Jaw Surgery and Dental Implants in Singapore Blog

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?

As dental implants becomes increasingly popular as teeth replacement, more and more people are having dental implants in their jaws. Today, it is has become a mainstream treatment in many clinics. Along with it widespread adoption, the incidence of complications arising from dental implants is also rising. Countries that have an earlier adoption of dental implants on a widespread scale are beginning to see many complications surfacing. This trend is also beginning to appear in Singapore.

There 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?

Dental 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.

The recent successes of Team Singapore in the Rio Olympics and Paralympics will no doubt spur both the able-bodied and the disabled to adopt a more sporting lifestyle. While physical fitness helps reduce the risks of diseases such as hypertension, stroke, heart attack, etc, the process of attaining fitness poses a risk to health as well. Many people fall and sustain fractures and sprains. The face and teeth are particularly vulnerable. Besides sports, motor vehicles accidents is a also a contributor to traumatic injuries to teeth. Fortunately, teeth that are loss due to trauma can be replaced with dental implants.

A patient came in with a gum swelling associated with a molar tooth. He has consulted a dentist who told him to extract the tooth and place an immediate implant. He then consulted another dentist who told him to extract the tooth and wait a few months before doing the implant. Feeling confused, he came for a third opinion, hoping that I will choose one or the other, making it two to one for a “majority” vote. However, I offered a completely different option. I referred him to a root canal specialist for assessment as to whether the tooth can be saved.

A few months ago, a patient from India flew in for a consultation about his implants which was placed a year ago. He had had two dental implants done to replace his two front teeth which were fractured due to a fall. The dentist who treated him at that time had extracted the remnants of the two teeth and placed the implants immediately to support a temporary prosthesis. Over the course of the year, the bone and gums had receded upwards, exposing part of the implants. This posed a real aesthetic problem as he had a high smile line that showed the exposed implant. He requested for the implants to be removed and new implants placed to support the prosthesis. This is one of the most difficult problems to solve in implant dentistry.

Many years ago, a patient for whom I was planning a full mouth dental implant treatment in Singapore commented that it cost more than his double by-pass surgery which he had just undergone the year before. Another full mouth implant patient put it in a lighter tone, saying it is like stuffing a BMW into his mouth. Yes, dental implant treatment is expensive. As such, dentists and implant manufacturers alike have been trying different approaches to bring down the cost. However, it is a tough balancing act, trying to bring cost down and maintaining high standards. The All-on-four protocol is one such approach and up to this point, it is proving to be rather successful. Can it replace the conventional approach altogether? Probably not. 

Many patients who need dental implants to replace their missing molars do not have sufficient bone and hence need sinus bone grafting to augment the bone mass to house the implants. Although sinus bone grafting has already evolved to be a commonly done procedure with good results, many patients are understandably concern and would like to avoid it if possible. Some may have a history of sinus disease and entering the sinus for bone grafting may cause a relapse of the disease. In others, there may be ongoing sinusitis which contraindicate the procedure altogether. For these patients, what are the alternatives?

I first heard about sinus lift almost thirty years ago when I was student. It was during a conference on dental implants and one of the surgeons present was advocating that all sinus bone grafting operations for dental implants should be done in a hospital operating room. It was a relatively new procedure back then and there were not a lot of long term studies on the potential complications and doing it in the milieu of an operating theatre provided more protection against adverse outcomes. Well, that was thirty years ago. A lot of research have gone into this procedure and much of what works and what does not are well published in the scientific literature. Today, the procedure is routinely done in dental clinics all over the world. However, this does not mean that complications do not happen anymore. As with all surgeries, complications can and will happen.