Yours Toothfully by Dr Chan Joon Yee

“Hello, Tan Ah Kow si bo?” [is that Tan Ah Kow]

“Wa see. Lee siang?” [that's me. who is this?]

“Wa see Dr Chan.” [I'm Dr Chan]

“Si mi Dr Chan? Ban kee ei si bo?” [what Dr Chan? Pull teeth one is it?]

“#$@%&^!

Yes, it must be one of those nightmares recalling those years in Hougang. We didn’t exactly breeze through dental school. We had a hard time with patients who didn’t trust us. We were give a hard time by lecturers who probably believed in no pain, no gain.

I remember how absolutely ecstatic I felt when MOH staff first addressed me with a Dr in front of my name. In the Army/Navy, it was “sir” here and “sir” there. I really looked forward to private practice, but alas, the “Drs” and “sirs” suddenly disappeared. Instead, heartlanders from Jurong to Hougang called me “ban kee ei”. It didn’t matter that my name was on the cards and the wall. I was still addressed as “ban kee ei” and like a “ban kee ei”, I was sometimes treated like a barber, sometimes like a char kway teow man and sometimes even like a maid.

“Slope or straight? How you want your sideburns?”

That’s the sort of questions i had to ask my denture patients. Made to the patient’s order. Forget about designing dentures the way the school taught. The patient wants it his way, you’d better make it his way to avoid all the argument or worse, non-payment.

“Chilli or no chilli?”

You’d better follow the patient’s taste. Don’t argue if they insist on chalky white teeth.

“I lazy to brush. Clean my teeth for me.”

That’s when you’re treated like a maid. It doesn’t matter if my teacher told me so proudly that we are consultants and educators of oral hygiene and not teeth-cleaners. In private practice, you clean teeth for a living.

It’s been more than 20 years now. I’m quite used to all that abuse. But one that I still can’t get over, is being called “ban kee ei”. I think there should be a law that punishes people for calling dentists “ban kee ei”. Fine? Imprisonment? Caning? No, that would be too light. Let’s implement a form of punishment called TAGAD. Anyone found guilty will be barred from all dental clinics in Singapore. All dentists here will not be allowed to treat them and they are not allowed to even step into a dental clinic for a period of 10 or more years depending on the severity of the offence.

What happens if they get a toothache while on TAGAD? Well, that’s what TAGAD is for. ToothAche Go And Die.

A person who sounded like an expert confidently declared that the economy is recovering. That’s because he has noticed that ordinary folks in T-shirts and bermudas are flocking to new property launches like a Singapore Idol audition. In the same breath, the expert thinks that dentists are not affected by economic downturns. He’s not alone. Many of my friends are surprised that dentists’ incomes are affected by a recession because they are still under the impression that dentists treat toothaches and nothing else.

Sure, dentists are trained to extract or fill up painful teeth, but how often do people have toothaches and need extractions? In fact, most progressive practices today do very few extractions. Even when a tooth is dead and infected, the treatment of choice is root canal. Educated, cooperative and motivated patients are expected to turn up regularly for hygiene visits even when they do not have any toothache. In the developed world, preventive dentistry (scaling, polishing, filling early cavities, mouthguards, removing impacted wisdom teeth) keeps many general practices busy. Yet, we often see people walking around with teeth encrusted with barnacles, oozing with plaque and bad breath. From the dentist’s point of view, it is extremely important that patients clean up the tartar on their teeth and arrest any early gum disease. From the average Singaporean’s point of view, it’s: no pain, no need to see dentist.

What else do dentists do? There is denture construction, crown and bridge work, implant dentistry. Again, in the developed world, people change their dentures every few years. They do crowns and bridges to restore broken or missing teeth. They also go for dental implants. All these procedures come under the field of restorative dentistry. From the dentist’s point of view, most people who have lost some teeth will require restorative dental treatment. It restores the person’s smile and function. However, we often see people walking around with missing teeth. Those who have lost back teeth often don’t bother to replace them, resulting in the remaining teeth drifting everywhere. From these people’s point of view, restorative dentistry is not necessary. Why? No pain, no need to see dentist.

A combination of preventive and restorative dentistry form thee bulk of the average general dental practitioner’s income. Both fields of dentistry can be rather recession prone. Take implant restoration for instance. An economic downturn of this magnitude will have a very drastic impact on patient acceptance of procedures like implants, crowns and bridges. For many practitioners who have upgraded themselves and acquired new skills to perform sophisticated procedures, the bulk of their income will come from these procedures and the handling of nasty toothaches. Tooth whitening and other cosmetic dental procedures form the bulk of treatment rendered in many upmarket practices.

But the “experts” are right in thinking that someone suffering from the intense pain of acute pulpitis will not hesitate to see a dentist regardless of economic situation. By the same token, they should also realise that only a nasty toothache will force a person to see a dentist regardless of economic climate. While it’s good that dentists are doing more root canals, more preventive and restorative treatment, these treatments may end up working against dentists by reducing the number of toothaches in a population which still cannot accept preventive dentistry as a necessity.

Dr Chen Xin Yu, a Taiwanese dentist, is the daughter of ex-presient Chen Shui Bian. From the time her father first took office until the latest money laundering scandals, she has been hounded by the media. I guess one of the reasons why the media loves her is because she is so “cute”. Her angry responses are so entertaining that entertainment programmes in Taiwan often feature Chen Xin Yu lookalike and imitation competitions.

You don’t have to be a dentist to know that people who behave this way are quite harmless. Gosh, even I am enjoying this.