Quality & Affordable Dentistry in Malaysia

What is Comprehensive Dental Care (in Malaysia)?

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Comprehensive Dental Care is the approach of examining, diagnosing and treating your mouth as a whole
Comprehensive Dental Care is the approach of examining, diagnosing and treating your mouth as a whole

Comprehensive dental care is really all about the type of dental care that you’d like to have anyway. It is the approach of examining, diagnosing and treating your mouth as a whole, not just as a single tooth or a single problem. It is your best assurance of getting the complete care that ensures you keep your teeth for a lifetime.

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Your Chronological Age and Your Dental Age

You can divide a person’s dental age into three categories which may be similar to the person’s chronological age or may be entirely different. In chronological age, we grow from being a child, to a teenager, to a young adult to an adult to an older adult to a senior to an elder.

The dental ages are youth, adult and elder.

Dental “youth” is characterised by no or minimal care other than regular maintenance care. A person with this dental age may have had orthodontic treatment, a few restorations (what lay people call fillings), dental sealants, tooth whitening and wisdom teeth removal. You see this mostly in young adults and teenagers who take care of their teeth and see the dentist on a regular basis.

Dental “adult” is characterised by more problems and treatment. More restorations may have been performed. A tooth may have been lost and replaced with a dental implant or dental bridge. This dental age may have had some gum disease therapy, a root canal or two, some crowns. Cosmetic treatment using porcelain veneers or crowns may have been done.

Incomplete care, partial care or piece-meal patchwork can lead to the next category:

Dental “elder” is characterised by the loss of all teeth and being forced to chew on the gums using removable dentures. THIS IS NOT WHERE YOU WANT TO BE. The older one becomes chronologically, the more difficult this dental age can be. Often having a dry mouth from medications can make wearing removable dentures very uncomfortable and painful.

• The more teeth you have and the better their condition or repaired condition, the ‘younger” you are dentally.

• Comprehensive care looks at all of your mouth and teeth and correlates it to all of you as a person.

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• Your goal should be to stay as young dentally as possible – dental adult or dental youth.

• The younger you are dentally, the younger your entire body seems and this appears to slow the aging process.

• The better the maintenance and prevention for your dental health, the less it “costs” you in the long run and the more youthful you remain.

The longer you wait to get the care you need, the more it costs you later on and the faster you age dentally.

The less you have regular, timely professional dental cleanings and exams, the more likely you are to have dental problems and “age” dentally.

Loss of all teeth as a young adult accelerates aging to dental elder and causes significant, sometimes debilitating bone loss in later years, creating a dental cripple.

Gum disease is the major culprit in tooth loss and dental aging.

• Neglecting your teeth costs you money, time, pain, health and worsening dental “age.”

• The longer you live, the longer you need to keep your teeth. People are living longer. Therefore, you need your teeth longer.

Chewing on your gums with or without removable dentures can accelerate the aging process.

• If you become a dental elder, act as quickly as possible to get back some teeth that are not removable.

• If you must stay in removable dentures, get the best ones possible. Having really well made dentures improves your appearance, preserves bone longer, and gives you the best fit possible. If you were going to wear only one set of clothes, you’d be pretty darn sure to get the best possible fit, longevity and classic style, right? What do you think you should do with your teeth?

• Dental implants give those who have lost one, a few or all of their teeth a second chance to recover and regain a dental age back to adult.

• The most difficult, challenging areas of dentistry are:

1. Those charged with stopping the loss of all teeth and thus becoming a dental elder (chewing on the gums.)

2. Converting a dental elder stage back to a dental adult stage using dental implants.

3. Challenging cosmetic situations to rebuild smiles as in a complete smile makeover.

4. Difficult bite situations.

5. Significant trauma that causes loss of a few or all teeth

Unlike chronological age, though, dental adult or dental elder can come to you as a chronological youth if there have been enough dental problems.

Dentists sometimes have 40, 50, 60 year olds that would still be called dental youths. We also have 20-somethings that are elders, where they’ve lost all of their teeth, which is sad.

As an adult, as your dental problems worsen and you lose more teeth, you move closer and closer to being an elder. It’s in this zone, in the late stage of adult dental treatment that we have the most complex care needs. 

Failing to treat serious problems differently from everyday dentistry leads to additional tooth loss. The problems of decay, gum disease and your bite mechanism magnify as you lose more and more teeth. One needs an intervention to stop from losing all the teeth. This is complex care dentistry.

The goal of complex care dentistry is to return the person back to a level of health that ensures he won’t have to chew on his gums with removable dentures. And this complex care is a whole new way of doing things because now it’s far more complicated, far more serious, frankly, more expensive. It’s certainly now become an investment in your dental health and is far removed from the “check-up dentistry” being performed for youths and for adults.

Complex care dentistry also includes using dental implants to regain lost teeth and function. This is not for the average dentist without training and experience.

