Friday, January 18, 2008

Prevention is better than cure

Prevention is vital to avoid tooth decay

To ensure you look after your teeth properly, you should routinely spend at least two minutes every morning and night and after meals brushing and flossing your teeth.

Controlling what you eat can help reduce your risk of tooth decay, too. Limiting your intake of sugary and starchy foods helps to prevent tooth decay and the need for dental treatment. Some of the bacteria in our mouths love the sugars and starches found in foods. They turn these into acid, which causes decay.

Help your children brush their teeth twice a day and after meals, and take them for regular check-ups at the dentist. Also, cut down the amount of sweet snacks your child is allowed (including acidic fizzy drinks). Luckily in Malaysia, our water supply is fluoridated, so it is not necessary to take fluoride supplements.

Why have a dental check-up?
Get in the habit of seeing your dental surgeon as often as they recommend, so that complicated and unpleasant treatments can be avoided. Most problems could be detected early, helping you steer clear of extensive treatment. There are good reasons besides toothache, for seeing your dental surgeon. They can often diagnose and prevent diseases of the tongue, lining of the cheeks (mucosa), palate and jawbones. As well as checking gums for disease, they may also spot the first signs of oral cancer (although only about seven percent of cancerous tumours occur in the mouth).

Your dental surgeon will give you a personal recommendation of how often you should have a check-up. Current guidelines recommend that for under-18s check-ups should be between 3 and 12 months, and for adults between 6 and 18 months.

This will:
• Ensure your teeth and gums are in good shape
• Allow the dental surgeon to remove any plaque which contributes to cavities and gum disease
• Enable the dental surgeon to spot serious oral health problems early when they can be treated successfully
• Enable you to learn how to brush and floss your teeth properly
• Build your confidence if you’re nervous, as you’ll get to know your dental surgeon and know what to expect at each visit
Oral Health Survey of Malaysian Adults 2000
According to the results from the Oral Health Survey of Malaysian Adults 2000, less than half of those surveyed cited making a dental visit within the last two years, and more than 50% of them did so only because they had dental problems.

Only about 13% made self-initiated ‘preventive visits.’

Only about 60% of those with problems of the oral cavity perceived a need to see a dental surgeon. In fact, about 50% of those with problems of the oral cavity did not make a dental visit within the last two years, the large majority perceiving their dental problems as ‘not being serious enough.’

It is pertinent to note that cost of treatment was not a barrier to dental treatment for a large majority of Malaysians; dental fees in Malaysia being among the lowest in the Asia Pacific region.

Public dental facilities seemed to rate quite highly by a substantial number of those surveyed. More than half of subjects attended a public facility, yet if given a choice of facilities, more than two-thirds would actually prefer to use a public facility.

The reasons for preference of public facilities were ‘reasonable charges,’ ‘good facilities and equipment’ and ‘convenient location.’ Those who chose private facilities did so mainly because of the ‘short waiting time’ and ‘convenient hours.’

Government poll results
Another poll asking “Where do you go for your dental treatment?” conducted by the Oral Heath Division, Ministry of Health found that 49% of Malaysians frequented Government dentists, 36% went to private dentists and an amazing 15% avoided dentists at all costs!

Afraid of the dentist?
Many people feel anxious at the prospect of seeing the dental surgeon and, for some, their fear prevents them from visiting for years. However, most practices are sympathetic and various methods of help are available.

Why we’re afraid
An unpleasant experience in the past may be the cause of the anxiety. Other common concerns include fear of injections, the anaesthesia not working, concerns about unnecessary treatment and anxiety about cross-infection.

Fear of the Fee
It’s not always fear of physical pain that makes people anxious about a dentist’s visit; in many countries, particularly the USA and UK, it’s also fear of the fee. As dentist Robert E Kroeger explains in his book How to Overcome Fear of Dentistry:
Because many fearful patients have not visited a dentist in 5-10 years or longer, they may have memories of dental fees from their last dental visit many years ago. When they are informed of the current fees for treatment, they experience ‘sticker shock’. The dental phobic may need some time to accept that his or her mouth deserves the best dentistry and that may cost a substantial amount.
There are ways to lessen this trauma to the back pocket. In Europe, the British, Germans, Austrians and Swiss are taking dental holidays in Hungary and Poland, where dentists charge a third to half of Western prices for similar quality dentistry performed with the latest high-tech equipment.

Americans with rotten teeth can take their families on a dental excursion to Costa Rica where you can shop and sightsee between visits to US-trained dentists who charge a fraction of the prices elsewhere.

The good news for Malaysians is that we have some of the lowest dental fees in the Asia Pacific region. So much so that dental tourism is fast gaining ground as an industry here in Malaysia with patients coming from Singapore, Indonesia and even as far away as Australia, Europe and Ecuador for affordable world-class dental treatment.

What can be done?
Don’t be embarrassed about expressing your concerns and talk to your dental surgeon. If you haven’t been for a while, you may wish to contact a number of practices first and explain your concerns over the phone.

If you need treatment, ask plenty of questions and make sure you understand exactly what will happen, which should help you to feel more in control. You may also wish to take a friend or relative with you for support.

If the thought of a long treatment session is worrying you, discuss it with your dental surgeon and work on a coping strategy, such as a hand signal if you need to take a break for a few moments.


Fear of dentists is not a uniquely Malaysian experience. In 1998, the American Dental Association found that over 23 million Americans delay dental care solely out of fear. All of these dental patients have some sense of nervousness when it comes to going to the dentist.

Sedation provides an option for these patients who want to get their teeth fixed but are fearful of the process. Sedation ~ the use of anesthesia during dental procedures ~ may diminish the fear in these patients, but will not obliterate the pain.

The candidates for sedation have one or more of the following characteristics:

  • Dental anxiety
  • Dental phobia
  • Inability to control movements due to conditions like Parkinson's Disease or cerebral palsy

There are several different methods of sedation as applied in dentistry. Dentists may choose to use only one, or, several of the following methods in combination:

  • Nitrous oxide
  • IV sedation
  • Oral sedative

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