Speaker 1: If it's a matter of health, it matters. Health Matters
Speaker 1: with Daniel Martin. Welcome in everybody, thank you for joining
Speaker 1: me and yes, what matters today.
Speaker 1: Dentures. I regularly read up a lot of um health articles, publications, journals,
Speaker 1: that kind of thing, and I recently went down the
Speaker 1: rabbit hole for a lot of these dental health, um,
Speaker 1: research publications looking at 3D printed materials being used as
Speaker 1: base materials for dentures, and that got me thinking, wow,
Speaker 1: that's great. Could we see 3D printed dentures?
Speaker 1: As the future, or are we reaching the point where
Speaker 1: hopefully we don't need dentures as a dental option anymore
Speaker 1: with better teeth preservation or maybe other options as well?
Speaker 1: Are 3D printed dentures next or maybe on their way out.
Speaker 1: Doctor Ansgar Cheng is back on the show, Prosthodontist at
Speaker 1: Specialist Dental Group based at Mount Elizabeth Orchard. Doctor Cheng,
Speaker 1: good to have you on board again. Hello.
Speaker 2: Well, good evening, everybody. It's nice being here again.
Speaker 1: A dentures still?
Speaker 1: In demand today, are they still an option that many
Speaker 1: patients need to explore?
Speaker 2: Well, first thing first, let's look at the numbers that
Speaker 2: we have. Now, surprisingly, you know, we know that in Singapore,
Speaker 2: on average, people live until about 84 years old. All right.
Speaker 2: By the time we finished about 1/3 of our lifespan,
Speaker 2: which is by the time we hit about 30,
Speaker 2: About 67% of the people still have all the teeth.
Speaker 2: That means about 13 do not have it, do not
Speaker 2: have all the teeth. And surprise, surprise, by the time
Speaker 2: that we reach 2/3 of our lifespan, which is by
Speaker 2: the time we're about 60, then about 2/3 of the
Speaker 2: people also do not have all their teeth as well.
Speaker 2: So many people actually are missing their teeth. And by
Speaker 2: the time when we hit 80s, only 10% of the people,
Speaker 2: actually 9% of the people have about 20 teeth in
Speaker 2: the mouth that are biting.
Speaker 2: Well, so do we need dentures? Yes, certainly we need
Speaker 2: to have some some form of replacement of teeth.
Speaker 1: Gosh, so it's still in demand. How about 3D printed dentures?
Speaker 1: Is that something at all happening in Singapore?
Speaker 2: Well, it's been happening for quite a little while already.
Speaker 2: This 3D printing business, well, now you ask a question,
Speaker 2: make me feel like an old guy, because the first
Speaker 2: time I'm in touch with this 3D printing technology was
Speaker 2: about 35 years ago. When I was a little boy,
Speaker 2: I was still new in the dental industry. Of course,
Speaker 2: back then, 3D printing was very exotic. We have a
Speaker 2: long name for it. It's called stereo letthographic technique.
Speaker 2: Now, back then 3D printing, you need to have a
Speaker 2: machine that would be big enough to fit into one
Speaker 2: standard HDB bedroom. Now think about it. Now, 3D printers
Speaker 2: could be just like the size of a bigger microwave
Speaker 2: at home, and you can easily buy them.
Speaker 1: Yeah. Is it being offered as an option for patients?
Speaker 1: Is it printing the entire denture or just the base material?
Speaker 1: How does it work today?
Speaker 2: Certainly, it's been offered and nowadays you have local labs
Speaker 2: and also international labs that has the capability of doing
Speaker 2: this because nowadays with the internet.
Speaker 2: With globalizations, you can have a lab over say 3000
Speaker 2: kilometers away that can take your order because you can
Speaker 2: easily send the files over and then they can get
Speaker 2: the job done and send the, the finished product back.
Speaker 2: So it's available, all right? And it's a viable alternative.
