Singapore, 6 April 2026 – Tan Tock Seng Hospital (TTSH) and Q & M Dental Group (Q & M) have partnered to close a critical care gap by creating access to Special Care Dentistry for frail patients and those with complex medical conditions, enabling more to receive care closer to home.
Formalised through a Memorandum of Understanding (MOU), the collaboration introduces a programme and bidirectional referral pathways. This comes at a pivotal time, following the formal recognition of Special Care Dentistry as a specialty in Singapore last July, reflecting the growing complexity of oral care needs as the nation's population ages.
Addressing the Care Gap in the Community
Special Care Dentistry supports patients whose physical, medical, developmental, cognitive or behavioural conditions make routine dental treatment more complex. Unlike a regular dental visit, it involves adapting treatment techniques, coordinating with the patient's medical team and developing personalised care plans.
The range of patients who need this level of care, and can be managed by upskilled community-based dentists, include those receiving antiresorptive therapy for osteoporosis, individuals with a history of head and neck cancer radiation therapy and older adults with oral frailty. Community-based dentists are especially well placed to help frail elders understand the effects of an unhealthy mouth on oral intake, thereby working towards sarcopenia prevention and improvement of overall nutrition and health.
Demand for special care dentistry at TTSH has been rising steadily. Around 4,500 dental patients each year - representing about 24% of the hospital's dental caseload - require oral care that must be closely coordinated with medical management. This caseload has grown approximately 18% per annum, with patients requiring a median of four visits per year. Yet a significant care gap persists.
Many of these patients do not require hospital-based care at every visit, but face barriers to accessing care for specialised needs in the community. For frail patients and their caregivers, travelling to the hospital for routine dental care can be physically challenging.
Oral health is closely linked to overall health outcomes. Difficulties with chewing, swallowing or maintaining oral hygiene can affect nutrition, recovery from illness and quality of life. Research led by TTSH clinicians found that poorer oral health among hospitalised older adults was linked to greater frailty, higher risk of malnutrition and functional decline[1].
Separate research by Duke-NUS Medical School points to a significant gap in preventive oral healthcare among seniors. Only about one in four had visited a dentist in the past six months, while nearly three in ten had not seen a dentist in more than five years.[2]
This underscores the importance of making routine dental care more accessible for patients with complex medical conditions and oral frailty.
Special Care Dentistry Capability Beyond the Hospital
Based on the current case mix, about 50% of patients seen annually for Special Care Dentistry at TTSH may be suitable for follow-up care in selected community clinics once their conditions are stabilised. This enables patients to receive ongoing care closer to home, in more convenient and accessible settings. The care model includes bidirectional referral pathways, ensuring patients can return to hospital specialists if their care needs change or become more urgent.
Dr Andrew Aw, Head,
Department of Dental Surgery at TTSH, NHG Health, said, "As our population ages, more patients require ongoing dental care alongside complex medical conditions. Many do not need hospital-based dental treatment at every visit. By strengthening community capability and establishing clear referral pathways, we can ensure these patients with specialised needs receive care in the right setting, while our hospital specialists focus on the most medically complex cases."
Professor Chin Jing Jih, Deputy Group CEO (Clinical & Academic Development), NHG Health, added, “This partnership between NHG Health's flagship hospital, Tan Tock Seng Hospital and Q & M is about building capability where it is needed. Given TTSH's deep clinical knowledge and expertise from geriatrics to stroke care, it is well-placed to train and support Q & M's strong network of community dentists to safely manage dental patients with complex medical conditions. By equipping these dentists with clinical competencies and protocols to handle higher-risk cases, more specialist dental care can be provided in the community. This reaffirms our mutual commitment to deliver care that is appropriate and value-based, measured by quality, holistic health, and timely access to care closer to home for our patients."
Building Capability at Scale
Through this partnership, Q & M plans to upskill 50 to 80 dentists, about 30% of its dentists, over the next two to three years under the Special Care Dentistry programme developed in collaboration with TTSH specialists at Q & M College of Dentistry. Upon completion of the programme, participating dentists will receive a certificate of participation, and they will be able to manage selected groups of patients with special care dentistry needs in community clinics.
The programme will focus on clinical areas commonly encountered in special care dentistry patients, including preventive dental care for patients receiving antiresorptive therapy for osteoporosis, dental management after head and neck radiation therapy, and care strategies for ageing adults at risk of oral frailty.
For example, a patient who has undergone head & neck radiation therapy is at a higher risk of oral complications such as dry mouth, which significantly increases their risk of tooth decay. Through the programme, community dentists will be able to identify such complications, provide tailored preventive advice and targeted treatments to protect the patient's health in the long term.
Dr Raymond Ang, Chief Operating Officer of Q & M Dental Group, said, "Q & M is pleased to partner with TTSH to strengthen community capability in Special Care Dentistry. Many clinics encounter patients with complex medical conditions who previously had limited options outside hospital settings. Through close clinical coordination with hospital specialists, our dentists will be better equipped to support these patients safely in the community."
Following the initial phase, Q & M will begin receiving referred patients at participating clinics, starting with its flagship clinic at City Square Mall. Selected clinics across its network are also expected to progressively enhance wheelchair accessibility to better support patients with mobility challenges.
Improving Affordability and Access
Participating Q & M clinics will extend a 10% concession to patients referred from TTSH Special Care Dentistry for routine oral health maintenance, such as scaling, polishing, and fillings. The 10% concession would be in addition to CHAS dental subsidies[3] for CHAS eligible patients.
Beyond cost savings, this partnership addresses practical challenges faced by vulnerable patients. For frail patients or those with limited mobility, travelling to hospital appointments represents an added burden. Receiving care closer to home reduces that strain for patients and caregivers alike.
As Singapore's population continues to age, demand for dental care that is closely integrated with their medical needs will rise. This partnership between TTSH and Q & M marks a step towards a more integrated population-based care model — one that closes a critical gap between hospital and community care, strengthens system capacity in the hospitals, and ensures patients receive the right care, in the right place at the right time.