She had a tumour successfully removed from her jaw but Meena was left with a severely collapsed cheek. Requiring expertise not available in her native India, she decided to come to Singapore.

 By Keith G Emuang (keithg@emuang.org)

“My mouth was a warzone! I couldn’t chew, swallow or speak properly at all. It was distressing,” recalls Meena, a 62-year old homemaker from New Delhi.

This was after she had surgery in June 2007 to remove a malignant tumour in the left side of her jaw. Meena had to undergo two months of chemo-radiation therapy thereafter. Although she had won the battle with cancer, there was a casualty – her upper jaw bone – or precisely the 25 per cent of what was left of it.

Even though the initial promise of oral rehabilitation had lifted her spirits somewhat, several months later, it became clear that her recovery was not progressing as she had expected. In fact, it had not progressed at all.

“My mouth was simply useless and I told my husband that this cannot go on. He agreed and that’s when we decided to do something about it.”

Only the best

Meena’s husband, a medical doctor, decided to speak to his colleagues whilst combing through several renowned medical journals. After a studious search, he identified the specific dental expertise that his wife required. However, the challenge was finding it.    

He shares, “There are many prosthodontists but not many have a super-speciality in maxillofacial prosthodontics. Moreover, we wanted a specialist with experience and who was recognised in the field.”

Prosthodontists are dental specialists who are skilled in the replacement of missing teeth and the restoration of natural teeth. Maxillofacial prosthodontists, on the other hand, treat patients who have defects of the head and neck (maxillofacial) region due to cancer, surgery, trauma, and/or birth defects.

Eventually, a shortlist of five maxillofacial prosthodontists was made and following an exchange of email and phone queries, he settled on one from Singapore. 

“Dr Cheng was very prompt with his replies and they were good responses too. Besides, his work had been published in several journals which mattered to me,” Meena’s husband says.

In late November 2009, the couple arrived in Singapore to meet Dr Ansgar Cheng, a Prosthodontist at Specialist Dental Group.

Straight to work

“Meena was distraught when I first met her. Although the combination of surgery and chemo-radiation therapy was effective in treating her cancer, there was not much meaningful work done to restore function to her mouth. Even the denture prosthesis she was given did not fit well,” outlines Dr Cheng.

According to him, Meena only had five functional teeth in her upper jaw. The rest, many of which had root canals done on them, were badly decayed as a result of the cancer therapy. Moreover, the dental bone on her upper jaw was completely gone, leading to another major concern.

“She was missing a seal between her nasal and oral cavity and this caused the accumulation of secretions which was hampering her speech and swallowing abilities. We had to give her a new platform to support the reconstruction of that seal, and new teeth too,” explains Dr Cheng.

A day after she arrived, Dr Cheng began work on restoring Meena’s mouth. By the time he was done in early December, some 17 days later, she had a functional rehabilitation on her upper jaw, five teeth reinforced by titanium posts, three root canals redone and 10 Zirconia crowns for protection and good aesthetic effect.

Meena also had a palatal obturator fitted which covered the hole in the roof of her mouth that leads to the nasal cavity. This obturator replaced the missing 75% upper jaw bone and the missing teeth.

A new beginning  

Dr Cheng remarks, “She was not just missing teeth. Meena was literally handicapped when she came in and her speech was unintelligible. Fortunately, we have managed to give her back significant function to her jaw and teeth, and within a reasonable time frame.

For almost two years, Meena had not been in the right state of mind to enjoy most things. Unable to bite and speak properly, her social life was affected. Today, she is a different woman and is quick to point out where her gratitude lies.   

“I was apprehensive when I first met Dr Cheng but his calm and patient demeanor put me at ease very quickly. By the second day, I had put my full trust in him.”

Dr Cheng adds, “The trust between doctor and patient is vital. So when a patient trusts in their doctor, it makes it very easy for the doctor to carry out treatment.”

According to him, Meena is expected to recover well. He even suggested she put her new jaw and teeth to the ultimate test, which Meena gladly complied. A day and a few pieces of chicken later, she was reassured.

On 16 December 2009, Meena flew back to India – definitely more confident, clearly more excited and audibly more vocal than when she first arrived. Her mouth had been restored and judging by her future plans once she gets home, so too was her lifestyle. 

  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.

              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.

Specialist Dental Group is proud to be Nobel Biocare’s Diamond Partner in Singapore.  The combination of our dental implant team’s clinical expertise and experience with Nobel Biocare’s technology and innovative dental products results in more predictable and effective results so that patients can enjoy a better quality of life.

Nobel Biocare is a world leader in innovative restorative and esthetic 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 Nobel Biocare Partner Program recognizes an elite group of doctors – those who are the most experienced in the art of dental implants.  The Diamond Partner status is achieved by clinics/dentists who perform a high volume of implant cases.

Specialist Dental Group’s dental implant team consists of five leading specialists:

Dr Neo Tee Khin (Prosthodontist), Dr Elvin Leong (Prosthodontist), Dr Ansgar Cheng (Prosthodontist), Dr Helena Lee (Periodontist) and Dr Ho Kok Sen (Oral Maxillofacial Surgeon)

The clinic’s founder, Dr Henry Lee, placed the first titanium dental implants in Singapore over 25 years ago. Specialist Dental Group’s strong history in dental implants continues with the multi-specialist team of dentists, who are all active in lecturing and publishing clinical articles about their dental implant cases. All the implant team members are adjunct /part-time faculty at the National University of Singapore’s Faculty of Dentistry. Specialist Dental Group celebrated its 30^th anniversary in 2009.

Teeth Replacement Options

Nowadays, the terms ‘dental implants’, ‘crowns’, ‘bridges’, ‘veneers’, and ‘dentures’ have become a well-known term in our daily lives; particularly for those people with single or multiple missing teeth. These procedures are predictable for tooth replacement and are sought after by patients who are conscious of improving their appearance as well as to improve essential functions such as eating and speaking. The success rate of these procedures is determined by several factors such as: the patients’ existing lifestyle, the implant materials & technology being used, and the expertise involved during the surgery.

In addition to providing conventional dental implant treatment, Specialist Dental Group also offers the NobelGuide Teeth-in-an-Hour procedure, which uses a combination of the patient’s CT scan and proprietary 3D software to plan the implant placement ahead of time. This results in minimally invasive surgery with quicker healing and the patient leaves the clinic with his or her new teeth in one hour. Specialist Dental Group has created a patient education video on the NobelGuide Teeth-in-an-Hour procedure.

Specialist Dental Group generally uses zirconium crowns for dental 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.

               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 

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

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.