The good news: now, like never before, you have choices. You can stop the progression of losing all your teeth by using dental implants. If you already have removable dentures, you can get dental implants to return you to the state of having teeth again and back into the dental adult stage. When these are done well, you can have the smile of the dental youth.

Make no mistake about it. This is the most challenging and difficult part of dentistry requiring a high degree of skill, training and experience. It is wholly different than check up dentistry found in dental youth and early dental adult stages.

Check-up dentistry costs less, takes less time, is easier to get done, is comprised of fewer visits, etc.

Complex dentistry is more difficult, the fees are exponentially higher, and requires more visits. Complex dentistry requires all the science and arts that we have as dentists combined together to provide you with the care you need to help you keep your teeth for a lifetime.

In other words, complex dentistry is required when your teeth get so bad you need a whole different level of care.

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Comprehensive care is the type of care that helps you maintain your optimal dental condition, no matter what stage of dental life you are in. If you’re a youth or if you’re the parent of a youth, then it is doing all the things that should be done to help that young person keep their teeth for a lifetime.

Comprehensive care also applies to adult care, from replacing a missing tooth if it’s lost, to working with a bite problem. And it deals with and eliminates problems that increase the potential for losing teeth.

Comprehensive care also includes complex care dentistry where we take the best of what we have to offer, whether it’s gum therapy, bite therapy, cosmetics, dental implant therapy, and smile design, and use them together to save or recreate healthy teeth.

There are really four reasons why people get in trouble with their teeth.

Reason #1

Dental decay, the old culprit that we have long known to be a problem. Thank goodness, dental decay in general is on the decline. Even today we are making new discoveries about decay. There are at least 32 acid creating, decay causing bacteria and there are five more probable ones. That’s a little scary, isn’t it?

Reason #2

The second is gum disease, also known as periodontal disease. With what we know about gum disease today and its effect on the rest of the body, gum disease is something we can no longer ignore. It has the potential to lead to your demise.

Reason #3

Stress. The stress caused by the way your teeth come together (occlusion) or body problems has an effect on your teeth. Your dental bite is also known as your dental occlusion – how your teeth meet and function. Your occlusion is influenced by teeth positions, jaw joints (known as tempero mandibular joints), muscles of the face, head and neck, muscle activity, oral habits, your chewing mechanism and how much force you put on your teeth either from bite forces or clenching and grinding.

A mismatched bite can be deadly to the longevity of your natural teeth and any dental work. Few people know if they are clenching or grinding since it often happens while sleeping. Usually your dentist can help you discover this. This bite problem may give you no pain at all, yet accelerate wear on your teeth by 10-20 times! The big majority of people who clench or grind have no idea they do it!

When your bite is “off” it requires you to accommodate to the mismatched position. We have seen long term headaches disappear when the bite forces were equalised and normalised for a person.

Reason #4

Systemic problems can affect your dental health also. GERD, also known as GastroEsophogeal Reflux Disease can breakdown the teeth rapidly, increase decay   and cause a tooth loss epidemic. All manners of systemic conditions and medications can dry the mouth, alter the immune capacities of the mouth and worsen gum disease and the ability to heal. Diabetes is among the worst culprits, increasing gum disease problems and increasing tooth decay.

Comprehensive care is about dentistry that is predictable. Dentistry that’s long-lasting. It takes into account everything in your mouth and your life as factors in designing the right kind of dental care for you. It considers your medical and dental history, as well as your present health, needs, wants and concerns.

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We know, for example, if we’re going to treat you comprehensively that we need to understand what your past dental experiences have been, be they good, bad or indifferent.

And something for you to realise, if you’ve had a bad dental experience in the past… it doesn’t have to be that way anymore. In fact, old-fashioned dentistry is really a thing of the past. Today, you can get things done more quickly, more comfortably, with better results and greater longevity than ever before with little to no discomfort.

Comprehensive care always starts with an interview of what your expectations are, a review of your history dentally, medically and emotionally. It’s taking a look at the whole of you, not just the mouth of you in determining what is the right care specifically for you and all your uniqueness.

Often times when there is significant work to do, we go beyond a regular dental checkup into what we call a complete dental physical. A complete dental physical is a thorough work up consisting of a series of photographs, multiple x-rays, molds of your teeth, facial evaluation, gum disease check and myriad other things that we do diagnostically to gather information. We do this so that we can make sure that all treatment that should occur, does occur.

The more problems you have, the more you need a complete dental physical. Just like when you go to the medical doctor – you can get a check-up for a specific problem, or you can get a complete physical. That complete physical will include a whole host of x-rays, blood tests, and heart checks like a cardiogram. We do something similar with the complete dental physical, but with different tests.

The goal is to leave no stone unturned so we can know your case by heart and know what your particular dental reality is. The goal is optimal treatment designed just for you.

Part of becoming a smart dental consumer is knowing your present level of dental health. Our process in performing a complete dental exam and physical is so you can gain that understanding. That way we can match your care to your needs in an optimal way.

