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The Marine Parade Community Club is organizing a dental talk for the public which will take place on Saturday, 4th September, from 1.30pm to 4.30pm at the Marine Parade Community Club Theatrette.
Specialist Dental Group is supporting this worthwhile event as part of our community outreach activities. Members of our dental team will be present to share their knowledge on the latest developments in dentistry and educate the community on how oral health is closely linked to their overall health.
Dr. Helena Lee, our Periodontist, will be speaking on “The Mouth and Body Connection”. Most people do not know that diabetes, heart disease, lung infection, miscarriage and pre-term child birth can be detected early by just looking at the patients’ gums. If you want to find out more, do not miss the opportunity to listen to her presentation.
Another topic that will be covered is “Solutions for Missing Teeth.” This is a joint Mandarin presentation by our Oral & Maxillofacial Surgeon, Dr. Ho Kok Sen, and our Prosthodontist, Dr. Elvin Leong. For those particularly with missing teeth, you may want to set aside some time to attend this presentation and discover various methods to replace your missing teeth and restore their functional and aesthetical aspect.
To register, you may contact Ms. Lynn Tan at (65) 6346 4900 – free registration exclusively for PAssion Card Members.
For more information, you can also go to: http://bit.ly/bme108
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Specialist Dental Group has launched an on-going series of blog posts by our individual dental specialists. All views provided are the dentist’s own opinions and are posted on this blog as part of our on-going efforts to educate the public about dental issues and other matters of interest relating to dentistry and healthcare.
I was in Hong Kong in July to celebrate my dental school reunion. It is hard to believe that it has been 20 years since I graduated from dental school. It was a sizeable gathering of old classmates and their families. After all, it was a meeting of people with whom we had spent five solid years together during our early adulthood.
We exchanged class notes in those days, and I can still remember clearly how we strived to thrive and survive in that intensive education environment. In contrast, when we see each other nowadays, we exchange notes, trying to see how each other has fared in the journey of life. Some of us have taken the specialist route and have become an expert in our chosen fields, some of us left our home town and settled elsewhere in the name of work and/or love.
One thing that did not change was that we all became 20-year-old kids again when we had our get together. We reverted to our original common ground – travelers in a life-long professional journey.
It is also true that many of us found that what we are practising clinically nowadays is quite different from what we were taught in dental school. While fundamental principles are still the anchor, it seems that disease patterns, treatment modalities and predictability of treatment outcomes have changed dramatically over the last two decades!
Dental science has advanced leaps and bounds with time and dentistry is arguably one of the disciplines of health science that has seen the most meaningful changes. In the past, people associated pain with dentistry, nowadays it is fair to say that dentistry is no longer painful but rather dentists are there to resolve one’s dental problems.
Dr. Ansgar C. Cheng is a Dental Specialist in Prosthodontics (Teeth Replacement) with Specialist Dental Group™. He is also an Adjunct Associate Professor with the National University of Singapore. He has a special interest in dental implants, cosmetic dentistry and treatment of medically compromised patients, including cancer patients. For more information about Dr. Cheng, click here
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Name: Belle Luer
Nationality: Malaysia
Procedure: Root Canal Treatment/Crowns
Belle Luer, a Malaysian, had made plans to celebrate Christmas and New Year’s in Cologne, Germany, with her husband’s family. Little did she know that in a matter of days, she would be cutting short her holiday celebrations to fly 10,000 kilometres to Singapore for emergency root canal treatment.
Belle had seen a dentist in Kuala Lumpur for a root canal and crown a few months earlier. However, it turned out that the root canal had been done on the wrong tooth as she had been pregnant at that time, and her obstetrician had recommended that she avoid a dental x-ray. The problematic tooth was left untreated and flared up on Christmas Eve when she was in Europe.
