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MESSAGES TO

Missing Teeth And Dental Implants

A DxD Session with Dr Gerald Tan


Ended on Fri Nov 30 2018
Ended
Have a question to ask?

Get Dr Gerald Tan's opinions on your questions! Only approved questions are displayed.

Top Answers


Hi Lauren,

I'm so sorry this has happened, and I hope you have recovered from your fall.

In the course of my work I have seen so many cases of dental injuries caused by accidental falls and I know how distressing it can be, especially if you have lost a tooth in front.

I really feel for you, and I hope you have already found a good dentist you can trust to restore the missing tooth.

To get straight to your question: "Is a dental implant the best option"?

Well, there is no easy answer to this.

But I would say yes, in most cases, getting a dental implant done to replace a missing tooth would be the best option.

However, there are instances whereby getting a dental implant done may not be the best option because of the following factors:

1. Prohibitively high cost

2. Trauma leading to a significant loss of bone and gum

3. Presence of systemic diseases such as uncontrolled diabetes 

4. Presence of uncontrolled gum disease

So it is often too simplistic to say that getting a dental implant done is the best option for everyone.

A good dentist should be able to to diagnose the severity of the injured area and after doing so, he should be able to advise you on the best treatment option that is best suited for your condition.

Dr Joanne Lam described dental bridges and dentures as viable alternatives to dental implants in her earlier reply.

Lastly, I would strongly recommend that you consider replacing the missing tooth to avoid drifting of your teeth, leading to a collapsed bite.

The more teeth you have missing, the more the remaining teeth have to compensate in terms of supporting your bite forces, which may lead to more wear and tear and other problems in the future.

I hope you found the above information useful, and I wish you a speedy recovery!

Kind Regards,

Dr Gerald Tan

6 Feb 2018

Hi Jo,

Thank you for your question about mini-implants. Dr Joanne Lam has answered beautifully in her previous post, and I would just like to add a few thoughts.
 
The use of mini-implants has certainly been controversial.
 

In the dental industry, there have been whispers or rumours of a few dishonest dentists offering mini-implants for patients when they are clearly not appropriate, just to persuade patients to undergo treatment at a lower fee.

It is difficult for patients sometimes to discern regarding the appropriateness of mini-implant use, because professional opinions regarding mini-implants can vary from dentist to dentist.

Patients find the low fees very attractive, they get mini-implants done, and sometimes as soon as months later, the mini-implants fail.

Mini-implants have their place in modern dentistry, but it is imperative that the dentist knows when to recommend for their use, in order to achieve the best long term success for the patient.

This only comes with experience, training and an honest mindset.

I hope you find the above information useful and dont forget to visit your trusted dentist for further advice if needed.

Kind Regards,

Dr Gerald Tan

7 Feb 2018

Hi there, thank you for your enquiry!

I understand that it can be frustrating when faced with a wide range of fees when trying to find a good dentist for your mom.

Many clinics all over the island offer dental implant surgery as a treatment option, from the smaller clinics in the suburbs, to the big group practices in town and finally the government institutions like the National Dental Centre.

I have written several articles about dental implants:

https://www.doctorxdentist.com/dental-implant-singapore

https://www.doctorxdentist.com/dental-implant-costs-singapore-dentist-tells-all

I hope as you read my articles and as you do more of your own research into the matter, you can come to your own decision about which clinic to bring your mum to.

For something as important as your mom's teeth, it may be prudent for you not to go for the absolute cheapest, but at the same time, perhaps at this point there is also no need to go to the top, most expensive dental specialist in Singapore.

My humble advice is for you to find a caring, honest and experienced dentist from a reputable clinic that charges a fair fee for good service as a good point to start. If your mum's case is complicated, you can always see someone more experienced later on, but its fair to expect to pay more then.

Also, you can always get a second or third opinion later if you feel that the first dentist you go to is not suitable for your mum.

Lastly it is my opinion that it is unfair to say that one brand of dental implant is better than another brand. All brands of dental implants available in Singapore have passed through strict HSA regulatory checks and are safe to use.

