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