The way we squeeze our toothpaste tube may contain secrets of our personality it seems. Think you know yourself? Find out using this test.
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The way we squeeze our toothpaste tube may contain secrets of our personality it seems. Think you know yourself? Find out using this test.
Wisdom teeth are the last teeth to develop and erupt into the mouth. They are more accurately labelled as the third molar teeth according to dentists. Most of us however would probably know them better as wisdom teeth due to the timing of their eruption, which coincides with the coming of age. We have a total
Wisdom teeth start its development during adolescence and erupts into the oral cavity during early adulthood. Most of us unfortunately do not have enough jaw space to accommodate these teeth. As a result, these teeth are unable to erupt fully and starts to jam itself against the tooth in front of it. Dentists often refer to this condition as an “impacted wisdom tooth”.
This include the ability to eliminate areas of food trap that often leads to recurrent gum infections (which manifest as episodes of pain or discomfort), prevent decay of the adjacent tooth that lies in front of it, and prevent premature loss of gum or alveolar bone due to chronic gum infection.
The surgeon will start by administering local anaesthetic to numb the affected wisdom tooth and its immediate surroundings. Patients who are especially anxious may also choose to do the surgery under sedation or general anaesthesia. The surgeon will thereafter proceed to make an incision along the gum line and expose the impacted wisdom tooth by removing some bone around it. Delivery of the tooth is often accomplished by dividing the tooth into 2 or more pieces to minimize the risk of nerve injury during removal. Finally, the surgeon will proceed to clean the socket and close the incision using stitches.
The average procedure time is 15 minutes.
The recommended age to remove wisdom teeth that are impacted is during early adulthood when healing is often swift and uneventful. The experience will also be more predictable as the roots of the wisdom teeth may not have fully formed yet and the jaw bone still relatively elastic.
The surgery itself is fairly painless as this will be managed using fast acting local anaesthetic agents. Patients often find the noise and vibration associated with bone removal and sectioning of the tooth to be slightly uncomfortable (as sound conduction through bone is more efficient than air). You will also be able to sense some pressure during the delivery of the tooth.
You should expect mild bleeding, swelling and discomfort over the surgery site for two to three days after the surgery. A small percentage of patients may experience bruising along the jawline and neck.
You are encouraged to rest at home during the first 24 hours after the surgery. This will allow for the formation of a proper blood clot and minimise the risk of prolonged bleeding. Avoid smoking, exercising and using a straw for the first 48 hours. It is recommended that you do not consume alcoholic beverages whenever you are on prescribed medication.
A soft or liquid diet is recommended for the first 3 days before slowly resuming to your normal diet thereafter. Your surgeon may advise the use ice packs and prescribe analgesics to help relieve the swelling and discomfort. You can keep the wound site clean by rinsing with an antiseptic mouthwash. You can brush the other teeth as per usual.
A follow-up visit with the surgeon is often scheduled about 1 week after the surgery to ensure that you are making good progress towards a full recovery.
A potentially, serious complication associated with wisdom tooth surgery is nerve injury. This is due to the close proximity of the wisdom tooth to the Inferior Dental nerve. Injury to the nerve will result in a persistent feeling of numbness or a tingling sensation affecting the lower lip, gums, chin or tongue after the surgery. Fortunately, these symptoms will often resolve over time in most cases of mild nerve injury. Only on rare occasions does the injury become permanent. The experience of the surgeon and the patient’s ability to cooperate during the surgery may play a significant role in risk reduction.
A more common complication is the occurrence of a painful condition, three to five days after the surgery, known as a “dry socket”. It occurs when there is an inexplicable failure to form a proper blood clot within the tooth socket. Your surgeon may suggest for you to abstain from using a straw, smoking and spitting (or do any other type of sucking action) immediately after the surgery to mitigate this risk. The complication will usually resolve by itself and immediate emergency management is directed at pain control for patient comfort.