Saddled with a 9 month old baby and a 6 year old son during the freezing winter, Belle was unable to see a dentist in Germany since the clinics were closed for the Christmas Eve, Christmas and Boxing Day holidays. She was in so much pain that she was on painkillers every couple of hours. She decided to cut short her German vacation and flew to Singapore to see Dr Ansgar Cheng of Specialist Dental Group, her family’s dentist. He opened the clinic to see her on an emergency basis on New Year’s Day.
Belle had a root canal procedure done and was relieved of her agony at the end of the one hour appointment. She was able to return to Kuala Lumpur the next day. Shortly afterwards, Belle returned to Singapore to have a zirconium crown fitted over the root canal treated tooth. She was very satisfied with the results and was amazed at how quickly her tooth healed and the relatively painless procedure. Dr Cheng also fixed an old crown which was not fitted properly. She was so impressed with Dr. Cheng’s work that she later opted to do all her dental work at Specialist Dental Group, and visited the clinic recently for teeth whitening.
Specialist Dental Group’s comments:
One of the common mistakes in root canal-treated teeth is the failure to provide a well-made dental filling. Research has shown that a reinforced foundation and a well-fitted dental crown are crucial in protecting a root canal-treated tooth and regaining function. We opted to make a CAD-CAM zirconium based dental crown because of its superior precision, excellent hardness and life-like appearance, which we believe is essential for a young lady with a busy work schedule and an active social life.
Root canal treatments are performed using a microscope. Research has shown that clinical outcome improves with high power magnification. Also, the surgical instruments that we use for root canal treatments are all electronically controlled with high precision. A combination of all these clinical aids and clinical expertise results in more predictability in the treatment outcome.
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In recent years, the words “medical tourism” and “dental tourism” have become a popular buzzword, particularly on the internet. According to Wikipedia, the phrases above refer to individuals who are seeking medical or dental care outside their local healthcare systems.
It may surprise people to know that dental tourism is not a new phenomenon in Singapore. In fact, Specialist Dental Group, formerly known as Henry Lee Dental Surgery, has been seeing international patients for over 30 years. Most of our foreign patients in those days were from the neighboring countries of Indonesia and Malaysia.
Why do people travel for dental services?
There are generally several reasons that patients would travel out of their home countries for dental treatment in another country:
1) Access to more advanced facilities/equipment or specialists that can manage complex cases; or
2) Quicker access to treatment, i.e. longer waiting list in their home country;
3) Lower cost of treatment in another country; or
4) A combination of the above factors.
While Singapore may not top the list for being the lowest in fees for medical or dental care, Singapore has a solid reputation for excellent healthcare facilities and expertise with complex procedures in the Asian region.
In some countries, it is not uncommon for a patient to shuttle from one clinic to another to see several types of dentists during the course of a particular procedure. This inevitably leads to a longer treatment period and time spent travelling from one location to another. In other countries, there is a waiting list before much needed dental treatment can be received.
At our clinic, it may be possible for patients who have undergone their initial consultation on their suitability for a procedure, to start off the procedure during the same visit…. as long as there are no outstanding dental treatment that needs to be done ahead of time, e.g. gum treatment or extractions.
It is also possible for patients to access different types of specialists with one appointment, if the appointment booking is made ahead of time – this is a savings of time and costs for patients. For example, a patient with gum problems who also had missing teeth, could have an appointment with a gum specialist (periodontist), prosthodontist (teeth replacement specialist) and oral surgeon during the same visit. In the same way, a patient who need a consultation for crooked teeth and a protruding jawline could see both the orthodontist (braces specialist) and oral maxillofacial surgeon) at the same visit.
Why has dental tourism become popular?
Dental tourism has seen a surge in growth in recent years due to several reasons:
1) Increased number of budget airlines making it affordable to travel overseas for dental treatment;
2) Increased access to the internet – more people are able to use the internet to search for healthcare providers via internet cafes, mobile internet access, etc
3) Increased media coverage of medical tourism and dental tourism – with more news stories on people who have travelled to another country to obtain medical and dental treatment, the interest (and demand) in becoming a dental tourist has also increased
4) More advertising and online marketing by healthcare providers as well as online word of mouth referrals /reviews by patients and their families
Considerations for dental travelers/dental tourists
If you are considering scheduling in a dental makeover on your next vacation / business trip, do your research ahead of time. Most clinics will have a website with information on the services provided and qualifications of their dentist.
