Monday, June 29, 2009

Economic Downturns

A person who sounded like an expert confidently declared that the economy is recovering. That’s because he has noticed that ordinary folks in T-shirts and bermudas are flocking to new property launches like a Singapore Idol audition. In the same breath, the expert thinks that dentists are not affected by economic downturns. He’s not alone. Many of my friends are surprised that dentists’ incomes are affected by a recession because they are still under the impression that dentists treat toothaches and nothing else.

Sure, dentists are trained to extract or fill up painful teeth, but how often do people have toothaches and need extractions? In fact, most progressive practices today do very few extractions. Even when a tooth is dead and infected, the treatment of choice is root canal. Educated, cooperative and motivated patients are expected to turn up regularly for hygiene visits even when they do not have any toothache. In the developed world, preventive dentistry (scaling, polishing, filling early cavities, mouthguards, removing impacted wisdom teeth) keeps many general practices busy. Yet, we often see people walking around with teeth encrusted with barnacles, oozing with plaque and bad breath. From the dentist’s point of view, it is extremely important that patients clean up the tartar on their teeth and arrest any early gum disease. From the average Singaporean’s point of view, it’s: no pain, no need to see dentist.

What else do dentists do? There is denture construction, crown and bridge work, implant dentistry. Again, in the developed world, people change their dentures every few years. They do crowns and bridges to restore broken or missing teeth. They also go for dental implants. All these procedures come under the field of restorative dentistry. From the dentist’s point of view, most people who have lost some teeth will require restorative dental treatment. It restores the person’s smile and function. However, we often see people walking around with missing teeth. Those who have lost back teeth often don’t bother to replace them, resulting in the remaining teeth drifting everywhere. From these people’s point of view, restorative dentistry is not necessary. Why? No pain, no need to see dentist.

A combination of preventive and restorative dentistry form thee bulk of the average general dental practitioner’s income. Both fields of dentistry can be rather recession prone. Take implant restoration for instance. An economic downturn of this magnitude will have a very drastic impact on patient acceptance of procedures like implants, crowns and bridges. For many practitioners who have upgraded themselves and acquired new skills to perform sophisticated procedures, the bulk of their income will come from these procedures and the handling of nasty toothaches. Tooth whitening and other cosmetic dental procedures form the bulk of treatment rendered in many upmarket practices.

But the “experts” are right in thinking that someone suffering from the intense pain of acute pulpitis will not hesitate to see a dentist regardless of economic situation. By the same token, they should also realise that only a nasty toothache will force a person to see a dentist regardless of economic climate. While it’s good that dentists are doing more root canals, more preventive and restorative treatment, these treatments may end up working against dentists by reducing the number of toothaches in a population which still cannot accept preventive dentistry as a necessity.

Monday, June 22, 2009

Wisdom Tooth Surgery

Wisdom Tooth Surgery is Medisave claimable at our Medisave Accredited Day Sugery Centre

The wisdom tooth is the third molar. Most people have one in each quadrant of the mouth. However, it is not uncommon to find individuals with less than 4 wisdom teeth.

Because this tooth usually erupts when the person is about 18-21 years of age, it is called the wisdom tooth. In reality, the tooth is often non-functional or even problematic.

When there is insufficient space in the jaw for the tooth to emerge fully, the wisdom tooth may get trapped under the gum and bone. Partial eruption makes the tooth susceptible to gum infection which may result in recurrent bouts of pain and swelling. Left alone for long periods, chronic gum infection can lead to fibrous growths or cyst formation.

In certain cases, the tooth may be slanted against the next tooth - the second molar. The resulting gap between the two teeth traps food and promotes bad breath as well as decay.

Wisdom tooth surgery is usually carried out to save the second molar or stop the recurrence of gum swelling. In some individuals, the eruption of their wisdom teeth coincides with the appearance of their front teeth being pushed together. Wisdom tooth surgery is also performed to allay fears of crowding/overlapping front teeth, though there is no strong evidence to prove that the crowding front teeth is the direct result of pressure from erupting wisdom teeth.

There are various categories of wisdom tooth impaction. Below are some of the most common positions that impacted lower wisdom teeth may end up.

