WEBVTT - Are 3D Printed Dentures next?

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<v Speaker 1>If it's a matter of health, it matters. Health Matters

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<v Speaker 1>with Daniel Martin. Welcome in everybody, thank you for joining

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<v Speaker 1>me and yes, what matters today.

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<v Speaker 1>Dentures. I regularly read up a lot of um health articles, publications, journals,

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<v Speaker 1>that kind of thing, and I recently went down the

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<v Speaker 1>rabbit hole for a lot of these dental health, um,

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<v Speaker 1>research publications looking at 3D printed materials being used as

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<v Speaker 1>base materials for dentures, and that got me thinking, wow,

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<v Speaker 1>that's great. Could we see 3D printed dentures?

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<v Speaker 1>As the future, or are we reaching the point where

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<v Speaker 1>hopefully we don't need dentures as a dental option anymore

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<v Speaker 1>with better teeth preservation or maybe other options as well?

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<v Speaker 1>Are 3D printed dentures next or maybe on their way out.

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<v Speaker 1>Doctor Ansgar Cheng is back on the show, Prosthodontist at

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<v Speaker 1>Specialist Dental Group based at Mount Elizabeth Orchard. Doctor Cheng,

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<v Speaker 1>good to have you on board again. Hello.

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<v Speaker 2>Well, good evening, everybody. It's nice being here again.

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<v Speaker 1>A dentures still?

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<v Speaker 1>In demand today, are they still an option that many

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<v Speaker 1>patients need to explore?

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<v Speaker 2>Well, first thing first, let's look at the numbers that

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<v Speaker 2>we have. Now, surprisingly, you know, we know that in Singapore,

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<v Speaker 2>on average, people live until about 84 years old. All right.

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<v Speaker 2>By the time we finished about 1/3 of our lifespan,

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<v Speaker 2>which is by the time we hit about 30,

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<v Speaker 2>About 67% of the people still have all the teeth.

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<v Speaker 2>That means about 13 do not have it, do not

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<v Speaker 2>have all the teeth. And surprise, surprise, by the time

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<v Speaker 2>that we reach 2/3 of our lifespan, which is by

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<v Speaker 2>the time we're about 60, then about 2/3 of the

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<v Speaker 2>people also do not have all their teeth as well.

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<v Speaker 2>So many people actually are missing their teeth. And by

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<v Speaker 2>the time when we hit 80s, only 10% of the people,

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<v Speaker 2>actually 9% of the people have about 20 teeth in

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<v Speaker 2>the mouth that are biting.

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<v Speaker 2>Well, so do we need dentures? Yes, certainly we need

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<v Speaker 2>to have some some form of replacement of teeth.

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<v Speaker 1>Gosh, so it's still in demand. How about 3D printed dentures?

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<v Speaker 1>Is that something at all happening in Singapore?

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<v Speaker 2>Well, it's been happening for quite a little while already.

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<v Speaker 2>This 3D printing business, well, now you ask a question,

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<v Speaker 2>make me feel like an old guy, because the first

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<v Speaker 2>time I'm in touch with this 3D printing technology was

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<v Speaker 2>about 35 years ago. When I was a little boy,

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<v Speaker 2>I was still new in the dental industry. Of course,

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<v Speaker 2>back then, 3D printing was very exotic. We have a

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<v Speaker 2>long name for it. It's called stereo letthographic technique.

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<v Speaker 2>Now, back then 3D printing, you need to have a

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<v Speaker 2>machine that would be big enough to fit into one

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<v Speaker 2>standard HDB bedroom. Now think about it. Now, 3D printers

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<v Speaker 2>could be just like the size of a bigger microwave

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<v Speaker 2>at home, and you can easily buy them.

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<v Speaker 1>Yeah. Is it being offered as an option for patients?

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<v Speaker 1>Is it printing the entire denture or just the base material?

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<v Speaker 1>How does it work today?

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<v Speaker 2>Certainly, it's been offered and nowadays you have local labs

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<v Speaker 2>and also international labs that has the capability of doing

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<v Speaker 2>this because nowadays with the internet.

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<v Speaker 2>With globalizations, you can have a lab over say 3000

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<v Speaker 2>kilometers away that can take your order because you can

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<v Speaker 2>easily send the files over and then they can get

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<v Speaker 2>the job done and send the, the finished product back.

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<v Speaker 2>So it's available, all right? And it's a viable alternative.

