♫۰♪۰My۰ working۰ place۰♫۰♪

Burmese model Mable Soe gets her teeth whitened for Xmas.

2010-12-22T12:07:00.008+08:00

Eee… Why Like That?

2010-12-13T23:05:00.003+08:00

That was my initial reaction to seeing those ugly trunks worn by the Singapore waterpolo team in the Asian Games. And after an initial “cooling down period”, I looked at them and went “eee… why like that?” again.

Not for an unnamed Singapore official in Guangzhou. He/she told The New Paper that it looked “obscene”. Next, Carol Tan, the resilience and marketing division director at the Ministry of Information, Communications and the Arts denied any involvement with the design of the trunks.

Ms Tan said: “We would have told them that their design is inappropriate as we want elements of the Flag to be treated with dignity.”

Not their fault.

Quite predictably, when team manager Samuel Wong heard about the complaints, he said: “There was no question of being disrespectful to Singapore or to the national flag. We sincerely apologise if it has offended anyone.”

A remarkable show of national pride, but Mr Wong and Ms Tan can save their apologies for me. I may find the design ugly and funny, but it will take a much bigger and thicker crescent moon to offend me. Apparently, the majority of Singaporeans are perfectly OK with the trunks. Even those who objected to them only had issues with the crescent moon and not with the stars. I’m not sure how small they’ll have to make the crescent moon to please everybody, but the last thing we need is for some puritanical prig to stand up and condemn the harmless trunks. And let’s not make the crescent moon too small or it’ll look paedophilic.

The trunks may look ugly and/or silly, but as a patriotic Singaporean, I’m not even going to say that they are ugly and/or silly. I’m going to say that they look great on our waterpolo team and all my support goes out to them. May they do our country proud and wear it over that unnamed official’s head after the match.

Screw Inner Beauty

2010-11-20T22:56:00.002+08:00

Screw Inner Beauty - lessons from the fatosphere by Kate Harding and Marianne Kirby.

I thought this book would be a wicked revelation of how superficial modern soceities are. I thought it would show us what really fills the minds of people who emphasise on inner beauty over outer beauty. I expected a funny, honest, candid and sarcastic style. Well, this book turned out to be totally beyond my expectations.

Well, it did start off with some revelation of hypocrisy by magazines that tell you to love yourself the way you are on one page and then carry tons of advertisements telling you how to change your looks for the better. Then, the authors revealed that they are fat and not ashamed of admitting it. That’s fine with me. It’s their own bodies. But the insights and advice that follow show how little they understand nutrition and physiology. It’s true that most people who embark on weight loss programs succeed at first but regain all the weight they lost, but that does not mean that the science behind dieting and nutrition is all wrong. Yes, experts have been paid to endorse programs and products. Some have even written books aimed more at selling than informing, but the science still holds. People become obesed because they take in too much and burn off too little.

Healthy At Every Size (HAES) is an interesting concept. I might even agree with it. No matter how some people exercise, they just can’t get rid of their thick thighs or buttocks. In fact, the majority of people who attend slimming programs aren’t even overweight. These are genuine victims of “media standards”. They should go for counselling instead of extreme weight loss programs if they are healthy in spite of an isolated chunk of stubborn fat that just wouldn’t go away. Perhaps they should even read the more sensible parts of this book.

However, there are many people out there who are indeed overweight and at risk of serious chronic illnesses. It’s factually incorrect for the authors to say that the majority of people will not be able to maintain their weight within healthy limits even if they exercise sufficiently and eat good food. The authors further postulated (wrongly) that there is no such thing as good food and bad food - just eat intuitively. That would be a recipe for disaster.

They seem to have forgotten that very few of our ancestors were fat because there weren’t much junk food, travelators and escalators back then. Malnutrition was a bigger (no pun intended) problem than obesity. We live in very different times and going intuitively with food loaded with trans fats and sodium without any discipline or knowledge to discern is exactly the source of weight problems (with accompanying health issues) in the developed world.

The part about choosing doctors who don’t tell you are obesed and at risk of certain illnesses is preposterous. How about avoiding the doctor who tells you you’ve got a tumour that needs to be investigated? Aren’t they supposed to be confident and in full acceptance of their bodies? Why bother to avoid doctors who comment on their weight? While I admire the authors’ positive outlook in life, I can’t help but conclude that they are people who are happy because they are blissfully ignorant or in denial.

I can’t comment on their advice on social life. I’ve never been fat and if one of them is happily married and other dating successfully, I guess, it’s OK to take some advice from them. Finally, take a look at Kate Harding’s picture below. Does she look that fat to you? Think twice before buying her book.

Bond & Conlour

2010-10-12T15:38:00.015+08:00

This Filipino Tai Tai's problem is quite obvious. Wear and tear chipped the biting edges of her upper incisors. Though she only complained about the chipped edge of the left incor, we decided to complete the picture, so to speak, by dong bonding on the left incisor and some contouring on the other teeth.

The chipped tooth has been repaired with composite resin. The other teeth have also been "sculpted".

Not many people will dare show their cases as this magnification.

Cost of Conscious sedation.

2010-09-25T21:43:00.008+08:00

We provide moderate conscious sedation for procedures taking less than 1 hour. Unlike deep sedation which is administered by an anaesthetist and costs $600 per hour, conscious sedation costs only $200. It is suitable for 1 simple wisdom toothe surgery or multiple extractions.

Getting To The Church On Time

2010-09-18T21:23:00.020+08:00

Here is one young gentleman we want to get to the church on time and having teeth like this just won't do . He was wearing a removable plastic denture. His central incisor is dead.

We did root canal for the dead tooth and bleaching for the other teeth.

His gums are still not "level". Gum surgery will be required to correct that and produce a more harmonious gum line.

We removed gum tissue on the left side.

Weeks after gum surgery shows remarkable healing. We prepared the 2 bridge supporting teeth.

The temporary bridge is in place. Even thought the shade of the temporary bridge is light, it appears darker than the patient's bleached teeth.

Cost of Root Canal Treatment

2010-08-19T08:57:00.003+08:00

If you are looking to do the root canal treatment in Singapore. Yes, you should ask for the cost of the treatment but the cheap root canal might not be the cheapest in the long run. Don't go to a dentist with whom don't have experience or you are not familiar just to get a cheap treatment. The better you should search to be sure first but I didn't saying that the dentist with the cheap fee won't do a good job .

How much does root canal treatment cost ? (in Singapore)

Central incisor, Lateral incisor (front tooth) about $ 350 - $400
Canine $400 - $600
First premolar, Second premolar $600 - $700
First molar , Second molar $700 - $950
(This price for GP )

For Endodontics Specialist about $950 - $2000

We are a Medisave accredited day surgery centre.

2010-08-08T21:20:00.005+08:00

Everybody wants to announce that after going through all that paperwork, briefings, training etc to become a Medisave accredited day surgery centre. Why do we go through all that trouble? Well, being able to draw from the patient’s Medisave to pay for surgical treatment is really cool. The patient is happy to tap into frozen savings, not having to pay cash and day surgery centres offering these services can look forward to better business from patients who may find it difficult to pay hundreds of dollars in cash. It’s a win-win situation.

Sure, the number of surgical cases rose after we became Medisave accredited. But along with those minority of genuine surgical cases, came a majority of irritating enquiries.

“Wa, your clinic accepts Medisave payment ah? Good wor. Ei, I do scaling can use Medisave or not?”

“For surgery only. Here is the list http://www.luckyplazadental.com/medisave/

“Scaling cannot ah? The filling can or not?”

“Please check the list of surgical procedures that are covered.”

“Filling also cannot ah? Then braces leh?”

It happens on the phone, it happens at the reception counter and it happens especially in email enquiries. Certainly, these people must either have seen the We are a Medisave accredited day surgery centre. sign at our clinic or saw our webpage with a list of claimable surgical procedures. So why do they still ask us these questions?

“Crown can or not huh?”

“Root canal can or not huh?”

As we receive more and more of these emails, we become more and more convinced that Singaporeans are becoming functionally illiterate. Is the word “surgery” such a piece of proprietary jargon that laymen can be excused for not knowing what it means? That’s obviously not true. Whenever we mention surgery to someone with an impacted wisdom tooth, he/she runs for the door. So why don’t people understand what surgery means when they see the word Medisave? Does seeing the word Medisave diminish one’s ability to read?

Perhaps it’s a little like the Hokkien pengs of yester-years who didn’t understand any orders in English except “book out”. Or could all these irritating enquiries come from spies acting on behalf of competitors who just want to see us wasting our time explaining to fake patients who pretend not to know? We may never know the source of the problem, but literacy aside, anyone not willing to pay for something not claimable is obviously not a very good patient to begin with.

Another Extreme Makeover by New Age Cosmetic Dentists's (Singapore)

2010-08-03T14:03:00.010+08:00

You don't need to be a dentist to tell that this is a challenging case. We marked her 2 canines for extraction. We'll also need to do some gum surgery on her laterals. Her incisors on the left side will also need to be "moved" to close the gap after the canine has been extracted.

Another look at how difficult this case is. Apart from extractions and gum surgery, we also need to do root canal on the incisors on the left side.

Extraction just done on the right side. There is hardly any gap between the lateral and the first premolar. This will be the easy side.

The other canine has also been extracted. Gum surgery done, exposing more crown height for the lateral incisors and the premolars. The gap on the right side is more significant.

Here's the patient's left side. There is a gap about half a tooth wide. We have already done root canal on the left incisors. We will later cut them off and rebuild with post crowns to close the gap.

4th day after surgery. Check out the healing.

The teeth have been trimmed down and temporary plastic crowns placed.

We will wait 2 months for the gums to stabilise, then we'll place emax crowns over them.

Emax crowns fitted, another ready for have nice smile.

Unbreakable Flexite Plus® Dentures

2010-07-20T15:50:00.001+08:00

Flexible dentures created a great deal of excitement when they were first launched. No more ugly metal wires. No more broken dentures. What's more, the denture can be bent or even twisted. It springs right back into its original shape. But the flexible denture fever quickly turned cold. Patients complained of dentures that didn't function (no chewing power) and caused pain whenever they tried to eat anything harder than boiled potatoes. Dentists complained of a material that curls up when trimmed and pressure spots that remain after trimming.

A few years ago, I had a debate with a manufacturer of a system of flexible denture material. I argued that basic prosthodontic principles dictate that major connectors of any removable denture cannot be flexible. For a long while, I have been making hybrid acrylic dentures with flexible clasps and rigid plates to take advantage of both systems. However, these dentures were breakable like acrylic dentures and the bond between the two materials was never perfect. I didn't believe that a fully flexible denture will work. True enough, many patients who have done their long-span flexible dentures have a lot of complaints.

Finally, one manufacturer recognised the problem and introduced a new partially flexible material. Flexite Plus is now our material of choice for all removable partial dentures. Unlike their predecessors which were flexible throughout and create problems when they are long-span, the new material is selectively flexible and shows rigidity when due.

The biggest advantage of this sort of dentures is that unlike the hybrid dentures I used to do, they are unbreakable like the former fully flexible denture systems. Like their fully flexible predecessors, they also do not have the unsightly clasps seens in chrome dentures. Flexite Plus clasps are still pink in colour. Unlike their predecessors, however, Flexite Plus plates are not flexible. This makes them capable of supporting chewing forces in long-span dentures.

New charges

2010-06-21T15:18:00.002+08:00

As our emax restorations become better known, we are also seeing more and more demanding patients. To compensate for our time, effort and increase in cost of material which we used to absorb, we will be increasing our charges for full ceramic restorations. Emax crowns will now be $900 per unit and zirconia crowns will cost $1000 per unit.

New Age Cosmetic Dentists team.

Is it "Sap Sap Sui" for you uncle?

2010-05-18T20:59:00.004+08:00

Shall we provide these entertainment for our surgery patients? Yes, i think we shall IF they will say YES to us after the consultation. How many of them won't say THAT'S EXPENSIVE? If they say "ok, i will do it."

Anyway, our clinic don't provide these kind of service at all. If you want, please bring it along on your surgery day.

We could provide IF NO ONE COMPLAINTS THAT WE ARE EXPENSIVE.

A RICH and EDUCATED man who scolded me on that morning. I remembered clearly that i told him "if you do any treatment in our clinic, we won't charge you any consultation fees". I thought he would understand my simple and broken english.

After he consulted the dentist, i told him "sir, it's $50 for your consultation." He starting to @#$%^&* to me. He scolded a lot of nonsense, i only can remember that he said "for me, $50 is just like a peanut! But i won't pay for it, because you told me that it's free consultation."

Wah!!! Since when i told him is "FREE"??? "If you do any treatment in our clinic, we won't charge you any consultation fees" doesn't mean IT'S FREE, am i right? Somemore he didn't do any treatment in our clinic, so of course we will charge for consultation fee. He was very angry. He said will ask lawyer to sue me due to i told him wrong information.

At that moment, i feel so innocent. I did nothing wrong. Is my english problems? Or the information i gave him is not clear enough?

After he @#$%^&*, he left clinic.

Well, that's the difference in between EDUCATED him and UNEDUCATED me! I think this is TOO MUCH for me!!!

Payment For Dental Surgery With Medisave

2010-05-07T21:55:00.002+08:00

Medisave audits have been driving many dental clinics crazy. Almost no clinic can escape without refunding money due to "overclaiming". It has been and will always be our clinic's policy to help our patients claim the maximum amount that MOH and CPF Board allow. We are not in the position to dictate or even advise our patients on what to do with their own money.

On the other hand, organisations which regulate the use of Medisave funds have the duty of protecting our patients' Medisave reserves. The maximum claimable amounts stipulated by MOH are not meant to cover 100% of the bill. As private practitioners, however, we always try our best to charge and claim in a way that results in no cash payment on the part of our patients. Nevertheless, this is not always possible. MOH has very rigid guidelines on the maximum claimable amount for a particular type of wisdom tooth condition. At the MOH side, the evaluation is based purely in xrays. It is common knowledge that Medisave is only for surgery and medication for chronic illnesses requiring long-term medication. Please DO NOT ask us if dentures, fillings, crowns etc can be paid for with Medisave.

Below is a detailed explanation on how much is claimable for each type of surgery:

1. Single Wisdom Tooth Surgery (maximum $950)

If your wisdom tooth looks like this on the xray, we will be able to claim up to $950 for the surgery. $600 is well within our charges for this surgery. If you present at our clinic for the removal of this tooth, we will take no cash from you.

If your wisdom tooth looks like this on the xray, we will only be able to claim up to $350 for the surgery. If you present at our clinic to remove this tooth, we may not be able to charge within the limit. Figure on paying about $200 in cash.

If your wisdom tooth looks like this, we will not be able to claim anything for you regardless of how difficult the extraction is. Sorry, we don't make the rules.

Surgical excision of 2-3 wisdom teeth (Max $1550)

If you are taking out 2 or 3 wisdom teeth at the same time and at least one of them looks like the second xray on top, you can claim a maximum of $1550. This may not cover you fully when all 3 extractions are difficult. You may need to fork out $200-$300.

Surgical excision of 2-3 wisdom teeth (Max $1850)

If you are taking out 2 or 3 wisdom teeth at the same time and at least one of them looks like the first xray on top, you can claim a maximum of $1850. This is within the range of our charges. You will not need to fork out cash even if both lower teeth require surgery.

Surgical excision of 4 or more roots/wisdom teeth (Max $2150)

If you are taking out all 4 of your wisdom teeth where at least one of them looks like the second xray, you can claim a maximum of $2150. If the upper teeth are simple extractions, $1400 will be well within our charges for the entire treatment. You will not need to fork out any money.

Surgical excision of 4 or more roots/wisdom teeth (Max $2600)

If you are taking out all 4 of your wisdom teeth where at least one of them looks like the first xray, you can claim a maximum of $2600. $2600 should cover everything. You will not need to fork out any money.

2. Surgical excision of soft tissue tumour ($200)

3. Drainage of Pus ($150-$200)

4. Root Canal Surgery (surgical removal of root tip after failure of root canal treatment) ($800)

5. Implant Surgery excluding crown $1250 to $2150 claimable

6. Biopsy ($200)

Change your gummy smile with crown lightening

2010-04-18T12:00:00.007+08:00

The patient shows a bit too much gum when she smiles.

We can tell that her teeth are not fully exposed. Quite a bit of her pearly whites lie beneath the gums.
Crown lengthening surgery exposes the covered teeth.

This is her new smile and gum line immediately after surgery.
We'll wait 2 months for the gums to stabilise before we make her veneers.

Do you want other people to respect you?

2010-04-05T20:52:00.003+08:00

It seems that a lot of people think that respect should just come to them. How can you really earn someone's respect?

Ms. Lee, came to our clinic yesterday. She was late for 45 mins by her appointment timing. When she came in our clinic, she looked so unhappy with everyone. I should say it more look like everyone was offended to her.

------ You need to do is respect others first. It doesn't matter who are they and so on. If you judge, you'll be judged. To do on to others as you want done on to you, treat others the way you want to be treated. You must respect those around you, before you'll get respect back.

Don't walk around mad or frustrated about what's happening in your life or in other people's lives. Take life as it comes. Be the first one to start up a conversation with someone, even if you don't know them. Find something you can talk about. If they're having trouble, help them out if they let you. Offer to lend a hand before you're asked...and most important, be honest with others and with yourself. If you know you won't be able to do something or can't make an appointment, don't lie just to make that person feel good that you'll meet with them. If you don't have time or have other things going on, tell them the truth. People respect an honest answer and an honest opinion.

