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. 

For the convenience of our blog readers who do not understand Bahasa Indonesia, we have summarized the relevant portion of the article in English below.

ACCURACY: 3D X-rays are used to ensure that the installation of dental implants is accurate at Specialist Dental Group

Apart from visiting the restructured hospitals in Singapore, we also visited several private hospitals in Singapore, such as Raffles Hospital, Thomson Medical Center, Specialist Dental Group in Mount Elizabeth Hospital, and Pacific Healthcare at Paragon Mall. In Singapore, the hospital is not just a place for treatment but also to beautify yourself or as a lifestyle enhancer.

At Specialist Dental Group, there is a method to straighten your teeth by using transparent aligners (Invisalign). According to Dr. Ansgar C Cheng, these aligners are very useful especially for those who may feel shy in wearing braces. Invisalign uses 3-dimensional computer technology to plan a comprehensive treatment, and consisting of a series of specially personalized aligners for the patient. Each aligner is used approximately 2 weeks before being replaced by the next, and gradually straightening your teeth until the final pair of aligners are used.

“You will not know that a person is wearing the aligners, because Invisalign is transparent (clear),” he said. 

Invisalign treatment takes about 1-3 years to complete, and may require an average of 10-50 pairs of aligners. Invisalign treatment is suitable to close gaps between teeth, or teeth that are mild to moderately crowded. “The benefits of using Invisalign, are because the aligners are not as obvious as conventional metal braces, and it is very easy to install and remove, which makes it easy to clean the aligners and the teeth,”  said Dr. Cheng.

In addition, Specialist Dental Group also provides dental implants in a single day. “Most dental implants take weeks, while it just takes a day here,” he said. 

More people are becoming aware that correcting their smile will have a major impact on their overall appearance. Solutions to imperfect smiles can be found by visiting the dentist…and in some cases, achieved in just one hour !

 Teeth Whitening

Teeth whitening brightens discoloured or stained teeth caused by food, coffee or smoking. It is a painless procedure which can be completed in less than one hour. A consultation and examination is first done to ensure that the patient is a good candidate, and to rule out existing gum problems or decayed teeth which may affect the treatment outcome. .

It is also important to keep in mind that daily oral hygiene is an essential part of maintaining teeth whitening results. Depending on one’s lifestyle and dietary habits, the whitening can last for as long as two years.

 Veneers

Veneers are thin, custom-made high strength porcelain or composite resin shells designed to fit discreetly over the teeth. It is another option available for discoloured teeth, worn down teeth, broken or chipped teeth, gaps between teeth, and uneven, misaligned or irregularly shaped teeth.

In addition to aesthetic benefits, veneers also have a functional purpose as they protect the surface of a damaged tooth. They may even replace the need for a crown in certain situations, eliminating the need for more invasive tooth preparation.

This is a good alternative treatment to braces, for moderately misaligned teeth that fulfil certain clinical requirements, as it can be completed in shorter period of time – as short as two visits to the dentist.

Composite Bonding

Composite bonding is another option in treating teeth with small chips or gaps or dark stains that do not respond to bleaching. This procedure involves applying a tooth-coloured polymeric resin to the tooth and moulding it into the proper shape. This is a painless procedure and typically takes less than 30 minutes to complete.  

Crowns

Crowns are restorations that cover or cap teeth, restoring them to their natural size, shape, and color. Crowns are indicated when there is a need to strengthen teeth that are mechanically weakened (e.g. teeth with large cavities). Our clinic usually uses zirconium crowns.

Zirconium-based dental crowns are superior in structural strength reinforcement and aesthetic quality. Instead of relying on a dental technician alone, well-fitting crowns could be robotically made using CAD-CAM technology with significantly reduced human intervention. Research has shown that the fit of these CAD-CAM crowns are excellent even at a sub-microscopic level.

Dental Implants

Dental implants replace missing teeth with natural-looking teeth that look, feel and function just like your own teeth. Conventional implants take between three to nine months for treatment to be completed as time is needed for the implant to integrate with the jawbone. With Instant Implants™ and Teeth-in-an-Hour implants, the time to complete treatment is much shorter, due to the skill of the dentist and the technology used.