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<v Speaker 2>The only thing is that one cost, cost base is

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<v Speaker 2>still a little bit higher than the um conventional dentures.

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<v Speaker 2>And in terms of functionality, they are very comparable as well.

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<v Speaker 1>That's interesting. I was hoping that the advent of 3D

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<v Speaker 1>printing technology would help lower the cost of the denture

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<v Speaker 1>in some way, but still, even 35 years on after

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<v Speaker 1>you first experienced 3D printing, cost is still a factor

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<v Speaker 1>in terms of the product.

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<v Speaker 2>Cost will slowly come down. There's absolutely no doubt about that.

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<v Speaker 2>There's absolutely no doubt about that. And one biggest advantage

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<v Speaker 2>of 3D printing is this. For example, sometime with old folks,

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<v Speaker 2>or just whatever is the reason, say my wife fought

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<v Speaker 2>with me, this with me, and throw away my dentures,

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<v Speaker 2>then how do we replace it? If it's a 3D

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<v Speaker 2>printing denture, all it takes is to retrieve the old file,

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<v Speaker 2>press the button, and then voila, you can have the

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<v Speaker 2>exact identical denture made in a heartbeat.

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<v Speaker 1>Is it still based though, on the mold that will

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<v Speaker 1>be taken?

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<v Speaker 2>Well, there are two ways to do it. One way

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<v Speaker 2>is to have a scanner to scan the mouth. OK?

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<v Speaker 2>Scanner is just a fancy way of, you know, robotic

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<v Speaker 2>look see. When you and I look see, when human

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<v Speaker 2>being looks see, we cannot output our information that we

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<v Speaker 2>look see. But robotic look see, we can digitize it.

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<v Speaker 2>It becomes signals, becomes, uh, uh, memories and storage. And

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<v Speaker 2>then that

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<v Speaker 2>And fit into a 3D printer and then print out

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<v Speaker 2>whatever that we need to get done. Another way is

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<v Speaker 2>to get a conventional impression of the mouth and then

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<v Speaker 2>scan the model. That's the other way. Each way have

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<v Speaker 2>the pros and cons, and there's a learning curve as well, OK?

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<v Speaker 1>Interesting to hear that, that the benefits are still comparable

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<v Speaker 1>to traditional, um, uh, dentures that are not 3D printed. I, uh,

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<v Speaker 1>some people might think I'll try and sell it as like, oh,

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<v Speaker 1>it gets a better impression of you, it's better, it

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<v Speaker 1>fits better, it'll work better. There's no real evidence to

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<v Speaker 1>show that it's quite comparable to existing dentures, is what

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<v Speaker 1>you're saying.

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<v Speaker 2>Well, scientific research have shown that they are comparable. And

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<v Speaker 2>put it this way, whatever

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<v Speaker 2>We get, say the next innovation is always compared with

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<v Speaker 2>the existing technology, no matter which field, it's always the same.

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<v Speaker 2>When we have an MRT compared with, say, buses, which

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<v Speaker 2>one is better? When we have an airplane, we compare

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<v Speaker 2>with something that is existing as well. That's always the case.

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<v Speaker 2>So it's not like the new technology is as so-called

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<v Speaker 2>only as good as the old one, but rather, we

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<v Speaker 2>have to have some sort of baseline to establish the

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<v Speaker 2>efficacy and the efficiency of it. Yeah.

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<v Speaker 1>So besides 3D printing, have there been any other technological

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<v Speaker 1>advancements or changes in the realm of the denture, or

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<v Speaker 1>has it stayed pretty similar to what it's always been?

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<v Speaker 2>If we are just focusing onto 3D printing, printing is

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<v Speaker 2>one way which is to add on layer by layer

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<v Speaker 2>to create it. Another way is to have a big

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<v Speaker 2>block of material, and then we cut it down, trim

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<v Speaker 2>it down to the shape that we need. That's one, OK,

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<v Speaker 2>we're just focusing on the denture. On the other hand,

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<v Speaker 2>of course, that could be like, say, dental implants, and now.

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<v Speaker 2>even as researchers, they look into actually growing teeth in animals,

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<v Speaker 2>in animals, not in human beings yet, OK. Yeah. But

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<v Speaker 2>that probably will come, well, hopefully in our lifetime. So Daniel,

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<v Speaker 2>make sure you and I stick around for a long,

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<v Speaker 2>long time.

