Specialist Dental Group has launched an on-going series of blog posts by our individual dental specialists. All views provided are the dentist’s own opinions and are posted on this blog as part of our on-going efforts to educate the public about dental issues and other matters of interest relating to dentistry and healthcare.
Mrs HW came into my office accompanied by her doting husband. I was very happy to note that she had put on a few more kilograms. Most physicians would not be happy to see a 60 year old lady put on so much weight, but for Mrs HW, it was exactly what I wanted to see.
It was hard to imagine that Mrs HW was starving to death just a couple of years ago. She had, at that time, been persuaded by a general dentist to undergo a series of elaborate procedures under intravenous sedation which lasted over 10 hours.
Instead of looking better and chewing with better efficiency, she was in great pain after the procedures. The alignment of the teeth of both her upper and lower jaw had changed so drastically that she was unable to chew food at all. After many adjustments and reassurances which lasted over 9 months, no improvement was seen.
The patient’s family was at their wits’ end. They sought help from their family doctor who then recommended that she come to see me. When I first saw Mrs HW, she was withdrawn, her body was weakened and muscles wasting due to lack of nourishment, and she was in a state of clinical depression.
With the help of the family doctor and a psychiatrist, we were able to improve her nutritional state. The next stage was careful diagnosis of her occlusion and oral rehabilitation. It took more than 3 months before she was able to chew normally again.
Today, Mrs HW has regained her cheerfulness and can now enjoy time with her husband and grandchildren. She can now return to her regular diet and bite onto her favorite crunchy Washington apples.
I have always emphasized to my students that the most important lesson in the practice of dentistry is: First, do no harm. It is good to see Mrs HW and be reminded of this Hippocratic Oath, lest we forget.
 We have on many occasions used intravenous or conscious sedation to control anxiety for patients who are anxious about dental treatment. However, we plan our procedures in great detail so that the patient only spends a minimal amount of time under sedation. To have such conscious sedation for more than 10 hours may not be in the best interest of the patient.
Dr Neo Tee Khin is a Director and Prosthodontist with Specialist Dental Group. He is an Adjunct Senior Lecturer with the National University of Singapore and an American-Board certified prosthodontist. Dr Neo is regularly invited to speak at dental conferences in Singapore, Malaysia, Indonesia and the region. He has a special interest in dental implants, crowns and the NobelGuide Teeth-in-an-Hour implant procedure.