In my office, we try to think in terms of what we call “thirty year treatment plans.” Which means whatever we do, we try to give it the capacity or possibility of lasting thirty years. We can’t guarantee that it will last that long, but we feel it is our duty to give our patients dental care that has the possibility of lasting that long with proper care and maintenance.

Unfortunately, I see a good deal of dental work done that almost seems as if it’s designed to fail within a few years.

When we’re doing dentistry, we’re not dealing with disposable razor blades.

What do I mean by that? Well, Gillette and Schick and all those other manufacturers of razor blades figured out long ago that they could give you the razor blade handle for free because they were going to charge you for the disposable razor blades. Once you have the handle, you’ll be paying for blades for a very long time. Dentistry done well should not be like that. We design our care so it can last.

We like to use a concept that has helped structures throughout history last for a long time. The roads, buildings and aqueducts made hundreds of years ago that are still standing were built with the concept of over engineering. These ancient engineers knew that they had to build structures that could withstand weather, man and father time. They had to build structures that were over-engineered so that the stresses of use would not weaken the materials and cause the structure to fall. It was too costly to have it fail before its time.

Today, most modern bridges and buildings meant to last are built with these concepts in mind. Take, for example, a modern bridge over an interstate highway.

Smart engineers build it so it can withstand five times normal weights and stresses it most likely will face from the pounding of trucks and cars crossing it.

This is the insurance that it will last. All materials wear out over time. The combined weights of the vehicles, forces of wind and rain, normal wear and tear, even gravity weaken structures over time. When a structure is built to withstand five or ten times the normal load bearing capacity, the stresses of use are minimal. The bridge lasts for tens or even hundreds of years.

We do the same as oral engineers and doctors. We over-engineer your dentistry so that it can last many years, even decades. We create the capacity for it to withstand the biomechanical stresses of everyday chewing and smiling and living. This is why we think in terms of thirty years of service or more.

The problem of engineering for “just the right amount” is what happens when the work is stressed beyond normal. Will it fail? Are you willing to risk it? Would you buy an insurance policy that was good only half the time? What if you got unlucky and the day you needed it, you weren’t insured?

We don’t want to count on luck. We want to be sure. Don’t you?

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Over-engineering does take more time, effort and energy and does cost a bit more, and the result is long lasting dental work that looks good, feels good, lasts and gives you peace of mind. The value of that is immense to you, wouldn’t you agree?

Unfortunately, we see much dentistry done for expedient reasons that will be lucky to last for five years. It is typically under-engineered. The sad truth is that unless you are a smart dental consumer who knows what to ask you could be fooled into thinking you were getting something you were not.

Incidentally, a lot of dental insurance companies will repay for things every five years. On the one hand, that is very good, and very bad on the other. It doesn’t take a math genius to figure out that you’re better off paying for something once and having it last a very long time than having it replaced every five years. Unfortunately, the latter occurs far too frequently.

So, don’t fall into the trap of “Scotch Tape dentistry.” It binds parts together and maybe doesn’t look too bad, but it’s a classic example of under engineering care that’s destined to fail, often at the worst possible time.

Now, you should expect something else from comprehensive care. It will cost you more than five-year or “Scotch Tape” care. That should make sense.

Remember that thirty-year care: 

1) in the long-run, is cheaper, 

2) feels better, 

3) looks better, 

4) works better over time, 

5) lasts longer and 

6) gives you peace of mind. 

Isn’t that what you want?

It is common for an individual to under-estimate the fees associated with comprehensive care when there are major problems, often by a third to a half of what it will actually be. A common mistake is to compare check up dentistry to complex care dentistry. They aren’t the same. And you don’t want check up type dentistry done when you have complex care needs, that could lead to very unsatisfactory results.

Understand this too: your dentist should understand the difference between check-up care and complex care. Comprehensive care involves doing the right thing no matter what your dental age is. It includes both check up care dentistry and complex care dentistry. Complex care deals with very difficult situations cosmetically, functionally and otherwise.

Comprehensive care is at once a better solution, and the right solution, and if you would ask any dentist what type of dentistry they would personally prefer, you’d almost always hear, “I’d like to have comprehensive care.”

Hopefully, you don’t find many dentists who need complex dentistry, but if they do, you can bet they want the best dentistry possible because they know the difference.

Summary

Comprehensive care dentistry is a way of diagnosing and treating dental cases so that optimal care is performed whether it is check up type dentistry or complex care dentistry. It is a way of looking at you and your oral condition as a whole, not as one tooth at a time.

If you have complex care needs, be sure that you get someone trained in complex care and its many thousands of nuanced methods so you can be assured that the right kind treatment fits your condition. Over- engineering is one of the best ways possible for you to ensure that your work has the bio-mechanical capacity to last for years and years.

As you might guess, there is far more to dental care than just these parts.

There are also biologic concerns of the tissues, cosmetic and smile design components and bifunctional parameters of the chewing mechanism. Your dental success also requires for you to be a partner in your care. This includes your home care and your regular professional hygiene maintenance visits in your office. Don’t worry. We can make it all understandable and easy for you.

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