No matter what the situation. When you see someone, smile. It's contagious, for the most part anyway. 95% of people you smile at, will smile back. They'll know that you are happy with yourself and with your surroundings. In turn, they'll give you respect by smiling back.------

Well, back to our patient. When i told her the total amount is $1xx.00. She asked "how much is the cleaning?" "$x0.00 for scaling and air polishing, another $x.00 for x-ray", i replied. She told me that "BUT I DIDN'T WANT TO TAKE X-RAY", so i told her that everyone of our new patient are compulsory to take a x-ray. She was very rude to said "but you didn't tell me!" I show to her immediately that we were written down on the medical history form. She just kept quiet and throw her ATM card to me.

After i passed the receipt to her, she just walk away.

Huh~ finally she left.

Please teach me what should i do?

2010-04-03T10:49:00.004+08:00

I still can remember clearly that our patient's husband blamed me late for work.

That was Monday. I was early reached clinic that morning, exactly 9.10am i reached.

When i squated, trying to unlocked the door, i heard he said:" Wah! A neh wua jia kui meng!..." He spoke to his wife in Hokkien. I felt so annoying, but i just kept quiet. Once i unlocked the door, i told his wife, "please go in and take a sit. Doctor will be coming in at 10am. Next time may be you can called up to book appointment in adbance, so that you no need to stand for so long to wait at outside. Some more we are open at 10 am."

I guess only blind people cant see that WE ARE OPEN AT 10am!!! I did't late, i was not only on time, i was early 20 mins than working time. She was politely replied me "it's ok. I called yu0 yesterday. But no one answered the phone."

I nearly vomit blood when i heard that. Yesterday was Sunday. Who is working on Sunday? I felt so helpless. I didn't bother about them after that until my boss came in.

Who can understand my feeling?

Teach me what should i do?

Ready to get new smile!

2010-04-01T22:50:00.011+08:00

This lady had always known that something was wrong with her smile. She thought it was just her protruding front teeth. Projected results of pushing her teeth back didn't help her see a favourable outcome. She also insisted on no braces.

She consulted us and was given a proposal for an extreme makeover incorporating gum surgery, root canal and emax crowns.

This is the gumline we thought she should have. All 4 front teeth must also be drastically shortened and pushed back.

The patient could tell that her upper lip and teeth were not "normal". This was her her very self-conscious "smile".

This is what she would look like if she had tried to smile naturally. Simply crowning her teeth backwards would not have helped much.

The patient is ready for crown lengthening surgery

Gum and bone were removed.

Suturing was done and her front teeth (root canal treated), were trimmed back and shortened.

It's barely 2 weeks after surgery. Healing is satisfactory. She is still hesitant about smiling, but this is roughly where her new gumline will be. The final exact position of her gums will only be known in 2 months. That's why we can only place temporaries.

Her temporaries will be removed in 2 months for impression taking.

Finally, the patient's emax crowns are ready. This is her new smile.

Posterior composites

2010-03-17T14:28:00.002+08:00

For the posterior composites we need only one appointment approximately on hour per tooth after already did the patient need to maintenance like use the normal brushing with the toothpastes and flossing. Avoid biting on extremely hard foods such bones, ice, meat, sugarcane etc. and can last about five to ten years for the cost will starts from $80 and above...

Why have to do Crown?

2010-03-12T13:02:00.003+08:00

Many patients call up and not really know what's a Crown?
Why have to do Crown and How much does it cost ?

A crown is commonly called a cap to cover / replaces that part of the tooth. The crown can be done for many reasons like you tooth chipped off , after root canal treatment done , your tooth discoloured or miss- shaped . The cost of the crowns is depend on the materials used and the skill of the dentist . For the crowns materials they are many type like metals, porcelain- metals, E-max , Zirconia .

Tips after done composite fillings

2010-03-11T15:32:00.002+08:00

1. Do not chew ice.
2. Brush normally at least twice a day
3. Floss teeth after meal, but pull floss out horizontally, not vertically.
4. Take multi - vitamins two times daily for one month before and after treatment
if gum tissue is inflammed.
5. Have your teeth cleaned or visit the dentist at least twice a year.
6. Make sure you are not grinding your teeth at night .
7. Don't bite your fingernails !
8. Don't pick at a newly bonded tooth with your fingernail. If you feel a rough edge with your tongue, return to the dentist to have the edge properly refinished.
9. To prevent fracture, avoid directly biting hard. And also try to avoid acids produced by sugar can attack the junction between tooth and restoration and cause stains and premature loss of the bonded restoration.

Implant Risk Factors : Implant Fracture

2010-03-09T13:59:00.003+08:00

Any experienced implant practitioner would have seen a good number of failures. From a surgical standpoint, success rate can be well over 90%. It’s not difficult to achieve such success rates because all that is needed to determine success of the implant is osseointegration - the process whereby bone grows onto the implant surface and “fuses” with it. This implant can then be loaded with a crown.

What happens after loading? It’s just like what happens after marriage. Nobody can be certain as many factors come into play. There are patients with poor oral hygiene. There are patients who grind their teeth at night. There are patients who love to chew on bones to get to the marrow. There are patients who abuse their teeth in ways we can’t even imagine. Practitioners who handle restorations and follow up over a period of time will be able to tell you that implants restorations can be highly problematic over the long term. Some patients will be quite happy with their implant restorations. Some will need to see their dentist every few months for some adjustments. The most common problems are screw coming loose, gum inflammation, bone loss, exposed threads. Sometimes, we see porcelain fracture. Sometimes, we get fractured abutments, fractured screws and even fractured implants. Practitioners who have not had any of such problems on their hands probably haven’t done enough implants.

Have you ever had a dry socket before?

2010-03-08T11:54:00.003+08:00

Dry socket is the most common complication following tooth extractions, such as the removal of impacted wisdom teeth. The most common of dry socket is significant pain and looks like a hole in the gum and it appears to have a yellowish. If you have a dry socket after extraction the teeth or after you removed wisdom teeth. I think you encourage to see your dentist or oral surgeon as soon as possible.

What's tooth decay?

2010-03-05T18:13:00.002+08:00

Tooth decay is the destruction of the enamel (outer surface) of a tooth. Tooth decay is also known as dental cavities or dental caries. Decay is caused by bacteria that collect on tooth enamel. The bacteria live in a sticky, white film called plaque. Bacteria obtain their food from sugar and starch in a person's diet. Tooth decay usually does not cause symptoms until you have a cavity or infected tooth.

When this occurs, symptoms include:

Toothache.
Bad breath or a foul taste in the mouth.
White, gray, brown, or black spots on the teeth.
Loose fillings.
A broken tooth
A tooth that is sensitive to pressure.

The pain may become worse when you:

Eat sweets.
Eat hot or cold foods or drink hot, cold, or acidic liquids, such as citrus drinks.
Chew food or gum.
Breathe in cold air.
Brush your teeth.

Severe tooth decay may cause a pus-filled sac to form in the bone at the base of a tooth. Symptoms of abscess include:

Fever.
Swollen glands.
A swollen jaw.
Deep, throbbing pain.

Advantages ( Dental Implant)

2010-03-03T11:11:00.003+08:00

Dental implant-supported replacement teeth look, feel and function like natural teeth. This means that you can eat and drink whatever you choose. But most importantly, dental implants often improve your quality of life in a very concrete way. People who have previously felt insecure about their smile can now have permanent teeth and that greatly improve their confidence and self-esteem.

Save healthy teeth - Implants do not require grinding healthy teeth. Implants preseve your adjacent teeth.

Eat whatever you want - Implants are stable and secure, so you can comfortably eat your favorite foods.

Keep looking young - When you lose your teeth, your jawbone shrinks - making you look older. Implants can help prevent this process.

An answer for life - Dental implants are the long - lasting solution - often for life.

Short surgery - Placing implants is typically quick and easy.

What is a dental implant?

2010-03-01T10:41:00.002+08:00

A dental implant is a small titanium screw that serves as the replacement for the root portion of a missing natural tooth. Dental implants can be placed in either the upper or lower jaws. Due to the biocompatible properties of becomes a good anchor for the replacement tooth. Dental implant can be used in solutions for replacing single or multiple missing teeth.

Diabetes and Oral Health:

2010-02-22T12:33:00.002+08:00

Diabetes is a condition in which the body does not produce or properly use insulin.

Insulin, a hormone made by pancreas, converts sugar and other foods into glucose. It then helps carry the glucose from the blood into your cells to be used for energy needed for daily life. Without insulin, your blood glucose level rises.

Diabetes makes all the tissurs in your body more susceptible to infection, including the tissues in your mouth. In fact, people with diabetes are twice as likely to develop gum disease when their blood glucose (sugar) levels are poorly controlled. Gum disease is caused by the bacteria in plaque - a sticky, colorless film that forms on your teeth. The plaque bacteria releases toxins that irritate the gums.

The root canal treatment procedure

2010-02-08T17:37:00.004+08:00

Know more about the root canal procedure.

Step 1 The first step in root canal treatment is to gain access to the dieased pulp by drilling a hold into the tooth.

Step 2 File used to remove dead pulp debris and bacteria.

Step 3 Examine by Xray to ensure the instruments go exactly to the end of the root and not beyond root.

Step 4 Paper point to absorb moisture.

Step 5 Medicament.

Step 6 Fill with Gutta Percha Points.

Could I Claim Medisave For My Wisdom Tooth Surgery?

2010-02-06T11:13:00.006+08:00

Are You Able To Claim Medisave For Wisdom Tooth Surgery?

Medisave have been and will always be our clinic's policy to help our patients claim the maximum amount that MOH and CPF Board allow.
Well, we are not in the position to dictate or even advise our patients on what to do with their own money.
The maximum claimable amounts stipulated by MOH are not meant to cover 100% of the bill. As private practitioners, however, we always try our best to charge and claim in a way that results in no cash payment on the part of our patients.
Nevertheless, this is not always possible. MOH has very rigid guidelines on the maximum claimable amount for a particular type of wisdom tooth condition. At the MOH side, the evaluation is based purely in xrays.

If your wisdom tooth looks like this on the xray, we will be able to claim from $650 for the surgery. We will take no cash from you.

X-rays below shown that the type of wisdom tooth are able to claim by Medisave.
There's quite a number of our patients managed to claimed medisave for their wisdom tooth surgery. 90% of them no need to pay any single for us for the whole process.

Something’s Got To Give

2010-02-02T11:55:00.004+08:00

Another impressive panel of “experts” was formed to help boost the economy. More enlightening advice to increase productivity. More “new” policies in the pipeline to control the flow of foreign workers. They decided that wine is good. Too much wine is bad. So what’s the plan? Increase foreign worker’s levy and keep the workers; the longer the better. Now why didn’t I think of that?

Strange world. Strange people. When billions are lost, people keep quiet. When there’s not going to be any football (don’t ask me which league, which match. I don’t watch football at all), you get angry protests from the public. This is my Singapore. The big and serious issues are discussed in hushed tones at the local coffeeshops. The petty ones get good and loud airing everywhere. Why? Because politically sensitive issues are downplayed by the media? Because football is a “safe topic” to complain about? But seriously, recreation is important.

You must either be very weird or very lucky to love your work. Even if you enjoy your work, you don’t want to be struggling to make ends meet when you’re in your 50s or 60s. But that is what’s happening in our society. Apart from a certain group of highly privileged people, we are all stressed out and struggling with all the hungry foreigners ready to take our jobs (even dentists are not safe).

At a dinner, a colleague of mine (Chinese man) joked that he wanted to send his children to India to study dentistry and then let them come back as “Indian dentists” since the chances of them getting into NUS are virtually NIL. We were put through a difficult and expensive course of study only to have foreigners coming in the “easy way”. We might as well raise our kids cheaply in a foreign country and then bring them back through the wide open doors on our shores if graduates who had gone through a much easier path (more holidays, less homework, lower school fees) are acccepted here.

Pass me another glass of wine. We might as well talk about football. Something’s got to give and drinking won’t always work. For me, it’s travel. It’s as important to me as football is to some guys. My Australian friend Lindsey who was beer-starved on an oil rig in Brunei once said that he needs beer more than he needs his wife.

Of course I wouldn’t risk the integrity of my skull by saying that, but people like my father simply cannot do without his daily yam cha sessions with his pals. Approaching 80 and after winning a battle against lymphoma 5 years ago, he is no longer worried about the big and small issues in life. He still does a bt of accounting every now and then, but sitting down with friends over a cup of tea and some tim sum is probably the most enjoyable thing for him. He doesn’t worry about whether his tim sum sessions earn him anything. He has a life.

In contrast, there are many young and stingy workholics who panic at the loss of $2 and they want to make every gathering with friends count. How many insurance policies can I sell? How many MLM downlines can I get from this outing? Which is why some people ask me what I stand to gain from my travels. How irritating. Of course I gain tremendously from these trips, but not in monetary terms. How do I explain that? Even Confucius can’t explain the four seasons to a grasshopper. Very often, I have to find excuses or highlight possibilities of finding treasures to justify a trip.

For many educated Singaporeans, a holiday means more than shopping, sleeping, watching trees grow, paint dry and catching up with the in-laws. For me, a trip without challenges and discoveries is a wasted trip. Not a real holiday.

I’m not a lazy person by any definition. In fact, I think I’m certifiably overworked and deserving of some reward. People who think I’m not working hard enough are just self-centered, inconsiderate and ignorant bozos. With so many tight and sometimes humanly impossible schedules, something’s got to give. I need to pick up my backpack and hit the dusty trails, write a story, take some nice pictures as much as football fans need to watch the World Cup, Father needs his tim sum and Lindsey needs his beer.

How I Know?

2010-01-28T12:00:00.001+08:00

Yes, it should be “how would I know?” in English, but a direct translation from proper Chinese 我怎么知道?, Singaporean Hokkien: “wa mana ei zai?” or Thai : “ja roo dai yung ngai” would be “how I know?”.

Like “how would I know?”, all the remarks above are often made in indignance or denial of responsibility. Sometimes, such denial is fair. For instance:

“How would I know you would come visit me if you didn’t call beforehand?”

“How would I know there is an appointment if you didn’t tell me?”

“How would I know you were standing behind the curtain?”

“How would I know you were sleeping under the car?”

When you do things or make plans that others cannot reasonably expect to do or plan, “how would I know?” is a reasonable response from them when something undesirable or disastrous happens.

But there are also instances where “how would I know?” is unreasonable. There are too many of such examples in my daily activities and encounters. Indeed “wa mana ei zai” is not a good excuse when such things are common knowledge. Of course, we can’t know everything; not even if it’s common knowledge. When these gaps are identified, the best thing we can do is to acknowledge our lack of knowledge, learn it, remember it and move on.

Of course, issues concerning “face” and “ego” affect everyone. We all feel good when our egos are stroked. We all feel unpleasant when we are embarrassed. Such feelings are universal. Not so universal, however, is the typical response from people whose egos are bruised. In some societies, including certain levels of our own society, shocking violence may greet a person who has not show respect for someone’s “face” or “ego”. Identifying and bringing someone’s mistake or shortcoming to light is sometimes viewed as an unforgivable sin. Simply criticising someone or forcing him to admit a mistake can result in extreme violence.

When dealing with these individuals, it would be wise to just walk away when they say “how I know?” when their mistake has been pointed out. Pursuing further for an apology may result in the scene above.

On a milder yet no less extreme and unreasonable note, there are cases where the ignorant control freak decides and dictates what everyone can do or can’t do and then turns around to shirk all responsibility when it turns out that their decisions have not been that good.

“This is your plan. Your idea. Look what’s happened.”

“How I know?”

“You insisted on this and that, threatening when it’s not done according to your wishes. Look what has happened?”

“How I know?”

Huh? Shouldn’t you be listening to others and not throw tantrums at people who may know better because they have been in the business for decades?

“How I know?”

Push it at your own risk.

Dental Assistants needed-------URGENT!!!**

2010-01-27T18:38:00.002+08:00

Job scope:

Arrange appointments with patients
Assist the dentists in their daily routines and operations

Requirements:

Min "O" levels and above
Best to have dental assistance experience
Able to work office hours, 5.5 work week
Able to converse in Mandarin and local dialects would be an advantag.

SINGAPOREANS/ SINGAPOREAN PRs / MALAYSIAN ARE WELCOME.

Interested applicants please send in detailed resumes with your recent photo to poohfa@hotmail.com

We regret that shortlisted candidates will be notified. *

What to do if food gets stuck in your dry socket after wisdom teeth removal?

2010-01-07T11:56:00.011+08:00

Many patients have get food stuck at the dry socket after removed wisdom teeth. How to clean and reach the dry socket?

This is Antiseptic Mouth wash , you can buy from any supermarket or pharmacy .

Rinse mouth wash to the glass.

Pull and suck in the mouth wash.

Need special cap to twist piston with the syringe .

Rotation-fitting
Direct spray to dry socket.

So now you can get clean all the food that stuck in your dry socket , you can do this twice a day after food. Will help you to clean the dry socket that food stuck in.

How to Straighten Your Teeth Without Braces

2009-12-29T17:12:00.016+08:00

A young and attractive childcare teacher cum part-time model turned up at our clinic with an interesting problem.

Her main complaint was tilted right incisor. She could not put on braces as it would affect her modelling assignments.

Apart from a tilted incisor on the right side, she also has a retained baby tooth in the canine position

The tilted tooth affects her smile very significant.

An xray solves the mystery. The patient's permanent canine decided to lodge itself in the upper jaw bone directly above the right incisor. The "hidden dragon" pushed the root of the incisor backwards (palatally), tilting the crown of the same tooth forward (labially).
For those who are not familiar with xrays, we'ce traced the buried canine out for you.