Dental implants have gradually evolved to become the gold standard for tooth replacement. It has the potential to offer patients a more natural, aesthetic, comfortable and lifestyle friendly solution when compared to removable or fixed dentures. Dental implants are very versatile, it can be used to replace a single missing tooth, multiple missing teeth or function as an anchor to stabilize a removable full denture.
Its construction consist of 3 main parts, a titanium rod that is anchored into the jawbone to replace the root of the missing tooth, an abutment that sits on top of the titanium rod, and finally a crown that fits over the abutment. Titanium is the material of choice because of its inert, highly biocompatible property with human tissues. This property allows for bone cells to attach and deposit bone around it, providing stability and retention. This phenomenon known as “osseointegration” occurs over a period of 3-6 months.
Dental implants like our natural teeth have the potential to provide us with many years of service.
Dental implants eliminate the need for adjacent teeth preparation associated with traditional teeth replacement options using fixed or removable dentures.
Dental implants help maintain alveolar bone thickness, which works together with the teeth to provide lip support and maintain the smile appearance.
Dental implants are held in place by the alveolar bone itself, eliminating the inconveniences, discomfort and embarrassment associated with removable dentures, allowing patients to resume their normal lifestyle.
Dental implants have demonstrated good survival rates in conscientious patients, in many long term studies and are comparable to other forms of teeth replacement, if not better.
Dental implants mimic natural teeth in function. Its stability allows us to chew food and speak normally, without the fear of it dropping out. This has a direct impact on a person’s physical, mental and social wellbeing.
Dental implants when placed early after tooth loss by experienced, competent surgeons in cooperative patients have a very high degree of predictability both in outcome and survival.
Anyone who is physically well enough to undergo a routine dental extraction will often be fit enough for dental implants. Dental implants are not suitable for the growing child as their alveolar bone is still developing. There is no upper age limit for dental implant treatment for healthy adults.
Patients with existing chronic gum disease or systemic diseases will need to work with their dentist and physicians to achieve proper disease control prior to embarking on dental implant treatment. Smoking is a negative lifestyle element that will compromise the success of dental implant treatment. Many studies have documented incidences of poor wound healing and poor “osseointegration” in habitual smokers.
Patients who have lost their teeth for many years may experience significant alveolar bone loss. These patients will often require implant site preparation via bone grafting or sinus lift to ensure that there is adequate bone volume prior to implant placement.
Firstly, the surgeon will carry out pre-treatment assessment by doing a clinical examination, taking x-ray or CT images, taking photos and constructing plaster models of your teeth. Thereafter, the surgeon will discuss the treatment options, procedure, risks and cost with you, to facilitate joint decision making.
Treatment often involves 2 distinct stages, a surgical stage and a restorative stage.
During the surgical stage, the surgeon will implant a surgical-grade titanium rod into the jaw bone under local anaesthesia. The implant site is prepared carefully using precision made drills under copious irrigation with sterile saline to ensure a snug fit. The incision is closed using stitches and allowed to heal. Patients who are easily anxious can opt to carry out this procedure under sedation or general anaesthesia. The procedure takes on average about 30 minutes per implant.
In selected cases, the surgical stage is carried out on the same visit for extraction of a tooth. Placing an implant in a fresh extraction socket have the benefit of reducing overall treatment time and convenience. The cost for such a procedure may be higher due to the need for bone grafting, as the root of the extracted tooth is often slightly larger than the titanium rod.
The restorative stage is carried out after successful osseointegration of the titanium rod. The period for osseointegration to occur may vary between 3-6 months depending on patient bone quality and quantity as well as the need for other adjunctive procedures during the surgical stage.
During the restorative stage, the dentist will proceed to expose the top part of the implant to fit an abutment. An impression is thereafter taken to enable the fabrication of a dental crown (cap) which will seat on top of the abutment. The dentist will also record the tooth shade using your natural teeth and the way you bite on the same visit. The fabrication of the final crown takes approximately 7 working days and will be fitted in on a subsequent visit.
