Smilefocus is delighted to welcome Debbie Fisher as a member of its Smile Team. Debbie is a qualified Dental Hygienist from the USA, with over 11 years experience. It is only recently that Dental Hygienists were recognised to work in Singapore, and Debbie is the very first American Dental Hygienist to be registered.  

Debbie explains her passion and commitment to her job this way: “It may seem strange that I really do enjoy only cleaning teeth, but for me that’s so important … good oral health needs clean teeth as well as healthy gums and a nutritious diet. Of course dentists give a good clean too, but what I do is focus only on the cleaning, because I have the time to do this.”

Beyond her passion for her work, Debbie is already actively involved in youth work in Singapore, and has a long history of teaching youth leadership skills.

Dr Christina Liew of SMILEFOCUS explains the reality of wisdom teeth.

Wisdom teeth, or third molars, are thought to have been bequeathed to us by our Stone Age ancestors. Their larger jawbones were able to comfortably accommodate 32 teeth and any gaps created by tooth loss were then filled by wisdom teeth moving forward. Thousands of years of evolution later, our jaws have reduced in size but our wisdom teeth remain.

Dr Jon Ryder of SMILEFOCUS explains the symptoms and treatment of gum disease – and how to avoid it!

The earlier gum disease problems are diagnosed and treated, the better the long-term prognosis is for eliminating extensive tooth loss. Left untreated, gum disease can result in loss of bone mass and supporting structures, causing tooth loss. Once recession has occurred, your gums will never grow back. But you can keep the condition under control and prevent it with daily brushing with a soft toothbrush, proper flossing and regular visits to your dentist.

 

 

Dr Jon Ryder D.D.S. (Iowa)
Dr Jon Ryder is from the USA and was previously an Assistant Professor at the College of Dentistry University of Iowa, where he taught restorative dentistry for many years. Dr Ryder is extremely experienced in using and training others in CEREC®– a computer-aided tool for creating crowns and onlays. With many humanitarian interests, Dr Ryder is currently providing dental and business management skills to a number of non-profit organisations in Cambodia.

Dr Leroy McCully of SMILEFOCUS reveals root canal treatment can be simple and pain free!

Your teeth are meant to last a lifetime. And with modern treatment methods, this is possible – despite damage or decay. Once upon a time a tooth with an infected nerve had to be extracted. Now it can be saved through root canal therapy (RCT) or endodontic treatment!
If the thought of RCT conjures up feelings of fear, you’ll be surprised to know such fears are more myth and hyperbole than fact, in today’s world of advanced dentistry. What many people realise after they’ve had RCT is it’s not only better than enduring the pain of living with a permanent toothache, but the treatment itself is pretty much pain-free!
Using a surgical microscope an endodontist is able to detect the finest details in the tooth’s structure, so is able to achieve optimum results. RCT is most commonly required:

• Following trauma – such as a physical blow to a tooth.
• To eliminate irritation caused by a deep decay or a very large filling.
• To rectify bacterial leakage of an old filling or crown.
• As a result of severe gum disease.

RCT involves the removal of the tooth’s pulp – a small, thread-like tissue once important for tooth development, but redundant in adult teeth. An infected pulp causes pressure and pain and is occasionally accompanied by facial swelling. Sometimes the deterioration of the pulp happens so gradually little pain is felt. However the bacteria can eventually destroy the pulp, exposing the bone surrounding the tooth to serious infection.
Once removed, the pulp is replaced with materials to heal any infection and seal off the root canal from the underlying jawbone. In this way, it is possible to leave the tooth intact. After RCT it may be necessary to have a crown fitted. This is because the tooth is more fragile after having the pulp and nerve removed and a crown adds extra protection.
Provided you follow good oral hygiene at home and maintain regular visits to your dentist, a treated and restored tooth can last a lifetime – so you can continue to smile with confidence!

Dr Leroy McCully BDS (Singapore) MSc Endodontics (London)
Dr McCully completed his post-graduate degree in Endodontics (Root Canal Treatment) at the University of London. He is a part time tutor at NUS and is particularly skilled in helping patients deal with dental anxiety – even performing treatments under IV sedation if required.

Dr Francine Chia of SMILEFOCUS explains how to manage a dental emergency.