Vertical impaction

Mesio-angular impaction

Horizontal impaction

Disto-angular impaction

The depth of the impaction will affect the degree of difficulty in removing the tooth, but angulation also plays a part. Generally, vertical impactions are easy to deal with while horizontal and disto-angular impactions are challenging. I have successfully removed wisdom teeth in all the above categories.

Most wisdom teeth in the upper jaw can be extracted without surgery. Wisdom teeth in the lower jaw are usually more troublesome. Most dental practices are only equipped to provide local anaesthetic. For relatively simple cases, local anaesthesia, delivered by injection, is usually sufficient.

Saturday, June 20, 2009

What is "Alamak"?

"Boy, lots of food here. Come down with Papa and your brother. I'm not buying dinner tonight, faster huh ."

Alamak Patient (in Hokkien or Teochew): "Nay, this one is the pull teeth one lor."

"I warn you first huh. (pointing finger at dentist's nose) I very scared of dentists one huh. You better don't frighten me huh."

It may surprise some people, but many heartlanders in developed and progressive Singapore still treat a visit to the dentist like a visit to the barber. They don't bother to bring any identification or make any appointment. They also may not co-operate in history taking. What's more, they often think that dentistry is a craft no more complex and demanding than changing tyres. In fact, they think that teeth are much easier to handle because they're smaller than tyres. Not to belittle mechanics, such unfair comparisons give patients the impression that we are always "overcharging".

The word "alamak" probably originates from a Malay slang meaning "oh dear". It is used here to describe a boorish, ungracious and kiasu heartlander who has no respect for dentists as professionals practising a complex and diverse form of healthcare that requires a tremendous investment in many years of education and training.

All the cases depicted below are real. Some are even typical and recurring. We are happy to note that our clientele has evolved over the years and currently, the majority of our patients are not alamak. This website has helped us a lot in our effort to upgrade ourselves to a cosmetic dental centre.

Tuesday, June 16, 2009

Secret To Get Rich???

Most self help books are useless and some are more useless than others, so when I read a self help book, I’m not looking for any real help. Instead, I look for honest opinions and insights on the topic being dealt with. This book does contain many good and honest insights into what makes a business as successful as the author’s.

Dominating your niche means going all the way to stand on top of your competitors. Sounds fierce? Well, the author begins with an intro for newbies on what entrepreneurship is all about. You must:
1. Have a reason to go into business
2. Think big and aim high
3. Be obsessive about it
4. Focus on profits
5. Burn bridges and don’t think about turning back

It’s only in Chapter 3 that the author starts talking about niche markets. How does one find a profitable one and avoid making the mistake that Crazy Horse in Singapore made? The answer lies in market research. The author went into pest management after finding out that most hospitality establishments in Singapore changed their pest control companies like the way people change their underwear. That’s because the service provided by most of these companies fall way below standards expected of them.

The author chose this niche because there was a desperate demand for better service and corporate clients were willing to pay a premium for it. The author gives us examples like Charles & Keith and Song of India restaurant - which I think are not totally appropriate as far as niche domination and providing something desperately needed are concerned.

Printed in large font at the beginning of Chapter 4, is the statement:

The bigger and more serious the problem, the more valuable your solution.

That’s very easy for us to agree with. Problems are everywhere. We identify those problems and solve them. We differentiate ourselves by doing things differently and better, charging more for it. To be a leader, one must also charge leading fees and provide top notch service. Not only that, one must dress and act like the industry leader, also making sure that employees are well-groomed and company vehicles well-polished.

The next few chapters further support the author’s belief in going all out to stand on top of all competitors. Networking is important. It’s not just who you know but who knows you. Get testimonials. Get awards. Overcome customer resistance with guarantees. Be a good leader to your staff. Scout for and retain talented people. Empower them. Implement new technology and ride on the next wave.

Even long before the book finishes, the astute reader should have realised that there are not too many secrets in this book. It may make him wonder why he’s spent $32.55 (before discount) on it. One of the reasons for the author’s success in his niche must have something to do with his less well-educated competitors. Better able to upgrade himself and acquire new skills and technology ahead of his competitors, it’s less difficult for him to outwit, outsell and outperform his competition.