The surgery itself is fairly painless as this will be managed using fast acting local anaesthesia agents. During the preparation of the bone, you may be able to perceive vibration or slight sensitivity.
The fitting of the abutment and crown during the restorative stage is relatively pain free. You are expected to help in the selection of your tooth shade and can expect some photographs to be taken. Patients who have high expectations with regards to the colour and shape of their crown may need to come in for more visits and incur additional cost as crown fabrication is done by hand. The crown is fitted in place once the dentist is satisfied with the way it contacts the adjacent and opposing teeth.
You should expect mild bleeding and discomfort over the first 2 days after the surgery. You may also experience mild swelling and/or bruising of the overlying skin if you have had simultaneous bone grafting done on the same visit. You are encouraged to rest at home during the first 24 hours after the surgery. It is also recommended that you do not perform physical exercise and consume hot food or beverages during the first 48 hours. Painkillers will be prescribed to help manage post-surgery pain as needed. Please do not consume alcoholic beverages whenever you are on prescribed medication.
Keep the implant site clean by rinsing with the antiseptic mouthwash after every meal for a week. You can brush the other teeth as per usual. A follow-up visit with the surgeon is usually scheduled one week after the surgery to check on your progress and ensure that the implant site is healing well.
Your dentist will guide you on proper implant care and maintenance after the final crown has been placed. A follow-up visit with the dentist is usually scheduled three months after crown placement to check on your progress and ensure that the implant is being loaded normally. Thereafter like normal teeth, it is recommended that you adopt good personal oral hygiene habits and visit your dentist every 6 months for preventive care.
Like all other surgeries, the placement of dental implants does carry a number of risks. Common complications include the failure of osseointegration due to infection, sinus issues when placing implants in the upper molar region, injury to adjacent teeth and injury to vital structures (e.g. blood vessels and nerves) that lie within the jaw bone.
Your surgeon will explain to you the incidence of such complications and the likelihood of success as it may vary significantly between different individuals and site. Dental implant treatment is considered a complex treatment procedure that requires a significant degree of competence and proficiency on the part of the surgeon.
Like our natural teeth, its longevity will depend on a combination of good personal and professional care. The evidence over the last 25 years tell us that dental implant treatment can be a very successful treatment option for patients who are willing and ready to take an active role in their care and maintenance.
Dental braces is used to reposition teeth, align the dentition and improve on a person’s bite.
Patients undergoing braces treatment can look forward to a more attractive smile, enhanced oral health, better chewing function, speech and self-esteem.
Active braces treatment takes between one and three years to complete. This treatment duration is dependent on the complexity of your condition, your age and motivation as well as the expertise of the orthodontist.
You can help reduce the treatment duration by being explicit about your desired treatment goals, keeping a high standard of oral hygiene, avoiding breakage or damage to the braces device, keeping appointments, complying with elastic wear and starting young. There is however no age limit for braces treatment.
It is recommended to have your 1st visit with an orthodontist when the dentition is changing over to the permanent set (between the age of 6 and 12 years). The most common reason for maligned teeth is due to inadequate spacing which disrupts the normal eruption of the permanent teeth. During this transition stage, the bite may also be affected by poorly positioned teeth or uneven jaw bone growth.
A consultation at this stage provides a valuable window of opportunity to detect and manage (or minimize) such disruptions in approximately 5% to 15% of the population. Fortunately, that also means that a large majority of children will not require treatment at this age.
The common age for braces treatment is during the early adolescent years (between the age of 12 and 16 years) when most of the permanent teeth have erupted. The adolescent patient often benefits from a faster and better treatment outcome due to the favourable growth spurt that coincides with puberty.