The "hidden dragon" was surgically removed and the defect was filled with bone graft.

The patient was pain free from the second day after surgery. We proceeded to do a root canal on the tilted tooth.

Here's the tooth with fibre post and composite core built up.

Shade matching was a challenge. We didn't want to follow the colour of her other teeth too closely as she may want to do something about the unsightly spots soon.

She may also wish to extract her baby tooth and replace it with an implant.

And here is the temporary crown.

Stay tuned to see our e- max crown when it's ready.

Madam Soupless @ Fat Fish Thai Steamboat

2009-12-21T12:07:00.002+08:00

“What? $5 for the soup? Steamboat is supposed to come with soup. How can you charge me for it? It’s not that I can’t afford to pay for the soup. It’s just that this is the most ridiculous thing I’ve heard.”

This was the argument I overheard at the next table. It was between an angry woman in her late 50s and the poor waiter trying hard to explain company policy. You might think that she was shocked by the bill when the waiter showed it to her. But no. She had not even started yet. The waiter was just informing her upfront that they would be charging $5 for the soup.

I was having steamboat dinner with my friend Tsun Han at Fat Fish Restaurant at the Admiral Country Club on a Saturday night. They serve steamboat which included a generous spread of seafood and sliced meat buffet style. Like one reviewer said, “the prawns were so fresh that they squirm”. The staff was also friendly and attentive. The ambience was pretty good without being packed with noisy crowds. Well, at least it wasn’t noisy until Madam Soupless turned up and complained about the $5 soup even before she started.

Let’s see. The restaurant charges $22.80++ per person which was cheap. Adding $5 to the total bill would mean an additional charge of only a little more than a $1 for 4 people. So would Madam Soupless be happier if she were charged $25 (2 people at her table) with no mention of soup cost?

The restaurant’s policy is just an example of itemised charges promoting “transparency”. If charging Madam Soupless $5 was enough to freak her out, I wonder what would happen if the restaurant gave her a bill which looks like this:

Food $18
Soup $5
Utensils $1
Gas $1

$100 + $7 GST is ridiculous? $107 no GST is good? Look who is being not just ridiculous but also stupid.

Implant (No) Surgery

2009-12-14T13:03:00.001+08:00

Most implants are placed into bone which has already healed over the extraction socket. This requires surgery. The gums have to be cut, a flap retracted and bone has to be drilled. The retraction of a gum flap almost always results in some pain and swelling.

To make the surgery less invasive, some dentists do it flapless. In other words, they drill straight through the gums into the bone without cutting and reflecting a flap. After the flapless operation, the patient tends to feel less pain. However, flapless surgery is “blind”. The surgeon will not be able to see if there are any perforations beneath the gums. Where bone thickness is not ideal, flapless surgery may not be safe or even possible.

What about inserting an implant into an extraction socket immediately after the extraction? If possible, the advantages are obvious. First, the patient does not have to go through implant surgery at a later date. It is flapless and relatively atraumatic. It is usually a one-stage surgery where no further surgery is required to expose the implant. As implants take 2-3 months to integrate, placing it at the time of extraction shortens healing and restoration time.

What is not so obvious, is the technical difficulty of placing an implant into an irregularly-shaped socket. When you drill a hole into a clean wall, you can control the exact depth and width of the hole. When you drill into an existing hole, it’s very difficult to control the final shape and size of that hole. It is imperitive that the surgeon gets good primary stability and is able to place a wide, socket width healing abutment over the implant at the end of the surgery. The success of immediate insertion depends very much on the surgeon’s skill and experience. It also depends on the condition of the tooth.

Immediate placement is not recommended when.

1. There is pus and acute infection.
2. The tooth is very shaky with advanced gum disease.
3. Surgical removal of the broken tooth is necessary.

The conditions for immediate placement are very similar to the conditions for required for socket preservation with Alvelac bio-scaffold. As long as the socket is walled with bone on all sides, immediate implant insertion is possible. Forget about socket preservation. The immediate placement of the implant provides socket preservation, fewer surgeries and shorter healing time without additional costs.

About the denture.

2009-12-08T11:49:00.002+08:00

Who are have a missing some of their teeth first choice is denture but is depending on the type of dentures are chosen for our clinic we have 4 types of dentures to sevice you like partial denture , chrome denture, flexible denture and Titanium denture. If you are looking for budgets denture, partial denture are affordable option for you.

But most of our patients concern about how long do we need get ready for a new denture for them. The answer is about 3 weeks to get ready for issue.

First of all, you need to call to make an appointment , consultation with the dentists. The 1st appointment consists of an oral examination and and a set of impressions of the upper and lower edentulous ridges. It takes 2 to 3 days to go for the 2nd visit.

The 2nd appointment consists of deciding how "long" to make the teeth, determining the plane of the tooth setup, and the bite of upper and lower teeth so that when you bite together, the upper and lower teeth line up correctly. This is called "wax-bite".

The 3rd appointment is called the "wax try-in". When the lab returns the loosely fitting tray from the 2nd appointment with the actual final plastic teeth lined up along the outer edge of the wax rim. The wax try-in looks just like a real denture, except that the base fits loosely on the gums, and the teeth are embedded in wax instead of plastic.

The 4th appointment is for the issue denture. So that when the patient walks out of the clinic with new dentures.

For a cost of denture our clinic starts from a few hundred dollars to a few thousand dollars you can call us for enquire.

Low cost dental treatment

2009-11-24T14:08:00.003+08:00

The internet allows people we have never met to become our patients. It often starts off with an enquiry. This is followed by a consultation, a discussion and finally, treatment planning and finally the actual treatment is done. This source of patients is not to be under-estimated. It’s how we managed to build up a cosmetic dental practice. That was 6 years ago.

In recent months, however, we received a lot of enquiries from people who seemed like potential patients. This may sound like good news, but it isn’t. In the past when trust was easier to come by, a high percentage of people who contacted us via the internet did show up for consultation and treatment. Nowadays, enquiries are much harder to handle. Folks who seem interested try to settle the treatment plan, exact costs, guarantees and number of visits over a few emails. They don’t seem to realise that dentistry cannot be practised online. A lot of details of exact costs, procedures etc cannot be determined without an examination. Even with that, unforseen circumstances may result in a change of treatment plan. Insisting on precise figures is difficult at best and unreasonable at worst.

An example. How much does it cost to do a filling. $80. patient turns up with deep caries involving the pulp. This would require root canal treatment and it’s going to cost much more than $80.

“Can you guarantee that it’s only going to cost $80? No hidden costs.” comes the question by email.

Of course not! How can the dentist tell how bad your condition is and whether a filling is all you need? Don’t these folks realise that as far as I’m concerned, it’s their tooth that is hidden from me and not my costs which are hidden from them.

“I just want to do a filling. If you can’t guarantee that it’s not going to cost more than $80, then I won’t come.”

????????!!!!!!!!

So what if we quote reasonable charges. Some folks may be suspicious why Dentist A charges less than Dentist B. So these folks ask even more questions in an attempt to determine how reliable a dentist is without even turning up for consultation. Some of these questions are irrelevant and some can be downright weird. The more they ask, the more uncertain they become. Someone ought to tell them that the real answers to their doubts don’t show up very well on email. So usually, it back to cost factors. Cheapest practice wins. Not to say that the cheap practices are no good, but what about this thing called trust?

C, a colleague of mine has just been diagnosed with diabetes. His doctor? None other than our schoolmate in JC. The doctor is not an endocrinologist. He is just a GP, but C and his family has been seeing him since he started his own practice more than a decade ago. C’s entire family has not been seeing any other doctor ever since. No matter where they go or how much they charge or what additional tests, medications and procedures they indicate, their pool of loyal patients who see them several times a year follow them. It’s all about trust.

If there’s such a thing as doctor-for-life, is there such a thing as dentist-for-life? I’m sure there are. Quite a few have followed me all the way from Hougang. How do you choose a dentist-for-life then? Simple. Try out a few dentists for simple, non-invasive treatment like scaling. Pick one you like, show up regularly for scaling and develop a close patient-dentist relationship with him/her. He knows you. He recognises the importance of the relationship and is far less likely to do anything “funny” than someone who is seeing you for the first time. So what if there’s no Medisave in his/her clinic? So what if the clinic would only allow a 70% claim of surgical fees? Do you have to look for a clinic that allows a 100% claim (like mine) and shoot 100 questions at me because you don’t trust me? Please go back to the dentist you trust. Entertaining all these doubts, mistrust and reluctance to pay consultation fees is a waste of time for me.

How To Making Your Teeth Whiter.

2009-11-22T14:17:00.007+08:00

In this article, I'll give an update on my latest "discoveries" in this ever-changing field.

1. Chairside or DIY
No change here. I always recommend DIY whitening. It's more economical and it works just as well. Some say it works even better than chairside whitening.

2. Effectiveness
Recently, a Japanese dentist published a paper on what kind of teeth bleach better than others and I found it a really interesting read. He mentions (surprisingly) that dentine doesn't actually bleach. It's the enamel that bleaches. I tend to agree with that because in many of my bleaching cases where dentine is exposed due to abrasion cavities, that part of the tooth won't whiten.

If it's true that only enamel bleaches, then it will mean that people with worn out and yellowed teeth are unlikely to benefit very much from bleaching. It also means that areas where the enamel is thicker, like near the incisal tip, will whiten much better than the necks of the teeth where the enamel is thinner. Hence, the location of the staining is very important. If the tooth is darker around the tips, then they will bleach well. If they are darker around the gum area, then they may not bleach well.

The bad news is, Asians tend to have thinner enamel than their Causasian counterparts. This means that Asian teeth will not bleach as well as Caucasian teeth. Many of the claims by the manufacturers of bleaching products are actually based on Caucasian teeth.

3. New Products
For our DIY kit, we're now using 9.5% hydrogen peroxide. We are no longer using 22% carbamide peroxide. The new product is clearly more effective than the old. Besides that, additives like amorphous calcium phosphate go into the new packaging. ACP has been shown to be capable of remineralising demineralised teeth by cauing calcium phosphate to precipitate. It's supposed to help control sensitivity.

Patient feedback confirms that a reduced level of sensitivity is experienced with the new formulation. Our 9.5% hydrogen peroxide take-home kit is the most popular bleaching kit at our office today. It may take a bit longer than chairside whitening, but it's more cost-effective.

For chairside bleaching, we are still using 38% hydrogen peroxide. Not much "improvement" in that area as hydrogen peroxide in those concentrations is highly caustic. For lasting results, all chairside whitening procedures must be followed up with the take home kit. The way I look at it, there's really no point in doing chairside whitening.

4. Procedures

No change in that department. Impressions are first taken and a set of customised bleaching trays are made. If you book your appointment in advance, the trays will be ready in 1 hour.

The mixing tip is attached to a double syringe. As the plunger is pushed, the two chemicals are mixed together and activated. Each syringe contains enough material for 3 upper and lower applications. 3 syringes give 9 applications.

The activated gel is placed into the customised bleaching tray. The trays are worn over the teeth for one hour 2 times a day. They are quite comfortable and are almost invisible. However, the trays must be pushed in for a snug fit. The flexible tray is pressed against the teeth to clear voids in the gel. Excess gel on the gums is wiped off.

Big is in, small is out?

2009-11-19T11:29:00.004+08:00

So what’s new? Wellness Village packed up and left without any warning, Customers who have paid for packages, some just before the spa closed down, are now left in the lurch. When something like this happens, civilised consumers would seek help from CASE.

And here’s the response. Consumers Association of Singapore (CASE) executive director Seah Seng Choon said that he was “not surprised” by the spa’s actions.

“Don’t be fooled by the location. Spas are generally small businesses, unless they have an international chain … Consumers have to be careful when transacting with them,” said Mr Seah.

Huh? Did I get that right? What was Mr Seah (former General Manager of NTUC Denticare) trying to say? That consumers must be careful transacting with small operations like mine? That small establishments are weak, unpredictable or even nonviable in today’s economy? That they should “merge” with or just surrender to NTUC? That dental patients would be safer and better off with the big group practices and establishments employing hundreds of dentists because Mr Seah wouldn’t be surprised if small and humble practices out there fold up and pack up quietly after collecting deposits for crowns and bridges? That the big medical or dental groups going for IPO are somehow more reliable? Big is in, small is out?

OK, so Mr Seah’s comments have drawn some flak and he has bothered to clarify that the numbers show that SMEs are usually the ones that leave customers in the lurch. I don’t think we need to be reminded of that. There are far more SMEs than big companies out there. Of course the failure rate of SMEs will be higher. I think the problem everyone who objects to Mr Seah’s remarks has, is the derisive way in which someone working for one of the largest organisations in Singapore that has put so many pop and mom operations out of business should add insult to injury. And by the way, if a certain ethnic group in the country is more prone to divorce (as shown by statistics), would Mr Seah warn other people from other ethnic groups not to marry them?

Just take a look at the food courts run by the big players. Impressive theme, impressive uniforms, unimpressive food. Chances of finding good hawker food is much higher in small, one or 2-man operated stalls without any designer decor or uniforms. So why is it so difficult for so many of my middle management friends to understand why I don’t belong to group practices with scores of dentists and dozens of branches?

Why are so many seemingly intelligent people so easily impressed by the size of the company providing a service? Is it because we see with our own eyes how the big boys strangulate the little guys as the new generation of consumers place less and less value on personal touch? Will we end up as a nation of employees under one big employer? What happened to the promotion of entrepreneurship? Were those messages only meant for the scholars heading our GLCs?

Gosh, I’d better be packing my bags and heading for Cambodia soon.

Second times our clinic came out on Straits Times.

2009-11-16T15:36:00.004+08:00

Today (Monday, November 16 2009) I saw my dental clinic on The Straits Times again, Page C4.

I was so surprised when I saw my clinic came out on Straits Times again today . 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.

Aesthetic Filling Materials

2009-11-16T15:14:00.006+08:00

This gentleman has "pits" on his upper lateral incisor. He is bothered by them but didn't know that something can be done.

Many people are afraid to fill these cavities for fear that the filling will look worse than the decay.

Now you can see the composite blends in nicely with the natural tooth.

Why we call my working place "New Age"?

2009-11-15T13:12:00.002+08:00

A patient asked my dentists yesterday why your clinic called “New Age”. My dentists trying to say that he is still young? No, it was Ris Low asking, but the term “New Age” is not well understood by the majority in Singapore. Does it represent youth? Modernity? Not quite.

In fact, a lot of New Age concepts are rather ancient from an Asian point of view. It’s only from the Western point of view that religions like Hinduism, Buddhism, philosophies like Cosmology, Gaia Theory, Yin-Yang Theory, Five Element Theory and practices like yoga, meditation, qigong, various forms of traditional healing are all considered “new age”.

Derived from the rebellious hippy mentality of the 1960s, the New Age Movement represents a rejection of traditional or conventional religious dogma as well as rigid social structures and protocols. In recent years, this rejection extends to the fields of conventional medicine and scientific theories. Unlike the hippies, modern New Age Movement “activists” tend to embrace a more moderate, down-to-earth lifestyle.

Wikipedia:
The New Age Movement includes elements of older spiritual and religious traditions ranging from atheism and monotheism through classical pantheism, naturalistic pantheism, and panentheism to polytheism combined with science and Gaia philosophy: particularly archaeoastronomy, astronomy, ecology, environmentalism, the Gaia hypothesis, psychology, and physics. New Age practices and philosophies sometimes draw inspiration from major world religions: Buddhism, Chinese folk religion, Christianity, Hinduism, Islam, Judaism; with particularly strong influences from East Asian religions, Gnosticism, Neopaganism, New Thought, Spiritualism, Theosophy, Universalism, and Western esotericism.

Calling his clinic “new age” has something to do with his interest (He is not an extremist) in the New Age Movement, he inclination towards Eastern religions/philosophies, his belief in TCM, qigong and fondness for New Age music which often include sounds from scorching deserts to the freezing Himalayas.

While our youngsters celebrate Halloween like it’s the coolest thing to do, many young Western professionals in the New Age Movement actually find our Taiji symbol to be the coolest thing on earth.

Use Your Medisave for Wisdom Tooth Surgery

2009-11-10T21:18:00.003+08:00

The wisdom tooth is the third last molars. 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.

Payment For Dental Surgery With Medisave

Medisave audits have been driving many dental clinics crazy. Almost no clinic can escape without refunding money due to “over claiming”. It has been and will always be our clinic’s policy to help our patients claim the maximum amount that MOH and CPF Board allow. We are not in the position to dictate or even advise our patients on what to do with their own money.

On the other hand, organisations which regulate the use of Medisave funds have the duty of protecting our patients’ Medisave reserves. The maximum claimable amounts stipulated by MOH are not meant to cover 100% of the bill. As private practitioners, however, we always try our best to charge and claim in a way that results in no cash payment on the part of our patients. Nevertheless, this is not always possible. MOH has very rigid guidelines on the maximum claimable amount for a particular type of wisdom tooth condition. At the MOH side, the evaluation is based purely in x-rays.

After Wisdom Tooth Surgery

You will get Swelling and difficulty when you are open your mouth .
bite firmly on the gauze provided for at least half an hour. Take your painkillers before the numbness wears out. Do not keep spitting or rinsing your mouth. Swallow your saliva. Put the Ice/cold packs are very effective in controlling swelling when applied immediately after surgery. Remember to apply it outside your cheek. Never put ice inside your mouth or apply for more than 20 mins at one time. Allow 10 min intervals between ice applications. Please do not smoke, drink very hot drinks or alcohol and do not exercise , exert yourself. Get plenty of rest at home and take care not to bite your lip when it is numb. And last one when bleeding has stopped, eat soft food and keep the wound clean. Remember to see your dentist for the follow up.