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<v Speaker 1>I'm gonna hold

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<v Speaker 1>on to my teeth as much as possible first, but

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<v Speaker 1>I've been looking at those statistics, up to what?

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<v Speaker 1>80 to 60% of people after a certain age might

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<v Speaker 1>have many of their teeth missing, right?

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<v Speaker 2>That's correct. That's correct. When we hit 60, about 60%

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<v Speaker 2>of the people would have, don't have all the teeth. OK,

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<v Speaker 2>that's quite alarming, OK.

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<v Speaker 2>Yeah.

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<v Speaker 1>what are we talking about in terms of those alternatives

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<v Speaker 1>to the denture? Let's say, I mean, the dentures are really,

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<v Speaker 1>it's cost effective, it's efficient for the people that need

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<v Speaker 1>it who have a significant amount of tooth loss as well,

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<v Speaker 1>because the other option is what? dental implants? And that

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<v Speaker 1>can be a very costly affair if you've got many

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<v Speaker 1>missing teeth, no?

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<v Speaker 2>That's correct, dental implants is one and the other one

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<v Speaker 2>will be dental bridges. Dental bridges has been around for

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<v Speaker 2>quite many decades as well. They have proven to be

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<v Speaker 2>very efficient and also comparable in terms of being a

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<v Speaker 2>replacement methodology.

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<v Speaker 2>And um yes, the most economical way is actually to

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<v Speaker 2>keep our own teeth. Sometimes people will have this association

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<v Speaker 2>that we're going to see a dentist is very expensive. Well,

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<v Speaker 2>because many of us, I'm guilty of that as well,

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<v Speaker 2>and that is that we only go to seek help

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<v Speaker 2>when we're in deep trouble.

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<v Speaker 2>And sometimes people say, oh, I, I, I'm so scared

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<v Speaker 2>to see dentist because it's painful. Hey, but you know what,

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<v Speaker 2>we don't cause people pain. We are here because I've

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<v Speaker 2>got a job because we are there to solve people's pain, OK?

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<v Speaker 2>It's not that we cause pain.

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<v Speaker 1>I can't only see the dentist when I've got a problem.

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<v Speaker 1>You should see a dentist to prevent the problem from happening.

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<v Speaker 2>Absolutely. That's most important. Prevention is more economical, more effective

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<v Speaker 2>as well.

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<v Speaker 1>So why

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<v Speaker 2>to

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<v Speaker 1>keep

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<v Speaker 2>your teeth?

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<v Speaker 1>Yeah. So I want to keep my teeth as well.

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<v Speaker 1>So that's why when I, when I hear those numbers

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<v Speaker 1>and those stats that you gave us, is that happening,

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<v Speaker 1>that loss of teeth for that quantum of people.

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<v Speaker 1>Is that happening because it's natural as one ages to

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<v Speaker 1>lose their teeth, to have gum res, um, reside, um, your,

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<v Speaker 1>your gums getting weaker, your jawbone getting weaker, resorption happening?

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<v Speaker 1>Or is it because of poor maintenance that that has

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<v Speaker 1>become an issue?

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<v Speaker 2>Originally, we all thought this is inevitable. We thought that

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<v Speaker 2>teeth will change. It's like our hair, our skin with

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<v Speaker 2>time passes, it will change for worse but not for better,

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<v Speaker 2>but actually, skin.

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<v Speaker 2>Or teeth are maintainable if we pay enough care to it.

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<v Speaker 2>And we know that populations, OK, into international research, what

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<v Speaker 2>they have found is that for population that they maintain

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<v Speaker 2>the teeth, can maintain professional maintenance and and so on.

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<v Speaker 2>And they will they actually can keep the teeth for

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<v Speaker 2>much longer time and it's like not just say 5% improvement,

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<v Speaker 2>we're talking about 50, 60% improvement, and that's significant. Imagine

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<v Speaker 2>that when we are 80 years old, instead of having

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<v Speaker 2>20 pairs of teeth.

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<v Speaker 2>I mean, 20 teeth is biting. We have say 30

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<v Speaker 2>of them, all of them biting. There's significant improvement, OK,

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<v Speaker 2>because by then, say, Daniel, when you and I are 80s,

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<v Speaker 2>there are few things that we don't want to do

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<v Speaker 2>and eating is one of the most enjoyable things to do.

