not everyone enjoys visiting the dentist; some may even have very bad previous experiences before.
• Sometimes dental anxieties may be a result of stereotypical portrayals from popular culture.
• Clinical atmosphere. The saying goes:  “Appearance matters”. Well in relation to managing our patients’ anxiety, this holds true. “Clinical” looking dental offices that emit the classical smell of disinfectant and the sound of the whining dental drill can also contribute to the anxiety factor in patients.

Allaying Anxiety

• Pleasant ambiance at the clinic. Dental clinics these days are decked out in warm interior décor together with comforting lighting while disinfectants are now odour-free. Television and music are available to entertain patients in the waiting room and in the treatment room.
• Good communication between dentist/dental team and patient is critical. Speak with your dentist regarding your oral health and let him or her know if you are anxious about the dental appointment and the treatment. By understanding and knowing more about the procedure, you will be in a better position to control your anxiety levels because you know what to expect.
• Access to Information. More information about the qualifications, experience, track record of your dentist and the procedure itself prior to treatment will also reduce anxiety as you would have a higher level of confidence in the dentist and would know that you are in good hands.
• Anti-anxiety oral medications can be prescribed prior to a dental visit to reduce anxiety levels; this will lead to a faster and smoother delivery of treatment thus making the entire dental visit more pleasant and acceptable.

Studies have shown that pain is more often experienced when people are anxious, anticipating the “worst”. With the fear of a stereotypical dental office setting removed and better communication and trust between the patient and the dentist, patients are in a better position to experience dental treatment without any pain.

Relief from Pain

Most dental treatment can be delivered with or without local anaesthesia. If the procedure is simple, local anaesthesia may not be needed. No one enjoys the sight of a needle or being pricked by one. Generally, if your dentist makes you feel secure and you feel comfortable in the soothing surroundings, a simple cleaning or filling can be performed without the need for injections.

Local anaesthesia is required for dental procedures such as deep cleaning, deep cavities, root canal treatment and many cosmetic procedures (crowns, veneers, etc.) Anaesthesia is also required for outpatient/ in-office oral surgical procedures such as simple and complex dental extractions, wisdom teeth removal, oral biopsies, gum surgery, dental implant placement, bone grafting etc.  With topical or surface anaesthesia applied first to the area, dental injections when delivered in a controlled and slow pace, can be with minimal or no discomfort at all.

Patients may also opt for in-office intravenous sedation, delivered by a team of well trained and qualified specialist anaesthetists. During the sedation procedure, vital parameters such as blood pressure, pulse rate and oxygen saturation levels are constantly monitored throughout the entire dental procedure to ensure the safety of the patient. Sedation is suitable for patients aged 7 years old and upwards.

Patients may also opt for general anaesthesia which is a very deep level of sedation requiring airway maintenance and breathing support with the anaesthetic machine. Hospitalisation may or may not be required; but a proper operating theatre facility and set-up is required, thus raising the total cost of treatment.

Patients may want to opt for in-office sedation as the best alternative.

Relief from Financial Pain

Besides dental pain, patients may also feel financial pain from undergoing dental treatment.

• “Prevention is better than cure”. Regular visits to your dentist are important to spot problems early. A small cavity is easy and more economical to treat than a huge and deep cavity that may require extensive treatment like root canal therapy and a crown.
• Speak with your dentist regarding treatment fees and payment methods to avoid any surprises. Certain dental surgical procedures are also covered by Medisave or certain insurance schemes. In addition, some clinics also have interest-free instalment plans available or are registered for the Baby Bonus Scheme which would aid in providing some relief from financial pain.

Your Dentist – Your Partner in Health

Dental treatment or procedures do not need to affect your lifestyle or work routine/ schedule. Pain is no longer in the equation with proper diagnosis, management and delivery of treatment. Certain implant procedures are now minimally invasive (keyhole) in nature. Oral surgery performed together with intravenous sedation offers minimal downtime for recovery and patients are back to their normal routine within 1 or 2 days.