MOST IMPORTANT you must take the antibiotics prescribed to you to prevent infection. We will also prescribe and dispense drugs for pain and swelling for you.

How to use Day White?

2009-11-10T17:30:00.003+08:00

Whitening Instructions for who need teeth whiter.
floss and brush your teeth. Twist off the clear plastic cap from the syringe and replace with the mixing nozzle. Place a small "teardrop" amount of gel in each tooth compartment in the tray. To guide you, the "gel drop" shown represents the average size drop you should dispense into each tooth compartment. Remember this is a guideline only. if you have small teeth, use a smaller "gel drop". Conversely, if you have larger teeth, use a slightly larger drop.

Place the tray with the gel in the mouth. Remove excess gel with you finger or dry toothbrush. When inserting the tray, becareful not to push the gel out, but be sure that the tray is completely seated. You may see "bubbling" within your trays while wearing them. This bubbling is acually part of the whitening process. Wear trays for at least 30 minutes, but no longer than 60 minutes. After whitening, remove and rinse the trays with cold water. Hot water may damage the trays. If necessary, use a toothbrush to remove any residual gel. Place the trays in the storage case, and store them in a cool, dry place Rinse and brush excess gel form the teeth.

Day white available at New Age Cosmetic Dentists.

Wish wish and wish...

2009-11-09T17:32:00.003+08:00

Everyone got their own dream and wish like their good job, good pay and bonus, strive sweep and toto. Of cause, most of us would want to be either a billionaire or millionaire, right?

The some of people who have the own business, they will wish to have a good business, good customers at the mean time also keep hoping and wishing their dream come true.

For me, i still like and enjoy with my work. But what's i wish is ... i wish can get a good patient like today. Suprisingly, we have a walk in patient who came from Holland. Past 3 weeks, her father and her went to Bangkok, Phuket, and PP Island for holiday. Due to "no direct flight" from Thailand to Holland, they needed to transit in Singapore. So they had about 5 hours to shop in Singapore.

She decided to look for a dental clinic to whiten her teeth. Her father told us that because she quited from smoking, so she wants to whiten her teeth. She was so excited. After We explained to her the kinds of whitening teeth treaments, she decided to have whitening chairside which cost her $650 only. During the her treatment, her father was told me that the cost of dental treatment in Holand are much more expensive if compare to Singapore.

The treatment only took her about an hour. She was so happy and satisfied with it.

"YES" Patient happy we also happy too. One of the good patient that i am looking forward...

Zirconia crown

2009-11-05T12:24:00.008+08:00

This Australian teacher has been brushing his teeth without mercy for many years - so much so that the bristles have worn out the necks of his teeth, causing "furrows" which gradually weakened the teeth.

One day, he bit on something hard and his lateral incisor snapped. We handled the emergency by doing a root canal followed by a temporary post crown built up freehand with flowable composite.
As a temporary measure, we "planted" a stainless steel wire into the space created after removal of the nerve. A composite crown moulded entirely freehand from flowable composite was built up around the wire.

All done within an hour. The patient will be called back for the permanent crown which will be customised to match the colour of the other teeth.

Here is the tooth prepared for post crown.

A zirconia crown is fitted

Generally, zirconia does not have the same translucency as emax. However, they still look quite natural. Why zirconia? It's easily twice the strength of emax.

Cheap Dentist In Singapore

2009-11-04T18:09:00.008+08:00

Have you ever facing the problem of seeking for experienced dentist with reasonable/cheap chargers in Singapore?

If it is YES, i would strongly recommended Polyclinic. But, do you have the time to queue up for the appointment? If you're having toothache right now, and what you need is root canal treatment ,wisdom tooth surgery. Singapore polyclinic will still refer you to the specialist. That might be fine with you. Of cause straight away you will be visiting the specialist to solve your pain. Another problem you have to face is to queue up at the specialist.

When you are having toothache, do you think you still have the patient to queue up for few days, a weeks or even take months for the appointment?

Well, you'll always have the second choice in your life. I am here to settle all the "problems" that you will be facing or you are having now. With the requirement of experienced dentist with reasonable/cheap chargers in Singapore.

Just email to me poohfa@hotmail.com . What's your problem ? we will try to solve and help your problem.

We can offer you the best price only.

2009-11-03T12:18:00.004+08:00

So what’s new? Kangaroo T shirts have gotten a bunch of outspoken fellows into trouble, stocks are still tumbling, Hong Kong’s financial regulators announced that they would guarantee all deposits for the next two years, using the territory’s foreign reserves as collateral, and our Finance Minister has once again said things that will leave many thinking Singaporeans scratching their heads.

“From the point of view of our system, it (guarantee for bank deposits) is not necessary because there is no lack of confidence in our system.”

Once in a while, I would get patients who want me to guarantee that their crown/bridge/implant will last x number of years. From a professional point of view, it is impossible to guarantee these services because there are so many biological variables involved. One patient may chew harder than another. One patient may brush harder than another. Another patient may love coffee, tea or wine. From an ethical point of view, it’s not honest or realistic for the dentist to guarantee. Some cases will fail and we all know it. But unlike ministers, we can’t declare that there is no lack of confidence in our services, “hence”, we can’t guarantee.

From a business point of view, however, it’s actually not too difficult to give such guarantees. The majority of cases will last x number of years. Even if the dentist has to redo some of those which don’t last x number of years for free, he is unlikely to suffer any losses as long as he has charged enough at the beginning. It sure is no fun having to redo a case that you’ve guaranteed but failed, but if it’s only 1% and if the guarantee boosts confidence and increases the absolute volume of your 99%, why not?

The same goes with well-known brands of electrical equipment. Even though consumers trust their products, brands like HP, Panasonic, Sony all guarantee their products. They are not worried about having to repair or even replace their products for free. Consumers know that the company will be able to afford it if their failure rate is low. With this knowledge comes confidence.

If any brand dares to stand out and say that there is no lack of confidence in their brand so they are not guranteeing it, then any discerning consumer will see the “logic” and quickly lose confidence in that brand. Why don’t you dare to guarantee if you are so sure that your system won’t fail? Nobody is going to cause me any anxiety by sticking his head out to guarantee my bank deposits. On the contrary, it’s reassuring to know that our “budget surplus” and massive “reserves” are not just things to boast about.

Get the better smile with e-max crowns.

2009-11-02T16:34:00.015+08:00

This middle aged lady has an obvious problem. Her 2 old crowns have come loose and her dentist failed to replace them in their original positions - which is understandable because they have detriorated so much.

We advised her to redo her PFM crowns with emax. After seeing what we have done for her daughter, she agreed.

The 2 old PFM crowns have deteriorated so much, it was impossible to seat them proper after they were dislodged. Notice the gap between the crowns as well.

Her original crowns were also protruding. She didn't have a choice of a better system back then.

Definitely warrants a redo.

We removed her old PFMs, masked the underlying colour.and impressions were taken.

The stumps were temporarily covered with temporary crown material.
After 1 week later her emax crowns is ready .

Yes , she come for fit her 2 emax crowns. Now she get the better smile!

Stronger & More Functional Dentures

2009-11-02T12:16:00.004+08:00

The teeth and "gums" used in a chrome denture are no different from those used in acrylic dentures. However, chrome, being much stronger than acrylic, allows a slimmer and sleeker design of the denture base. Not only can the base be thinner, it can also cover a smaller area of the mouth. Higher accuracy also provides a better fit. It's not surprising that in most cases, chrome dentures are superior to their acrylic equivalents. If function and durability are what you want in a denture, then go straight for chrome dentures.

The above denture demonstrates a situation called the free end saddle. When it occurs on both sides of the lower jaw, it is a challenge to the most skilled dentist. I would not advise anyone to have an acrylic bilateral free end saddle denture done. A good set of clasps on the remaining teeth will stop the denture from sliding backwards when the wearer bites. But the sinking force at the unsupported end may cause discomfort or even pain. A chrome denture may lessen the discomfort. Acrylic dentures almost always perform poorly under such circumstances.

Are there any disadvantages of chrome dentures over acrylic dentures? Well, first of all, chrome dentures are more expensive and take a longer time to construct. It is also important to note that chrome dentures often show more metal than acrylic dentures with thin wire clasps. Are you OK with the thick chrome clasps and rests? There are patients who deny that they are uncomfortable about the thick metal claps on their chrome dentures but keep complaining about other vague or non-existent problems instead. It is important to be frank with your dentist. However, one real problem with very large full upper chrome dentures, is the weight. In cases where the patient's upper jaw is not well-endowed with a high ridge or deep palate, full chrome dentures will be heavy and unretentive.

Another an actress replacement Single Implant @ My Dental Clinic

2009-11-01T12:15:00.005+08:00

This young actress showed up at our clinic with a hopeless premolar on her right side.

As her job requires her to look good in front of the camera all the time, she cannot afford to go without a tooth.

We extracted her tooth and inserted a tiny one-tooth Flexite immediate denture.

With pink coloured nylon claps and no coverage of her palate, she was able to look good before the camera and not have a denture plate interfere with her speech immediately after her extraction.

2 months after extraction, she came in for implant surgery. The healing was not very good and the bone quality not as good as we had wanted it to be, but we managed to insert a 4.5mmx8.5mm Osstem GSII implant into the space.

The extraction space after 2 months. Healing is not perfect, making the surgery a challenging one.
The implant is in place. The blue fixture mount was removed and the wound was stitched up. She reported only mild discomfort after surgery and went straight back to work. The restoration phase of the treatment will take place in 3 months. We will post the updates then...

The question for dental implant.

2009-10-26T13:34:00.003+08:00

Patient ask :

I heard from internet sources that dental implants last forever. A friend of mine had an implant done a few years ago and now it’s loosening. The dentist says my friend has poor hygiene. If implants last a lifetime, why is it that poor hygiene can cause it to loosen?
Admin answer :

Dental implants MAY last a lifetime. Their durability is dependent on several factors. True, implants don’t decay, but like natural teeth, the gums and bone surrounding an implant can get infected due to poor oral hygiene.

Chronic inflammation “melts” away the bone holding the implant. Even with very good oral hygiene, some of the older designs of dental implants have microgaps inherent in the system which trap bacteria and cause chronic inflammation, giving rise to bone resorption even with good oral hygiene.

With better knowledge nowadays, dentists are less likely to use systems which have microgaps. Still, inflammation and bone resorption will set in if implants are not properly maintained.

Whitening

2009-10-25T22:26:00.002+08:00

About Teeth whitening, have you ever wondered why almost every hunk or babe in the TV series Baywatch had such glistening white teeth? Well, of course no one would have paid too much attention to Pamela Anderson’s teeth, but the worst kept secret in Hollywood is, they all had their teeth bleached. That pearly white, “starry” smile used to be called the Hollywood smile. And it used to cost thousands of US$. Not anymore. The Hollywood smile has descended to the realm of mere mortals. Not only is tooth whitening readily available in dental practices all over the developed world, the cost for the procedure, like the US$, had come tumbling down.

Back in the good old days (20 years ago) dentists were taught that only non-vital, root canal treated teeth could be bleached. In those days, we would open up the pulp chambers of non-vital teeth, place hydrogen peroxide into the chamber and then, heat up the potent solution with a hot instrument. The whitening effect came fast and was very effective. Every science student can tell you that heating up hydrogen peroxide will cause it to decompose into oxygen and water. It’s the heat that speeds up the process and release whitening oxygen into the microscopic pores in the inside of the teeth.

Then, vital bleaching hit the market not long after I first started practising. Suppliers started telling us that even vital teeth which have not been root canal treated can be bleached with peroxide gel applied on the outer, non-porous surface of the tooth. It didn’t sound probable, but the “magic light” suspended our disbelief.

Fanciful light equipment like plasma arc lights, LED lamps, lasers etc burned holes through many a dentist’s pocket. It turned out that many dentists have either forgotten their basic sciences or somehow decided to go along with the suppliers’ marketing strategy. Light does not activate peroxide decomposition. Not plasma arc light and definitely not LED light which is cool. It’s heat that does it, so perhaps laser does work, but we can’t use heat on vital teeth or we’ll kill them. As far as bleaching is concerned, a safe, non-heat-generating light is a useless light.

Not only were some of these equipment bulky and expensive to rent, the hype generated by aggressive marketing tactics resulted in unrealistic expectations on the part of both dentists and their trusting patients who have paid about S$900 to S$1200 for mediocre results.

Tooth whitening with carbamide peroxide has been around for almost as long as I've been practising dentistry. However, very few dentists had their bleaching products flying off the shelves. I was curious enough to have tried out a wide range of products, encountered almost every kind of tooth discolouration and after countless complaints and praises, I more or less figured out some of the realities of tooth whitening. It’s not magic. It works for the majority of people but the degree of whitening varies from individual to individual. It doesn’t work for just anybody. Maybe that’s why not every lifeguard you see below is smiling. And the expensive, fanciful equipment are a big rip-off.

Cost of tooth whitening @ my clinic

2009-10-22T21:22:00.002+08:00

Cost of tooth whitening at my clinic starts from $400 for a customised DIY tooth whitening kit. Come for impression taking and wait for just one hour to collect the kit. No second visit required.

9 applications, can be completed in 4.5 days if you do it twice a day, one hour each time. The bleaching trays are super thin and virtually invisible, so you can wear them on your way to work or while you're watching TV.

Why save bad teeth?

2009-10-22T15:12:00.003+08:00

Controversial topic, but definitely worth discussing. I’ve often come across patients keen on saving teeth which are virtually hopeless. Of course, there will be dentists out there who are willing to take on these cases. Most of these cases are extremely challenging, prone to failure and expensive. Should these teeth still be saved? I think the patient needs to make a very well-informed choice and come to a decision accepting responsibility for the outcome.

There will be some successes in salvaging one of these “hopeless” cases, but neither practitioner nor patient should be carried away by all the hype in “new technology”. Take a look at the case below. The best option for this patient (and I would do it for my own mother) is to extract those 3 lower front teeth abd replace them with implants. But there are patients and dentists out there who would take up the challenge save those teeth. It’s OK as long as everybody understands the outcome and long-term stability of such measures.

Why Save Bad Teeth? Dental ‘Heroics’ Unnecessary And Failure Prone
29 Aug 2009

For years, it was common practice for dentists to perform repeat root canals and other procedures to save teeth compromised by extensive decay, gum disease and bone loss. Today, the American Academy of Implant Dentistry (AAID) said times have changed and patients should forego prolonged dental heroics to save failing teeth and replace them with long-lasting dental implants.

“There really is no justification for undergoing multiple endodontic or periodontic procedures, and enduring the pain and financial burden, to save a diseased tooth,” said John Minichetti, DDS, speaking for the AAID. “The days are over for saving teeth till they fall out. Preserving questionable teeth is not the best option from both oral health and cosmetic perspectives.”

Losing a tooth is an emotional decision and patients must clearly understand the oral health and cosmetic implications of preserving questionable teeth. Even though patients often resist losing natural teeth, in many cases the best outcomes occur from extracting them and inserting implants, which look and function like natural teeth.

“Our patients expect restorative dental procedures to make their smiles more attractive and long- lasting. In most cases, implants deliver the best results, as the ultimate goal is to achieve an esthetic and functional restoration for years to come,” said Minichetti.

Published studies have shown there is a higher failure rate of root canal procedures vs. dental implants. In some cases, root canals fail because abscesses occur, and oral surgery is required to clean out the infected area.

Minichetti noted that a recent study published in the Journal of Oral Implantology showed that single-tooth dental implants are 98.5 percent successful after seven years and there was no discernable bone loss in almost all the implant sites. First-time root canals fail 5 percent of the time, according to the American Academy of General Dentistry, and at much higher rates in repeat procedures. Further, endodontic surgical re-treatments, according to published studies, have success rates ranging from 37 to 87 percent.

Saving compromised teeth in the esthetic zone with periodontal treatments also can have unfavorable cosmetic results, according to Minichetti. “Periodontal procedures to save decaying natural teeth can require raising the gum line and exposing teeth roots to anchor a new crown,” he said. “The crown needs something to hold onto, so you have to push the gum tissue up with unfavorable cosmetic impact.” He noted that patients should always ask the dentists how their smiles will look if they chose to save a questionable tooth in the esthetic zone with a periodontal procedure.

Source: American Academy of Implant Dentistry

The food Kingdoms

2009-10-20T10:57:00.000+08:00

Not long after Kaelyn Ong gave a not so flattering review for the cakes and desserts at a shop at Joo Chiat called Obolo in her popular food blog, she received an email from the folks at Obolo telling her to remove the posting or run the risk of being sued.

http://myfoodsirens.wordpress.com/2009/10/02/obolo/

Sued? For what? For not liking their cakes and telling others about it? It doesn’t take an legal expert to see that Obolo may have been a bit ahead of itself. We haven’t heard Stephen Speilberg suing movie reviewers who said unflattering things about his work. Yes, J.K. Rowling has sued people for plagiarism, but I’ve never heard her sue any reviewer or hater who didn’t like Harry Potter. What about Governor Arnold Schwarzenegger? Has he sued anybody for laughing at his acting and his not so intellectual movies? Why are our local cake shops behaving like some of our local politicians then?

Maybe I’ve already answered my own question. But unlike the pitifully tenacious politicians at the receiving end of endless lawsuits, Miss Ong drew a tide of supporters on her side. Obolo was blasted for its bullying tactics. Everyone was calling for a boycott.