Well, I guess even this “secret” is an open one. We are seeing more and more graduates engaged in businesses traditionally handled by the academically challenged. I know a temple medium who speaks fluent English. With so many intelligent competitors who have as much access to cutting edge technology and an equal ability to learn new things from developed countries, it won’t be long before it becomes impossible for to rise above a level playing field unless someone has an unfair advantage (e.g. rental-free father’s shop) to begin with.

This book has not been a waste of time for me. I don’t expect too much from self help books these days, but the author’s long road to success is an inspiring one. I admire what the author has done even though very few of those who have read the book will be able to achieve the same.

Monday, June 15, 2009

“Student Promotion”

Get a whitening gel and trays at $295 only!

Hurry up!
Call us now @ 62358316 for an appointment
While stock last***

Terms & Conditions:
  • Must present student pass upon arrival
  • Strictly by appointment only
  • Valid until 30th July 2009

Crown Lengthening

Ask : Jan Schuneman

before making additional veneers the gum has to be operate (reductio, lift up the gum), after a couple of weeks the ceramics. Yes indeed she very beauty and I'm sure with a perfect treatment she will be a model! Those are cases what we do nearly every day....

Answer : Dr Chan

Using conventional crown lengthening techniques, the gum level takes 2 months to stabilise. With laser, you may be able to get away with 2 weeks, but I wouldn't take the risk, especially when bone is involved. One month perhaps.

Sunday, June 14, 2009

"adjust denture"

I made a set of dentures for an old lady a month ago. It was a challenging case. Yes, that dreaded bilateral free end saddle again. I took care to design a chrome denture that would not move too much whenever the patient bites. But as free end saddle dentures go, there would always be a dragging effect in the saddle area.

As a rule, I warned the patient not too have such high expectations. As usual, the patient agreed and as usual again, the complaints keep coming in. This time, the one relaying the complaints were none other than her American-accented daughter. The Hokkien-speaking patient was nowhere in sight.

“Just trim the denture here and here.” she said, pointing to the appliance.

“I need your mother to be here to ascertain where the trouble spots are.” I said.

“Let me tell you. They’re here and here.”

“We need to be more precise than that. It’s useless for me to trim the denture without any reference to sore spots in the patient’s mouth.” I tried to explain.

“How do you know it wouldn’t work? You haven’t even tried.”

Well, suffice to say that even people who speak with an American accent may not know how dentures work.

Saturday, June 13, 2009

Aloe Vera Gel

Aloe vera gel is made with the most concentrated amount fresh Aloe Vera leaves on the market, this cooling gel forms a protective barrier that helps retain moisture and promote healing. Aloe vera gel is a clear, cool, transparent gel that comes from the aloe plant. It is used topically for a number of skin problems. The gel forms a protective barrier which helps maintains moisture and promotes healing. It helps cuts, scrapes, and scratches heal more quickly (superficial, minor ones). It seals off an injury and helps new cells form. Aloe vera works for burns, sunburns, and frostbite. It increases blood flow to areas of burned tissue, which hastens the healing of cells. The gel has enzymes that relieve pain, reduce inflammation, and decrease redness and swelling. It also has anti-fungal and antibacterial properties.

I had been using an Aloe Vera gel for two weeks . What's I do is apply Aloe Vera gel in my face let for 5 - 10 minutes and than wash with the cold water. It is really work , my face was improved.

Friday, June 12, 2009

Consult my dentists

Welcome to New Age Cosmetic Dentists’ virtual consultation room. We’re here to give a little background information on the treatment you may wish to have at our clinic. Here are a few points to note.

1. We are clinicians and not webmasters. Replies will not always be prompt.
2. We will not be able to offer second opinions or an accurate diagnosis before we examine you.
3. All entries are moderated.
4. We respect your wish to be anonymous, but all IPs are logged for our own protection.

As more questions are received, we will still publish the newest entries on top, but at the same time, we will create categories. For example, all root canal enquiries will be grouped under one category while enquiries concerning implants will fall under the implant category. This will make it easier for our visitors to search our archives for the answers they’re looking for.

Wednesday, June 10, 2009

Dental Implant

Not all patients are good candidate for dental implants. You must consult with your dentist and see if you are suitable for this treatment procedure or not. You will surely not want to undergo a procedure that is not suitable and suffer from complications.

