Name                     : Ken Lee

              Nationality           : Malaysian

              Procedure           : Dental Implants & Crowns

“Losing both my premolars affected my confidence while talking to clients but this will happen no more. I can have a bigger smile now!”                           - Ken Lee

“I am happy” said Ken Lee, a freelance website designer, when asked about his dental implants and crowns experience at Specialist Dental Group.

 Ken had lost two of his pre-molars when he was 18 years old. He did not feel confident to laugh freely or smile broadly when taking photos. He was also shy to speak with people. Ken had heard about dental implants as a solution for missing teeth but thought that the treatment was too expensive at that time.

Several years later, when he was working with a website services company, he came to know about Specialist Dental Group and the various dental treatment offered by the clinic.

Ken was treated by Dr Elvin Leong and Dr Ansgar Cheng, prosthodontists at the clinic. Dr Leong did a thorough examination. He also consulted with Dr Patricia Yeong, an orthodontist, to discuss various options available for his dental problems.

Ken decided to proceed with dental implant and crown treatment.   As the clinic had an interest-free installment payment arrangement available for UOB credit cardholders, this made the cost of the treatment more affordable.

Both Dr Cheng and Dr Leong worked together to provide dental implants and crowns for Ken.  At the end of the treatment, Ken was delighted with the result – he could now wear a big smile and laugh out loud without fear of embarrassment.

Specialist Dental Group Comments:

Dental Implants are a long term predictable solution in replacing missing teeth. The dentist needs to examine the patient and see his/her suitability for the treatment. Conventional dental implants take about 3 to 6 months to complete as time is needed for the implant to integrate with the jawbone. In certain situations, patients may be able to benefit from Instant Implants or the NobelGuide Teeth-in-an-Hour procedure.  

The important key to every dental treatment is the preliminary consultation and examination. This is when the treatment options are discussed, also when patient and dentist can address other concerns, such as fear of pain, financial arrangement, and patient’s expectation. Proper diagnosis is the first step to successful treatment outcomes.

Article written by Keith Emuang (keithg@emuang.org)

                 Name: Robert Santoso

                 Procedure: Teeth Whitening

                 Nationality: Indonesian

We all want to strike that all-important impression at work. Smart threads, grooming and even etiquette classes are helpful tools but there’s one other that has, perhaps, the biggest impact of all.  

There’s a saying that people seldom notice old clothes if you wear a big smile. Fair enough. But does that mean if you can’t afford to smile, then splurging a month’s pay-check on expensive power suits will do the trick? Unlikely!

Take Robert Santoso, a high-flying company director. Early in his career, the industrious 33-year old bachelor had toiled for every rung up the corporate ladder. Various postings took the Indonesian-born from his homeland to Australia until he finally ended up in Singapore in 2007.

“I’ve been smoking for the past 10 years and this made my teeth yellow. As a result, I felt uncomfortable meeting up with business associates and clients. Clearly, it had affected my smile and working life.” Though he was determined to do something about it, his ruthless schedule meant that he had precious little time to do so.

Seeking a solution

With less travelling required during his Singapore posting, Robert could finally take time off to sort out his dental woes. Recalling a colleague’s recommendation, he got in touch with Specialist Dental Group (SDG) to see how they could help whiten his teeth. 

He reveals, “A company shareholder actually went to there to have dental implants done. He had nothing but good things to say about the dental specialists there and the quality of treatment he received. So I needed no convincing.”

Prosthodontist, Dr Neo Tee Khin, who first saw Robert in January 2007, recalls, “His teeth were deep yellow with spots of brown stains. There were also multiple dark discolorations located at the proximal surfaces of the front teeth.”

According to Dr Neo, there can be multiple causes for this discoloration. The patches of brown were due to external stains acquired through smoking or drinking coffee and tea. Apparently, even curry and red wine have the potential to create external stains. Nonetheless, these are easily removed by polishing since they are superficial in nature.

Another cause of discoloration may be due to cavities or recurrent cavities around previous fillings. This can be fixed through tooth-colored fillings with colors that properly match the teeth.

As for the internal colour of teeth, foods with a strong colour may affect it while ageing is a possible cause of darkening.  Unfortunately, these types of internal discoloration cannot be removed by brushing or polishing. The best way to remove most of these types of stains would be through In-office whitening or home whitening using a professionally administered peroxide-based gel or a combination of both.