So why did Obolo do such a silly thing? Because they thought that as a young undergrad, Miss Ong would get frightened, give in to their threats and do as told? Well, that might have worked with me when I was Miss Ong’s age. But times have changed. Miss Ong’s defiance spoke volumes of the youngsters today. You can’t push them around anymore.

But then again, something didn’t and won’t really change. In spite of all the bad publicity, Obolo is unlikely to suffer much. That’s my prediction. Why? Because foodies are cheap. The endure rudeness, arrogance and profiteering from “good” hawkers just to get their fix. And just before I wrote this blog entry, I was at a noodle stall at Lucky Plaza. I ordered a chicken noodle and it took them ages to deliver. It’s only when i stared angrily at the other customers who got their food before me that they bothered to explain the cause for the delay - by shouting across 4 tables. When my food finally arrived, they didn’t even bother to apologise. In spite of such rudeness and arrogance (and their food is not exactly great), the stall still sees an enless stream of customers. Courtesy and good service are not criteria for success in this food business here. Every successful stall swarming with customers and long queues probably sees itself as a little kingdom and the hawkers running them act like kings.

I dare now imagine how I would be treated if their soy chicken were a bit more tender and their gravy a little more flavourful. The photo below is not taken at the stall I patronised. The last thing I want is to advertise for them.

Dental Implant Charges @ Dental Clinic

2009-10-19T12:36:00.002+08:00

Sleeping implants $300 cash $900 Medisave.

Implant placement + abutment placement + porcelain fused to metal crown using Osstem®/Dentium® implants S$3000 (S$900 payable with Medisave)

Mini implants + porcelain fused to metal crown for lower front teeth S$2500 (not Medisave claimable)

Full ceramic (zirconia) crown using Osstem®/Dentium® implants S$4000 (S$900 payable with Medisave)

Multiple unit PFM bridge (4 implants, 10 teeth) S$14,000

Multiple unit PFM bridge (6 implants, 12 teeth) S$18,000

Implants for denture support S$2500 each (minumum 2)

Additional Procedures (applicable to some cases only)

Bone grafting procedure to thicken ridge using Biogen® or Synthograft® S$500-S$1000

Internal sinus lift procedure using Biogen® or Synthograft® S$500

Sinus Grafting procedure using Biogen® or Synthograft® S$1000

Additional soft tissue graft using Alloderm S$300-S$800 (depending on size)

Another feed back from our patients

2009-10-17T21:35:00.008+08:00

This two patients did treatment with us and I accidently found our patient's feed back from www.revahealth.com Thanks Valley Yong and Mangoes.

Below is what I got from revahealth webpage.

From : Valley Yong,

"Of course I will go back"

Valley Yong, from Malaysia.

Were you pleased with the treatment?

My wisdom tooth surgery was done by Dr. Chan. It costs me $450. Well, I think this is a reasonable price.

Would you recommend the clinic?

The assistants is very polite and gentle.

Would you return for further treatment?

Of course i will go back to visit him. I have appoitment with Dr. Chan every six months.

Treatments

Extractions

100% Communication
Friendliness
Price
Location
Satisfaction

This review has been verified by RevaHealth.com

From : Mangoes,

"I will recommend the clinic to my friends"

Mangoes, from Singapore.

Were you pleased with the treatment?

Scaling and Air Polishing + Teeth Whitening

Would you recommend the clinic?

Yes, of course, I will recommend to my friends.

Would you return for further treatment?

I will go back to see dr. Chan every six months.

Treatments

Teeth Whitening

Treated By

Treated by Dr Chan Joon Yee in Singapore

by : http://www.revahealth.com/dentists/singapore/central-region/orchard-road/hougang-dental--orchard#tab_reviews

Information About Dental Implants

2009-10-17T10:16:00.010+08:00

A dental implant is an artificial tooth made from titanium for replacements missing teeth.
But how much do you know about the implants?

Different implant systems or brands have different connections and configurations, but most of them have similar components or parts. The part that is often called the implant or the fixture, is the titanium screw that you see on the left.

The first stage of implant surgery is always to place the fixture into the bone. Obviously, the implant practitioner cannot just drill into the jaw bone blindly. He/she must look at xrays and determine a safe region in the jaw to place the fixture without perforating bone and causing any damage to vital structures.

After a hole is drilled in the jaw bone, the surgeon selects an implant of appropriate length and diameter and then proceeds to drive the implant into the bone. If bone width and quality are good, the implant will present good initial or primary stability. Implants which have gained good initial stability even before they have fused with the bone have a 98% rate of successful integration.

After implant placement, a healing period must be allowed. For the lower jaw, this is usually 2 months. For the upper jaw, it is usually 3 months. For bone grafted implants without good initial stability, it may take 6 months or more.

Once the implant practitioner is quite certain that the fixture has integrated with the bone, he/she will proceed to the next stage of implant restoration.

If the surgeon is confident of the bone quality and done a one stage surgery, an abutment can be directly connected to the implant. If the implant fixture has been covered with gum during the surgery, it must first be surgically exposed before the abutment is connected.

After connection of the abutment, it will be obvious that the implant is present even though it is hidden beneath the gums. The abutment projects from the gums and forms a pillar of sorts for the fabrication of a crown. There are many ways in which the restoring dentist can prepare the crown. The simplest and most straightforward method is to take an impression of the abutment and then cement a crown over it. Another method is to build the crown into the abutment itself and screw the crown-abutment complex into the fixture. These crowns are screw-retained instead of being permanently cemented.
Cemented crowns are can be very economically fabricated, but once permanently cemented, there is no turning back. Screw-retained crowns and bridges can be removed by the dentist for periodic maintenance. However, they are more costly to produce.

In an ideal situation, the crown covers over all the metal of the abutment. This situation is not always sustainable. Metal may be exposed due to wear or to bone resorption after several years.

What is bone grafting?

2009-10-13T21:37:00.003+08:00

When a patient goes for dental implant consultation, a topic that frequently pops up is the issue of bone grafting. What is bone grafting and why is it so important? Our natural teeth are supported by bone. Once teeth are lost, the bone loses its purpose and function. The result is resorption. Anybody who has lost all his teeth will have sunken lips and cheeks. Unfortunately, implants also need good bone in order to stay firmly embedded in our jaws. For individuals who have lost their teeth for a long time, the bone is often not ideal for implant surgery. To solve this problem, dentists use a technique called bone grafting.

How is bone added to one’s jaws? The procedure is a surgical one. The dentist must first separate the gums from the underlying bone and then place a matrix over the exposed bone. This matrix will form a framework for the bone cells to build on. Grafting materials may be divided into the following categories.

1. Autografts are “real bone” taken from a donor site to be transplanted on a receptor site in the same individual. As it is the patient’s own bone, there is no chance of rejection. This sort of bone represents the gold standard for grafting materials. The most obvious disadvantage is that you’re robbing Peter to pay Paul. Instead of just one surgical site, there are now 2 sites. The pain/morbidity is often increased.

2. Allografts are materials derived from another individual of the same species. The donors are people who have pledged their organs before their death to better the lives of other others. Of course, bones from dead people must be thoroughly sterilised before they can be used on living people. After grafting, this sort of material is eventually replaced by the host bone.

3. Xenografts are much more often used used than allografts. These materials are processed from animal bone. Cows and horses are the usual sources. Like allografts, they are thoroughly sterilised. They are very safe and no known case of mad cow disease arising from bone graft has been reported. With time, the grafted animal bone will also be converted to host bone.

4. Synthetic Bone can be made from coral, ceramics or different forms of calcium phosphate. The obvious advantage is the safety from cross infection. Rejection is not a serious concern, but synthetic bone will never be completely resorbed and replaced by host bone. Particles of synthetic bone form a matrix around which the host bone will grow. The grafted area will always contain synthetic bone particles embedded in host bone.

How much does it cost for taken out wisdom tooth?

2009-10-13T18:13:00.008+08:00

How much does it cost for taken out wisdom tooth?
If you want to remove wisdom tooth we charge from $450 and above, it depends on the position on your wisdom tooth.

Many patients call up and ask me how much my dentist will charge them for wisdom tooth surgery. If you already done with your X-ray , you can refer to the photo as below.

May I know it there any extra charges?
No, This charges is already included x-ray, medicines, gauze, mouth wash and when you come back for remove stitches.

Can I use my medisave for wisdom tooth surgery?
Yes, most of our patients can claim full amount from the medisave.

If I don't have medisave , what should I do?
Our clinic accept cash, net , visa , amax and diners club.

Do I have pay deposit or payment if I go for wisdom tooth surgery?
No, you no need to pay deposit just bring you Ic along before you are going for surgery.

Can I use my husband medisave?
Yes, you can use your spouse and your parents medisave. But if you need to use your spouse or your parents medisave please bring them come a long with you and his/her Ic .

Is very painful or not? I am very scared .
If your very scared/nervous of pain you can required for GA (general anaesthetic) but you have to pay extra $650/hour.

Can you tell us , what's the difference?

2009-10-12T15:06:00.006+08:00

This yoga instructor has been very self conscious about her less than perfect smile. Take a close look and you'll see what's the difference?

Before

After

Looking good starts with a great smile today!

2009-10-12T13:10:00.013+08:00

This yoga instructor has been very self conscious about her less than perfect smile. Take a close look and you'll see why.

Her problem is quite obvious. Her left central incisor is somewhat elongated.
There is also quite a big gap between her left incisors.

The obvious solution is to trimmed down the elongated teeth after root canal treatment.

The gap is even more obvious now that the teeth have been trimmed shorter.

Note also that the two central incisors are not in alignment. We recommended 3 emax crowns for this patient.

Here are her finished emax crowns. Note the vast improvement. However, the patient finds her right lateral incisor a bit short and sunken.

To create some semblance of symmetry, bonding was done to prop up the lateral incisor and also to lenghten it.
Here are the results. The lateral incisor looks good for the moment, but bonded teeth may stain or chip over time.
A veneer would be ideal for that bonded tooth.

Which dental implants brands is suitable for you? (2)

2009-10-12T12:34:00.005+08:00

Osstem Implant

Osstem implant made in Korea.
The cost about $3000 - $3500.

Grinding teeth

2009-10-09T11:41:00.000+08:00

For those who think that "grinding teeth" is a simple task. These are just the norms and guidelines for standard crown preparations. Variations to the norms must be creatively made by the dentist in non-standard cases . When it comes to bridges, there is an added element of alignment that has to be taken into consideration. Dentistry is not just about "grinding teeth".

The risky wisdom tooth sugery cases.

2009-10-08T16:29:00.003+08:00

Not directly related to cosmetic dentistry, but we often get referrals from orthodontists to remove wisdom teeth. Most wisdom tooth surgeries are uneventful. However, due to anatomic variations, vital structures may sometimes get in the way of the surgeon.

Nerve injury will then be a possible risk. Check out this article and learn how to assess your own risk from your x-ray.

Wisdom teeth can be troublesome. The last teeth to erupt in the mouth, they often end up half buried, hitting against the next tooth or even lying down horizontally. A variety of problems will follow when these teeth fail to erupt properly. Some “deviant” wisdom teeth can trap food and cause bad breath. That’s not all. If these food traps are not properly cleaned out, decay and gum infection will follow.

Ouch! That sounds painful already, but left untreated, wisdom teeth can cause even more painful damage. Many people end up losing the next tooth. Some suffer from recurrent gum boils. In most cases, the best and perhaps only treatment is the surgical removal of that “deviant” tooth.
Different kinds of impaction will require slightly different techniques. In practically all cases, the gums will need to be cut. Next, the bone surrounding the tooth may need to be trimmed away. For the simple cases, the tooth can be removed at this juncture. If the tooth is angulated against the tooth in front, s further step is necessary. The tooth needs to be divided into 2 or more parts. The deeper and more angulated it is, the more bone needs to be trimmed and the tooth may also need to be further divided into smaller parts.
Needless to say, some wisdom teeth are more difficult to remove than others. The degree of difficulty and the risk often depends on the depth of the impaction, the angulation relative to the next tooth, the curvature of the roots, the quality of the patient’s bone, any medical condition, oral hygiene and even the attitude of the patient.
Surgical intervention is never a perfect cure. Complications can occur and it may not be because of the dentist’s lack of skill or care. Prolonged bleeding and infection are relatively easy to manage. Much more difficult to manage, would be nerve damage and prolonged numbness.

The xray above shows a high risk, difficult operation which I’ve successfully performed recently. The risk of nerve damage or paresthesia depends very much on the anatomic location of the nerves relative to the wisdom tooth. The closer the nerve to the tooth, the higher the chance of nerve damage during surgery. The dentist will be able to assess the risk of nerve damage to the inferior alveolar nerve from your xray. This nerve runs in your lower jaw bone and hence, its entire course in the bone is almost always visible in a panoramic xray. If your dentist uses digital xrays, you may bring a thumb drive to copy the file and see for yourself where the inferior alveolar nerve lies.

I’ve traced out the course of the nerve in the above patient for you just in case you can’t see or identify it. If the nerve is close by, it would mean that the chances of nerve injury will be high. If the tooth is not giving any problems, leave it alone. If it’s troubling you or if it is necessary to remove it for orthodontic treatment, then you must weigh out the risk versus benefit. To do that, you must be aware of the consequences of nerve damage.
1. Feeling of numbness of the lip and chin even after the anesthesia has worn off.
2. Drooling.
3. Inability to hold food at one corner of the mouth
This has to be one of the trickiest wisdom tooth surgery I’ve done. Nevetheless, I was cautious and made sure that the nerve was not cut. After surgery, the patient above suffered loss of sensation on the left side of her lip and chin. The numbness recovered partially after a few days. Near complete recovery was felt after 2 weeks. The nerve was probably just slightly displaced during the surgery.

Check out this other xray. This surgery took me more than one hour. Technically, it was more difficult than the other surgery you saw earlier. However, the nerve seems somewhat further. Do you know where it is?

It’s been traced out for you in the xray above. After the anesthesia wore off, this patient experienced a loss of sensation on her left lip just like the other patient. However, this patient recovered fully in just 2 days. The nerve was obviously just minimaly disturbed.
Thankfully, I have not encountered a single case of permanent nerve damage in almost 20 years of private practice. Many patient’s who have undergone a particularly difficult or risky surgery would experience prolonged numbess for a day or two. Some recovery after a week or two. The majority would have recovered after a month. The longest a patient ever took to recover from numbness under my care, was 6 months.
Looking at these figures, nerve damage certainly doesn’t seem as frightening as it sounds. Nevertheless, it is important to note that even in the hands of the most skilled and experienced practitioner, something unexpected can happen. If your xray looks anything like those above, you should do a risk assessment with your dentist to determine if you would like to go through with it.
Having said that, the majority of wisdom tooth surgeries (over 98%) heal uneventfully. Note that these two cases are atypically complicated.

Wisdom tooth

2009-10-02T12:12:00.000+08:00

The wisdom tooth is the third molar. Most people have one in each quadrant of the mouth but some people also have four wisdom teeth - two in the upper jaw and two in lower jaw. However, it is not uncommon to find individuals with less than 4 wisdom teeth.

Because this tooth usually erupts when the person is about 16 - 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.

This OPG X-ray depicting four impacted wisdom teeth, you can see two wisdom teeth in the upper jaw and two wisdom teeth in the lower jaw. In this case for the upper no need required surgery but for the lower one required surgery anywhere if you are Singaporean or Singaporean PR the total of this surgery you can use your medisave for both of this surgery. (Full amount, No need cash, No need deposit required )

Feed back from our patients.

2009-09-30T14:51:00.002+08:00

This patient did two wisdom teeth surgery with us early on July 09 , we just found a post on her blog.

Photo below it's her OPG x-ray before she did surgery.

From her blog:

Friday i was on leave to go hospital for my thyroid appointment.

Silly me mix up the timing... i suppose to reach at 945am but i reach at 845am.

I though my appointment is 9am.. stupid me.. go buy a newspaper and read slowly.

The doctor is very nice and really explain every single things to me.

She ask me not to worry as my wan is very small issue.

Just control my temper and relax myself.
re-schedule was done...

4months away from now for scanning and blood test.

That cost me about $200.

Went home to have a nap first...

Dental appointment at 2:30pm to extract two of my wisdom tooth.

Meet up with Gillian for lunch as she working at TANGS.

Have a great lunch.. yummy Pizza Hut with some add on.

2 persons order so much but can't finish it..

Extraction was done at

New Age Cosmetic Dentists

304 Orchard Road #05-42 Lucky Plaza

Tel: 6235 8316

I recommence this clinic, the staff and doctor are very nice..

I was so afraid of the pain, they keep talking to me in the

process and make sure i wont feel any pain.

The right tooth was really very fast but the left side is too

deep spend about 45mins to extract it.

Everything was fine... just the sewing part make me freak out..

I can feel the string going out and in again... faint

Lot of blood... but i don't feel any pain is still numb, the bleed stop about 1hour later.

I can start feeling the pain and swollen..

Only can take porridge or soup.. i cant chew anything.

I only can brush my front roll of my teeth's and

use the mouth wash to clean my other teeth's.

Finally i did the extraction after 1 year of nagging.

Total was $1,200.00 to extract both teeth's, all deductible by Medisave.

by Joanne

http://itsmylifejournal.blogspot.com/search/label/amanda

Chrome Denture From S$500

2009-09-29T13:36:00.001+08:00

Stronger & More Functional Dentures

Acrylic dentures are not the best type of prosthesis for anyone, dentist or patient. Except for the rare, cynical grouch who is constantly in denial, no patient who has swapped his acrylic dentures for a set of shiny chrome dentures has ever regretted it. Chrome dentures are similar to acrylic dentures except in the base or framework of the prosthesis.
The teeth and "gums" used in a chrome denture are no different from those used in acrylic dentures. However, chrome, being much stronger than acrylic, allows a slimmer and sleeker design of the denture base. Not only can the base be thinner, it can also cover a smaller area of the mouth. Higher accuracy also provides a better fit. It's not surprising that in most cases, chrome dentures are superior to their acrylic equivalents. If function and durability are what you want in a denture, then go straight for chrome dentures.