- what is the standard of dental care in the country you are thinking of having your dental work done?
- Do you know anyone who has had dental work done there? How did it turn out?
- What is the qualification of the dentist who will be performing the procedure? Is the training/qualification recognized in your home country?
- Is he or she a specialist dentist or a general dentist? A dental specialist may charge more for a procedure but he or she also has had more extensive training/experience in a particular area, and will be more equipped to handle complex or difficult cases.
- Where was he or she trained, and how much experience does he or she have with the procedure in question?
- What methods of communication are available with the clinic/dentist – e.g. email? Telephone? How prompt is the response?
- How detailed is the clinic about the cost of the procedure and what to expect? Do you feel comfortable about the amount of information that has been provided?
Once the research has been done, the tickets booked and the bags packed, bring out the sunglasses and enjoy your dental vacation. You will find that it is a life changing experience !!!
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Specialist Dental Group has launched an on-going series of blog posts by our individual dental specialists. All views provided are the dentist’s own opinions and are posted on this blog as part of our on-going efforts to educate the public about dental issues and other matters of interest relating to dentistry and healthcare.
Mrs HW came into my office accompanied by her doting husband. I was very happy to note that she had put on a few more kilograms. Most physicians would not be happy to see a 60 year old lady put on so much weight, but for Mrs HW, it was exactly what I wanted to see.
It was hard to imagine that Mrs HW was starving to death just a couple of years ago. She had, at that time, been persuaded by a general dentist to undergo a series of elaborate procedures under intravenous sedation which lasted over 10 hours.[1]
Instead of looking better and chewing with better efficiency, she was in great pain after the procedures. The alignment of the teeth of both her upper and lower jaw had changed so drastically that she was unable to chew food at all. After many adjustments and reassurances which lasted over 9 months, no improvement was seen.
The patient’s family was at their wits’ end. They sought help from their family doctor who then recommended that she come to see me. When I first saw Mrs HW, she was withdrawn, her body was weakened and muscles wasting due to lack of nourishment, and she was in a state of clinical depression.
With the help of the family doctor and a psychiatrist, we were able to improve her nutritional state. The next stage was careful diagnosis of her occlusion and oral rehabilitation. It took more than 3 months before she was able to chew normally again.
Today, Mrs HW has regained her cheerfulness and can now enjoy time with her husband and grandchildren. She can now return to her regular diet and bite onto her favorite crunchy Washington apples.
I have always emphasized to my students that the most important lesson in the practice of dentistry is: First, do no harm. It is good to see Mrs HW and be reminded of this Hippocratic Oath, lest we forget.
[1] We have on many occasions used intravenous or conscious sedation to control anxiety for patients who are anxious about dental treatment. However, we plan our procedures in great detail so that the patient only spends a minimal amount of time under sedation. To have such conscious sedation for more than 10 hours may not be in the best interest of the patient.
Dr Neo Tee Khin is a Director and Prosthodontist with Specialist Dental Group. He is an Adjunct Senior Lecturer with the National University of Singapore and an American-Board certified prosthodontist. Dr Neo is regularly invited to speak at dental conferences in Singapore, Malaysia, Indonesia and the region. He has a special interest in dental implants, crowns and the NobelGuide Teeth-in-an-Hour implant procedure.
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Name: Gregory Taye
Nationality: Singaporean
Procedure: Dental Implants
“There is nothing like a good set of teeth on you to build your own confidence… Everything you do, you do with a big smile” – Gregory Taye
Gregory had never expected that one day he would be able to smile again – he had been wearing dentures ever since his teeth became loose. The dentures irritated his gums and felt unnatural. He could not enjoy food properly as the dentures were so big that that the taste and texture of food were missing. He also lost self confidence.