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<v Speaker 1>I don't want to subsist on soup and rice only because,

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<v Speaker 1>so that's the thing, when people have teeth loss, malnutrition

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<v Speaker 1>is something that can happen as well, because they're afraid

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<v Speaker 1>and fearful of eating certain foods or certain food types,

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<v Speaker 1>and then malnutrition can occur. It's linked to a whole

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<v Speaker 1>host of other health issues. So in reality, I use,

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<v Speaker 1>can I be a 70 year old person with my

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<v Speaker 1>full set of teeth, or should I expect some teeth

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<v Speaker 1>to come out?

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<v Speaker 2>I would say absolutely. When you're 70, 80, if you're

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<v Speaker 2>faithful and to maintain your teeth, you can have all

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<v Speaker 2>of them in your mouth. OK? And I'm dead serious

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<v Speaker 2>about this. And many times when I see my patients,

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<v Speaker 2>for the good boys and good girls, I would say,

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<v Speaker 2>you know what, my bet is that you will never

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<v Speaker 2>need to have dentures, but please don't prove me wrong. Yes.

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<v Speaker 1>Don't take this as a challenge, OK?

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<v Speaker 2>Yeah, one bet with me, you know, you lose. I

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<v Speaker 2>hope that you lose in this case.

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<v Speaker 1>Let's talk about some of the WhatsApps that are coming

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<v Speaker 1>in at 963-119-38. Ah, this one is an interesting one.

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<v Speaker 1>by the way, we're joined on today's edition by Doctor

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<v Speaker 1>Ansgar Cheng, who's a prosthodontist, specialist dental group, Mountain Lieth Orchard.

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<v Speaker 1>This person is asking about the idea of caps and

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<v Speaker 1>veneers and whether that can help as well. Now, here's

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<v Speaker 1>the thing, that's more of an aesthetic thing. It's not

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<v Speaker 1>about replacing.

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<v Speaker 1>A tooth that's missing. Correct? Let's clarify that a bit,

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<v Speaker 2>please. Correct. Caps and veneers, we have to build it

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<v Speaker 2>on top of teeth, on top of relatively healthy teeth. Uh,

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<v Speaker 2>cosmetic dentistry is big, OK, but cosmetic dentistry is not

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<v Speaker 2>exactly as cosmetic surgery, because, for example, we have a

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<v Speaker 2>new nose. We don't expect ourselves to smell better. We

0:11:39.780 --> 0:11:42.179
<v Speaker 2>have new eyelids, we don't expect ourselves to see better,

0:11:42.390 --> 0:11:44.789
<v Speaker 2>but teeth, you have to make it functional. It's not

0:11:44.789 --> 0:11:46.789
<v Speaker 2>just pretty. You have to get a bite.

0:11:48.150 --> 0:11:50.270
<v Speaker 1>So is that actually, well, I mean, is that used

0:11:50.270 --> 0:11:52.859
<v Speaker 1>a lot in Singapore? I'm curious, the idea of veneers,

0:11:53.349 --> 0:11:53.739
<v Speaker 1>it is.

0:11:53.830 --> 0:11:57.069
<v Speaker 2>That is actually used quite a bit in Singapore because

0:11:57.070 --> 0:12:00.830
<v Speaker 2>we do have certain, certain, certain segment of population that

0:12:00.830 --> 0:12:06.228
<v Speaker 2>is very aesthetically driven, OK. Ladies, OK, um, younger populations,

0:12:06.349 --> 0:12:09.570
<v Speaker 2>then they would do that, OK. But there's um

0:12:10.150 --> 0:12:13.270
<v Speaker 2>It's a personal choice. It's a personal choice. It's really

0:12:13.270 --> 0:12:15.989
<v Speaker 2>like cosmetic surgery. Do we want to have our ear

0:12:15.989 --> 0:12:19.309
<v Speaker 2>tucked in? Do we want to have, you know, double eyelid?

0:12:19.349 --> 0:12:22.400
<v Speaker 2>I don't know. OK, or a new nose, OK. That's

0:12:22.400 --> 0:12:23.820
<v Speaker 2>a very personal choice.

0:12:24.150 --> 0:12:27.929
<v Speaker 1>But if it's building built on top of the existing tooth, yes,

0:12:28.030 --> 0:12:30.709
<v Speaker 1>isn't there like a gap in between that staff can,

0:12:30.869 --> 0:12:33.109
<v Speaker 1>is it hard to maintain? Well,

0:12:33.270 --> 0:12:35.150
<v Speaker 2>if it's well made, that should not be the case.