Which dental implant brands is suitable for you?

2009-09-28T17:11:00.000+08:00

When you have a missing tooth , you wish to do a replacement by implant. Do you know, what the dental implant brands are you prefer?

Many patients are very confuse about which the system implants is suitable for them, how much does is cost?

In Singapore , there are have more than 10 system implants

Nobel Biocare

Nobel Biocare made in Sweden .

The cost about $5000 - $8000.

to be continue...

Cost of Root Canal Treatment (Endodontics)

2009-09-28T14:21:00.001+08:00

Root Canal treatment available at my dental clinic.

Know more about root canal.

Our teeth are actually very tough and well-protected structures. The outermost layer is enamel - the hardest known organic substance. The next layer is bone-like dentine and further down, is the highly sensitive pulp which is made up of blood vessels and nerves.

It is the pulp that is responsible for conveying symptoms of sensitivity when a tooth is decayed or worn down by abrasive forces or acidic foods. It was also cells in the pulp that laid down the enamel and dentine during the formation of the tooth when we were babies. Once the tooth has fully formed, the pulp shrinks down and serves the sole purpose of forming secondary dentine as the tooth wears down. The older the tooth, the thicker the dentine layer and the smaller the pulp becomes as it closes in on itself. Arguably, the pulp serves little function (except to warn us that our tooth has decayed) after the tooth is fully formed and "matured". The inside of the tooth does not need a blood supply anymore. The surrounding alveolar bone and periodontal ligaments are the structures that hold the tooth in its socket, not the pulp. In fact, in many cases, the pulp is a liability.

Being the sensitive tissue that it is, the pulp sends out strong signals to the brain when it is irritated. If the source of irritation is removed quickly enough, the pulp will stop sending signals and the individual sleeps well again. But if the source of irritation is not removed or if it's removed too late, the pulp may suffer irreversible damage. The signal the pulp sends out becomes continuous and unbearable. We call this condition acute pulpitis.

Keep your teeth before will too late, root canal treatment starts from $250 - $750 . (The price included PA X-ray, No GST, No consumables fee)

Whiten you teeth with out laser

2009-09-25T10:39:00.000+08:00

Fast-acting take home kit: S$400 (with amorphous calcium phosphate)
(includes customised trays & 3 tubes of 9.5% hydrogen peroxide gel with ACP)

Ready in 45 minutes; not 1 week

Gel refills: S$150 per set for fast acting, low sensitivity gel.

Chairside bleaching (no laser) + maintenance kit S$800
(includes 2x 1-hr sessions) + maintenance trays and gel

Touch up/maintenance refills S$150
(includes 4 tubes of 9.5% hydrogen peroxide gel)

Tray replacement S$50 each, S$90 per set (for patients on record only)

Mini Implants

2009-09-24T11:54:00.000+08:00

I recently received a question on mini implants and let me take this opportunity to highlight one of the many differences between mini and standard implants.
The patient had mini implants placed in his front lower jaw recently. A bridge was constructed and the patient felt uncomfortable because the bridge seemed to be pushing against his tongue. What could be the cause for this problem?
I have not seen the patient, but I would guess that the implants were placed quite far back on the ridge of his lower jaw due to the lack of bone. Of course, with standard implants, the dentist would need to do the same. However, most standard implants come in 2 pieces - the implant/fixture and the abutment while mini implants always come in one piece. The abutment is part of the fixture.

When a standard implant is not placed in ideal position - for instance it’s placed close to the tongue, an angled or slanted abutment can be connected to correct the inclination. With most mini implant systems, this is not possible as the abutment is always in line with the fixture.
Patients who opt for mini implants in situations where ideal implant placement is difficult or impossible are putting themselves at risk of an uncomfortable, non-functioning or unaesthetic restoration.
Having said that, I do use some “mini implants” myself. However, these implants are not that mini. The smallest I would use is a 2.5mm diameter implant. Normally, I would go for the 3.1mm which is hardly a mini implant. The advantage of the system I’m using is that the abutment can be bent into position if the fixture is not in an ideal alignment.

This simulates the use of an angled or slanted abutment to correct any alignment issues. Do bear in mind that all mini implants and standard implants that come in one fixture/abutment unit cannot have their alignment corrected after placement.

Cost of Titanium Denture

2009-09-23T14:46:00.000+08:00

This is Full Titanium Denture (front view)

Many people who use titanium spectacle frames will be familiar with the lightness of this very strong metal. Considerably more expensive than chrome, titanium is much lighter and hence more suitable for the construction of full upper plates. The above denture, made with a titanium base, has the strength of a chrome denture and the weight of an acrylic denture. Titanium dentures are suitable for patients who want a strong metal-based denture that feels as light as plastic. So if you are thinking to change or make a new denture , you can consider Titanium Denture.

Cost Estimation
Titanium Denture From S$1000.

What is cosmetic dentistry?

2009-09-23T14:21:00.000+08:00

Q. What is cosmetic dentistry?

A. Cosmetic dentistry is the art and science of altering a person's existing tooth colour, form or alignment to achieve a condition that best matches an aesthetic norm.

Q. Is cosmetic dentistry a dental specialty?

A. No. There is no such dental specialty. Nevertheless, there is plenty of scope for the practice of cosmetic dentistry in the various dental specialties like prosthodontics and periodontology. However, cosmetic dentistry is very much an art. How good a cosmetic dentist one is depends a lot on his eye for aesthetics and his ability to improvise or think out of the box. Many tricks of the trade are not taught in dental school.

Q. What is intravenous sedation?

A. This is not a dental procedure and we will call in an anaesthetist to administer a drug through a vein in the patient's hand. The patient then goes into a deep sleep while the dental procedure is carried out. The patient recovers in minutes after the drug is stopped.

Q. What is your most common cosmetic procedure?

A. Our most common cosmetic procedure is bleaching or tooth whitening followed by crown repositioning or "instant orthodontics".

Q. What is your most common gum surgery procedure?

A. We often do gingivectomy to recontour red and puffy gums which almost cover up the teeth. We also do some crown lengthening procedures to expose teeth and eliminate gummy smiles. For more complex procedures, we call in our periodonic colleagues.

Q. Are implants the best way to replace missing teeth?

A. Like all treatment modalities, implants have their advantages and disadvantages. Unless your bone condition is ideal, implant supported crowns and bridges will not give a superior cosmetic result without extensive preconditioning surgery. If function is your main concern, implants will probably satisfy you better than other restorations. Restoring flattened jaw bones cosmetically with implant bridges can be a major challenge. The success rate for implants in the upper jaw is considerably lower than that for the lower jaw. The time taken for implant restoration is also relatively long. Of course, the costs are significantly higher than other forms of tooth replacement. Do remember that implants do not necessarily need to go with fixed restorations like crowns and bridges. Implant stabilised dentures may be a better option in some of the non-ideal cases.

Q. Can general practitioners do implants?

A. Implants are composed of the fixture (surgical) and the restoration (crown/bridge/denture). Traditionally, the fixture was done by the oral surgeon while the restoration was done by the prosthodontist. Nowadays, implant courses are available to all GPs. Our colleagues who are OMS (oral maxillofacial surgery) specialists agree that most dental implants can be placed by experienced GPs. At New Age Cosmetic Dentists, we have successfully handled simple to challenging surgical cases.

Q. Is implant dentistry part of cosmetic dentistry?

A. Unfortunately, many implant restoration cases are often not as ideally asesthetic as we want them to be. Aesthetic implant restorations often require a very lucky patient or very complex gum and bone grafting procedures.

Q. How safe am I from getting AIDS from the clinic ?

A. Contrary to what many people may think, HIV is not a hardy organism at all. Strong detergents are known to destroy it. However, we're not taking any chances, especially with spore-forming viruses like hepatitis B. We autoclave all our metal instruments at 132^oC under steam pressure for 5 minutes. Instruments for invasive procedures are sealed in plastic envelopes during sterilisation. We cut them open when they are needed. Needles, gloves and other plastic instruments are used only once.

Q. Do you do braces?

A. Braces form an important component in cosmetic dentistry. Unfortunately, our centre is basically a one-man practice and Dr Chan does not have time to master orthodontics. However, we have teamed up with our orthodontic colleagues to be able to recommend practitioners who will suit our patients' budget or style.

Q. Do you treat children?

A. Our clinic does not specilaise in paedodontics. We are only able to treat co-operative children.

Q. Do you treat wheelchair bound patients?

A. We can handle most wheelchair bound patients who are able to co-operate. We do not charge extra fees.

Q. Do you follow special protocols for amalgam removal?

A. Even though we are a 100% amalgam free clinic, we do not believe in the amalgam toxicity to the same extent as some practices in the US. We simply remove our amalgams with high speed water spray and high vacuum suction. Some revolutionary practitioners in the US have insisted that the patient be "spacesuited" and given a separate air supply, followed by megadoses of "patented" detoxifying nutrients before and after treatment. We do not go to such extents.

Q. Why are my emails not replied?

A. There may be a lot of information on this site, but please note that we are a serious, hands-on, bricks and mortar business. This website is meant only to provide basic information and to serve communication purposes. We welcome serious enquiries pertaining to any specific problem that any patient or potential patient may have. We look forward to meeting the enquirer in person for examination and treatment planning. Please note that we are not just a free information centre. Our clinical duties take top priority and in the process of replying numerous emails, we may not have time to entertain enquirers who have no intention of visiting us. If you need much more general information than what you managed to find here, please check out the American Dental Association website, buy some dental books from Amazon.com or check out your local library.

Complete Implant Restoration, Osstem implant starts from $300/-

2009-09-21T16:10:00.004+08:00

Why wait if you can afford it? We are a one-stop implant restoration centre, performing each step from surgery to final restoration under one roof and the same pair of hands.

A stock of Osstem^TM GS II dental implants ready for placement anytime. This is the most popular implant system at our centre at this moment. It is an affordable Korean system that works well even under difficult situations.

A stock of Osstem^TM MS "mini" dental implants ready for placement anytime. This is the lowest priced system we have. We have successfully restored many lower front teeth with them.

We have our very own Osstem^TM GS II implant surgical kit.

We have our very own Osstem^TM MS implant surgical kit.

OUR OSSTEM PATIENT

There is adequate bone width on the mandible, thanks to the torus mandibularis.
We managed to place 3 implants.

1 month after surgery. The lower implants have been loaded with temporary crowns.

2 months post op. We did a screw-retained bridge for his lower.

to be continue.....

Gengi Gel with Hyaluronan

2009-09-18T12:00:00.000+08:00

What's Gengigel ?

Gengigel is an innovative product providing long acting biotechnologically manufactured hyaluronan of High Molecular Weight.

When you need Gengigel?

Gengigel is for localised oral in flammation help heal and maintain naturally like bleeding gums, sore or damaged tissue, tooth extraction sites, wisdom tooth surgery, crown lengthening and dental implant.

Cost of sleeping Implants.

2009-09-18T11:13:00.000+08:00

When you lose a tooth, you don't just lose a tooth. Bone surrounding the tooth will shrivel away as it becomes redundant. And bone is everything in dental implantology. The longer you delay implant treatment, the more your bone will shrink, complicating implant surgery and restoration in the future. It's a pity that many patients have been unable to have implants placed soon after they had their teeth extracted due to various personal reasons and economic conditions.

When these people are finally ready to restore their lost teeth, these teeth may have been missing for many years. Bone deficiency may result in painful, complicated surgery and a high risk of implant failure which advanced practitioners are so familiar with.

What is the best way to prevent your precious bone from melting away like an ice cube? You place an implant into that spot within 2 months after extraction. In some cases, we can even insert the implant on the day of the extraction. That implant can stay sleeping underneath your gums until you are ready to restore it.

How much does that cost you? Just $300 in cold cash.

No, we're not kidding. For implant surgery, you can pay up to $900 from your Medisave account. We take a total of $1200, so you only pay $300 in cash. When you are ready to restore the implant (after graduation, landing a job etc), we can restore it for you for $1800. Or if you want another dentist to restore it, we wouldn't mind either. We just don't want people to lose their precious bone simply because they can't afford implants at a certain time in their lives.

Please note that if you choose to have another dentist restore your implants, we will take no responsibility for the outcome of the restoration.

Eat safety today

2009-09-17T18:07:00.000+08:00

Once time I read the health magazine and they talking about what are we eating?
It's look very simple but not simple ....(Why?)

Did you know that French fries and potato chips may be doing more than just clogging your arteries and adding useless calories?

A peer-reviewed study of acrylamide levels in these foods suggests that it is present in dangerous levels. Acrylamide is a know carcinogen and neurotoxin that is formed when foods are baked or fried at high temperatures. The tests conducted by the Center for Science in the Public Interest (CSPI) on some popular brands of french fries and chips found that the acrylamide in fries was at least 300 times the amount allowed by the Environmental Protection Agency(ERA) in a glass of water.

In addition, this food contained trans fats (artery-clogging fat that's been linked to raising bad cholesterol and lowering the good kind) that increase the risk of heart disease, diabetes, stroke and cancer.

"I estimate that acrylamide causes several thousand cancers per year in americans," said Clark University research Professor Dale Hattis, in response to this study.

by ezyhealth&beauty
to be continue......

Secret in Hollywood smile.

2009-09-14T14:40:00.000+08:00

Have you ever wondered why almost every hunk or babe in the TV series Baywatch had such glistening white teeth? Well, of course no one would have paid too much attention to Pamela Anderson’s teeth, but the worst kept secret in Hollywood is, they all had their teeth bleached. That pearly white, “starry” smile used to be called the Hollywood smile. And it used to cost thousands of US$. Not anymore. The Hollywood smile has descended to the realm of mere mortals. Not only is tooth whitening readily available in dental practices all over the developed world, the cost for the procedure, like the US$, had come tumbling down.

The Bleaching Conspiracy?
The moment tooth whitening became a mass market thing, something unfortunate happened. Marketing efforts by various manufacturers of dentrifices churned out an array of relatively cheap whitening gels, pastes and liquids which gave consistently poor results. One TV ad even said that with their product, nobody would ever need to pay their dentist hundreds of dollars for whiter teeth. Hardly any one of those products is still being sold in Singapore. Why were these products ineffective? Because the strength of peroxide (the active ingredient in bleaching gels) in them is too low. Meanwhile, at the dentist’s office, fanciful “laser whitening” procedures were performed. These procedures seemed to work very well, but within days, the teeth started yellowing again. In the end, they only worked marginally better than the OTC products but cost many times more.
Back in the good old days (20 years ago) dentists were taught that only non-vital, root canal treated teeth could be bleached. In those days, we would open up the pulp chambers of non-vital teeth, place hydrogen peroxide into the chamber and then, heat up the potent solution with a hot instrument. The whitening effect came fast and was very effective. Every science student can tell you that heating up hydrogen peroxide will cause it to decompose into oxygen and water. It’s the heat that speeds up the process and release whitening oxygen into the microscopic pores in the inside of the teeth.
Then, vital bleaching hit the market not long after I first started practising. Suppliers started telling us that even vital teeth which have not been root canal treated can be bleached with peroxide gel applied on the outer, non-porous surface of the tooth. It didn’t sound probable, but the “magic light” suspended our disbelief.
Fanciful light equipment like plasma arc lights, LED lamps, lasers etc burned holes through many a dentist’s pocket. It turned out that many dentists have either forgotten their basic sciences or somehow decided to go along with the suppliers’ marketing strategy. Light does not activate peroxide decomposition. Not plasma arc light and definitely not LED light which is cool. It’s heat that does it, so perhaps laser does work, but we can’t use heat on vital teeth or we’ll kill them. As far as bleaching is concerned, a safe, non-heat-generating light is a useless light.
Not only were some of these equipment bulky and expensive to rent, the hype generated by aggressive marketing tactics resulted in unrealistic expectations on the part of both dentists and their trusting patients who have paid about S$900 to S$1200 for mediocre results.
Tooth whitening with carbamide peroxide has been around for almost as long as I’ve been practising dentistry. However, very few dentists had their bleaching products flying off the shelves. I was curious enough to have tried out a wide range of products, encountered almost every kind of tooth discolouration and after countless complaints and praises, I more or less figured out some of the realities of tooth whitening. It’s not magic. It works for the majority of people but the degree of whitening varies from individual to individual. It doesn’t work for just anybody. Maybe that’s why not every lifeguard you see below is smiling. And the expensive, fanciful equipment are a big rip-off.

Frequently Asked Questions

2009-09-10T11:24:00.000+08:00

Q. What is cosmetic dentistry?

A. Cosmetic dentistry is the art and science of altering a person's existing tooth colour, form or alignment to achieve a condition that best matches an aesthetic norm.

Q. Is cosmetic dentistry a dental specialty?

A. No. There is no such dental specialty. Nevertheless, there is plenty of scope for the practice of cosmetic dentistry in the various dental specialties like prosthodontics and periodontology. However, cosmetic dentistry is very much an art. How good a cosmetic dentist one is depends a lot on his eye for aesthetics and his ability to improvise or think out of the box. Many tricks of the trade are not taught in dental school.

Ask about Dental Implant

2009-09-10T11:16:00.000+08:00

hannah ask :

There are basically two types of implants. Those that are placed on the jaw bone, but under the gums, and those that fit into the jawbone similar to the root of a natural tooth. Each type offers solid, non–mobile support for replacement teeth which act and feel like natural teeth. Since both types are attached to your jawbone they can provide distinct advantages over traditional methods of replacing missing teeth.