Advances in dental diagnostics and treatment coupled with highly trained and qualified dental health professionals can bring dentistry to the next higher level: Pain-Free Dentistry.

Remember your dentist is there to take away your pain; start treating your dentist as your partner in oral health preservation and smile transformation and you will begin to feel less anxious about your whole dental visit.

As a one stop centre for specialist dental solutions; Specialist Dental Group is always striving to meet our patients’ needs more effectively and efficiently. One such way is by having the latest equipment such as a Digital Panoramic X-Ray system as well as a Cone Beam CT Scanner installed in our clinic.

Digital Panoramic X-Rays

• Patients benefit from a state-of-the-art patient-positioning system which makes the x-ray taking procedure quick, simple and accurate. Images from all different positions of the head (lateral, horizontal or chin to head imagery) can be taken and analyzed at the same time. 
• The digital images are also transmitted into the treatment room in seconds – enabling the patient and dental specialist to discuss the x-rays almost immediately after they are taken. This is especially beneficial to patients with time constraints. 
• Digital x-rays are also much safer for patients as the level of radiation is significantly lower than traditional x-rays (which is already very low).
• In addition, the accuracy of the images producted digitally assists our dental specialists in planning surgery and measurements.

 Cone Beam CT Scanner

The CT scanner provides three-dimensional imaging of a patient’s overall oral and maxillofacial anatomy

• It can be used for a wide cross-section of situations, including dental implants, jaw surgery, treatment of temporomandibular jaw problems (TMJ or jaw joint problems) and sinus surgery.
• It is also extremely useful as an aid for dentists in visualizing patients’ internal anatomy and analyzing the exact position and orientation of patients’ critical structures such as nerves, sinus, nose, teeth roots, or even any previous implants.

With the use of technology, the margin of safety in clinical procedures is even wider, and procedures are carried out more efficiently and effectively. .. .

The best part of all these new technology at Specialist Dental Group for patients is the added convenience of having everything under one roof – there is no longer any need to go to another location to have CT scans taken.

Currently, Specialist Dental Group has a Cone Beam CT scanner, a digital x-ray machine, a lateral cephalometric machine and a surgical microscope. All nine treatment rooms are equipped with computers to enable viewing of CT scans, digital xrays and videos. 

The K1 and K2 Classes at Kiddiewinkie Place went to school on November 4 with a sense of anticipation….. they were going to visit the dentist that morning ! Most 5 and 6-year olds may not find a trip to the dental clinic something to be excited about – but that could be due to the fact that visits to the dentist are associated with tooth aches or other dental problems.

As part of our community outreach program to children to educate them about the benefits of healthy teeth and to make a dental visit a pleasant one, Specialist Dental Group hosted about 60 children and teachers from the school. This was the second such event for our clinic, after the success of the Nanyang Kindergarten visit in October.

Dr. Ansgar Cheng and Dr Helena Lee spoke to the children about the importance of brushing their teeth well so that the naughty bacteria would not have a party on leftover food in their mouths or make holes in their teeth.  They also showed proper brushing techniques and had some of the children try out their tooth brushing skills on the tooth model.  

The children were introduced to “mama straw” and “baby straw”, who were very thirsty indeed, and they had a chance to see how quickly these two straws could drink the water in the cup.

They also had a chance to feel the ticklish polishing brush, which could not only polish their teeth to make them sparkle, but also buff their nails… needless to say, the little girls were delighted !

Our staff and dentists also enjoyed interacting with the children who were very responsive to questions from our team. Specially made glove balloons were awarded to those who could answer a pop quiz on oral care.

Many thanks to Lion Corporation for generously sponsoring Kodomo toothbrushes and toothpaste for the children as well as a colouring sheet of the Kodomo lion. Systema toothbrushes and toothpastes were also provided for the teachers. We appreciate your support.

We also received a lovely thank-you card from the kids and teachers at Kiddiewinkie Place. It was a pleasure having them over. We hope everyone had a positive experience from their visit to the dentist.