0:12:35.270 --> 0:12:38.309
<v Speaker 2>If it's well made, maintenance function, it should be.

0:12:38.385 --> 0:12:41.974
<v Speaker 2>Pretty much like your normal teeth. And we always say this, OK.

0:12:42.015 --> 0:12:44.335
<v Speaker 2>In order to keep your teeth, maintain your teeth, the

0:12:44.335 --> 0:12:49.174
<v Speaker 2>rule is 222. Brush your teeth twice a day. I

0:12:49.174 --> 0:12:51.224
<v Speaker 2>don't care what time, you just brush your teeth twice

0:12:51.224 --> 0:12:54.375
<v Speaker 2>a day, 2 minutes each time, because it takes that

0:12:54.375 --> 0:12:58.255
<v Speaker 2>long time to have a thorough cleaning, OK? 22, and

0:12:58.255 --> 0:13:00.854
<v Speaker 2>the 3rd 2 is this, see a professional, see a

0:13:00.854 --> 0:13:04.255
<v Speaker 2>dentist twice a year to have your dental checkup and cleaning.

0:13:04.414 --> 0:13:06.655
<v Speaker 2>So the rule is as simple as 222.

0:13:07.090 --> 0:13:08.849
<v Speaker 1>Let's talk about that if I do that.

0:13:09.729 --> 0:13:13.609
<v Speaker 1>And obviously, if you have that balance in terms of

0:13:13.609 --> 0:13:16.770
<v Speaker 1>your healthier lifestyle, your diet, bone health, that kind of thing.

0:13:17.789 --> 0:13:20.760
<v Speaker 1>We could potentially maintain our full set of teeth, or

0:13:20.760 --> 0:13:23.150
<v Speaker 1>as much of it as possible as we age. Talk

0:13:23.150 --> 0:13:25.590
<v Speaker 1>to me more about the care and maintenance to make

0:13:25.590 --> 0:13:29.880
<v Speaker 1>sure that we don't have dentures in future. Besides 222,

0:13:29.989 --> 0:13:32.789
<v Speaker 1>I know people that are investing heavily in, I mean,

0:13:32.830 --> 0:13:36.030
<v Speaker 1>there's all sorts of things that people buy nowadays online, unfortunately, like, oh,

0:13:36.080 --> 0:13:38.190
<v Speaker 1>you buy this to get whiter teeth, you buy this

0:13:38.190 --> 0:13:40.390
<v Speaker 1>to get stronger teeth, you take this to have stronger bones,

0:13:40.429 --> 0:13:43.190
<v Speaker 1>health gums, teams. Do, do we need to worry about

0:13:43.190 --> 0:13:46.859
<v Speaker 1>other aspects, healthy gums, healthy bones, jaw, that kind of stuff?

0:13:47.479 --> 0:13:51.039
<v Speaker 2>Well, online stuff sometimes, one thing that I personally do

0:13:51.039 --> 0:13:54.559
<v Speaker 2>worry is that we don't know what's the source. So

0:13:54.559 --> 0:13:55.599
<v Speaker 2>the credibility

0:13:55.599 --> 0:13:58.510
<v Speaker 1>whitening strips, the amount of whitening strips that are sold

0:13:58.510 --> 0:13:59.280
<v Speaker 1>apparently are quite

0:13:59.280 --> 0:13:59.679
<v Speaker 1>shocking.

0:14:00.080 --> 0:14:02.030
<v Speaker 2>There's a little bit, yes, there's a little bit of

0:14:02.030 --> 0:14:05.599
<v Speaker 2>a concern. So I'll be very cautious about that. Common

0:14:05.599 --> 0:14:07.400
<v Speaker 2>sense thing about what we need to do about our teeth,

0:14:07.440 --> 0:14:10.760
<v Speaker 2>for example, have we taken our vitamin D on a

0:14:10.760 --> 0:14:11.549
<v Speaker 2>regular basis?

0:14:12.239 --> 0:14:15.679
<v Speaker 2>OK, because we know their strength and bones. Have we

0:14:15.679 --> 0:14:18.319
<v Speaker 2>taken our vitamin C? It could be as simple as

0:14:18.320 --> 0:14:21.559
<v Speaker 2>eating an orange and apples. All right. We know that

0:14:21.559 --> 0:14:24.940
<v Speaker 2>it's good for our gums. For example, in Singapore, our

0:14:24.940 --> 0:14:26.960
<v Speaker 2>national dish, chili crab, pepper crab.