• Implants restore proper chewing function and so you can enjoy foods previously too “Difficult” to eat.
• You feel confident that your replacement teeth won’t move or loosen.
• You regain the closest thing to the look, feel and function of your natural teeth.
• Throw away those sticky adhesives.
• Forget about unsightly partial denture clasps which place damaging pressure on remaining natural teeth.
• Eliminate irritated and painful gums.
• Improve your speech by eliminating or reducing the “Fullness” of full or partial dentures.
• Replace missing teeth with the look and feel of natural teeth without having to “Cut down” healthy teeth.
• Dental implants help stop the progressive bone loss and shrinkage of your jawbone by “Mimicking” the roots of natural teeth.

• Dental implants are clinically proven with a success rate in excess of 90%.

Admin reply :

Dentists must be careful that “commercials” like the one above will set patient expectations very high. When things don’t turn out right, the dentist involved will have a lot of questions to answer.
Implants are indeed the ultimate way to replace missing teeth - provided conditions are favourable. Many patients who wish to have their missing teeth restored with implants are not ideal implant candidates.

If you have any required e-mail to us at poohfa@hotmail.

The young actress decieded to do treatment @ My clinic.

2009-09-06T15:08:00.000+08:00

This young actress chipped her front tooth. Even though there was no nerve exposure, she decided to do root canal treatment followed by an emax crown.

We explained the options to her. Both bonding and veneers will increase the bulk of the tooth and ma...ke it look even more protruding.

By doing root canal, cutting back the tooth and then rebuilding it, we can effectively reposition the tooth and make it look straight.

The right central incisor looks short because it is protruding. it is also chipped at the corner.

The lateral incisor was a little instanding. As the patient has budget constraints. We did a little bonding to bring out the lateral incisor. Root canal is done on the protruding incisor.

Another view. The left central incisor was also bondedso that all 3 teeth will look harmonised when the protruding tooth is crowned.

An emax crown has been fitted. Check the alignment.

She'll look even better if the 2 adjacent teeth are laminated with Empress veneers. bonding has its limitations.

As the finishing for the emax and bonding can be quite different, the patient is advised to have veneers on her other 2 teeth.

Cost of Full Ceramic Crowns.

2009-09-05T12:38:00.000+08:00

Everyone who has had an angry member of the family thrown a porcelain plate at him will raise an eyebrow when told that his crown is going to be made with porceelain. In the past, porcelain had to be backed with a metal core if the crown is to last more than a couple of years in function. These crowns were known as porcelain fused to metal (PFM) crowns. While they were strong and lasted for many years, PFM crowns posed aesthetic challenges. This is because metal will impart an ugly greyish colour to porcelain. To mask this greyish colour, an opaque layer must be painted on the metal. This is why many PFM crowns look flat. Light does not penetrate it like it does a natural tooth. A black line also appears at the gum margin after a while as wear and tear sets in.

Of course, there were patients who insisted on having metal-free crowns. Full porcelain jacket crowns (PJC) were done, but these crowns never lasted for than a few years as unreinforced porcelain just isn’t strong enough to withstand chewing forces.

Some years back, a new material called Empress came into the market. Like glass, Empress can be made to mimic the translucency of natural teeth. Like glass which can be made bullet proof, Empress can be made stronger than conventional porcelain. The fracture strength is about 200MPa. In spite of the increased strength, many Empress crowns and bridges fractured within a few years.

About 4 years ago, the same manufacturer that gave us Empress brought in a new, improved material called emax. Just as aesthetic as Empress, emax is even stronger, with a strength of 400MPa. With emax around, there is now no reason to make PJCs or PFMs for front teeth.

The patient wants to straighten his lateral incisors

The teeth to be rearranged were trimmed down

Completed emax crowns fitted. Teeth look straighter now.

Asian Beauty

2009-09-03T11:58:00.000+08:00

Some eye candy to sweeten things up a bit.

My way.

2009-09-03T11:41:00.000+08:00

Somebody said that it isn’t fair for me to just reject people suffering from information overload. I’ve got to show people how I handle information overload. The information overload coming from the mailbox is easy to take care off. There is a nice row of recycling bins lying between Tangs and Lucky Plaza. Sometimes, a look at the envelope can help me decide whether it’s better off in the recycling bin.
As for information overload from the internet, that’s even easier to switch off. I sometimes do a “negative search”. What’s that? When a salesperson comes to me with a new product … let’s call it Bestooth. I’ll listen to what the salesman has to say, then I go online and enter “Bestooth sucks”. I’ll see all the negative reviews. Of course, some of these negative reviews are written by idiots who have axes to grind. But not that many idiots have the time to grind them. What if I miss out on an opportunity to try an excellent product? My experience in dental practice tells me that exisiting materials and instruments are quite adequate for almost all procedures that are performed in any regular dental practice like mine. New is not always good. Just take a look at the new nano composites. Expensive and no big deal at all. Give me good old microhybrid any day.
A few years back, I attended a continuing education course where the speaker compared several brands of of adhesives in the lab. The conclusion, a certain brand (the one his company is selling) came up top in all the tests. But what is the significance? I have used the worst performing adhesive (according to his tests) and it has worked well in most cases. I have used his brand of adhesive (proven to be the best) and a few cases didn’t turn out well. So which is the best one of them all? I have no answer. But that does not mean that I don’t know which ahesive to use. They all work well with the proper technique! The trouble is, when a patient asks me which adhesive is best, he/she may be expecting the answer that will show that I know what I’m doing?
We dentists are all bound by the system. We have no choice but to get involved in continuing education. This puts us at great risk of information overload. The way to prevent this overload is simple. Just switch off. It takes a little practice to know when to sign in for points and then just switch off, but it shouldn’t be too difficult.

The patient who has overdone his/her research and listened to 100 opinions too many should understand that it’s more than sufficient to read up on some basics, enough to choose a good dentist. Once a dentist has been chosen, one should probably stop asking others for their opinions. I get rather cross when someone under another dentist’s care wants me to comment on a colleague’s management of the case halfway through the treatment. Interestingly, some patients get rather cross when they get different treatment plans from different dentists. They expect all dentists to handle a case in exactly the same way. The truth of the matter is, there is no single “best” way to treat a patient. By seeking different opinions, these patients are generating their own information overload. Shop by all means, but if you drop, then it’s your own fault.
Life is short and I think we can all do with a little more sleep.

Cosmetic Dentists

2009-08-27T10:38:00.000+08:00

The strangest patients I’ve met are those think that I should give them a discount for insulting me. Do people not realise that if they want a discount, they should at least say something nice to the one who is in the position to give them a discount? Flattery may not work all the time, but being nice is the necessary first step to getting a discount.

My friend recently posted me a YouTube video. I realised that there are good places where one can get very cheap dental treatment. Perhaps that’s where I should refer some of my troublesome patients.

Many companies that provide services have taglines. Some are catchy pieces of advice like:

“Don’t leave home without it”

“Just do it”.

Some are boasts like

“The ultimate driving machine”
“The happiest place on earth”
“The world’s favourite airline”

Others are promises, pledges or guarantees if you will.

“Melts in your mouth, not in your hands”

“When it absolutely, positively has to be there overnight”

The problem with such promises is that it’s not always easy to live up to them. For the cosmetic dentist who dares to call himself a cosmetic dentist, patients can expect miracles. Take the example of lady who walked into my clinic recently. She had a terrible looking bridge. I’m always happy to see such cases because it’s so easy to make an improvement.

Not so in this case. After numerous waxups and trials of provisional bridges, she was still not satisfied. She started pointing out ways in which her new bridge differed from her old, ugly bridge as if she was suddenly missing the ugly old bridge. Nightmare. Numerous things to change, numerous times, they were changed back because the changes asked for were just not right. It’s too late to re-access the psychological profile of the patient and the patient, from her point of view, must be wondering if I’m really good enough dedicate myself to cosmetic dentistry. Why do other cases look so perfect in other people’s mouths but not in hers? Shouldn’t I be treating my patient’s equally?

In despair, I sought help from a great man. In a recent speech he made, I learned something important. Cosmetic dentistry is an aspiration and not an ideology. It’s going to take decades or even centuries to reach such goals. Equal treatment for all cases is false and flawed, and completely untrue.

Some people may not believe that these words came from a great man, but what are great words but words that cannot be challenged. Obviously, I lack such greatness and must therefore continue adjusting that stupid bridge.

Dental Implants

2009-08-24T10:58:00.000+08:00

Dentistry is no longer a sunset profession. Every couple of years, something truly new or even revolutionary emerges in the field of implant dentistry. More and more, these replacement teeth are becoming as good as the real thing. In fact, they are getting better than the real thing. Even though implants are vulnerable to gum problems, they are even more firmly anchored in bone than natural teeth and your implants will never require any root canal treatment as they have no pulpal liabilities.

In the more developed countries, patients have sued their dentists for not offering implants as an alternative. Indeed, implants can be superior to other forms of treatment like dentures and bridges. The failure to offer and suggest implants is seen as a disservice to the patient. Yes, we do get patients asking about implants every now and then. However, it’s going to take quite a while before the general population in Singapore learns that implants are not just a more expensive treatment option pushed by dentists for economic reasons only.

At the other end of the spectrum, are patients or even dentists who are “advertisement-educated”. Information they received is often biased or hyped. This may result in problems for both patients and dentists. It’s a long learning curve for dentists and patients alike. Experience and scepticism make all the difference.

Root Canal Amnesia

2009-08-18T17:06:00.000+08:00

In the heartlands where price sensitivity is highest, root canal treatment is probably the most common necessary treatment that is rejected by the patient because of cost factors. For someone with no income, paying $300-$1000 for root canal can be difficult. It’s OK if the patient is willing to extract the tooth. Problems arise when the patient insists on keeping the tooth but is only willing to pay for a filling, thinking that root canal is only indicated as an excuse for the dentist to charge more.

This puts everyone in a no-win situation. Many heartland dentists reluctantly fill up teeth which should be endodontically treated first. When there is no pain, the patient assures the dentist that he is OK with a temporary filling and will do something about it later. When the patient gets pain afterwards, they forget all about the filling being temporary and they having been advised to do root canal previously.

IV Sedation

2009-08-05T10:58:00.000+08:00

Outpatient Intravenous Sedation.

No Hospitalisation. Sleep Through Your Surgery, Wake Up, Walk Home

S$600 per hour (includes cost of drugs and anaesthetist charges)

After 17 years in private practice, I have met numerous patients who tell me they have "dental phobia". In reality, most people do not have a genuine phobia for dental treatment. By "dental phobia", they usually mean that they just want to be pampered.

Well, whether it's true dental phobia or patients just want to be pampered, we can reduce anxiety with intravenous sedation. If you wish to be pampered and have no "budget problems", we recommend IV sedation for wisdom tooth surgery, implant surgery and even difficult extractions. "Intravenous" means that the drug is injected into a vein, usually in the back of the hand. After the needle is inserted, a plastic tubing is left in place for continuous infusion into the vein. The tube stays in place throughout the procedure.

The patient's pulse and oxygen levels are measured using a pulse oximeter. This gadget clips onto a finger and measures the pulse and oxygen saturation of the blood. It will warn the dentist and anaesthetist if your oxygen level is low. To be kiasu, we would give our patients supplemental oxygen through a nasal cannula throughout the procedure. The device also comes with a cuff around the arm to measure blood pressure at regular intervals.

What drugs are used?

The most commonly used drugs for IV sedation are benzodiazepines. These are sedative drugs sometimes prescribed as sleeping pills. Examples include Dormicum. Someone who has been consuming sleeping pills regularly for years may not react well to benzodiazepines. The patient may be "knocked out" when the drug is administered in a bolus but effects of sedation are gradually lost as the operation progresses.

Propofol is usually preferred for a deep and a consistent level of sedation throughout the operation. The advantage of Propofol is in its rapid recovery time of less than 5 minutes. Because of the short duration of its action, the drug must be continuously administered. We do this by pumping Propofol using an electric infusion pump. The dose rate is set by the anaesthetist.

What about safety?

IV sedation is very safe when carried out by an anaesthetist. Statistically speaking, the mortality rate is literally 1:1 million. In contrast, the mortality rate for general anaesthesia (GA) is 1:598,000.

However, contraindications include pregnancy, known allergy to the drugs used, alcohol intoxication, CNS depression and some instances of glaucoma. Cautions include psychosis, impaired lung or kidney or liver function, and advanced age (above 70). Heart disease is generally not a contraindication.

What are the advantages of IV sedation?

* IV sedation tends to be the method of choice if you don't want to be aware of the procedure - you "don't want to know". The alternative in the US is oral sedation using Halcion, but oral sedation is not as reliably effective as IV sedation.

* The onset of action is very rapid, and drug dosage and level of sedation can be tailored to meet the individual's needs. This is a huge advantage compared to oral sedation, where the effects can be very unreliable. IV sedation, on the other hand, is both highly effective and higly reliable.

* The maximum level of sedation which can be reached with IV is deeper than with oral or inhalation sedation.

* The drugs produce amnesia for the procedure. The patient forgets the trauma of the operation even though he/she may not be unconscious.

* The effects of intubation and nausea from GA are not found in sedation. No fasting and long preparations are required before the operation.

Are there any disadvantages?

* You need to bear with the initial discomfort of having a needle inserted into your hand.

* It is possible to experience complications at the site where the needle entered, for example haematoma (a localised swelling filled with blood).

* Patients may become dependent on IV sedation such that they want IV sedation even for non-invasive procedures like fillings.

* Recovery from IV administered drugs is not complete at the end of dental treatment. You may need to be escorted by someone who can take care of you.

After IV Sedation:

(1) Have a companion (sorry, we don't provide) take you home and rest for the remainder of the day.

(2) Have an adult stay with you until you're fully alert.

(3) Don't perform any strenuous or hazardous activities and don't drive a motor vehicle for the rest of the day.

(4) Don't eat a heavy meal immediately. If you're hungry, eat something light, e.g. porridge or bread.

(5) If you experience giddiness, lie down for a while or have a glass of isotonic drink.

(6) Don't drink alcohol for the rest of the day.

(7) Take medications as directed by your dentist.

(8) If you have any unusual problems, call your dentist.

What's should I do ? If my patient wants high quality, look nature, prefect BUT very cheap.

2009-07-31T11:25:00.000+08:00

It happens often enough in any dental practice. A patient walks in to have a new denture done. He tells you all the horrible things the old denture is doing to him. He wants those things rectified. You faithfully design a different denture that addresses all his concerns.

Patient’s Denture Wish List
1. Teeth that look new
2. Teeth that look real
3. Whiter teeth
4. Teeth with more bite
5. Sexier teeth

When the new denture is ready, the patient, spits it out, can’t tolerate for one second and start comparing the “merits” of old denture with the demerits of what you’re just done. It doesn’t matter if you pull out that wish list written in the patient’s own handwriting and signed against “sexier teeth”. They think the new teeth you’re giving them just ain’t sexy.

Most dentists will reel from the shock of seeing a happy, enthusiastic patient walk in for the first visit, only to be entertaining a critical and uncooperative one at the end. Can these cases be spotted at the beginning and weeded out before taking the case? I find it difficult. During initial examination, the dentist may be able to establish how the patient felt and what the patient wanted at that point in time. They may feel that their old denture had teeth which were too short. They wanted longer teeth, bigger teeth, whiter teeth… Even if the dentist could read their minds at that point in time, he would have seen that they wanted longer teeth. But once the longer teeth are issued, they begin to sound funny, feel funny and chew funny, they may decide to take issue with their new dentures in the most unexpected ways, saying that it’s uncomfortable, unstable and just not right.

The vast majority of dentures do require some adjustment before issue. Nothing is perfect - especially a set of new dentures to which the patient is not accustomed. In the vast majority of cases, patients are satisfied after adjustments are made. If the new dentures are significantly longer, larger or thicker than the old ones, then a period of adaptation (with 100% patient participation and cooperation) is required. Only in rare cases are redoing the denture necessary. If the patient is agreeable to a redo of the denture, this time without such a great departure from their old set of dentures, then, an amicable conclusion is still possible. And it usually ends up amicably. Even if the patient is unwilling to bear the cost of the redo, the dentist would still be in the position to end off with a satisfied patient - something more important to the dentist than making a profit out of every single case.

Just for the sake of job satisfaction, many dentists are willing to redo dentures. But not all patients allow the willing dentist to redo. What if the patient declares that he has lost all confidence in the dentist even before wearing the denture for any reasonable length of time (less than an hour)? He is not asking for a redo. He is asking for a refund.

Reading their minds now, the dentist may see a totally different patient from the very nice and accommodating one on the initial visit. So mind reading doesn’t help. What might help, is a third eye that can look into the future and predict trouble and unpleasant responses from initially nice and friendly patients. How I wish I can do that.

Speeding Up Our Life Cycle

2009-07-30T11:00:00.005+08:00

Are you one of those parents who always need to be around when your child is doing his/her homework? I may not remember much of my primary school curriculum, but I’m sure I didn’t do algebra at Primary 1!

Ali has 3 marbles more than Tom who has 1 marble more than Jerry. If Jerry has 2 marbles, how many marbles do Tom and Ali have?