Speaker 2: The only thing is that one cost, cost base is
Speaker 2: still a little bit higher than the um conventional dentures.
Speaker 2: And in terms of functionality, they are very comparable as well.
Speaker 1: That's interesting. I was hoping that the advent of 3D
Speaker 1: printing technology would help lower the cost of the denture
Speaker 1: in some way, but still, even 35 years on after
Speaker 1: you first experienced 3D printing, cost is still a factor
Speaker 1: in terms of the product.
Speaker 2: Cost will slowly come down. There's absolutely no doubt about that.
Speaker 2: There's absolutely no doubt about that. And one biggest advantage
Speaker 2: of 3D printing is this. For example, sometime with old folks,
Speaker 2: or just whatever is the reason, say my wife fought
Speaker 2: with me, this with me, and throw away my dentures,
Speaker 2: then how do we replace it? If it's a 3D
Speaker 2: printing denture, all it takes is to retrieve the old file,
Speaker 2: press the button, and then voila, you can have the
Speaker 2: exact identical denture made in a heartbeat.
Speaker 1: Is it still based though, on the mold that will
Speaker 1: be taken?
Speaker 2: Well, there are two ways to do it. One way
Speaker 2: is to have a scanner to scan the mouth. OK?
Speaker 2: Scanner is just a fancy way of, you know, robotic
Speaker 2: look see. When you and I look see, when human
Speaker 2: being looks see, we cannot output our information that we
Speaker 2: look see. But robotic look see, we can digitize it.
Speaker 2: It becomes signals, becomes, uh, uh, memories and storage. And
Speaker 2: then that
Speaker 2: And fit into a 3D printer and then print out
Speaker 2: whatever that we need to get done. Another way is
Speaker 2: to get a conventional impression of the mouth and then
Speaker 2: scan the model. That's the other way. Each way have
Speaker 2: the pros and cons, and there's a learning curve as well, OK?
Speaker 1: Interesting to hear that, that the benefits are still comparable
Speaker 1: to traditional, um, uh, dentures that are not 3D printed. I, uh,
Speaker 1: some people might think I'll try and sell it as like, oh,
Speaker 1: it gets a better impression of you, it's better, it
Speaker 1: fits better, it'll work better. There's no real evidence to
Speaker 1: show that it's quite comparable to existing dentures, is what
Speaker 1: you're saying.
Speaker 2: Well, scientific research have shown that they are comparable. And
Speaker 2: put it this way, whatever
Speaker 2: We get, say the next innovation is always compared with
Speaker 2: the existing technology, no matter which field, it's always the same.
Speaker 2: When we have an MRT compared with, say, buses, which
Speaker 2: one is better? When we have an airplane, we compare
Speaker 2: with something that is existing as well. That's always the case.
Speaker 2: So it's not like the new technology is as so-called
Speaker 2: only as good as the old one, but rather, we
Speaker 2: have to have some sort of baseline to establish the
Speaker 2: efficacy and the efficiency of it. Yeah.
Speaker 1: So besides 3D printing, have there been any other technological
Speaker 1: advancements or changes in the realm of the denture, or
Speaker 1: has it stayed pretty similar to what it's always been?
Speaker 2: If we are just focusing onto 3D printing, printing is
Speaker 2: one way which is to add on layer by layer
Speaker 2: to create it. Another way is to have a big
Speaker 2: block of material, and then we cut it down, trim
Speaker 2: it down to the shape that we need. That's one, OK,
Speaker 2: we're just focusing on the denture. On the other hand,
Speaker 2: of course, that could be like, say, dental implants, and now.
Speaker 2: even as researchers, they look into actually growing teeth in animals,
Speaker 2: in animals, not in human beings yet, OK. Yeah. But
Speaker 2: that probably will come, well, hopefully in our lifetime. So Daniel,
Speaker 2: make sure you and I stick around for a long,
Speaker 2: long time.
Speaker 1: I'm gonna hold
Speaker 1: on to my teeth as much as possible first, but
Speaker 1: I've been looking at those statistics, up to what?
