The Imperial Dental Specialist Centre (IDSC) is an integrated dental, orthodontic and aesthetic centre. A centre dedicated to excellence, it provides solutions for many dental, skeletal, soft tissue and craniofacial needs, in a comprehensive, holistic and well-planned manner. Apart from specialising in Invisalign and dental implants, IDSC features innovative technologies for better diagnostic and treatment pathways, resulting in unparalleled smiles and oral function for years to come.
Four of IDSC’s consultant dentists speak about some of the centre’s featured treatments and solutions, revealing how procedures work, and how beneficial and advantageous they are.
Smile and Face Design with Invisalign by Dato’ Dr. How Kim Chuan
Invisalign – an orthodontic treatment – can alter and improve facial shape in a powerful yet non-invasive manner. By correcting upper and lower arches while considering proportional relationships between the cheeks, chin and lips, facial contours may be augmented and enhanced. In short, if patients complain of broad, A-shaped faces, doctors may create slimmer, more even V-shaped contours through proper consultation and Invisalign’s unparalleled technology.
The patient in our photos has procumbent teeth. By retracting the teeth with Invisalign, we improved structural relationships between the teeth, nose and upper lip. Before treatment, this patient possessed Class 3 (crossbite) teeth. Because her front incisors interfered, her smile was non-aesthetic, displaying more lower teeth. We aligned dental units, but also intruded the lower teeth behind top dental units. This birthed an aesthetic smile, but optimal Class 1 oral structures. From lateral views, we further expanded the upper arch so that the lower arch sits comfortably behind the overhead teeth. Where the nose, chin and lip relationships were concerned, we subdued the chin. By allowing the chin to rest behind the upper lips, we created symmetrical and harmonious relationships between the aforementioned facial features.
Implants vs. Dentures by Dato’ Dr. How Kim Chuan
Patients believe missing teeth can be resolved with dentures. However, dentures are nothing more than plastic or acrylic plates which compress tissues. Despite dentures addressing aesthetic qualms, long-term compression leads to future bone loss or resorption. Once resorption happens, bone shrinkage follows, causing decrements within archforms and facial structures, eventually triggering facial collapse. Subsequently, lower jaws may rotate upwards and hide the upper teeth during laughter or smiling. A resultant effect of excessive lower teeth display is austere facial ageing where patients look much older than their chronological age.
Implants are the only viable method to bone preservation. When implants are placed, prosthetics will integrate with bones. Like planting trees, implants embedded within bone become rooted, strengthening and supporting all structures including hard and soft tissues. Once implants are fixed, dental practitioners move forward with crown and bridge placements atop embedded prosthetics. This not only reinstates facial heights and whiter teeth but also restores structures in a three-dimensional manner, to address facial collapse. By appropriately correcting distorted structures, mandibles are rotated back to original positions for accurate upper incisor display. In summation, dentists have capabilities of reinstating smiles and youthfulness through hard and soft tissue support via the utilisation of implants. Moreover, patients needn’t worry about transient outcomes or future bone resorption, as implants are permanently rooted within hard tissues.
From a professional standpoint, although dentures may be ‘quick-fix’ solutions, they cause more harm than good. In truth, bone resorption loosens oral appliances and ages the face. If patients want ideal solutions to missing teeth, implants are the gold standard as prosthetics integrate with bones, sustain hard and soft tissues, and maintain facial support and youthfulness for years to come.
Why We Take X-rays by Datin Dr. Alice Wong
Dentist are often asked why we take X-rays (radiographs). We also encounter patients who are apprehensive of its radiative risks. Dental radiographs are images of your teeth that your dentist uses for oral health evaluation. These X-rays capture images of interior teeth and gums through low levels of radiation. Since we can only see about one-third of the actual tooth, X-rays provide valuable information that we cannot otherwise visualise. This, in turn, helps your dentist identify problems. I’m pretty sure you wouldn’t feel comfortable if your doctor had a blindfold on, would you?
To help put in perspective why dental radiographs are so important, here are a few facts. X-rays are very common tools, just as important as teeth cleaning. They look for decay between teeth, and help dentists check for decayed underfillings, and infections at the tip of the root. X-rays also help us examine the area thoroughly and check for bone loss associated with gum disease.
How often do you need X-rays?
The frequency of dental radiographs depends on the person. Your medical and dental history, as well as your current health, are factors. Some people may need X-rays as often as every six months. Others with no recent dental or gum diseases, or whose teeth have been regularly checked, may only get one every few years. If you are a new patient, we like to take a set of new radiographs as part of the initial exam to establish a baseline record from which to compare changes that may occur over time. We also take x-rays if we need to address any concerns that aren’t visible to the naked eye.
Children may need to have dental x-rays more often than adults because dentists may need to monitor growth of their adult teeth. This is important because it can help patients determine if baby teeth require extraction to prevent complications, such as adult teeth growing behind baby teeth.
Are X-rays harmful?
The amount of radiation is minute, and we mean super small. A dental radiograph only gives off 0.005 mSv (microsieverts). This comes up to a day’s radiation, or what you naturally are exposed to on a daily basis. All of us are exposed constantly to background radiation produced by the natural environment – even such things as climbing mountains or flying in a plane adds to the amount of radiation but again, in minute amounts. To put it to scale, dental X-rays only have five percent of the radiation emitted during chest X-rays.