A smile returns

With various causes requiring different treatment approaches, it was thus important for a detailed dental examination and X-ray to ascertain the exact factors involved in Robert’s case.

Once completed, scaling and polishing were done to eliminate the surface stains and also to allow Dr Neo to evaluate the base colour of Robert’s teeth. Thereafter, In-office whitening using the Zoom System was performed.

Dr Neo explains, “In this procedure, the teeth were first isolated before a peroxide-based gel was applied on them. The gel was then activated using a specially designed light system for an hour. Because of the extent of his teeth’s discoloration, home whitening with a customised tray and peroxide-based gel had to be done for another few days. It then took about two weeks for the colour of his teeth to stabilise.”

Robert declares, “I’m very happy with the outcome. My teeth are clean and healthy and I tend to take better care of them nowadays. I’m also more confident during business meetings and enjoy my outings with friends.”

 Robert cites the patience, professionalism and expertise he received by the dental specialists, their assistants and even the customer service staff, as nothing short of ‘first-class’. 

“It was easy to trust everyone there and they always made sure I was comfortable and stress-free. Thanks to them, I’ll be smiling a lot more from now on.”

 Specialist Dental Group’s Comments

Teeth whitening is the most effective method for removing stains due to ageing or the excessive consumption of food with strong colorings. However with discolorations acquired through the use of certain medication at a young age, veneers (thin custom-made porcelain shells designed to fit discreetly over the teeth) may be required. Therefore a detailed examination to ascertain the cause of discoloration is important.

The result of In-office teeth whitening generally last about 2 years depending on the diet preference of the patient. For maintenance, regular tooth-brushing and flossing with six-monthly dental check-ups should be sufficient.

More information on teeth whitening can be found here.

By Moonlake Lee

 I am a regular reader of Sumiko Tan’s columns in the Straits Times – she is a good writer and always has an interesting perspective on issues of daily life. 

Sumiko’s recent May 2, 2010 article in the Straits Times on her experience with Invisalign certainly grabbed my attention (and I am sure, the attention of many Invisalign patients and dentists/orthodontists).  Titled “In Dental Prison”, she recounted her negative experience wearing the Invisalign aligners for her upper teeth and her trepidation on wearing braces for her lower teeth.

Readers may have come to the general conclusion after reading the article that braces and Invisalign are uncomfortable and restrictive and that one has to decide whether the cost of being subject to such treatments is justified, particularly if it is for aesthetic reasons alone. Having recently completed Invisalign treatment myself (and having worn braces many years ago), I wanted to suggest a few pointers for those considering Invisalign or braces treatment

• Knowing what to expect ahead of time would be helpful in psychologically and practically preparing oneself for the procedure. Any treatment where teeth (and bones) are being moved will inevitably result in some level of discomfort but having an idea of what is involved will usually smoothen the transition.  
• Having a positive frame of mind and a good understanding of the treatment also goes a long way in reducing anxiety.  The experience of the Invisalign patients (myself included) at Specialist Dental Group has largely been nothing less than good  - in fact, many eagerly awaited the appointment with the orthodontist to have the Invisalign aligners issued for the first time. I certainly couldn’t wait to start my treatment.

From a personal perspective, I actually found that wearing Invisalign was rather liberating. There were no restrictions on the types of food or drinks consumed as long as one removed the aligners prior to eating. I could still enjoy coffee/tea (just let it cool down first) and also soft drinks – I just had to make sure to rinse later.

Putting on and taking off the aligners was something that became routine. Just discretely use your hand to shield your mouth when you remove the aligner… or get an “Outie” tool to help make removing the aligner easier.  

• Ideally, one should brush one’s teeth after eating and before putting the aligners on again. I was really good about it for the first couple of months… and then I confess, I became a little less diligent and just rinsed well after meals… that was OK too. I guess I was lucky.
• Any sharpness in the edges of the aligner can easily be corrected at the dentist’s office. I had no issues with this for my aligners.  
• In terms of payment of fees, when it comes to Invisalign, check with your clinic on their payment policy. Our clinic generally collects a deposit when treatment is confirmed, and subsequently, patients can pay in installments at each review appointment.  Some clinics may also have arrangements with credit card companies where the treatment fees may be spread out over a longer period of time.