Braces / Invisalign

Braces function to straighten crooked teeth or close the gap between teeth. Aesthetic braces such as ceramic (tooth coloured) braces and invisible braces (lingual braces) are gaining popularity. Invisalign, a series of removable clear aligners are also a discreet, aesthetic and comfortable way of perfecting your smile….almost without anyone knowing.

Walk Out with that Beautiful Smile

While there are many options available for smile makeovers, your teeth are there to reflect your inner well-being. The most important consideration for a lasting and healthy smile is to have regular check-ups, brush/floss well, and maintain a balanced diet and lifestyle. This is the real secret to looking great, at any age!

A Tradition of Excellence

Specialist Dental Group™ has been established at the Mount Elizabeth Medical Centre in Singapore since 1979 and celebrates its 30^th anniversary this year. The Group is one of the largest multi-specialty dental clinics in Singapore and has nine treatment rooms in two clinics served by a team of seven leading dental specialists.

“Not many dental practices in Singapore have the distinction of being around for such a long time,” says Dr Neo Tee Khin, Managing Partner of Specialist Dental Group™. The late Dr. Henry Lee, founder of the clinic, was a well established oral surgeon who placed the first titanium dental implants in Singapore more than 20 years ago. This strong foundation in dental implants has continued today with Specialist Dental Group™ being one of the leading dental implant providers in Singapore.

According to Dr Ansgar C Cheng, Co-Managing Partner of the Group, the clinic was renamed Specialist Dental Group™ in 2008 to reflect the breadth and depth of the comprehensive dental solutions under one roof provided by its internationally trained/ qualified multi-specialty team.

The clinical team at Specialist Dental Group™ includes dentists with specialty training in prosthodontics (teeth replacement), periodontics (gum treatment), orthodontics (braces) and oral & maxillofacial surgery. Signature dental solutions include Teeth-in-an-Hour implants, Instant Implants™, conventional dental implants, Invisalign®, braces, oral surgery, gum treatment and crowns.

“The idea of a multi-specialty practice arose due to the higher demand and expectation of our patients. Having all our specialists in one place improves communication among them resulting in an excellent standard of care and convenience for our patients,” adds Dr. Neo. Patients benefit with reduced waiting times and can access dentists from different specialty areas with one appointment.

Another convenience is that due to the location of the clinic in a premier medical centre, patients can also schedule their medical and dental visits on the same day in the same building, minimizing the need to take extra time off their busy schedules.

The dental team at Specialist Dental Group™ is also experienced in treating patients with medical conditions such as cancer, stroke, diabetes and heart problems. One of the services offered to patients prior to undergoing cancer treatment (e.g., radiation or chemotherapy) or a major medical procedure (e.g. organ transplantation or heart surgery) is a Dental Assessment. Dental Assessments minimize the risk of oral complications developing in the middle of cancer treatment or post-surgery as a result of a pre-existing dental condition such as an infected tooth or gum disease. The significant cost savings and avoidance of physical and emotional trauma are some of the benefits of having a dental assessment.

Contribution to the Professional Community and to Public Awareness

Most of the dentists at Specialist Dental Group™ have taught or are currently teaching at the National University of Singapore and other international universities. They are also active contributors to international scientific journals and sit on the editorial boards of such publications. As opinion leaders in their respective specialty areas, they are regularly invited to speak at local and international dental conferences.

On the public awareness front, the dental team at Specialist Dental Group™ is passionate about educating the public about oral health, innovations in dentistry and the connection between good oral health and a healthy body. In conjunction with the 30^th anniversary of Specialist Dental Group™’ this year, the clinic organized a public seminar with Channel NewsAsia – Putting the Sparkle Back Into Your Smile – A Dental Seminar that Bridges Function & Aesthetics, which was very well received with an audience of almost 600 people attending to learn more about oral health.

Getting Connected

In addition to the comprehensive information on dental procedures on the Specialist Dental Group™ website, patients are also able to make appointment bookings and enquiries as well as view videos. Specialist Dental Group™ also has a Blog, Facebook Fan Page and a Twitter account in order to be more accessible to patients.