Pregnant and still worried about getting X-rays? Current research has okayed the use of radiographs while pregnant. However, we definitely only recommend them if you’re having a problem. It’s perfectly fine going ahead with routine dental check-ups and cleanings, but avoid X-rays unless issues arise. When pregnant, it’s best to keep up with visits due to the hormonal changes which can wreak havoc in your mouth.
Braces by Dr. David Tan
Fixed appliances – commonly known as braces – are utilised to straighten teeth, and have been available for many years. They consist of small brackets which are stuck onto teeth using dental adhesive. Wires that run through the brackets exert force, resulting in dental movement. The wire is similarly changed as teeth become straighter. In response, the jaw’s bones along teeth will slowly remodel, as teeth move into optimal positions.
Traditional metal braces are by far the most common type of fixed orthodontic appliance. Ceramic braces are a variation of the traditional system, providing a far less noticeable option, as brackets are translucent ceramic combinations which blend nicely with teeth’s natural colours.
The total treatment duration depends on the difficulties of each unique case. Patients are required to return for clinical review – on average – every month, depending on your dentist’s recommendations.
There are two common brace brackets: steel or ceramic. Traditional metal braces are by far the most common type of fixed orthodontic appliance. Ceramic braces are a variation of the traditional system, providing a far less noticeable option, as brackets are translucent ceramic combinations which blend nicely with teeth’s natural colours. Nonetheless, ceramic brackets are pricier and generally less durable than their metal counterparts.
During braces treatment, other orthodontic appliances like springs, elastic bands and Temporary Anchorage Devices (TADS) may be added for improved tooth movement. TADS are small, screw-like dental implants which are temporarily inserted into jaw bones to provide stable anchorage for better dental movement. They are normally applied to those requiring gummy smile correction.
Gum Disease by Dr. Raymond Su Wei Siong DDS (UKM), Msc Dental Implantology (UCLan, England), FICD
Periodontal disease or gum disease is an infection of the supporting tissues and bone that hold teeth in place. If left unchecked, gum disease can lead to dental loosening, and teeth which pop right out of their sockets. Nine in ten Malaysians have experienced periodontal disease and dental caries, says a 2016 study done by the Malaysian Ministry of Health. As such, prevalence of this functionally destructive disease is at an all-time high.
According to the National Institute of Dental and Craniofacial Research, gum disease mainly affects adults in their mid 30s and 40s. Causative factors include poor oral hygiene, smoking, chronic illness like diabetes, certain medications, and genetic susceptibility.
Typical treatment pathways are scaling and root planing. These conservative solutions are non-surgical methods of cleaning the surfaces of the teeth and their roots, which are exposed due to gum recession. Scaling and root planing remove tartar, plaque and bacteria from the gums surrounding the root, and promotes healthy regeneration of the gum’s tissues. Alternatively, and if gum disease is severe, surgical intervention may be necessary. During the procedure, gums are cut and flapped back, allowing deep cleaning around the root underneath. The gums are then sutured back into place to allow healing.
In my practice however, I use state-of-the-art lasers to treat periodontal disease. This laser technology offers minimally-invasive pathways for severe gum disease or periodontitis which has affected bone and tissues which support teeth. This technology is gentler and more targeted than traditional flap methods which utilise scalpels. Hence, treatments aren’t just more comfortable, but offer less trauma, faster healing and less downtime.
What is Laser-assisted Periodontal Therapy (LAPT)?
During LAPT treatment, I use a special soft and hard tissue laser – WaterLase laser – which removes diseased tissues, leaving healthy tissues intact and bacteria free. Unlike most periodontal lasers, the WaterLase combines laser energy with patented waterjets to cut off soft tissues and bone without heat. The ‘cool cutting’ reduces swelling and post-operative sensitivity.
The laser cauterises blood vessels and nerve endings to reduce bleeding and pain, allowing doctors to clean infected bone and prepare roots in order for gums to reattach. With the WaterLase laser, there’s no need for scalpels or instruments to cut gums or invade bones. The beauty of LAPT is how it allows me to selectively remove diseased gum tissues with pinpoint accuracy whilst leaving healthy tissues intact and bacteria free.
· No cutting with scalpels means no stitches and easier recovery with minimal bleeding
I am a 28-year old professional who’s planning to undergo Invisalign. I have very crowded teeth and have never experienced tooth extractions. If I were to undergo orthodontic treatment, will I need to extract my premolars or wisdom teeth? What are the benefits of tooth extraction, are they absolutely necessary, and what are the extra costs of this?
Kei, Bukit Tunku
My six-year old son is losing his baby teeth. Although most of his baby teeth are falling out normally, his adult front tooth is beginning to erupt behind his baby tooth. This overlapping baby tooth is starting to turn brown and the adult tooth behind this baby tooth is erupting abnormally. I understand that my son will need to extract this baby tooth but I’m also wondering if he may or may not need braces later due to the abnormal eruption of the adult tooth.
What if I told you dentists have the skill and know-how to fix everything ranging from unappealing smiles, overlapping teeth, or even no teeth at all? Dentists pay attention to all facets of the facial and oral structure in order to create functional, beautiful smiles that last a lifetime. Four Consultant Dentists from the Imperial Dental Specialist Centre share how they deal with common or complicated dental problems patients face.
Visiting the dentist every six months is not something anyone looks forward to, but it is one of the most important appointments to keep. At a check-up dentists do more than search for decay. Besides filling cavities and sloughing away tartar build-up, dentists also check for signs of oral cancer, gum disease, and seek problems beneath the surface through advanced technology, all while improving functionality and keeping good habits in check.