For a small minority of individuals (less than 5%), the orthodontist may recommend that treatment be delayed until late adolescence / early adulthood due to the presence of significant disharmony between the jaw bones (which support the dentition). Delaying treatment to allow for skeletal maturation in these individuals allow for treatment to be more predictable and efficient.
Your orthodontist may take x-rays, impressions and photos of your teeth (and face) to better assess and monitor your condition during the consultation process.
The treatment experience can be variable between patients and is highly dependent on your condition and system (or device) being used.
You should expect teeth movement to cause mild to moderate discomfort (often describe by patients as a dull ache or tenderness affecting the teeth when biting) for 2 to 3 days after each adjustment appointment. Patients who are prone to apthous ulcers may experience an increase in incidence during treatment. This can be managed using braces relief wax and topical steroid or analgesic ointments. Most patients adapt to the presence of braces within the first 3 to 4 weeks and will be able to eat, sing or play musical instruments as per usual.
Some patients prefer a less conspicuous appearance during treatment. You are encouraged to discuss the suitability of ceramic brackets or aligners with your orthodontist if you have similar concerns.
You should expect to wear your retainers full time (morning and night) during the 1st year after braces treatment. They often feel strange and cause speech difficulties initially. The retainers can be removed for eating, brushing, sports and the occasional important event. Wearing the retainers well will allow the supporting bone and gums to mature, rewarding you with longer term stability. From the second year onwards, your orthodontist will likely convert you to part time wear (i.e. approx. 8 to 10 hours nightly). He may continue to review your progress every 6 to 12 months.
Patients who have difficulty complying with removable retainers should highlight this issue early so that a fixed retainer can be placed. A fixed retainer consist of a fine wire that is bonded on the back surfaces of the front teeth. They tend to trap food and make it harder for you to floss in between teeth. Regular preventive dental visits with your favourite dentist is an absolute must for patients with fixed retainers.
For most people, orthodontic treatment is an elective procedure that involves much effort, time and cost. It is therefore a common expectation that the treatment be safe and the outcome be lasting.
Relapse, whereby teeth that have been previously aligned tend to return towards their original position, is one of the common difficulties encountered by patients. This phenomenon affects approximately two thirds of all treated patients to varying degrees. Relapse is not entirely preventable as the position of the teeth is determined by the tone of the lip and tongue muscles as well as the supporting gums throughout life. Your orthodontist would have prescribed you with a set of retainers to prevent relapse and protect your investment.
Braces treatment is possible because of the ability of bone to remodel. During treatment, bone cells actively release enzymes that facilitate bone removal and deposition around the roots of the teeth. This may affect the roots themselves, causing them to shorten in predisposed patients (e.g. patient who suffers from endocrine disorders or have experienced trauma to the teeth prior to braces treatment). The degree of shortening is often mild (less than 1mm) and does not affect the longevity or health of the teeth. Only in rare instances, it is severe enough to warrant a discontinuation of braces treatment.
Teeth with deep fillings or a history of traumatic injury are susceptible to pulpal devitalisation during treatment. Such teeth often have a compromised blood supply and is less tolerant of movement. Your orthodontist will recommend root canal treatment for these teeth should it be needed.
Invisalign takes a novel approach to straightening teeth, by using a series of custom-made removable trays to help you achieve a confident smile without the use of traditional brackets and wires. The aligner trays are made of smooth, comfortable and virtually invisible plastic. Wearing these aligners over your teeth full time, will gradually and gently shift your teeth into place, based on the exact movements prescribed by your orthodontist.
Invisalign offers many great advantages for adults and teens who require orthodontic care.
Many adult patients seek orthodontic care because they didn’t have it as a teen or experienced relapse from their previous orthodontic treatment. With Invisalign®, adults can now straighten their teeth without drawing attention and function confidently at work. It can also be safely used with existing dental work such as veneers, crowns, bridges, and dental implants.
Invisalign Teen is designed especially for teenagers. It’s a great fit for their lifestyles because the aligners can be removed before eating, playing an instrument, during contact sports, for brushing or when making an important presentation. Invisalign Teen also comes with six replacement aligners in case they are misplaced or damaged.