0:14:27.609 --> 0:14:30.080
<v Speaker 2>You can have the meat, please don't bite the shell.

0:14:30.320 --> 0:14:32.849
<v Speaker 2>Get your nutcrackers to crack the shells, OK.

0:14:33.239 --> 0:14:35.520
<v Speaker 2>And another thing is that when we are using our

0:14:35.520 --> 0:14:37.890
<v Speaker 2>forks and spoons, and that's one thing that I observe,

0:14:37.969 --> 0:14:40.919
<v Speaker 2>you know, anecdotally, and sometimes people just break their teeth

0:14:40.919 --> 0:14:43.250
<v Speaker 2>because they are just too happy eating the chicken rice

0:14:43.250 --> 0:14:45.219
<v Speaker 2>and buy on the fork and spoons. So

0:14:45.219 --> 0:14:48.049
<v Speaker 1>trauma is also a situation to be cautious of.

0:14:48.210 --> 0:14:51.690
<v Speaker 2>Well, just be gentle, just be gentle. Yeah, don't do

0:14:51.690 --> 0:14:53.849
<v Speaker 2>anything silly on it. Like my mom used to say

0:14:53.849 --> 0:14:55.809
<v Speaker 2>when I was a little kid, don't do anything that

0:14:55.809 --> 0:14:58.289
<v Speaker 2>makes me worry, OK? And I tell my patient that

0:14:58.289 --> 0:15:01.289
<v Speaker 2>as well, because if you break your teeth, it's bad

0:15:01.289 --> 0:15:02.330
<v Speaker 2>for you, good for me.

0:15:03.190 --> 0:15:06.799
<v Speaker 1>Exactly. Well, I'm hoping, I'm hoping that while dentures are

0:15:06.799 --> 0:15:10.280
<v Speaker 1>still necessary today, looking at the numbers of people dealing

0:15:10.280 --> 0:15:12.760
<v Speaker 1>with tooth loss that you described as well, while that

0:15:12.760 --> 0:15:14.840
<v Speaker 1>is the reality of today, I'm hoping we can reach

0:15:14.840 --> 0:15:18.559
<v Speaker 1>the point where more of us are seeing our dentist

0:15:18.559 --> 0:15:21.349
<v Speaker 1>regularly and taking care of our bone and gum health

0:15:21.679 --> 0:15:24.320
<v Speaker 1>to the point that we don't need the denture. Could

0:15:24.320 --> 0:15:25.640
<v Speaker 1>that happen one day, you think?

0:15:26.489 --> 0:15:29.419
<v Speaker 2>I hope that would, that would, that would be achievable.

0:15:29.549 --> 0:15:32.390
<v Speaker 2>I really hope so. OK. Uh, when is it? I

0:15:32.390 --> 0:15:35.030
<v Speaker 2>don't know, but I maybe take a long time, but

0:15:35.030 --> 0:15:37.349
<v Speaker 2>I'm very, very determined to live for a long, long

0:15:37.349 --> 0:15:39.830
<v Speaker 2>time to stick around to see that day to come. OK?

0:15:39.989 --> 0:15:41.450
<v Speaker 2>So then you will stick with me, OK?

0:15:42.030 --> 0:15:43.070
<v Speaker 1>I'll be there hopefully.

0:15:43.244 --> 0:15:45.994
<v Speaker 1>Full set of teeth as well. Doctor Cheng, a pleasure

0:15:45.994 --> 0:15:47.575
<v Speaker 1>talking to you. Thank you once again for talking to

0:15:47.575 --> 0:15:50.184
<v Speaker 1>me about the latest indenture technology. Thank you.

0:15:50.575 --> 0:15:52.354
<v Speaker 2>Thank you very much. Have a good day. He's

0:15:52.354 --> 0:15:55.565
<v Speaker 1>Doctor Ans Gucheng, who's a prosthodontist at Specialist Dental Group

0:15:55.565 --> 0:15:58.765
<v Speaker 1>based at Mount Elizabeth Orchard. This has been today's Health Matters.

0:15:58.835 --> 0:15:59.875
<v Speaker 1>I'm Daniel Martin.

0:16:05.340 --> 0:16:09.299
<v Speaker 1>Before making any decisions based on the information in our program,

0:16:09.419 --> 0:16:11.619
<v Speaker 1>please consult a medical professional.