Ideally, a person who has healthy gums and enough bones on the jaw is suitable to undergo this procedure of dental implant. The dental implant or the artificial teeth is placed at the jawbone and this is why a person must have strong jawbones to be able to undergo this procedure of treatment.

Mostly dental implant is used for replacing a missing tooth.

Teeth loss can happen due to many reasons, but this does not mean that this condition cannot be corrected. It may be that a person is experiencing missing teeth because his teeth had to be extracted due to excess decay. Teeth loss can also occur due to accident and old age besides following unhealthy dental habits.

Good candidates:
  • good health
  • healthy gums
  • enough bone to anchor the dental implant in the jaw
  • commitment to daily brush and floss the implanted teeth and surrounding gums
  • commitment to make regular visits to the dentist
Problematic candidates
  • young patients whose jawbones have not fully developed
  • pregnant women
  • heavy smokers
  • alcohol or substance abusers
  • patients receiving high-dose irradiation of their head or neck
  • people with chronic diseases or systemic problems, including high blood pressure, diabetes, connective-tissue diseases, hemophilia and significant immune deficiencies.
  • patients taking steroids or drugs that suppress the immune system
  • people who severely grind or clench their teeth
*** Smoking retards healing and reduces the chance of implant success.

Dental implant is a device that is specially designed to be placed at the jawbone to aid and provide a support for the growth of teeth, bridge or crown.

Monday, June 8, 2009

How to improve her smile?

By any standards, this is a beautiful Asian girl. But she shows a gummy smile and has gaps between her upper front teeth.

A slight smile shows only gaps between her teeth.

A broader smile reveals more gums than teeth.

What would you recommend or what do you think can be done to make her even more beautiful?

Sunday, June 7, 2009

Ask my dentist

Ash ask : Hi Dr Chan,

I am 54 years old. Lost most of my upper teeth save for two back molars and a canine due to extractions when I was very young. Currently using upper denture. I notice that that when I position my teeth such that the upper and lower front teeth are barely touching each other, I look fine but the moment I attempt a full bite, ie letting my upper and lower molars rest on each other, I look old with two severe lines (& folds) running down from the corners of my mouth to my jaws, and the lower portion of my face from my mouth to my chin appears to have lost much height compared with my younger days. Will asthetic dentistry or implants correct the problems so as to attain a younger appearance? Would appreciate your advice. What will be estimated cost of such procedure? Thank you.

Dr. Chan answer : Hi Ash,

The key concern here is to open up your bite. Your remaining teeth could have been shortened or moved such that when you bite all the way, your mouth becomes overclosed.

We’ll need to examine those remaining teeth to see if they are worth saving. If not, a set of full dentures will open up your bite. Bear in mind, however, that we may have to make 2 or more sets of dentures of gradually increasing height so that you can get used to your new bite.

Implants will certainly help hold your dentures, but if you have adequate ridge height, they may not be necessary.

Extractions aside, a full set of upper and lower dentures (acrylic) cost S$1200. Extractions will cost S$80 each. If the remaining teeth are not to be extracted, crowning will probably be necessary. Each porcelain fused to metal crown will set you back S$600. Then, you would also need partial dentures which will cost a little less than full dentures.

You can consider doing implants after you’ve gotten used to your new bite. To improve function and retention of your dentures, you would need 2 implants on your lower jaw and 4 on your upper. They will cost you S$3000 each.

Saturday, June 6, 2009

Cost of Dental Fillings

Amalgam Fillings
Believe it or not, the amalgam filling has a more than 150 - year proven track record. It is still one of the most reliable, predictable and safe materials with which to fill a cavity.

Composite Fillings
Studies over the past thirty years have shown composite resin to be a safe restorative material. There is no scientific evidence that composites cause adverse health effects in the general population.

But Composite fillings more costly than amalgam filling because need the technique for plancing them is much more demanding and more time to place. If you are thinking to replace your old filling to composite filling, it costs $80 and above.

Friday, June 5, 2009

Change we need???

Change but no Change

The word CHANGE worked wonders for President Obama. It would only be wise for others to follow, but when the followers have very different ideas about change in mind, the results can be funny.