Apart from the cosmetic reasons to have one’s teeth straightened, there are also functional reasons why orthodontic treatment may be necessary, and not just for vanity’s sake.  Crooked teeth are often difficult to clean and maintain. They are susceptible to dental decay and gum disease. This can make treatment extensive and costly if delayed until much later. Speech can also be affected in some instances where the teeth are poorly aligned, or when the upper and lower jaws are not in correct alignment with each other.

Finally, if one is considering braces or Invisalign treatment,

• take time to read about what is involved. There are many websites with useful information on these procedures. You can read about these at the Specialist Dental Group website but also on the manufacturers’ websites, (e.g. Invisalign and GAC) and the websites of dental associations, (e.g. Singapore Dental Health Foundation and the American Dental Association)
• Speak with others who have gone through the experience and obtain practical tips from them.
• General dentists and specialist orthodontists have different training and experience. Find one that you are comfortable with who is able to discuss the various treatment options for you.
• Some patients may be told that they need to have extractions in order for optimal results. While no one would like to lose teeth that are otherwise healthy, do consider your dentist’s/orthodontist’s expert advice carefully – he or she is experienced in doing many of these procedures and your teeth may need to have the extra space in order to be aligned properly.

Know yourself and your habits – if you lack discipline to faithfully wear the Invisalign aligners, you may want to consider having fixed braces instead.

              Name: Moonlake Lee

              Procedure: Invisalign

              Nationality: Malaysian

 Having previously worn braces when I was in secondary school many years ago, my teeth had since moved (i.e. relapsed) away from their corrected position. I had been thinking for some time of getting my teeth straightened again but was not very keen on having the conventional braces treatment at this point in my life.

I had read about how the Invisalign removable clear aligners were aesthetic and comfortable to wear… sort of like “contact lens.. .. for the teeth.”  It certainly looked like an interesting option for me. Since I was working with colleagues who were also experienced in providing Invisalign treatment, it was a great opportunity for me to try out the procedure for myself – as the old saying goes, “the proof of the pudding is in the eating”…

Consultation

Part I

First, I had a consultation with Dr Patricia Yeong, Specialist Dental Group’s orthodontist, to confirm that I was a suitable candidate for Invisalign treatment.

Dr Yeong took digital x-rays of my teeth and jaw to get a better picture of my dental condition. An impression was made of my teeth. Photos were also taken of my profile and my teeth – the “before” shots….

Part II

About two weeks later, I had another appointment – this time to view the ClinCheck 3-D visualization of my teeth movement. It was rather neat to have an idea of how my teeth would look like after treatment.

After the ClinCheck treatment plan was explained to me and approved by me, Dr Yeong made modifications to the plan, and submitted the confirmation to the Invisalign head office in the USA.  This started the process of having the series of customized aligners manufactured for me… all the way in Mexico.

Treatment

About one month after viewing the ClinCheck software, my first set of Invisalign aligners were issued. I was to have 7 pairs of aligners or 14 aligners in total.

Dr Yeong helped insert the aligners and there was a feeling of tightness around my teeth. It took a couple of minutes for me to learn how to put the aligners on and take them off.. but this process became smoother as I became used to the aligners. My speech was initially affected but not to a great deal…  I was back to normal again within a day or two.

Three pairs of aligners to me (each individually packed and numbered). I was to change the aligners every two weeks and move on to the next aligner in sequence. This cut down the number of dental appointments to once every 6 weeks, rather than monthly as in the case with conventional braces.   

I was to wear the clear aligners ALL the time except during meal times and when brushing my teeth. Pretty much 20-22 hours a day.

The cool thing was that many people did not realize that i was wearing the aligners… they were so transparent that even my children (who are usually sharp eyed) did not notice anything different when i first went home with them on!! The analogy about Invisalign being “contact lens for the teeth” was true – they were only noticeable if one looked closely.   I wore the aligners when i went for a birthday makeover and even the photographer and make up artists were impressed (check out the photo above and see if you can tell that i am getting my teeth straightened !!)