Gregory went for a dental consultation with Dr Neo Tee Khin, a prosthodontist with Specialist Dental Group (SDG), and found out about a new procedure to replace missing teeth – NobelGuide Teeth-in-an-Hour. He was excited to learn that he was a good candidate for this procedure. Using proprietary 3D software by Switzerland-based NobelBiocare and Gregory’s CT scan, Dr Neo and Dr Ho Kok Sen, an oral maxillofacial surgeon with SDG, planned the placement of the implants ahead of time. The key-hole procedure was minimally invasive with no down time… and best of all, Gregory was able to get his new set of teeth in about one hour after the surgery began ! He was able to eat immediately after the surgery, and was back to his normal routine right after the procedure.
As Gregory had the opportunity to have the NobelGuide Teeth-in-an-Hour procedure on both his upper and lower jaws, he was also in a unique position to experience the difference between wearing dentures and having dental implants at the same time.
According to Gregory, “The difference between the dentures in your mouth and the implants are two different feelings – When you have dentures in your mouth, it’s like you’ve got something stuck in your mouth…and when you have implants, you are like having your normal teeth on into your mouth.”
Specialist Dental Group Comments:
The NobelGuide Teeth-in-an-Hour procedure is a revolutionary high tech method to replace multiple missing teeth. The new teeth look, feel and function just like natural teeth. It is also a painless procedure and provides convenience to patients as fewer appointments are needed in a very short period of time to complete the treatment. The whole procedure takes about one hour with both implants and the teeth placed at the same time. About two to three weeks is required from the time of the initial consultation to the time of the surgery to allow time for a custom-made surgical guide to be fabricated in Sweden and shipped to Singapore.
Dr Per-Ingvar Branemark, the father of modern dental implants, once said, “No one should die with their teeth in a glass of water.” There are now many options available for those using dentures or those with missing teeth.
You can also view the Specialist Dental Group patient education video on the NobelGuide Teeth-in-an-Hour procedure and find out more about Gregory’s dental journey.
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Teeth grinding, or bruxism, can occur consciously or subconsciously. We consciously grind our teeth when we are chewing or at times, when we are angry. This type of grinding is rather benign because our conscious self stops the grinding before any damage is done. One of our patients is a professional sportsman and he grinds his teeth hard during training or competition.
The other type of grinding is subconscious. Anaesthesiologist colleagues have mentioned that patients may gnash their teeth when they are entering and/or waking up from general anesthesia. The most common type of teeth grinding by far would be grinding at night during sleep. Some earlier research studies also indicate that newly placed ill-fitting dental fillings may also cause teeth grinding.
Why does teeth grinding only happen at night?
Grinding can occur at any time, whether day or night. Unlike day time grinding, there is no inhibition mechanism operating to tell the person to stop grinding when he or she is asleep. Also, during the night, it is generally more quiet and family members are around. Therefore, this is the time when teeth grinding is often noticed.
Night time teeth grinding usually occurs during the time we are falling asleep, dreaming, or when we are waking up. That is the time when our brains are semi-active and the brain stem is actively giving out signals, including the activation of jaw muscles and results in night grinding.
It is also common for children to grind their teeth at night. However, this is mostly self-limiting and the vast majority of children out-grow this phase.
Day time stress is also another reason for grinding. When people are under stress, they generally do not sleep well.
What are the consequences of teeth grinding?
Regardless of the type of grinding, the concern is the magnitude of the grinding force. Research has shown that the force exerted during night time teeth grinding could be a multiple of normal day time maximum bite force as there is minimal inhibition mechanisms in place to prevent grinding with excessive force during this time.
Grinding of teeth over a long period of time may lead to accelerated wear on the teeth, which in turn, causes reduction in the height of the lower face, speech problems, incapacity in chewing, loss of support to the lips and generally, an aged-looking face. It can also lead to jaw, oral and facial pain, and head and neck muscle pain, which is sometime referred to as craniomandibular disorders or temporomandibular joint (TMJ or jaw joint) disorders.