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Specialist Dental Group’s seminar, Putting the Sparkle Back into your Smile, organized together with Channel NewsAsia, was held on Saturday, August 1, 2009 at the Suntec Convention Centre auditorium from 2pm to 5:30 pm.

Drs. Elvin Leong, Ansgar Cheng, Ho Kok Sen, Eugene Chan, Patricia Yeong, Neo Tee Khin and Helena Lee

Close to 600 people spent several hours listening to six dental specialists from our clinic share about the latest developments in their respective specialty areas of dentistry.

“This is the first time that Specialist Dental Group™ has embarked on such a major public education program,” said Dr. Neo Tee Khin, Director and Prosthodontist with Specialist Dental Group™.

“We thought that this was a great way to commemorate the 30th anniversary of our clinic,” added Dr. Ansgar C Cheng, Director and Prosthodontist with the clinic.

Specialist Dental Group™, formerly known as Henry Lee Dental Surgery, was founded by Dr. Henry Lee, a well-respected oral surgeon. Dr. Lee also placed the first titanium dental implants in Singapore more than 20 years ago and this strength in dental implants has continued to be reflected in the multi-specialty team at Specialist Dental Group™.

Staff of Specialist Dental Group

Comprehensive Selection of Topics Covered

Almost every major aspect of dentistry was covered from the relationship between oral health and overall health, to pain and anxiety management, and the latest developments in replacing missing teeth, straightening teeth, and creating a smile makeover.

• Dr. Helena Lee - “The Mouth & Body Connection,”
• Dr. Neo Tee Khin - “Restoring your Sparkling Smile”
• Dr Patricia Yeong - “The Straight Truth About Braces”
• Dr. Eugene Chan - “The Straight Truth About Invisalign”
• Dr. Ho Kok Sen - “Dental Surgery Now Pain Free”
• Dr. Ansgar C Cheng - “Filling Gaps & Brightening Smiles”

The question and answer session

A Question and Answer Session was also held after the six presentations and the dental specialists answered questions on various topics including implants, braces, cracked teeth, whitening toothpaste, and many more.

Invisalign display

Nobel Biocare display

Sponsors of the event and the goody bags included Ezyhealth & Beauty, Nobel Biocare, Invisalign, Cosmetic Surgery & Beauty, Sensodyne, Parkway Health, Listerine, Lion Corporation, Clorets, Vicks, Salonpas, SA Dental and Philips Sonicare .

Goody bags

A beautiful smile is an asset. Facial proportion, dental health and aesthetics contribute to creating that unforgettable smile. Some are blessed and born with good looks, and others can enhance what they have.

Benefits of Straight Teeth

Straight teeth contribute significantly to an attractive smile, and can do wonders for one’s self-esteem and self-confidence. For some, it can even alter their attitudes on life and lifestyle.

Aesthetics are not the only reason for straightening teeth. 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.

Trauma of dental tissues can also result from a bad bite. Protruding front teeth are prone to accidental injuries. Sometimes, a deep bite (excessive overlap between upper and lower teeth), crossbites (single tooth reverse-bite), or jaw discrepancies create a traumatic bite. For some people, there may be gum trauma where a bad bite chews at the gums, causing gum recession or ulcerations and loose teeth. For others, a bad bite or jaw positions can put additional strain on the jaw joints, resulting in joint pains and tension headaches.

Children and the Orthodontist Visit

The American Association of Orthodontists recommends that all children have an orthodontic check up not later than 7 years old. Although it is unusual to start treatment before the age of 7, early orthodontic consultation allows potential problems to be identified and preventive measures taken, e.g. discouragement of a thumb-sucking or pacifier habit, or the prevention of early loss of primary teeth due to poor oral hygiene.

Interceptive orthodontics may be indicated in some children between 7-12 years old if they have traumatic bites or jaw discrepancies. Comprehensive orthodontics usually commences around the time when all the permanent teeth have erupted. This involves the use of fixed braces to straighten and align teeth.

It is a misconception that braces are only suitable for children or teenagers. Braces can still work for adults. With advancements in technology and orthodontics, there are also options for more aesthetic orthodontic devices to straighten teeth.