It was actually quite easy to remove the aligners when i wanted to eat or drink something hot and so they did not affect my social life / food enjoyment at all.. just the snacking, which wasn’t such a bad thing.  The side benefit to this was that I snacked less (which hopefully helped weight control) and I had cleaner teeth…  I also carried a toothbrush and mini toothpaste with me everywhere I went.

Post Treatment

I completed Invisalign treatment in about 8 months and am now wearing retainers to maintain the position of my teeth. The retainers are also clear and look very much like the aligners that I have become used to wearing.

Dr Yeong has informed me that I will need to wear retainers for the long term if i want my teeth to remain in their corrected position… they should be worn all the time for the initial period post-treatment, and later on, I only need to wear them at night when sleeping.

I am delighted with the results. While the costs of Invisalign treatment are not low, people should look at this as a long term investment – after all, as long as one continues to wear the retainers to maintain the correct position of the teeth, the benefits gained from treatment are life-long. … which may be of more value than a couple of name brand designer bags or slimming treatments ….

To learn more about Invisalign, click here. 

               Name: Anne Howe

               Procedure: Dental Implants and Bridges

               Nationality: Australian

“I couldn’t be happier with both these doctors, the work they carried out, the detailed care they took, and the friendliness they showed towards me was above and beyond.”                                                                                                         -  Anne Howe

Anne played golf and tennis regularly and listed scuba diving and sky diving as some of her outdoor activities.  Based on Norfolk Island, she actively volunteered for the past 20 years in rescuing and raising injured or orphaned Australian native birds and animals. She also volunteered for an organization that cared for children with cancer.

When it came to her dental well-being, Anne decided to take matters into her own hands after being told by her Australian dentist that her jaw was going out of alignment.  She consulted with an Australian specialist and obtained a quote for the treatment involved. Finding the fee rather steep, she researched the internet for dentists in Asia after hearing that high quality dental work could be done less expensively there.

After comparing information on dental surgeons in Thailand, India and Singapore, she finally decided on Dr Myra Elliot, an oral maxillofacial surgeon based at the Mount Elizabeth Medical Centre in Singapore. Anne had visited Singapore several times previously and felt safe in the country. Singapore also had a reputation for high standards of work and honesty. Dr Elliot, in turn, recommended Dr Neo Tee Khin, prosthodontist at Specialist Dental Group (SDG) to assist with the prosthesis treatment for Anne.

Anne’s treatment involved having teeth removed and dental implants placed to support a bridge. She also had general dental treatment.  According to Anne, the overall cost of her dental treatment was about the same as having the work done in Sydney by the time she paid for airfares, accommodation and sundry expenses. However, she enjoyed 3 excellent trips to Singapore, which was starting to feel like a second home, and that was a bonus.

Specialist Dental Group’s Comments:

Dental implant treatment has been long documented to be an effective and lasting solution for replacing missing teeth. Teamwork and coordination between the oral surgeon and the prosthodontist is important for a successful outcome. Implant teeth can be supported with dentures, crowns or bridges.

The best treatment option will be recommended after a thorough examination and consultation with the dental specialist. Many patients have reported significant changes in their confidence level after completion of dental implant treatment and are able to enjoy a wider variety of food and social activities. The new teeth look, feel and function just like natural teeth, and should be cared for in the same way as one’s natural teeth 

     Name:             Moonlake Lee

     Procedure:     Teeth Whitening

     Nationality:     Malaysian

I had my first experience with teeth whitening this morning. Being a staff member of a dental clinic, it is actually surprising to many people that I have not had my teeth whitened prior to today.

While I did not see the need for whitening in the past, the timing this time was right since I had an event coming up. I also thought that this would be an educational opportunity for myself and for others to know what it would be like to go through teeth whitening treatment.

Before the Process

The dentist gave me a mirror and explained what I could expect to see after the whitening treatment – I would see a difference in the areas between my teeth, and also on the surfaces of the teeth themselves.

I did not need to take an impression for a customized bleaching tray as I was able to use my retainers (from my just completed Invisalign clear aligners treatment) for the home whitening portion of the treatment.

The teeth whitening procedure started off with the dentist taking some photographs of my teeth, to establish the “before” shots…   Clinical photos are not the most flattering photos…. A lip retractor was used to separate the lips so that the gums and teeth were clearly seen.