Speaker 1: 80 to 60% of people after a certain age might
Speaker 1: have many of their teeth missing, right?
Speaker 2: That's correct. That's correct. When we hit 60, about 60%
Speaker 2: of the people would have, don't have all the teeth. OK,
Speaker 2: that's quite alarming, OK.
Speaker 2: Yeah.
Speaker 1: what are we talking about in terms of those alternatives
Speaker 1: to the denture? Let's say, I mean, the dentures are really,
Speaker 1: it's cost effective, it's efficient for the people that need
Speaker 1: it who have a significant amount of tooth loss as well,
Speaker 1: because the other option is what? dental implants? And that
Speaker 1: can be a very costly affair if you've got many
Speaker 1: missing teeth, no?
Speaker 2: That's correct, dental implants is one and the other one
Speaker 2: will be dental bridges. Dental bridges has been around for
Speaker 2: quite many decades as well. They have proven to be
Speaker 2: very efficient and also comparable in terms of being a
Speaker 2: replacement methodology.
Speaker 2: And um yes, the most economical way is actually to
Speaker 2: keep our own teeth. Sometimes people will have this association
Speaker 2: that we're going to see a dentist is very expensive. Well,
Speaker 2: because many of us, I'm guilty of that as well,
Speaker 2: and that is that we only go to seek help
Speaker 2: when we're in deep trouble.
Speaker 2: And sometimes people say, oh, I, I, I'm so scared
Speaker 2: to see dentist because it's painful. Hey, but you know what,
Speaker 2: we don't cause people pain. We are here because I've
Speaker 2: got a job because we are there to solve people's pain, OK?
Speaker 2: It's not that we cause pain.
Speaker 1: I can't only see the dentist when I've got a problem.
Speaker 1: You should see a dentist to prevent the problem from happening.
Speaker 2: Absolutely. That's most important. Prevention is more economical, more effective
Speaker 2: as well.
Speaker 1: So why
Speaker 2: to
Speaker 1: keep
Speaker 2: your teeth?
Speaker 1: Yeah. So I want to keep my teeth as well.
Speaker 1: So that's why when I, when I hear those numbers
Speaker 1: and those stats that you gave us, is that happening,
Speaker 1: that loss of teeth for that quantum of people.
Speaker 1: Is that happening because it's natural as one ages to
Speaker 1: lose their teeth, to have gum res, um, reside, um, your,
Speaker 1: your gums getting weaker, your jawbone getting weaker, resorption happening?
Speaker 1: Or is it because of poor maintenance that that has
Speaker 1: become an issue?
Speaker 2: Originally, we all thought this is inevitable. We thought that
Speaker 2: teeth will change. It's like our hair, our skin with
Speaker 2: time passes, it will change for worse but not for better,
Speaker 2: but actually, skin.
Speaker 2: Or teeth are maintainable if we pay enough care to it.
Speaker 2: And we know that populations, OK, into international research, what
Speaker 2: they have found is that for population that they maintain
Speaker 2: the teeth, can maintain professional maintenance and and so on.
Speaker 2: And they will they actually can keep the teeth for
Speaker 2: much longer time and it's like not just say 5% improvement,
Speaker 2: we're talking about 50, 60% improvement, and that's significant. Imagine
Speaker 2: that when we are 80 years old, instead of having
Speaker 2: 20 pairs of teeth.
Speaker 2: I mean, 20 teeth is biting. We have say 30
Speaker 2: of them, all of them biting. There's significant improvement, OK,
Speaker 2: because by then, say, Daniel, when you and I are 80s,
Speaker 2: there are few things that we don't want to do
Speaker 2: and eating is one of the most enjoyable things to do.