Types of Braces

The conventional type of braces is stainless steel. There are also braces more aesthetically appealing than their metal predecessors, such as ceramic braces which are tooth-coloured so they are less obvious. Lingual braces, or braces that adhere to the back of the teeth instead of the front, are also available. Another option is Invisalign. It makes use of a series of transparent aligners to gradually straighten the teeth. These ‘invisible’ aligners are comfortable to wear and are removable.

Every individual is unique and every face is different. The treatment plan and objectives may differ for each. Discuss with your orthodontist your concerns and expectations, and find out about the treatment, alternatives, risks and benefits, as well as costs and payment plans before you decide.
For more information on solutions to straighten your teeth, click here

Specialist Dental Group™, formerly known as Henry Lee Dental Surgery, was founded by Dr. Henry Lee, a well-respected oral surgeon. Dr. Lee also placed the first titanium dental implants in Singapore more than 20 years ago and this strength in dental implants has continued to be reflected in the multi-specialty team at Specialist Dental Group™.

According to Dr. Ansgar C. Cheng, also a Partner and Prosthodontist with the clinic, six leading specialists from the clinic will be sharing their expertise with seminar attendees on the following topics:
· The Mouth & Body Connection;
· Restoring your Sparkling Smile;
· The Straight Truth about Braces;
· Dental Surgery Now Pain-Free; and
· Filling Gaps & Brightening Smiles

Tickets for the event can be purchased from SISTIC at http://www.sistic.com/

Major Sponsors of the Seminar include Nobel Biocare, Invisalign, Ezyhealth & Beauty and Cosmetic Surgery & Beauty.

Goody Bag Sponsors include Parkway Health, Lion Corporation, Sensodyne, Listerine, SA Dental Supply, Clorets, Vicks, Hisamitsu and Philips.

Invisalign was launched in Singapore in 2005 (it was launched in 2002 in Hong Kong and Australia). Specialist Dental Group has four Invisalign-accredited dentists on our team, including Dr Eugene Chan and Dr Patricia Yeong. Gone are the days of the “metal mouth”…. with Invisalign, you can go about your daily activities with minimal disruption to your schedule. You can also eat anything you like as the aligners are removed for meals, and put on again after you have brushed your teeth….this also leads to better oral hygiene.

Background Facts

* Invisalign has been around for about 10 years in the USA – over 950,000 patients have been treated worldwide

* More than 52,000 dentists have been trained in Invisalign

* Over 500 new Invisalign cases everyday

* Over 20 million aligners have been shipped worldwide

How Invisalign Works

Invisalign uses clear aligners to move teeth. The aligners are changed every two weeks, allowing gradual movement of teeth and minimizing discomfort. These aligners are customized for every patient. Patients are generally given three sets of aligners and they only see the dentist every 6 weeks to check on the progress of their case. Thus, there is reduced frequency of appointments needed compared with braces which requires appointments on a monthly basis.

Key Benefits of Invisalign

1) Teeth are straightened invisibly – as mentioned above, few people can tell that you are wearing Invisalign….it is analogous to wearing contact lenses. Patients using Invisalign smile more during treatment and it does not affect their social life.

2) Invisalign aligners are removable – you can eat or drink anything and can easily brush/floss your teeth resulting in beetter oral hygiene. Studies have shown that Invisalign wearers have better oral hygiene and less gum problems compared with braces patients.

3) Comfortable – since there are no brackets, there are fewer abrasions to the mouth during treatment. The teeth also feel less sore since less force is used as the aligners are changed every two weeks, compared with the monthly adjustment for braces.

The Invisalign Consultation

Your dentist will examine your dental condition and discuss with you the various options to straighten your teeth, including the advantages and disadvantages of each method. If you decide to proceed with Invisalign, an impression of your teeth will be taken as well as a photograph (front and profile) of your current dental condition.

Your dental impression will be sent to a CT scanning machine and incorporated into the ClinCheck 3D animation software. This is a web-based computer program which will show the movement of your teeth from start to finish. Your dentist will discuss the ClinCheck case with you and make any necessary adjustments to your treatment plan. Once approved, all the clear customized aligners required for Invisalign treatment will be fabricated. For more information on Invisalign, please click here.