“CHANGE is in the air for Singapore’s political system,” reports a local a newsPAPer. ”But change must be tethered to fundamental principles — three, according to Senior Minister Goh Chok Tong.”

First, they must be fair to all contesting parties and “not be biased in favour of one party or the other”, said Mr Goh, ahead of details to be announced this week by the Prime Minister.

Oh, of course. We certainly wouldn’t want any changes resulting in one party controlling all the newsPAPers, the TV and radio stations. I can’t imagine what would happen if our newsPAPers become a mouthpiece for Dr Chee Soon Juan. How come this first fundamental principle sounds funny even without any input from Mr Brown?

Second, they must result in a strong, effective Government. “We do not want a system which ends up with a weak, hung Parliament. And then you have a coalition Parliament that is politically unstable for Singapore.”

Huh? Level the playing field, but we must still win all? Why can’t a coalition government be stable? Because the strong government says so?

And third, these changes must “facilitate representation for diverse views in Parliament, including views of the Opposition parties”.

But such facilitation to previously disadvantaged opposition parties may well result in a “mixed” parliament and a government that is not as “strong” as it wants to be. How should this apparent contradiction be resolved? I’m sure SM Goh and the folks with him have their plans in place. I’m just not so sure if CHANGE has any real meaning when all is said and done. Imagine saying such things to the American people in President Obama’s shoes. Why not copy all the way and promise some change we can believe?

By Dr. Chan Joon Yee.

Thursday, June 4, 2009

Xiaxue's Smile

Wendy Cheng (aka Xiaxue) is probably Singapore's most popular blogger. Since she appeared before the camera, many viewers discovered that their star blogger has a gummy smile.

You can see her teeth look a bit short , when she smile is too gummy and her gums cover too much of some teeth while leaving the other the right length?
So her smile can be significantly improved with crown lenghtening.

Come to Orchard Road

It was a sad moment when my dentist sent what might be last denture case to SJ lab.

Some background info. SJ stands for Simon and Joseph. The two were formally dental technicians with the SAF. After the left the army, they decided to put their skills to good use and started a dental laboratory at Defu Lane, churning out highly economical dentures of acceptable quality. For the past 17 years at Hougang, My dentist had been sending my denture cases to SJ. They have never disappointed me. Every morning without fail, the SJ delivery man (never got his name) would ride down to the clinic on his little scooter to send or collect cases.

After the move to Orchard, my dentist still sent the denture cases to them. It was a bit inconvenient for SJ because he had to bring the cases down to Hougang for them to be collected and then bring the completed cases back from Hougang to Orchard. But with Hougang closed down, there is no more delivery and collection there.

One evening, My dentist paid a visit to SJ and spoke to Joseph about collecting cases from Orchard. There is still a demand for cheap temporary dentures at Orchard. Joseph said that he was sad to lose an old customer. But his biggest problem is that to enter the city to collect cases, whatever little profit he makes from the denture will be wiped out by parking and ERP charges.

How ridiculously obvious to some yet not to others. So what to do? He has to send the denture cases to new labs which do collect from Orchard. But many of these technicians are not familiar with my style like Simon and Joseph. What’s more, they charge a lot more. Maybe that’s to cover their ERP and parking costs. Apart from numerous phone calls from unfamiliar technicians who need clarification for my instructions, denture costs have also gone up tremendously. Can no longer afford to charge Hougang rates for my old regulars from Hougang.

We’ve been told by a wise leader to eat fish if chicken gets too expensive. Must be talking about ikan bilis as fish is always more expensive than chicken. What about dentures? If ERP charges are going to stop the cheap dental labs from coming down to Orchard, perhaps they could take the MRT? Let’s see how these wise leaders carry a few dozen stone casts and dentures down Orchard Road every day. Fish is cheap and stone casts have no weight. Which world are we living in?

Monday, June 1, 2009

My dental clinic on The Straits Times.

Today (Monday, June 1 2009) I saw my dental clinic on The Straits Times , Page C4.

I was so surprised when I saw my clinic came out on Straits Times. There's many dental clinics in Singapore, but we were so lucky was selected by them for F.O.C. advertising. Thank you so much for Straits Times.