Answer:

Let Jerry have j marbles
Tom has j+1 marbles
Ali has 3+j+1 marbles
Given that j=2
Therefore Tom has 2+1=3 marbles
Ali has 3+2+1=6 marblesWell, at least that was the way I was taught to do this sort of “problem sums”. I don’t know how smart other people and their kids are. But I certainly wouldn’t have a clue as to how many marbles Ali and Tom have when I was in Primary 1. And I don’t expect my 6-year-old son to be able to do that. To me, this is probably Primary 4 work. Why are they teaching it at Primary 1 now? A chill runs down my spine when I imagine what they might teach in Primary 2, 3, 4, 5, 6.

If you think that’s not bad enough, have you heard of the Primary 2 kids who had to write book reviews as homework? Almost every child would seem to have read a book that no child would find interesting. Almost every child would get an A for their insightful review copied from Amazon.com. My son would probably get an F because instead of a book review, I’d be the only parent who would write an essay on how stupid the whole exercise is.

We are a nation obsessed with upgrading, efficiency and bang for buck. That’s not a bad thing - provided we don’t let things get out of hand. Compared to my son and other kids in school today, I went through primary school at a very comfortable pace. It’s not just about enjoying childhood. It’s also about being true to yourself. So what if my homework was never flawless? At least I understood most of it and did it myself. So what if my projects were made out of cheap cardboard and coloured paper? At least my parents didn’t have to scrimp on the next meal to get materials that would make my project look as professional as the others.

If learning is forever, why rush into it? More importantly, how much does a Primary 1 kid really need to know at Primary 1? Are the schools really in such need to show that they are improving and reaching ever higher standards? What simpler way to show “improvement” than bringing Primary 2 work to Primary 1.

Wow. That’s an impressive improvement. What do we do next year? Let’s bring the Primary 3 work to Primary 1. Wow!

The end point? There is no end point in theory, but for practical reasons, most people would stop at an MBA or a PhD. And my friend who holds an MBA (and a very expensive one too) just got retrenched for the nth time. He has been switching careers, attending diploma courses to help him remain employable. After multiple humbling career switches with equally humbling salaries, he still ended up retrenched. It’s quite baffling that with so much more experience, he is worth much less than he was young. He’s finally considering becoming a tour guide - a job done very well by another friend of mine who only finished his O Levels.

Is it because this friend of mine didn’t learn about how many marbles Ali has when he was in Primary 1? Would our kids not fall into the same predicament when they hit 40 because the education system they are under is now an improved one that will make sure you won’t wash toilets or drive taxis if you have an MBA?

I’m glad that I can sometimes decide my own worth. My years of experience are tangible and worth something in the field of dentistry. While I can still hold handpieces and scalpel blades steady, I don’t have to retrain and acquire new skills in a food court or toilet to remain employable. Not so for many friends my age. Many of them have reached their “employ by …” age. Like the primary school system, everything is being sped up in Singapore. We can’t wait to graduate. We can’t wait for the IRs to be built. We can’t wait for the next rally at the stock market.

So why not attain O Level knowledge by Primary 6. Retire to wash toilets by 40 (already happening). Draw CPF at 90. No, this is one thing which will only be slowed down. Happy speeding on the other lanes.

~~~End~~~

Crown Lengthening Case

2009-07-30T10:39:00.011+08:00

Smiles are not just affected by tooth positions. They are also affected by gum levels. Gum surgery can correct gum levels.

Her main concern is her crooked teeth. To fix that properly, it would be good to first correct her gum level. The gum level ought to be where it's indicated by the black dots.

The gums are peeled back to expose bone.

The gum level around the 2 "sunken" teeth has been brought up. The next step is to change the positions of the teeth.

It's a week after gum surgery, our patient is back for her crown preparations. Her canines have been root canal treated. We ground them down to gum level, then placed fibre posts inside the canals.

The crowns of the canines are rebuilt from scratch to conform with the crown positions we want.

The rest of the teeth are carefully prepared to conform with the final tooth positions we want.

The prepared teeth are protected with temporary plastic crowns. We will wait for the gum level (after surgery) to stabilise before we take impressions for the final e-max crowns. So far, we have already successfully realigned the patient's teeth.

Case completed.

Horsing Around

2009-07-26T23:08:00.000+08:00

Oh no! I had a drop too much of Knock Out Beer and I’m dreaming again. I bought a horse in Australia (the girl is part of the package). I wanted to keep it as a pet. Then I found out that it was used for racing (the girl was the jockey). So I sold the horse …

Yao mo gao chor ah?

If I find out that a horse has been used for racing, then all the more I should keep it in my own stable, my own ranch (with a decent room for the girl) and not sell it. But then, this was just a dream and dreams don’t have to make cents … I mean sense.

And I also dreamt that I spent millions upon millions of other people’s money to build a titanium building. Then angry mob came to tear down the building, melted down the titanium and the expensive metal was turned into thousands of dental implants for edentulous patients who would otherwise not be able to afford it.

More Knock Out Beer. And another dream. This time, I dreamt I was CEO designate for some company running a sovereign wealth fund. I panicked. I didn’t know anything about managing SWFs. The job was killing me. I was losing billions and people were staring, pointing fingers at me. I had to find a replacement, a scapegoat if you will.

I found him. But the guy was too smart to be a scapegoat. He soon realised that like Obama, he’ll be inheriting a disaster in the making. He quits over “strategic differences”. Whatever that means. It’s just a dream. I’d better go back to work and stop horsing around.

Going for wisdom tooth surgery.

2009-07-20T13:19:00.005+08:00

Pre-operative instructions for patients undergoing surgery.
1. Have a good meal a least 4 hours before surgery. Comsume only water after that.
2. Make sure all the medications you are taking are made known to the surgical team.
3. Avoid supplements like ginseng and gingko biloba for at least 4 days before surgery. Consult TCM practitioner if in doubt.
4. Do not smoke.
5. Maintain good oral hygiene.
6. Have an adult to accompany you home after the surgery if you are to be sedated.

Post - operative care for patients who have just undergone surgery.
1. Bite as hard as you can on the gauze provided when the surgical site is still numb.
2. Be careful not to bite your lip before anaesthesia wears out. Ulcers may occur due to stretching or accidental biting.
3. Swallow overflowing saliva. Do not keep rinsing your mouth. If you need to spit, do so very gently.
4. Avoid drinking through a straw.
5. Do not blow your nose. Sniff if there is mucus. Pinch your nose when sneezing.
6. Do not consume hot drinks, alcohol or coffee for the first 48 hours.
7. Do not smoke.
8. Apply cold compress on the cheek or lip over the surgical site during the first 24 to 48 hours.
9. Stop cold compress and rinse your mouth with warm salt water after 48 hours. Maintain good oral hygiene.
10. Avoid food that requires chewing for at least 3 days.
11. Avoid physical exertion for at least 5 days after surger.
12. Follow all instructions on medication.
13. Panax notoginseng promotes healing. Consult your TCM practitioner for a suitable formula.
14. Call the clinic immediately if "sand" leaks out from the would.

Teeth Whitening FAQs.

2009-07-19T22:48:00.009+08:00

Q: Why bleach my teeth?
A: It's mainly for cosmetic reasons. Whiter teeth look cleaner, healthier and younger. In the reel and real world, cosmetic reasons can make a world of difference. The cast from the TV series Baywatch had their teeth bleached. The wannabes below obviously had no tooth whitening budget.

Q: Can all teeth be bleached?
A: Crowns and fillings do not bleach. Brown or grey teeth are much harder to bleach than yellowish teeth. Make sure that your teeth have a uniform colour and not a patchy appearance.

Q: Do you do laser whitening?
A: No, we do not do laser whitening. Our system is chemically activated and works just as well. Laser whitening will cost about $1200. This is because the dentist needs to rent the machine and buy the bleaching gel from the same company. The high advertising costs must also be paid for. For laser whitening, the total cost to the dentist can be as high as $900 per patient. The bulk of what you pay for goes to the supplier.

Q: How quickly can I see results with the take home kit?
A: Results are noticeable after an hour's application. It takes about 4 days of continuous wear (1 hour 2 times a day) to reach maximal results.

Q: What sort of results can I expect?
A: You will never get chalky white teeth. Going two shades whiter is a reasonable expectation. Results do vary and satisfaction cannot be guaranteed as some teeth may not bleach well in spite of our best efforts.

Q: Can everyone go for bleaching?
A: Bleaching is not recommended for pregnant women.

Q: What are the side effects?
A: Sore gums and sensitive teeth are common side effects. However, it's often temporary. See your dentist if it gets uncomfortable.

Q: How long does it last?
A: Re-treatment may be required every 1-2 years or so. It depends on your diet and how well you maintain your teeth. Coloured drinks and some herbs will cause staining very quickly.

Cost of one plate of Char Kway Teow

2009-07-14T13:50:00.001+08:00

Somebody suggested that we can consider reintroducing non-air-con buses. Unthinkable? Not so. The only problem is, our public transport system does not always let the market decide. Peanuts can tip the balance. Let me illustrate.

Just yesterday, at some old coffeeshop at Hougang, I decided to have an unhealthy char kway teow for lunch. The last time I ate at the stall, the char kway teow was priced at $2 and $3. Obviously, the $3 plate had a larger serving of noodles and cockles. And to make myself feel less guilty about eating such an unhealthy dish, I would always order the $2 plate. The $3 serving was almost 2 times larger. Apparently, the $3 plate was not very popular.

A surprise awaited me at the stall when I went there yesterday. There was no more $2 char kway teow. Instead, it was either $2.50 or $3. Yep, I fell for the trap. $2 is now $2.50. $3 is still $3. Which one would I order? $3 of course. The hawker may not have really increased the price of his $3 char kway teow. However, by increasing the price of his $2 char kway teow by 50 cents, thus closing the gap between “regular” and “large” to only 50 cents, he has definitely increased the demand for the $3 “large” plate. How ingenious.

Now we go back to the topic of non-air-con buses. Will there be any takers? I’m sure there will be. Some old folks, some foreign workers, backpackers etc. But what about the fare? How much less than the air-con buses? Half the price? Wait a minute. The public buses in Singapore don’t have windows that can open. They can’t just use the vehicles whose air-cons are not working to run the non-air-con services. They’ll have to buy new buses or import old buses from neighbouring countries. Either way, it means spending money which in turn means that the fares can’t be too low. Being unprofitable is a death sentence in Singapore, even though some companies that are far from unprofitable continue to squeeze their customers who have little or no choice. If there is little difference between fares charged for air-con and non-air-con buses, which type will our wise consumers go for?

Cost of tooth bonding

2009-07-13T13:34:00.011+08:00

When a painted wall in your home becomes indelibly stained, what do you do? Yes, you'd paint it. If you decide to make the wall less stainable and easier to clean, you could also bond ceramic tiles to it.

In dentistry, bonding is the method by which a dentist adds a tooth coloured material to the surfaces of your teeth to mask underlying discolouration, cavities, gaps or undesirable contours or alignment. Like the wall in your home, there are 2 methods of bonding, namely direct and indirect bonding.

Direct Bonding

We have upgraded to a new cordless LED curing light (left). The light is cool, it's more powerful in terms of pure light intensity and does the job in half the time that older machines take. The older halogen light unit (right) is cumbersome and heat-generating.

Before

After

The tooth or teeth to be treated are first trimmed to reduce or roughen the surfaces that are to be bonded.

Next, chemicals are applied to the surfaces of the teeth to improve the grip in much the same way you would apply paint primers. Then, a composite material of the desired colour is applied to the surface of the tooth and allowed to harden. The results are faster and more dramatic than bleaching. You can theoretically "paint" your teeth as white as you want.

For shape or alignment correction, the dentist will add material to the tooth to thicken it in some areas. By selectively thickening certain parts of a tooth that are slightly out of place, the treated tooth can be made to flush with the other teeth. In a similar way, teeth can be slightly enlarged by adding material to close gaps between them. Putting on braces may be the ideal treatment for crooked teeth, but bonding yields immediate results and costs much less.

One limitation to bonding is that you can only add but not subtract. To correct the positions of teeth that are too bulging, you'll have see an orthodontist. Another setback is the strength and durability of composites. These materials seldom last more than 5 years. You are likely to need repairs and patch up every few years.

Cost Estimation
Tooth coloured fillings/bonding S$100-S$200

Could you remember me "doctor" ?

2009-07-10T11:03:00.002+08:00

Everyone who can read this must remember the time of film cameras, negatives and 3R prints that could cost 40 cents each. You had to bring your roll of film to the studio for processing and wait a week. Then, as more and more people could aford cameras, tiny photo-developing booths/kiosks took over the job of the studios. Processing could take just one day, then 20 minutes. I remember getting receipts from these booths that said: “Goods not collected within 6 months will be discarded”. Which is fair, considering the lack of space in the tiny little booth.

Many people don’t realise that dental clinics have their fair share of “trash” in the form of plaster models. Once the dentures, crowns or bridges are completed, these models are practically useless. The more patients we see, the faster they pile up. If we were to keep all these models from day 1, we would need to rent a warehouse to store them.

So what happens to dentures that are not collected? We call up the patient to remind them. But we can’t keep reminding them, can we? Of course not. We have better things to do. But what if the patient turns up 2 years after the denture was first made expects to collect it? You may have guessed it by now, we had one like that just a week ago.

If I were in that patient’s shoes, I would feel nervous, apologetic with only the faintest hope that the dentures will still be around. But as you may have guessed it again, this patient was angry and demanding. Insisting denture or refund of deposit. But what do people understand by deposit? Isn’t it something to protect the business in case the patient/customer abscorns, abandons treatment or dies halfway? Unfortunately, many seemingly educated Singaporeans refuse to acknowledge the fact that they have been irresponsible. They cannot blame the clinic for discarding their uncollected dentures and forfeiting the deposit.

“But I have already paid! But I have already paid!”

“We reminded you to collect your dentures. You didn’t respond”

“I was busy what”

How to make them understand? Perhaps they do understand. Could it be that just because they didn’t need or want the new denture back then and suddenly decided 2 years later that they wanted it? Yes. They could make the denture first, pay only half the fees as deposit and then collect their dentures when they are “ready”.

Isn’t it amazing the kind of service some of our patients expect us to provide? How do we manage this sort of cases? Charge them for storage?

Instant Orthodontic

2009-07-08T11:29:00.023+08:00

What do brides to be and air stewardesses have in common? They have no time to put on braces before that last interview with the airline management or the appointment with the photographer. Since 2003, our clinic has been helping many hopeful air stewardesses pass that last interview and take off on a high flying career with "instant orthdontics". We have also helped many brides and bridegrooms to be to get their smiles ready for the camera.

There is actually no such thing as "instant orthodontics". In fact, we don't do orthodontics at our clinic. The illusion of instant orthodontics is created by a technique which involves elective root canal treatment and the crowning for crooked teeth with full ceramic crowns. In some cases, additional procedures like gum surgery may be required.

Case: Hopeful Air Stewardess

This is a classic case that brought our humble practice in the Hougang heartlands into the recommendation list of an airline's management. The patient is a young and attractive teacher on her way to a new career as an air stewardess (or cabin attendant if you want to be PC). Below is a plaster model of her teeth before treatment.

From the inside, we can see that her two central incisors are protruding forward. The incisor on the right side was even rotated. Her lateral incisors were also sunken relative to the rest of her teeth. It's our duty to inform her that the ideal treatment for her case is orthodontics. She would have to extract a couple of teeth, put on braces for 2 to 3 years. She rejected the option because as an air stewardess, she would not be allowed to put on braces. She also needed to look good in time for her final interview.

I took impressions of her mouth and studied her case closely. The twisted right central incisor was marked (x) for elective root canal treatment. I would have to break off the crown and then rebuild it from scratch. The two lateral incisors only needed to be "thickened up" with crowns to put their outer surfaces in alignment. The tilted canine on the right side could be set straight also by covering it with a crown.

Below is what we call a diagnostic wax-up. It's similar to a mock up of the final result we can get. It's done by adding wax to recontour the original study model. Of course, the twisted crown was broken off on the model and reset in a new position. In this wax-up, I included the canine on the left. The patient decided to do just 5 Empress^® crowns from her right canine to the left lateral incisor.

I performed the root canal treatment as planned and then cut the crowns accordingly. The impressions were sent to the lab and in a week, they were ready for cementation. The plaster models below was taken from the patient after the crowns were cemented. Note that we managed to completely realign 5 of her teeth by crowning. Root canal was only required for one tooth.

It should be noted that "instant orthodontics" is a compromised and less than ideal solution. Vital teeth which have been crowned in this case may require root canal and quite a bit of follow up treatment in future.

Cost Estimation
The above case would cost about S$4200 today

Case: Anxious Bride To Be

This young lady has canines that are protruding, lateral incisors with too much gum covering and tilted backwards. Straighten her teeth and make her gum level even? This bride to be became anxious and excited after she saw our website and realised that something can actually done to change her smile before she and her hubby go before the camera.

We first performed gum surgery on her 2 lateral incisors to even out her gum line before we even attempt to bring her lateral incisors forward. We can see from this picture on top that her two canines are bulging out.

The next step is to perform elective root canal treatment to remove the nerves inside her canines. The two protruding teeth were cut off at the top, glass fibre posts were cemented in the root canal spaces and built up.

All 6 of her front teeth have been prepared for crowning. However, her gums have not healed from the surgery yet. That's why we've decided to place temporary plastic crowns for her.

Here she is with her temporary crowns. They don't look very natural, but the straightening effect is already there.

Two months after the surgery, we took impressions for her final crowns. 6 emax crowns were then cemented. She's ready to go before the camera.

Cost Estimation

This case will add S$6000 to the wedding budget.

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A young and attractive childcare teacher cum part-time model turned up at our clinic with an interesting problem.

Her main complaint was tilted right incisor. She could not put on braces as it would affect her modelling assignments.