Speaker 1: I don't want to subsist on soup and rice only because,
Speaker 1: so that's the thing, when people have teeth loss, malnutrition
Speaker 1: is something that can happen as well, because they're afraid
Speaker 1: and fearful of eating certain foods or certain food types,
Speaker 1: and then malnutrition can occur. It's linked to a whole
Speaker 1: host of other health issues. So in reality, I use,
Speaker 1: can I be a 70 year old person with my
Speaker 1: full set of teeth, or should I expect some teeth
Speaker 1: to come out?
Speaker 2: I would say absolutely. When you're 70, 80, if you're
Speaker 2: faithful and to maintain your teeth, you can have all
Speaker 2: of them in your mouth. OK? And I'm dead serious
Speaker 2: about this. And many times when I see my patients,
Speaker 2: for the good boys and good girls, I would say,
Speaker 2: you know what, my bet is that you will never
Speaker 2: need to have dentures, but please don't prove me wrong. Yes.
Speaker 1: Don't take this as a challenge, OK?
Speaker 2: Yeah, one bet with me, you know, you lose. I
Speaker 2: hope that you lose in this case.
Speaker 1: Let's talk about some of the WhatsApps that are coming
Speaker 1: in at 963-119-38. Ah, this one is an interesting one.
Speaker 1: by the way, we're joined on today's edition by Doctor
Speaker 1: Ansgar Cheng, who's a prosthodontist, specialist dental group, Mountain Lieth Orchard.
Speaker 1: This person is asking about the idea of caps and
Speaker 1: veneers and whether that can help as well. Now, here's
Speaker 1: the thing, that's more of an aesthetic thing. It's not
Speaker 1: about replacing.
Speaker 1: A tooth that's missing. Correct? Let's clarify that a bit,
Speaker 2: please. Correct. Caps and veneers, we have to build it
Speaker 2: on top of teeth, on top of relatively healthy teeth. Uh,
Speaker 2: cosmetic dentistry is big, OK, but cosmetic dentistry is not
Speaker 2: exactly as cosmetic surgery, because, for example, we have a
Speaker 2: new nose. We don't expect ourselves to smell better. We
Speaker 2: have new eyelids, we don't expect ourselves to see better,
Speaker 2: but teeth, you have to make it functional. It's not
Speaker 2: just pretty. You have to get a bite.
Speaker 1: So is that actually, well, I mean, is that used
Speaker 1: a lot in Singapore? I'm curious, the idea of veneers,
Speaker 1: it is.
Speaker 2: That is actually used quite a bit in Singapore because
Speaker 2: we do have certain, certain, certain segment of population that
Speaker 2: is very aesthetically driven, OK. Ladies, OK, um, younger populations,
Speaker 2: then they would do that, OK. But there's um
Speaker 2: It's a personal choice. It's a personal choice. It's really
Speaker 2: like cosmetic surgery. Do we want to have our ear
Speaker 2: tucked in? Do we want to have, you know, double eyelid?
Speaker 2: I don't know. OK, or a new nose, OK. That's
Speaker 2: a very personal choice.
Speaker 1: But if it's building built on top of the existing tooth, yes,
Speaker 1: isn't there like a gap in between that staff can,
Speaker 1: is it hard to maintain? Well,
Speaker 2: if it's well made, that should not be the case.
Speaker 2: If it's well made, maintenance function, it should be.
Speaker 2: Pretty much like your normal teeth. And we always say this, OK.
Speaker 2: In order to keep your teeth, maintain your teeth, the
Speaker 2: rule is 222. Brush your teeth twice a day. I
Speaker 2: don't care what time, you just brush your teeth twice
Speaker 2: a day, 2 minutes each time, because it takes that
Speaker 2: long time to have a thorough cleaning, OK? 22, and
Speaker 2: the 3rd 2 is this, see a professional, see a
Speaker 2: dentist twice a year to have your dental checkup and cleaning.
Speaker 2: So the rule is as simple as 222.
Speaker 1: Let's talk about that if I do that.
Speaker 1: And obviously, if you have that balance in terms of
Speaker 1: your healthier lifestyle, your diet, bone health, that kind of thing.