My teeth were then cleaned – this is usually a good option for those that have light stains on their teeth… my teeth are prone to stains and sometimes, a good scaling and polishing is all you need to get your teeth gleaming again.

As I was an existing patient and the dentist was familiar with my dental history, there was no need to have a pre-whitening consultation.  However, for those who are new to the clinic, a pre-whitening consultation (which takes place at the same appointment as the whitening) is important as there are some situations where whitening is not recommended, e.g. those with gum problems, sensitive teeth, deep cavities, etc.

During the Process

The dentist placed a protecting plastic covering on my lips and gums to protect them during the whitening process.  I was also informed that they would be applying a whitening gel on my teeth, and a special light would be shined on the gel to activate the bleaching ingredients in the gel.

The dentist explained that there would be two cycles of treatment, each lasting about 20 minutes.  I grabbed the opportunity to sit back and relax for 40 minutes while listening to a CD of Michael Jackson’s hits… certainly brought back the nostalgia of the 1980s…

The time flew rather quickly and before I knew it, the dentist was telling me that the teeth whitening treatment was all done.  The protective plastic covering was removed and I was told to rinse well.

After the Process

“After” shots were taken of my teeth as my lips were retracted again. I was given a mirror so I could have a good look at my teeth and there was certainly a visible difference after the bleaching treatment was done.

I was also provided with a take home whitening kit and given instructions on how to administer the whitening gel and the de-sensitizer gel. A handout on Post Treatment Instructions for Whitening was also given to me.

According to the dentist, the bleaching results would be enhanced or maintained with a take home post-whitening kit.  I was supposed to use this diligently for the next 2 weeks. I was also to avoid eating foods or drinking drinks that would stain the teeth… at least for the next 24 hours. Thus, no red wine, tea, tomato sauce, curries and other food or drinks of such nature.

Conclusion

I was delighted with the results… I could see a marked difference between my “before” and “after” photos, and at least in my situation, the teeth whitening treatment turned out well. 

There was some slight sensitivity  – it felt like ‘tingling” in my teeth, but the sensation was not at a level that caused discomfort.  I was able to have a good lunch shortly after my treatment.

I am looking forward to the continued sparkle in my teeth …..

Some practical things to bear in mind:

• Go for a washroom break BEFORE the whitening treatment unless you are sure you will be fine sitting in the dental chair for at least 40 minutes
• Bring your CD or iPod so that you can enjoy some relaxing music or your choice of music. Otherwise, feel free to ask if the clinic has a video or CD for you to borrow during your treatment.

               Before Teeth Whitening                                                        After Teeth Whitening

For more information on Teeth Whitening, click here.

Dr Marzella, Dr Neo Tee Khin, Richard Soh, Dr Ansgar Cheng and Dr Ho Kok Sen

A team of dentists from Specialist Dental Group and Universitas Trisakti performed the NobelGuide Teeth-in-an-Hour Live Surgery procedure before a group of approximately 200 dentists in Jakarta on Saturday, February 20, 2010. This revolutionary procedure enables dental implants to be placed in one hour, and was the first time that this procedure was performed in Indonesia.

According to Dr Neo Tee Khin, Prosthodontist with Specialist Dental Group, “With this Nobelguide Teeth-in-an-Hour procedure, people who have missing teeth can get new teeth that look, feel and function just their natural teeth – all in an hour.”

The Live Surgery event was part of a workshop organized by the Indonesian Society of Implant Dentistry with the collaboration of Universitas Trisakti and sponsored by NobelBiocare.  Dr Neo and Dr Ho Kok Sen, Oral Maxillofacial Surgeon with Specialist Dental Group, were instrumental in planning and providing clinical expertise for the procedure together with Dr Marzella Mega Lestari from Universitas Trisakti.

The patient, Richard Soh, 56, is from Singapore and previously lived in Jakarta for a few years. Mr Soh had been wearing dentures for many years on both his upper and lower jaw. He found the dentures uncomfortable and he could not fully enjoy his food. After the NobelGuide Teeth-in-an-Hour procedure, Mr Soh was able to eat almost immediately – and he enjoyed a full lunch that afternoon and was able to eat as normal the rest of the time.