The Academy of General Dentistry (AGD) in the USA has released the results of a survey conducted among their members,  with 33% indicating that the No. 1 cause of sensitive teeth for their patients was aggressive toothbrushing. The next most common cause of teeth sensitivity were consumption of acidic food and drinks.  To read more details, click here. Specialist Dental Group also wrote a blog posting about sensitive teeth last month.

Possible causes of teeth sensitivity

1. gum disease
2. wear and tear of teeth
3. overbrushing /type of toothbrush used
4. decayed teeth
5. consumption of carbonated drinks
6. hormonal changes
7. teeth whitening
8. broken or cracked teeth
9. bulimia
10. acid reflux

The AGD survey is consistent with our clinical experience. Dr Helena Lee, Specialist in Periodontics at our clinic was recently quoted in a My Paper story on sensitive teeth stating that our clinic had seen a 10% increase in patients with sensitive teeth compared with five years ago.  In the AGD survey, nearly 60% of the 700 dentists reported an increase in the frequency of tooth erosion in the same time frame of comparison.

To read more about tooth erosion and consumption of sports drinks, click here.

Tips for Sensitive Teeth Problems:

1. Brush with a soft-bristled brush with gentle strokes. 
2. Floss between teeth;
3. Don’t use a toothpick.
4. Visit your dentist at least once in 6 months for thorough check-up and scaling
5. Rinse after consuming soft drinks or eating acidic food
6. Use a de-sensitizing toothpaste – there are several in the market

With the trend towards healthier lifestyles, running and other sports, the consumption of sports drinks, power bars and gels has also risen. One of the things to be mindful about when consuming these too frequently, is the impact of these drinks and food on your teeth.

Sports Drinks

According to Dr Elvin Leong, Prosthodontist with Specialist Dental Group, the important thing to remember with sports drinks is, like all other foodstuffs, to take them in moderation. The frequency of drinking and the time that teeth are exposed to the acidic drinks will affect the severity of erosion.

Athletes who are involved in endurance events usually get re-hydrated every few kilometers. In a typical marathon or triathlon competition set up, seldom do professional or amateur participants drink continuously over their event. Furthermore, athletes only take part in these events several times in a year. Therefore, considering all these factors, the impact of the sports drinks on those athletes is not an issue.

Some recommendations are:

• Drink in moderation, i.e., only if you need to and not on a daily/regular basis;
• If possible, plain water is still the best thirst quencher without risk of acid erosion to teeth
• Rinse the mouth with plain water after drinking the sports drinks

 At present, there is very little scientific research to validate the number of times one should drink such drinks or if drinking from a straw would be more beneficial than sipping or drinking at one go.

 Power bars and Gels

Power bars and gels are meant to be a last minute energy supply during long drawn endurance type sports events that typically last more than a few hours. For shorter events, there is simply insufficient time for the body to digest, absorb and utilize them as energy source. Power bars and gels are not meant to be regular meal substitutes on an everyday basis.

There are many brands of power bars or gels. In general, power bars and gels contain high levels of simple sugars, which are easily absorbed and utilized as an energy source. Power gels tend to be simpler in terms of nutrient formulation. The gel form is meant to be swallowed faster. Many power bars contain significant levels of fat and nuts which take longer to be digested and absorbed as an energy source. Power bars are meant to be well chewed up before they are swallowed. The key difference is the duration that the contents stay in the oral cavity. According to Dr Ansgar Cheng, Prosthodontist at Specialist Dental Group, the shorter that these stay in the oral cavity, less harmful to the teeth they may be.

It is natural to relate high sugar content to dental caries. On a regular basis, athletes practice at a fraction of the distance of their favorite long event, and thus the need for consumption of these last minute supplements is low. In Singapore, due to the hot weather, athletes tend to consume a lot of fluids during and after their training, which may neutralize the harmful effect of the sugar content.

Currently, the relationship between dental caries and supplement consumptions is not very well established.