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

I have always counted my blessings in life – I was raised in a vibrant city at a rather prosperous period of time. I have parents who encouraged and supported my siblings and I to get a meaningful education – All four of us graduated from the University of Hong Kong, something which was rare in the 1980s. As kids, we never starved and never needed to worry about a shelter over our heads although my parents came from humble backgrounds.

If it were not because we had great teachers all along, life would have been very different. My father is a one-of-a-kind thinker/philosopher/businessman/teacher. I attended the St Louis School, a Catholic high school with unusual teachers, including a reptile scientist/national class soccer player who was an excellent biology teacher.

The time that I spent at Northwestern University, Chicago and UCLA during my post-graduate dental training was absolutely life-changing too. I credit this to my 2 ‘Johns’. My early exposure to my prosthodontics specialty under Northwestern’s post-graduate program director, Dr. John Chai, was nicely complemented when I went on to study maxillofacial prosthodontics under the world famous professor, Dr. John Beumer at UCLA.

I still remember trying to assess my odds of getting into UCLA and my conclusion was that the odds were very low. Yet, with the help of Dr. Michael Engleman, I ended up as one of three maxillofacial prosthodontics residents at UCLA in 1992 – my co-residents included a chair professor from Korea (Dr Hong Soon-Ho) and a sought after opinion leader in prosthodontics from the mid-west, USA (Dr Robert Faulkner). What impressed me was that both of my 2 ‘Johns’ are super high IQ human beings – I can still remember the great feeling of enlightenment when I listened to them.

Dr. John Beumer and his lovely wife, Jan, were in Singapore recently. John gave a fabulous two-day course with the Prosthodontic Society of Singapore.

Hearing him in his lectures again after so many years reminded me how lucky I was that he was my teacher 18 years ago… and he is now a friend. It was also wonderful to see that my two little girls, aged 6 and 7, had so much fun shaking hands with the numero uno in maxillofacial prosthodontics and a giant in implant dentistry.

I am currently active in teaching as an Adjunct Associate Professor at the National University of Singapore’s (NUS) Faculty of Dentistry, and also with the NUS Graduate Diploma in Dental Implantology. Why do I teach? Besides enjoying the interaction with the students and fellow dentists, I do it because I owe it to all my great teachers along the way.

               Happy Teachers Day!!!

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

 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. 

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

   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.

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 !!!

Specialist Dental Group is recruiting – if you are an experienced dental hygienist, read more to see if you are our ideal candidate:

• training and qualification as a dental hygienist (or equivalent)
• several years of experience working as a hygienist
• experience working with international patients, or work experience in another jurisdiction would be an advantage
• excellent clinical skills and communication skills
• ability to work as part of a team
• patient centred with a customer service focus

Our clinic opens 5 1/2 days a week and offers the opportunity to work with a great team of people.

To apply, click on our application form.

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.

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.

  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.

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.