Patient eating watermelon minutes after the surgery

“The NobelGuide Teeth-in-an-Hour procedure is minimally invasive – there is no swelling or pain, and the recovery is very quick,” added Dr Ho Kok Sen.

Professor Ansgar Cheng of Specialist Dental Group also provided a briefing on the NobelGuide Teeth-in-an-Hour procedure. “Our clinical experience shows that the success rate of this procedure is about 99%”, said Dr Cheng.

For more information on the Teeth-in-an-Hour procedure, visit: http://www.specialistdentalgroup.com/services/serv_teeth_in_an_hour.php

Nobel Biocare is the world leader in innovative restorative and aesthetic dental solutions. It has the largest share of the global dental market and has developed numerous advancements in dental implants over the past 40 years. The company is the leading innovator of computer-aided design and manufacturing as well as computer-aided implant treatment planning and guided implant installation. For more information, visit www.nobelbiocare.com

Specialist Dental Group is the leading multi-specialist dental clinic in Singapore. Based at the Mount Elizabeth Medical Centre, the clinic celebrated its 30^th anniversary in 2009. Its founder, Dr Henry Lee, placed the first dental implants in Singapore over 25 years ago. The dental team consists of 7 internationally trained/qualified specialists in different areas of dentistry. Specialist Dental Group offers comprehensive specialist dental solutions under one roof. For more information visit www.specialistdentalgroup.com

Benefits of Whiter Teeth

Teeth whitening or bleaching is a quick method to restore the sparkle back into your smile. Apart from having a whiter smile, another benefit of gleaming pearly whites is the positive impact this has on one’s confidence and self-esteem. A side benefit is a more youthful smile since yellow and stained teeth are often associated with ageing.

Consultation with the Dentist is Important

A dental examination and consultation is important to assess whether teeth whitening is appropriate.

While most people will be suitable candidates for whitening, those with gum problems, tooth infections, ulcers or sensitive teeth may have to address outstanding dental issues before having teeth whitening done.

In addition, the dentist will determine the cause of the stained or discoloured teeth. Tooth discolouration can be due to either external or internal causes, and the treatment is different for each.  Smoking, as well as tea, coffee and soft drink consumption are some of the biggest causes of external staining. At times, irregularities on teeth surfaces may contribute significantly to the uptake of external stains too. For external discolouration, a proper cleaning and teeth whitening should be sufficient to restore the sparkle to the smile.

Internal or intrinsic discolouration could be the result of a dead or infected tooth or a result of medication (e.g. tetracycline stains). Treatment for intrinsic discolouration is more complicated. In such cases, bleaching alone may not be sufficient, and other types of treatment, such as veneers or crowns may have to be considered.

There are also different shades of stains on the teeth that play a part in determining how the final result of whitening would look like. For example, teeth that have yellow stains or brown stains would respond best to bleaching treatment, compared with teeth that have a grayish tinge.

The key to effective treatment is to get a proper examination and diagnosis. Your dentist would be able to identify the causes of your concern and the relevant treatment.

The process

Teeth whitening can usually be completed in an hour’s visit to the dentist.

A whitening gel is carefully applied to the teeth. A safe, whitening light is used to activate the gel and bleach away stains on the teeth. Once the gel is activated, it remains on the teeth for 20 minutes until the process completed. Several rounds of this process are performed in the clinic during the visit.

What to expect?

Teeth whitening is a painless procedure and patients who undergo this treatment will be able to resume their daily activities immediately although on rare occasions, some teeth may experience sensitivity to cold drinks or air. But, nothing to worry about as this will settle with time.

Teeth that are whitened generally stay that way for approximately 24 months; however certain stain-inducing lifestyle habits such as smoking or drinking coffee, tea or red wine, will increase the likelihood of a patient requiring teeth whitening treatments from time to time.

What’s next?

Maintenance is required in order to keep the result achieved after the treatment. Thus, in some cases, dentists will also provide the patients with a take home kit, so that they can do touch up from time to time, as advised by the dentist.

Lastly, basic rule of thumb applies, maintaining a good oral hygiene is essential. Dental cleaning, combined with regular check-ups to your dentist will help in giving you healthy teeth and a good looking smile.

For more information on teeth whitening, click here.