Yours Toothfully by Dr Chan Joon Yee

“Doctor, why did my implant fail?”

“Erm … it’s a tactical decision to intercept the intruding aircraft to Changi Airport and cause 23 flight disruptions for nearly an hour …”

Oops. Wrong excuse. But seriously, it’s not always the dentist’s fault. Implants are not very good for the practitioner’s health. Every time an implant patient calls up, my heart would skip a beat. Most of the time, it’s a false alarm. Still, implant failures are pretty serious issues that can get a patient really angry.

Why? (and an often a very angry why), the question that only the practitioner needs to answer. I’m not trying to shirk responsibility, but very often, I think the implant suppliers need to answer a few questions too.

Let’s face it. The field of implant dentistry is now red hot. Save for few old and retiring professionals are still in denial and proclaiming that implant dentistry is still “experimental”, it won’t change the fact that implants will be THE thing in dentistry for many more years to come. But like every new technology out there, competitors in the business of producing implants are constantly under pressure to steal the limelight from their rivals in the industry.

Recently, the implant system I’ve been using quite frequently came out with a new prototype that claims to be even better than their already very good old component. The director of the supplying company personally handed me the components, telling me I was the first in Singapore to use it. She asked me to try it out give her my feedback. Well, it seemed that later users gave her the feedback before I did. The new prototype sucks. Fortunately, my patients did not suffer much from it. Just an extra trip to the lab. But the moral of the story is ought to be taken up by the other makers of implants.

Don’t innovate just for the sake of getting into the news with some new, “revolutionary” prototype when the old, tried and tested model has been working well for a long time. We’re talking about our patients’ well-being here. As dentists, we have no access to the details of the patented designs. All the theories behind these new prototypes are sound. It’s just that when put into people’s mouths, the research data does not mean anything.

The X and Y generation of surfers may not be so easily taken in by advertisements from the manufacturers, but their “we’re the best” messages are everywhere. First, our local suppliers get fooled. They in turn fool dentists who confidently use these products on their patients. At least the patients can choose to ignore advertisements. Dentists are made to attend continuing education seminars/exhibitions where sexy new innovations keep gyrating in front of them. Even cynics like me get fooled sometimes. It’s not that these products or systems are not reliable. It’s just that they are not as good as they’re claimed to be. The dentists are the ones carrying the baby, so to speak.

There isn’t one leading implant system which does not keep innovating to get into the news. But genuine breakthroughs in any field of science often take many years or even decades. How can there be so many breakthroughs and amazing new products being created within just a few years or even months? It all has to do with what I call “compulsory innovation” just like our continuing “education” which is really all about attending irrelevant, sleep-inducing lectures to collect points.

As our society progressed, we’ve been brainwashed into thinking that innovation, upgrading, continuing education and being first are always good things. People not in the civil service should know that things are not so simple in the real world. Trouble is, we don’t call the shots. In fact, we have little or no say over any of the compulsory requirements imposed on us. Happily, there is something which dentists can do to protect their patients. I recommend that we bring our mp3 players and opaque contact lenses to drown out everything we hear and see at seminars/exhibitions. I have learned more from books and the internet than any of these compulsory activities.

By the way, does anyone know that Singapore is the first … Well, let’s just say that this dental maverick will not walk but run from the next supplier who says: “Dr Chan, you’re the first in Singapore to try out …”

BANGKOK — A popular new Thai soap opera about love and infidelity in the skies has angered Thai Airways flight attendants who yesterday demanded that the show be cancelled for casting their profession in an unrealistic and immoral light.

The Air Hostess War, which broadcast its first three episodes last week, has captivated viewers with a story line that includes a dashing married pilot having an affair with a flight attendant, and love triangles that lead to fighting in the aisles and steamy sex scenes at stopover cities.

The soap opera, however, did not appeal to the Thai Airways International union, which issued a letter urging the Culture Ministry to order the show to be pulled from the air.

“This soap opera is insulting and damaging to the reputation of flight attendants,” said Thai Airways flight attendant Noppadol Thaungthong, leading the union’s action. “It’s all about sex and air hostesses beating each other up in the cabin because of love and jealousy. This kind of thing never happens.”

(Of course this sort of thing can never happen. What would Khun Noppadol’s wife think if such things can happen? So what really happens?)

Representations will also be made to Thailand’s Channel 5 television station — which broadcasts the show — and the chiefs of Thai Airways and the air force, said the union’s acting president Somsak Srinual.