With Singapore’s temperate climate conducive to outdoor activity, it’s no surprise accidents involving trauma to the mouth and teeth are very frequent. The most injured area of the body during contact sport is the mouth. Slippery marble floors and swimming pools are also hazards. In emergencies, quickly identifying the extent of trauma and taking the appropriate action is essential.

Avulsion – complete tooth knocked out of the gum

1. Locate the tooth and check there’s no obvious damage to the root. Providing there’s not too much trauma and blood, the patient should lick the tooth clean. Alternatively, the tooth can be washed in plain milk – don’t use water!
   
2. If it’s a baby tooth don’t try to replant it, as the pressure can damage the adult tooth still to come through.
   
3. Try to replant an adult tooth by holding it in place using finger pressure or by biting on a handkerchief.
   
4. If not replanting the tooth, keep the tooth under the injured person’s tongue or inside their cheek. Alternatively, place the tooth in plain milk or salt water. As a last resort, place the tooth in plastic wrap, a wet towel or water. If the tooth has been fractured off rather than completely knocked out, try to find the fractured piece – as it can often be re-bonded. Place the piece in salt water or tap water.
   
5. See a dentist as soon as possible, preferably within one hour of the trauma.

For more serious injuries involving bone fractures to the face, take the patient to hospital immediately, with a visit to the dentist later to check for tooth damage. The signs and symptoms of serious injuries can be nosebleeds, swelling, bruising and possibly impaired vision. Pain when swallowing or talking, or irregular alignment of bottom teeth to upper teeth are also signs of a serious injury. In these circumstances, treat all fractures by placing a cold compress over the area to reduce swelling, bleeding and pain. If there’s excessive bleeding, apply direct pressure to the wound.
Severe pain, even when unaccompanied by visible symptoms, may also indicate an emergency. For example, root canal infections have no visible symptoms, but the pain can be excruciating and shouldn’t be ignored. The first rule in any emergency is to stay calm. This is the most important way to help your child or family member.


Dr Francine Chia BDS (Adelaide)
Dr Chia has worked in general dentistry in Tasmania in a large private practice. She particularly enjoys creating positive changes to improve smiles, while encouraging optimal oral hygiene and health.

Dr Ong Yean Sze of SMILEFOCUS explains how to prepare your child for their first dental visit.

Your child’s first visit to the dentist should be around their first birthday, or when their first tooth erupts. A quick check at this early stage will identify factors which may contribute to your child’s risk level for dental decay. Your dentist can also recommend preventative care measures, such as diet modifications and show you how to care for your child’s teeth.
          It’s also important to recognise that regular visits to the dentist from a young age encourage life-long habits, ensuring your child maintains good dental health once they’re old enough to care for their teeth themselves. As such, it’s essential your child’s first visit isn’t a frightening experience – for them or for you! Children have no preconceived ideas about the dentist and no reason to be fearful, so don’t share any of your own scary stories. To get through your child’s first dental visit follow these helpful dos and don’ts:

DO

• Familiarise your child with the dental clinic by taking them along when a family member has a dental check-up.
• Schedule your child’s appointment earlier in the day, when they’re alert and fresh.
• Treat the dentist visit as a routine event and be low key about it. Answer questions honestly but not too specifically.
• Be patient if your child is frightened or non-cooperative – sometimes it’s better to reschedule.
• Let your dentist decide whether you stay in the room during treatment. Children often respond better when their parents aren’t present.

 DON’T

• Wait for an emergency before visiting the dentist.
• Make the visit the high point of the day – otherwise your child will suspect something is up.
• Use bribery or threats in an attempt to encourage good behaviour.
• Threaten the child with a visit to the dentist when they don’t clean their teeth.
• Say negative words, such as pain, pull, jab, drill, or phrases such as “it won’t hurt much” or “it won’t be too bad”. These only create anxiety.
• Try to explain exactly what will happen. Your dentist has special words and ways to explain procedures to children.

Daily dental care can then be followed by you and your child at home. And regular check-ups every six months with your dentist will ensure your child’s teeth remain healthy and white for life.

Dr Ong BDS (Wales), M.Sc Distinction Paedodontics (London), FAM (Singapore)
Dr Ong Yean Sze is particularly skilled in dealing with difficult or nervous children, as well as those with special needs.