Speaker 1: We could potentially maintain our full set of teeth, or
Speaker 1: as much of it as possible as we age. Talk
Speaker 1: to me more about the care and maintenance to make
Speaker 1: sure that we don't have dentures in future. Besides 222,
Speaker 1: I know people that are investing heavily in, I mean,
Speaker 1: there's all sorts of things that people buy nowadays online, unfortunately, like, oh,
Speaker 1: you buy this to get whiter teeth, you buy this
Speaker 1: to get stronger teeth, you take this to have stronger bones,
Speaker 1: health gums, teams. Do, do we need to worry about
Speaker 1: other aspects, healthy gums, healthy bones, jaw, that kind of stuff?
Speaker 2: Well, online stuff sometimes, one thing that I personally do
Speaker 2: worry is that we don't know what's the source. So
Speaker 2: the credibility
Speaker 1: whitening strips, the amount of whitening strips that are sold
Speaker 1: apparently are quite
Speaker 1: shocking.
Speaker 2: There's a little bit, yes, there's a little bit of
Speaker 2: a concern. So I'll be very cautious about that. Common
Speaker 2: sense thing about what we need to do about our teeth,
Speaker 2: for example, have we taken our vitamin D on a
Speaker 2: regular basis?
Speaker 2: OK, because we know their strength and bones. Have we
Speaker 2: taken our vitamin C? It could be as simple as
Speaker 2: eating an orange and apples. All right. We know that
Speaker 2: it's good for our gums. For example, in Singapore, our
Speaker 2: national dish, chili crab, pepper crab.
Speaker 2: You can have the meat, please don't bite the shell.
Speaker 2: Get your nutcrackers to crack the shells, OK.
Speaker 2: And another thing is that when we are using our
Speaker 2: forks and spoons, and that's one thing that I observe,
Speaker 2: you know, anecdotally, and sometimes people just break their teeth
Speaker 2: because they are just too happy eating the chicken rice
Speaker 2: and buy on the fork and spoons. So
Speaker 1: trauma is also a situation to be cautious of.
Speaker 2: Well, just be gentle, just be gentle. Yeah, don't do
Speaker 2: anything silly on it. Like my mom used to say
Speaker 2: when I was a little kid, don't do anything that
Speaker 2: makes me worry, OK? And I tell my patient that
Speaker 2: as well, because if you break your teeth, it's bad
Speaker 2: for you, good for me.
Speaker 1: Exactly. Well, I'm hoping, I'm hoping that while dentures are
Speaker 1: still necessary today, looking at the numbers of people dealing
Speaker 1: with tooth loss that you described as well, while that
Speaker 1: is the reality of today, I'm hoping we can reach
Speaker 1: the point where more of us are seeing our dentist
Speaker 1: regularly and taking care of our bone and gum health
Speaker 1: to the point that we don't need the denture. Could
Speaker 1: that happen one day, you think?
Speaker 2: I hope that would, that would, that would be achievable.
Speaker 2: I really hope so. OK. Uh, when is it? I
Speaker 2: don't know, but I maybe take a long time, but
Speaker 2: I'm very, very determined to live for a long, long
Speaker 2: time to stick around to see that day to come. OK?
Speaker 2: So then you will stick with me, OK?
Speaker 1: I'll be there hopefully.
Speaker 1: Full set of teeth as well. Doctor Cheng, a pleasure
Speaker 1: talking to you. Thank you once again for talking to
Speaker 1: me about the latest indenture technology. Thank you.
Speaker 2: Thank you very much. Have a good day. He's
Speaker 1: Doctor Ans Gucheng, who's a prosthodontist at Specialist Dental Group
Speaker 1: based at Mount Elizabeth Orchard. This has been today's Health Matters.
Speaker 1: I'm Daniel Martin.
Speaker 1: Before making any decisions based on the information in our program,
Speaker 1: please consult a medical professional.