The series could very well deter young people from entering the industry if they believe the lifestyle was so racy and emotionally draining, he added.

(On the contrary, Khun Somsak, I think this series could well attract more young, virile and happening youngsters to the profession than you can imagine.)

But Channel 5 says it has no plans to pull the soap opera but will consider suggesting that scenes found to be offensive be edited out, said spokeswoman Thawinan Kongkran.

“The producer says the soap opera reflects all sides of the profession,” Ms Thawinan said. “If some scenes are inappropriate, as the labour union says, we will ask the producer to change that.” — Agencies

Is it just me or is everybody who takes the MRT feeling that the trains are getting more crowded since cab fares have gone through the roof? I really feel sorry for our taxi uncles. The media keeps reporting that they are earning more while all we see are the long taxi queues (no passengers) outside Lucky Plaza and Paragon. How do we deal with this problem? Hey, since means testing is the hot topic now, why not do means testing for people taking the MRT? Sorry, your income is too high. You cannot take bus or MRT. Go take a taxi. Blacklist their EZlink cards. Make them go toot toot when they try to board a bus. Let the gates at MRT stations refuse to open for them. That will certainly ease the crowd at MRT stations that we see now.

An interesting patient called up to ask about a bridge on his upper anterior. He told me over the phone that he had 2 missing teeth, was wearing a denture and suddenly decided to do a bridge - a week before he departs for an overseas assignment that will keep him away for 6 months. Seeing the urgency of this case, I got everything prepared for the patient when he arrived. I would cut the bridge, take the impressions and fit the temporaries in 1 hour, get the lab to collect the case immediately after that and have the case issued before the patient leaves for his overaseas assignment.

When he arrived, I felt obliged to offer him PFM and full ceramic. Once we’ve cemented the bridge, it would be a waste of time and money to replace it. He had to decide if aesthetics were paramount. If so, it would be better for him to do an emax bridge once and for all. But the cost frightened him. He wanted to “make a call” and disappeared without paying consultation.

Hmm … should I have just cut a PFM for him and not bother to give him a more attractive (expensive) option? What about testing the means for these patients too? After all, this patient claimed that this was going to be his first job and he had no money. Really? I’m sure Mr Khaw an provide us with more reliable info on the patient’s actual financial background (this guy lives on a piece of landed property). Your income too high, you cannot do dentures. Cannot even do PFM with non-precious metals … That will be the day.

It was a sad moment when I sent what might be my last denture case to SJ.

Some background info. SJ stands for Simon and Joseph. The two were formally dental technicians with the SAF. After the left the army, they decided to put their skills to good use and started a dental laboratory at Defu Lane, churning out highly economical dentures of acceptable quality. For the past 17 years at Hougang, I’ve been sending my denture cases to SJ. They have never disappointed me. Every morning without fail, the SJ delivery man (never got his name) would ride down to the clinic on his little scooter to send or collect cases.

After the move to Orchard, I still sent my denture cases to them. It was a bit inconvenient for me as I had to bring the cases down to Hougang for them to be collected and then bring the completed cases back from Hougang to Orchard. But with Hougang closed down, there is no more delivery and collection there.

One evening, I paid a visit to SJ and spoke to Joseph about collecting cases from Orchard. There is still a demand for cheap temporary dentures at Orchard. Joseph said that he was sad to lose an old customer. But his biggest problem is that to enter the city to collect cases, whatever little profit he makes from the denture will be wiped out by parking and ERP charges.

How ridiculously obvious to some yet not to others. So what to do? I’ll have to send my denture cases to new labs which do collect from Orchard. But many of these technicians are not familiar with my style like Simon and Joseph. What’s more, they charge a lot more. Maybe that’s to cover their ERP and parking costs. Apart from numerous phone calls from unfamiliar technicians who need clarification for my instructions, denture costs have also gone up tremendously. I can no longer afford to charge Hougang rates for my old regulars from Hougang.

We’ve been told by a wise leader to eat fish if chicken gets too expensive. Must be talking about ikan bilis as fish is always more expensive than chicken. What about dentures? If ERP charges are going to stop the cheap dental labs from coming down to Orchard, perhaps they could take the MRT? Let’s see how these wise leaders carry a few dozen stone casts and dentures down Orchard Road every day. Fish is cheap and stone casts have no weight. Which world are we living in?