By Cheah Ui-Hoon

BRUSH your teeth, floss, and visit the dentist about once a year: That's the standard advice given for oral care.

And then you get hit with a root canal - not to mention whacked by the bill which can range from $500 to over $1,000 per tooth - and you wonder what went wrong with your oral health regime.

It could be because it's too basic a regime, and not one tailored to your individual oral needs.

In general, there's low awareness of preventive oral healthcare among Singaporeans, say dentists here.

'The high cost of dental care may be the result of the way we approach oral health. If you don't take preventive measures and seek treatment only when necessary, then the one-off treatments - for advanced conditions - might seem pricey,' points out Dr Chung Kong Mun, president of the Society of Periodontology (Singapore).

Getting a personal oral profile is the key to better oral health.

However, although there are tools and techniques out there that can accurately reveal a person's oral profile, they're seldom employed because of low demand.

'When it comes to good oral hygiene, it's not a one-size-fits-all solution. Disease risk differs from person to person with some with genetic predisposition for oral problems,' highlights Dr Chung.

There are test kits out there, for example, for saliva flow and the nature of saliva including bacteria profile.

'People have different characteristics of saliva, and this can be affected by medication and conditions like cancer as well,' he points out.

For high-risk cases, eating sugar or starch will have one's saliva pH plunging which exposes teeth to acid attacks, which in turn decalcifies the enamel in teeth, making them more porous. When this happens, bacteria enters these micropores more easily.

Low-risk cases would be people who don't brush often, don't floss, don't even rinse with mouthwash, and they only need to visit the dentist once a year to maintain their oral health.

One diagnostic instrument which is more commonly encountered is the OPG x-ray - or OrthoPantomoGraph x-ray - that allows dentists to examine deeper structures such as bone quality and quantity, and tooth quality.

It also shows up abnormal development, the jaw joints and sinus issues.

Dentists like Dr Andrew Lui and Dr Gareth Person at Dental Essence (a new clinic located at Tudor Court) strongly recommend that new patients take the OPG x-ray, 'because they serve as baseline data for us to compare with future x-rays,' explains Dr Lui.

The digital OPG x-ray also has lower radiation exposure, and it can be emailed to patients who would like a record.

The cost of a screening ranges from $80 to less than $200, and patients may need to take another OPG two to three years later if they want.

'It's not diagnostic in its own right, but it's a nice screening tool,' he adds, especially for showing the maxillary sinus position which is important in assessing upper implant placements or extractions.

Another preventive procedure they'd recommend are fissure sealants for children who are having their first permanent molars.

Fissure sealants are a thin layer of resin that fills the tooth's biting surface, where decay typically tends to form.

'We strongly recommend them for children aged six and above, because their teeth are less mature and therefore more vulnerable. And then there's no drilling involved, it's painless, and it's effective for up to seven years,' says Dr Pearson, adding that adults should consider them too.

Here's another pointer for oral care: Brush your teeth first thing in the morning.

According to Dr Chung, saliva flow slows down in the night, while bacteria in the mouth continues to flourish overnight - so when you wake up in the morning and take a drink of milk, or eat starches like toast, the teeth are subjected to an acid attack.

Also, your oral profile changes if you've been on medication, so take note.

'People who've had radiotherapy tend to have high risk of caries, and are two to three times more likely to get gum disease,' says Dr Chung.

In the end, the best dentistry is not to do too much, say dentists who prefer to take the conservative approach to dental care.

'If you visit the dentist often for checkups and cleaning, then that minimises the need for treatment,' advises Dr Lui.

uihoon@sph.com.sg

This article was first published in The Straits Times.