On your first visit, your orthodontist will review your dental and medical history, listen to your concerns and conduct an oral examination. Rest assured that he will spend time to answer all of your questions about orthodontic treatment and the financial considerations involved. He will commence to take the records only if you consent to proceed with treatment.
You will be invited back for fitting of your aligners once they are ready. During this appointment, your orthodontist will check the fit of your 1st pair of aligners and bond small tooth coloured attachments to your teeth to enable your aligners to work more efficiently.
You’ll be scheduled for future visits every six weeks for checkups and adjustments. Our practice assistants will do their best to ensure that future appointments are convenient for you. Our general dentist will also attend to you twice a year to ensure that your teeth and gums remain healthy throughout treatment.
Your orthodontist will be responsible for taking pictures, impressions and x-rays of your current teeth and smile. Using this information, a 3D digital model of your teeth is created and used to fabricate a series of customized aligners that will gently shift your teeth into position. ClinCheck, a proprietary software by Align Technologies allows you and your orthodontist to review the treatment plan and make adjustments to ensure the best possible outcome.
Invisalign is completely removable so you will be able to eat, drink, brush and floss as normal. Every two weeks, you’ll start using a new pair of aligners, and eventually, your teeth will be in the position prescribed by your orthodontist. You will need to wear the aligners for at least 22 hours a day to stay on target.
There are no diet restrictions with Invisalign because you remove them before you eat. You don’t have to worry about breaking off a bracket or having a wire bother your gums because you ate the wrong thing. When you’re done eating, simply reinsert your aligners back onto your teeth.
The aligners are comfortable and clear so no one will know you’re wearing them. You can still take part in all of your extracurricular activities and continue your active lifestyle. There are no metal brackets to attach and no wires to tighten. You just pop in a new set of aligners approximately every two weeks, until your treatment is complete. You’ll achieve a great smile with little interference in your daily life. The best part about the whole process is that most people won’t even know you’re straightening your teeth.
The cost of Invisalign’s treatment depends on the complexity of your teeth movements, treatment duration and treatment sequence that has been designed for you by your orthodontist. No two treatment plans are exactly alike, because no two mouths are exactly alike.
Like traditional braces, Invisalign is offered with different payment options. We are accredited providers for most medical and dental insurers and accept credit card and NETS payment. Our interest free instalment plan provides you with absolute peace of mind.
Invisalign repositions teeth as safely and effectively as traditional braces and are approved by the US FDA as medical devices. Treatment success is dependent on your ability and willingness to wear them for at least 22 hours a day. Invisalign has been used by more than 1.5 million adults and teens worldwide and has enjoyed a very high satisfaction rate.
CHAS cardholders are eligible to receive subsidized outpatient dental treatment at Parkway Dental Practice.
CPF members can use their Medisave to pay for approved day surgery procedures at Parkway Dental Practice.
We work with reputable healthcare insurers and leading managed care partners to deliver comprehensive, innovative and cost-effective solutions.
Dr Yong has been practising dentistry for almost two decades. He is well versed in the different types of braces systems available and have helped patient of all ages achieve predictable outcomes within a reasonable time.
Dr Wong has extensive experience in oral maxillofacial surgery and dental implants. She has the ability to help patients make informed decisions on their choice of care and is actively involved in teaching.
Dr Heng has won international awards for her dissertation and publications in the area of periodontology. She is our expert in the field of gum surgery, gum grafting, gum regeneration and dental implants.
Dr Chia qualified at the National University of Ireland. She is a vivacious, compassionate and friendly person. She enjoys treating patients of all ages and is also responsible for spearheading our social initiatives.
Dr Dovban has been practising dentistry for more than 7 years. He has a strong interest in periodontology and have recently completed his Masters training in Periodontology at the National University of Singapore.