A- A A+
Home > Patients and Visitors > Health Library

The Journey to a Brighter Smile

Oral health plays a vital role in the overall well-being of a person.

Many people may have the misconception that all forms of dental treatment are painful and will tend to neglect their oral health. With new approaches to dental treatment and multidisciplinary care, dental treatment has transformed the perception of many patients as the whole experience can be made more comfortable and pleasant. Read on to find out more about a patient's oral health journey.


Oral health encompasses the daily care and maintenance of the oral tissues. This comprises two components: the hard tissues and soft tissues. Teeth and bone make up the hard tissue component, while the lips, cheeks, gums and tongue make up the soft tissue component. Teeth are made up of three main layers: enamel, dentine and pulp (Figure 1).

Without proper care and maintenance, oral neglect can lead to a myriad of problems such as tooth decay and gum disease. A root canal infection will occur if tooth decay progresses to the pulp chamber and swellings can develop with abscess formation (Figure 2).

Tooth decay can be prevented by reducing the frequency of sugar intake while proper tooth brushing technique with a daily flossing regimen may prevent gum inflammation called gingivitis. Individuals with increased risk of dental decay may supplement their daily oral hygiene routine with the use of fluoride mouth rinses.

Fearful no more

Ms Elaine Ou was first presented to the Tan Tock Seng Hospital (TTSH) Dental Clinic in early 2009 with the hope of realigning her teeth prior to her wedding day. She had been referred to Dr Vivien Tan Hui Ling, the Head and Senior Consultant of Dental Clinic by her family members.

She had been reluctant to seek dental treatment earlier as she had an innate fear of the dentist from her primary school days. She had overcome her fear for the initial visit with the encouragement of her sister, who had also undergone treatment with Dr Vivien several years earlier.

Initial findings

Relevant radiographs were obtained and diagnostic casts were prepared. The treatment options available were discussed with Elaine to provide her with a better understanding of the commitment required for treatment to proceed. Although the timeline was challenging, both Elaine and Dr Vivien decided to embark upon the proposed plan.


Circumstances were compounded by the fact that Elaine was at a higher risk of developing dental caries.

An atypical extraction scheme was decided upon whereby her grossly decayed upper left canine tooth was removed as very little tooth structure was remaining for the tooth to function even with prosthetic restoration.

Three other premolar teeth and her wisdom teeth were also removed under general anaesthesia. Concurrent removal of the teeth under general anaesthesia expedited the commencement of braces without compromising Elaine’s comfort levels.

Clinical course

The molars were banded and activation began.

Elaine was compliant with her six-weekly reviews as her wedding day drew closer. On 8 January 2010, the eve of Elaine’s wedding, she had the orthodontic brackets removed and tooth-coloured composite resin restorations placed on her upper front teeth to achieve desired aesthetics for her special day. The bride was, without a doubt, the most beautiful person at the wedding.

Elaine had returned on 22 January 2010, after her honeymoon, to have her orthodontic brackets replaced and treatment continued. Upon completion of her braces treatment in April 2011, Elaine had further tooth-coloured composite resin restorations placed before commencing on definitive crowns on her upper teeth.

Dr Ang Kok Yang, the dental officer in-charge of Elaine’s case together with Dr Vivien, had prepared five upper teeth to receive crowns to provide adequate protection against fracture during function. Retainers were subsequently fabricated to hold the teeth in their new positions. Elaine’s new smile had warmed many hearts at the end of treatment. Her whole outlook on dentistry had been changed for the better. When she returned for an annual review in December 2012, she had progressed to the next stage in life: motherhood. The arrival of her little bundle of joy, a new baby girl, made her smile even wider than ever. This time, she no longer dreads her dental visits.

5 Quick FAQs for a better health!

Do our loved ones with no teeth or on tube feeding need oral hygiene?

Definitely. Studies have shown that for people on tube feeding, normal bacteria in the oral cavity eventually get replaced by bacteria that can cause serious lung infections.

What happens when you neglect an elderly's oral hygiene?

Poor oral hygiene often leads to 2 main types of dental diseases known as Gum Disease and Tooth Decay. Both of these can cause discomfort or pain and can lead to infection. The pain and infection from these dental diseases can further worsen the confusion associated with dementia.

What are some problems associated with poor oral hygiene care?

Problems associated with poor oral health can be very detrimental. They include, negative effects on self-esteem, poor nutritional status, difficulty in improving diabetic control and an increased risk of pneumonia (especially in elderly with swallowing problems) – All of which leading to an increased incidence of hospitalisations and mortality among the elderly.

What are signs of oral discomfort among elderly patients?

Some common behavioural indicators among the elderly include:

  1. Food refusal
  2. Refusing to wear dentures
  3. Facial expressions such as grimacing
  4. Increased restlessness, agitation, shouting
  5. Disturbed sleep
  6. Aggressive behaviour

What are some ways to prevent gum disease among elderly patients?

To simply put: brush teeth twice daily, ensure that dentures are properly cared for & visit a dentist regularly. Anti-plaque mouth wash can be helpful in preventing gum disease — but ONLY if it won't be swallowed.

More retail items for dental care in older adults can be purchased at Dental Clinic (Clinic 6B, Level 6, TTSH Medical Centre). 

Last Updated on