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Jaw Surgery and Dental Implants in Singapore Blog

Cost of Dental Care in Singapore

Malaymail.com article on Singapore dental careI was preparing a treatment plan for a patient last night when a Whatsapp message from a colleague came in. He forwarded me a post for Malaymail.com entitled “Why Johor Dentists can expect even more Singapore patients than over before”. And another on Channel News Asia Facebook with a headline saying that “9 out of 10 Singaporeans are concerned about cost of dental care”. This is indeed a reversal of the trend 30 years ago when Europeans came to Singapore as dental tourists; they get their dental work done and have a holiday at the same time and pay a fraction of what they would have to pay if they had done the same work in their home country. Thirty years on, as a developed society, has Singapore Dentistry become like that of Europe?

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Dental implants in an underbite patient

underbite_2Rising affluence and awareness among patients in Singapore have led to an increase in demand for specialist procedures such as orthognathic surgery. Underbite deformity, where the lower jaw is disproportionately longer than the upper jaw is possibly the most corrected dentofacial deformity in Singapore today. However, not so a generation ago. Baby boomers, or in the Singapore context, the Merdeka Generation, often did not have the benefit of such services when they were young and many have uncorrected underbite. With advancing age and a lack of proper care in their younger days, total or partial loss of dentition is common. Many seek to replace their missing or decayed teeth with dental implants. In replacing teeth in a patient with an underbite, do we set the teeth in the original cross bite position or do we aim to reconstruct the dentition into an ideal Class I bite?

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Missing Teeth and Jaw Deformity in the older patient

Most dental implants patients are usually older adults who have lost some or all dentition over the course of many years. On the other hand, corrective jaw surgery patients tend to be younger, those in their late teens and twenties. However, there is a group of patients who have dentofacial deformities that require orthognathic surgery but somehow did not get around to doing it when they were younger but in their later years, require dental implants to replace their missing or failing dentition. For such patients, orthognathic surgery may be done in conjunction with dental implants to restore not just a functional dentition but an improvement of facial aesthetics as well.

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Implant Dentistry; General Dentist or Specialist?

bigstock-Woman-Dentist-Giving-Her-Patie-69458989-2There has been much debate in recent weeks within the dental profession about the competency of dentists to do certain procedures. The issue has attracted a lively debate amongst various dental organizations. The Ministry of Health and the Singapore Dental Council has begun seeking feedback on “Better competency development for safe and quality dental care for patients”. Two of the oft-cited procedures that were considered to be of higher risk and may need additional training and certification are implant dentistry and wisdom tooth surgery. While this debate is on-going who should patients requiring such service go to? We will address the issue of implant dentistry first.

 

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Cheapest dental implant in Singapore

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Cost is probably one of the biggest factor when a patient considers having dental implants. Indeed implant dentistry is arguably the most expensive dental procedure. However, it is also fast becoming the treatment option of choice amongst most patients who lose their teeth. What was once a “luxury” has become a necessity, at least relatively speaking.This is probably due to our high standard of living in SIngapore and hence rising expectations of the people. Along with the increase in demand, dental implant manufacturers and dentists find ways to lower the cost of implant dentistry so that the majority of patients can afford. How cheap is the cheapest implant in Singapore today?

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Dental implants vs root canal treatment

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Dentists are taught to save teeth. Cavities in teeth are caused by bacteria eroding away the enamel and dentine. At this stage, the decayed portion of the tooth can be drilled away and the resultant defect filled with an inert material such as amalgam or increasingly, tooth colored composites. If the decay had progressed deeper into the pulp of the tooth, root canal treatment, aka endodontic treatment,  whereby the pulpal tissue is removed from the root canals of the tooth and then sealing the empty canals with a filling, can often save the tooth from extraction. However, if the decay has progressed even further as to leave minimal sound tooth structure, extraction may be the only choice left. This is where dental implant come in as a replacement for the missing tooth. Where do we draw the line as to when it is better to remove and replace than to salvage the tooth?

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What qualification to look for in a dentist for dental implants?

bigstock-Professional-Medical-Doctor-Te-72465052.jpgThere are about 2000 dentists in Singapore and the majority does not provide dental implant services. This is because of the relative novelty of implant dentistry, becoming mainstream only in the last twenty years or so, and that most dental schools do not teach it as part of its core curriculum in the undergraduate program. How can a patient identify which dentist to choose for dental implants?

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Bringing down the cost of dental implants

bigstock-Coins-in-glass-money-jar-with--86673011-1.jpgA few days ago, I attended a seminar conducted by the Economics Society of Singapore on the “Contentious issues in Healthcare”. Naturally, rising healthcare cost is a hot topic. Economists look at big picture numbers such as GDP often treat the delivery of healthcare as a single entity, encompassing public and private healthcare. Journalists often highlight the high fees charged by private clinics to exaggerate the rising cost. To be sure, cost is rising but it is cost more by factors other than doctors’ professional fees. So where is the money going to? Let’s use implant dentistry as a model.

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Why is the cost of dental implants in Singapore so high?

bigstock-White-Tooth-And-Yuan-On-Scales-83857337.jpgDental implant treatment is arguably the most expensive treatment in dentistry. Over the years, the feedback that I got from patients included descriptions such as “more expensive than open heart surgery” and “stuffing a BMW into the mouth”. So, let’s get it upfront, it is expensive. However, most times, it is cheaper than heart surgery and the good news is that while heart surgery is often mandatory if you don’t want to die, dental implants are elective. So, as much as I hate to admit it, the car analogy is probably closer. But you don’t have to buy a BMW. You can choose to get a Hyundai or you can even choose to walk. Let’s look at the difference between a “BMW” implant and the “Hyundai” implant. And it’s not the country where they are made.

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Dentofacial aesthetics for the older patient

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A colleague once told me this story about a patient of his. An elderly gentleman came in with several badly decayed front teeth. The teeth were quite rotten, discolored and malaligned. He thought to himself that he could be a hero to this patient because no matter what he did, he would have vastly improved the function and aesthetics of his teeth. However, as he commence the restorative work, he discovered that restoring function was the easy part but aesthetics is a different ball game, the profile of the patient notwithstanding. The patient was exacting in his demand for aesthetics, no different from a younger patient. A mutual friend who was in the car industry then said that the guy who drives an old beat up car to a car dealership to collect his new car will not accept a single scratch on the new car. How true.

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