There are pros and cons to every implant brand available and some dental surgeons prefer to use one brand better than another for various reasons. It does not mean that the most expensive implant brand is the best for all clinical situations and conversely, it does not mean also that the cheapest implant brands are automatically lousy for all clinical situations.

It is more important that you find a good dentist that is able to diagnose the problem accurately and to be able to indicate several treatment options for your mum to make an informed choice. If your mum eventually chooses to get dental implants done, a good dentist should be able to indicate for the correct type and brand of dental implant , that would work best in your mums unique situation.

I hope this information is useful for you and i wish your mum every success in finding a dentist she can trust!

Kind Regards

Dr Gerald Tan

5 Feb 2018

Dear Lizzy,

Thank you for your question and for being so candid about your phobia for dental treatment. It takes courage to face your phobia and to try to overcome it, and finding the right dental surgeon is so important in helping you to have the confidence to get the dental implant treatment that you need and want.

To get straight to the point, there is no such thing as a dental implant specialist in Singapore, or anywhere else in the world. The field of Dental Implantology is not recognised or registrable as a specialist field in Singapore or anywhere else in the world. If this changes , i would be the first to take whatever qualifying exams that are necessary to register myself as a dental implant specialist! However, i do not foresee that this change will come anytime soon.

In Singapore, these are the 3 categories of dental surgeons that are legally allowed to perform dental implant surgery for their patients:

1. General Dental Surgeons who are fully registered with Singapore Dental Council (SDC).

2. General Dental Surgeons who are conditionally registered with SDC ( But they have to be supervised ).

3. Specialist Dental Surgeons, regardless of their field of dental specialty, who are registered as specialists with SDC.

For these 3 groups of dental surgeons, it is NOT a legal pre-requisite to show proof of further training in the field of dental implantology, in order to be legally allowed to perform the treatment.

Therefore, in theory, any dental surgeon who falls into any of the 3 categories above, is legally allowed to perform dental implant surgery for their patients even if they have no prior experience doing so. The onus is on the dental surgeon to ensure that he is competent and confident in performing the dental implant surgery for the patient, before actually doing so.

Having said that, it is fair to say that most dental surgeons would be responsible enough to ensure that they are properly trained in dental implants before even attempting to perform dental implant surgery on their patients.

The problem is , the term "properly trained" can be subjective.

There is a myriad of dental Implantology courses, diplomas, degrees and qualifications out there in the dental marketplace today. Some of these courses last only half a day, and the longest ones over a few years. Some are conducted in Singapore, and many others conducted overseas. The vast majority of such courses are NOT recognised by the Singapore Dental Council to be registrable as displayable postgraduate qualifications.

I have written several articles on DxD about dental implants in Singapore, as well as dental implant costs in Singapore.

In your research for a good implant dental surgeon, you may find online or through word of mouth recommendations that there are some dental surgeons who are more " well- known" for being "good" at dental implants. 

It is not fair for anyone to make a sweeping statement to say that all category (3) specialist dental surgeons are better or more experienced than all category (1) and (2) general dental surgeons in performing dental implant surgery. Likewise, the converse is also true, so therefore i do not blame you for realising that finding a dental surgeon whom you can trust in dental implant surgery is not as straightforward as you would have hoped. 

At the end of the day, after you have done your research, it is most important that you find a good dental surgeon that you can connect with, feel comfortable with and whom you can trust to be honest and caring , diligent with his work and skilled and experienced with dental implant surgery.

I wish you all the best and if you have time, do spend a few minutes reading some of my other articles that i have written on dental implants. 

Kind Regards,

Dr Gerald Tan

4 Apr 2018

Dear Lizzy,

Thank you for your question and i do not blame you at all for feeling confused, astonished and maybe even angry or suspicious!

There is no easy and straightforward answer to your question as i do not know your specific dental needs versus your friends specific dental needs.