Many times, patient who come to our clinic because of jaw joint problems turn out to be teeth grinders at night.
How does one stop grinding their teeth?
Many researchers have studied the clinical strategies to stop night grinding. These include muscle relaxant medication, electro-stimulation or relaxation, and bite correction. However, up to this point of time, there is no single predictable method that can totally stop a person from grinding their teeth at night.
From a management point of view, the strategy is to keep the teeth wear in check and manage other clinical symptoms when they arise. One of the proven treatments to reduce damage from grinding is through the use of a dental splint. A dental splint helps to relieve discomfort associated with teeth grinding and effectively reduces excessive teeth wear.
On the other hand, if the cause of the grinding is clearly due to a newly placed but ill-fitting dental filling and the patient reports that the filling feels ‘high’, then the obvious solution is to correct the ill-fitting filling.
It is also commonly believed that yoga and other forms of relaxation training may help to reduce teeth grinding through stress reduction.
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Specialist Dental Group has launched an on-going series of blog posts by our individual dental specialists. All views provided are the dentist’s own opinions and are posted on this blog as part of our on-going efforts to educate the public about dental issues and other matters of interest relating to dentistry and healthcare.
Profession = Training + Vocation
I’ve been a dentist for 17 years. Add the four years of dental school and that will make it 21 years in the profession.
The word “profession” refers to training that leads to a specific skill or skill set that allows one to work at a level of expertise”, possibly for the rest of one’s work life. To me, “profession” also includes the word “vocation” – implying the use of one’s talents/training/profession for the greater good of others. I see this combination of training + vocation reflected in the medical profession in general, and dentistry, in particular.
Seeing patients at the clinic is part of my everyday life. Sometimes, the work is complex and challenging; other times, less so. Imagine working with your hands, hunched over a mouth, adjusting the light source to see clearly in order to do good work. All this at the same time while trying to keep a pleasant demeanor when faced with a person in pain. It’s no easy task.
What keeps me going? The satisfaction of a job well done, relieving pain and bringing comfort to the patient are a major part of the rewards of being a dentist. Most gratifying though, is to see a person who was initially so fearful of dental treatment, presenting with a mouthful of infection, who can be eventually restored to full oral health and function.
No matter how difficult or tiring the procedure had been for me, the satisfaction is priceless. It is in these situations that I feel God is using me to help others.
Learning and Teaching
The training of a dental student is tough, to say the least. They need to transfer the knowledge from textbooks to patient treatment, honing their technical skills within the short span of four years.
During my days as a dental student, I had the benefit of having my father, Dr Henry Lee, as a mentor. He was an oral surgeon of amazing skill and speed. But above all, he displayed his humanity in relating to his patients, always listening and being empathetic towards them. He was also ever willing to pass on his skills and experience to other dentists.
I didn’t realize that I inherited that innate love for teaching from him too until I accepted a part-time teaching position at the dental faculty at the National University of Singapore last year. It’s only one morning a week supervising the undergraduate clinic in Periodontics. But after a few sessions, I realized that I enjoyed relating to the students. I also brought all the years of clinical experience into teaching them – looking out for signs in the mouth that textbooks can’t describe or giving tips on working on areas that are difficult to access.
I’ve discovered that teaching is a 2-way street – as my students pick up clinical skills, I am also learning something from them as well. It may not be about dentistry per se, but maybe discovering something about myself as a person and seeing everything from a different perspective.
I look forward to going to work each day (though this was not necessarily what I thought as a young dentist). I feel really blessed to have a job I love, and doubly blessed when my patients express their appreciation after seeing the results of their treatment.
Dr Helena Lee is a Periodontist with Specialist Dental Group. She holds an appointment as an Adjunct Clinical Tutor in the Department of Preventive Dentistry, National University of Singapore. She has co-authored several papers in peer-reviewed journals and has lectured at professional local and international conferences. Dr Lee has a special interest in the treatment and prevention of periodontal disease, gingival plastic surgery, soft and hard tissue grafting and dental implants.
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