But in general terms , you must understand that just like fingerprints, everyone has unique dental issues and needs, especially when it comes to the complex field of dental implants 

When you go to see a dental professional, you are consuming a service, not a product. This means that there is often no cookie cutter approach to everyones dental needs. Because of this fact, it is reasonable to expect that most dental clinics can only provide you with a range of fees for implants , according to the difficulty of the case, instead of one standard fee for all. 

In your particular situation, you maybe quoted $5k because your case maybe more complex than your friends case .

The key questions to ask is: Why is your case more complex? Is your higher fee truly justified as compared to your friend's case which only cost him $3.5k?

In my humble opinion, the only way to find out for sure, is to ask your dentist. Hopefully, he will be able to explain to you why that in your particular case, it will be more expensive than compared to your friends.

There is a myriad of factors that may result in your case being more complex than others. Some of these factors can be very technical and is beyond the scope of this reply. Some of the easier to understand factors have been mentioned in the previous answers by my esteemed colleagues.

Here are 2 articles that i have written about dental implants that you may find useful in your search for an answer:

https://www.doctorxdentist.com/dental-implant-costs-singapore-dentist-tells-all

https://www.doctorxdentist.com/dental-implant-singapore

I wish you all the best in your dental implant journey and all the best in finding a dentist you can trust and feel comfortable with!

Kind Regards,

Dr Gerald Tan

17 Apr 2018

Hi Shailene,

Thank you for your question about mini-implants. I get this question a lot at my practice and I am happy to share with you and other readers my views on the matter. 

The use of mini-implants has certainly been controversial.

The key to success for any mini-implant case starts with understanding its indications and contraindications and its pitfalls when indicated wrongly.

Latest scientific evidence concludes that Mini implants have limited applications, and should be considered only in certain cases. Here are some common examples when Mini Implants can be considered:

1. Supporting a removable denture

2. Replacing very small lower front teeth in adults , where the stress of the bite is low.

3. In certain orthodontic cases for anchorage, and only for period before they are removed.

Mini dental implants are not indicated to replace back molar teeth whereby the bite forces are high. Mini implants are too narrow and structurally not strong enough to withstand the stress of the bite in these areas.

In the dental industry, there have been whispers or rumours of a few dishonest dentists offering mini-implants for patients when they are clearly not appropriate, just to persuade patients to undergo treatment at a lower fee.

It is difficult for patients sometimes to discern regarding the appropriateness of mini-implant use, because professional opinions regarding mini-implants can vary from dentist to dentist.

Patients find the low fees very attractive, they get mini-implants done, and sometimes as soon as months later, the mini-implants fail.

Mini-implants have their place in modern dentistry, but it is imperative that the dentist knows when to recommend for their use, in order to achieve the best long term success for the patient.

This only comes with experience, training and an honest mindset.

In  your particular case, if you are looking to replace your back molar teeth, i would strongly recommend that you get conventional dental implants done instead of mini dental implants.

I hope you find the above information useful and dont forget to visit your trusted dentist for further advice if needed.

Kind Regards,

Dr Gerald Tan

26 Apr 2018

Hi Harnizah,

You may consider one of the following:

1. Periodontal treatment to try to maintain your loose teeth for as long as possible ( This option is viable only if your teeth are slightly loose )

2. Extractions of your loose teeth and replacing them with dentures.

3. Extractions of your loose teeth and replacing them with dental implants.

4. Extractions of your loose teeth and doing nothing else.

It is important for you to note that your dentist should make an attempt to find out the root cause of your loose teeth, so that he/she can implement the correct treatment plan.

The following factors can have a negative effect on your gum health thereby leading to loose teeth:

1. Poor oral hygiene leading to gum disease.

2. Smoking

3. Diabetes

4. A pathological and imbalanced bite

5. Other autoimmune or systemic factors

I wish you all the best in finding a good , experienced dentist that you can trust and build rapport with!

Kind Regards,

Dr Gerald Tan

27 May 2018

Top Questions


I have a browned/chipped off surface spot on my front teeth. Could I get a filling done, or what are other good treatment options?