Dr Samintharaj Kumar

The history and photo suggests a wisdom tooth which lacks sufficient space to erupt. This is a frequent cause of gum swelling at the back. When there is insufficient space for the wisdom tooth to erupt, there is typically gum that covers part of it. This condition is called pericoronitis and is known to be painful. The best way of management will require removal of the wisdom tooth. However you can have some antibiotics, painkillers and a mouthwash as an interim measure. Removal of the wisdom tooth procedure is relatively painless and can be a quick procedure.

I am glad you have asked this question as it sounds like you are probably on the verge of choosing a dentist to help with this long standing problem of chronic wisdom tooth infection. Having that bit of flesh over the back of the wisdom tooth typically allows food to get stuck underneath. This leads to inflammation and frequently infection. Whilst antibiotics are a great way to 'buy time', I would advise thinking of a more permanent solution ie: removal of the wisdom tooth.

The answer to the question truly depends on a number of factors. The most important thing is about what your dad wants. For example, if he does not want any form of surgery at all, then a denture or perhaps a dental bridge may be instead a better option for him. Whilst a denture would be suitable for him to regain confidence and smiling, there is a difference in terms of bite strength a dental implant has over a denture. It would be possible to bite into an apple with a denture, however it would be far much easier if he had dental implants to eat harder food.

Traditionally patients have been advised to wait anything from 3-6 months before a dental implant has been placed. This is to allow the extraction site to heal completely with bone. This approach and is still used by myself in certain patients - dependent on their previous medical history and whether they smoke. There are some advantages of having a dental implant placed on the same day as the extraction: One including removing the need to have a secondary procedure (ie: the placement of the dental implant) done on a separate occasion.

Hi there, Thank you for your email. Medisave is a national medical savings scheme setup by the Government of Singapore to help subside surgical treatment for Singaporeans and Permanent Resident. It helps you meet future personal or immediate family's hospitalisation, day surgery and certain outpatient expenses. In terms of dental implants, you are allowed to use up to $950 of Medisave per implant. This is only for the surgical phase where the dental implant is placed. You will not be able to use Medisave for the crown of the dental implant.

The process of eating and digestion begins with the teeth. With a missing tooth, a number of things happen. Typically biting efficiency is reduced and there is now space for adjacent teeth to move in and eventually change the way you bite. There are many options for a replacement tooth other than a dental implant. This includes leaving the extracted tooth site alone, a denture or a dental bridge. Depending on the health and existing oral condition of the patient, your dentist will advise the best replacement method.

Good morning, I get asked this question quite frequently in clinics. Did you know that up to 10% of us have gummy smiles ? Hence there are solutions for you and I am sure you will be comfortable with one of the options suggested below: There are a few reasons as to why one can have a gummy smile. Depending on these variables, the dental surgeon will recommend options tailored to your condition and needs. These options can be either short term or long term solutions.

Hi there and thank you for your question. It is true that there is a possibility of temporary or permanent nerve damage following the removal of a lower wisdom tooth. I usually tend to ascertain this risk with the use of an Xray and quite often a 3D CT scan if the nerve is seen to be very close. This nerve that you refer to, supplies sensation to the lower lip and chin area on the same side of the wisdom tooth. Hence the natural concern and worry - as no body wants a numb lip !

It is always worrying for parents when the permanent teeth start to erupt and appear to be crooked. Yes you are correct to be worried about milk teeth which are not shaky at this stage. This can be due to the permanent teeth not erupting immediately below the milk teeth and in very rare conditions where the permanent teeth are not present at all. You should seek an experienced dentist or orthodontist to examine your child. Typically an xray will be taken to check for the presence and location of the adult teeth.

Hello J I wonder why you think it is safe for you to undertake Myobrace treatment without the professional guidance of a myobrace practitioner. Not all biting problems or crowded teeth are treatable using Myobrace. Yes Myobrace is a known modality but it is not the single solution and that is why you should seek professional advice from someone doing both conventional braces, Invisalign and Myobrace. I'm personally a fervent supporter of myofunctional treatment, and treat a large range of ages of children with Myobrace.

I understand that both you and your family are concerned about your father's blood pressure. It sounds like there is a possibility of 'white coat' syndrome where the blood pressure is increased only due to the 'nervousness' a patient might have when he sees a dentist or doctor. As you probably know, it is not advisable for an extraction to be done where the blood pressure is very high and the cause is not established and treated. Such patients are also at a higher risk of bleeding after extraction and hence why it is crucial that he is treated by an experienced practitioner.

Hi Karen There is a wide range of fees for wisdom tooth removal. Here in Singapore the costs can range anywhere from $150 - $2000 from a simple wisdom tooth extraction to a complicated wisdom tooth surgical removal. You may be able to use Medisave towards a partial claim if the removal requires surgery ie: drilling of bone to remove the tooth or broken decayed wisdom teeth. Some of my patients also wish to have removal of wisdom teeth under intravenous (IV) sedation or general anaesthesia (GA). This is of course dependent on how nervous one is.

There are options apart from dental implants: typically a denture or a bridge. These methods of replacing missing teeth are efficient. However a dental implant is typically known as the best alternative to a missing tooth. There are of course medical conditions which might dissuade a dentist from doing implant surgery on patients. These conditions include poor oral hygiene, low calcium or osteoporosis. One of the greatest misconceptions include getting replacement teeth whenever the patient believes he is she is ready. The thing is, teeth move all the time.

Hi Cerise Yes good question. It is quite important to understand why you have such a concern in the first place. If a dentist has recommended this to you, then I would presume a dental xray has been done and there might be a reason as to why he or she has advised removal in the absence of any pain. Many patients have come in with wisdom tooth pain and said to me: "Doctor. there has been no pain in the wisdom tooth area until TODAY. WHY ? " Worse. such patients may already have had irreversible damage to the 2nd molar (in front of the wisdom tooth).

I have had a good look at the photograph. Yes you are correct. These are indeed 'mamelons' which are completely normal and are of no clinical significance at all. Mamelons are actually 3 round protuberances which are a result of how a tooth germ cells forms enamel. Typically we see these at a very young age and after a few years of tooth wear either due to eating food or grinding the opposing tooth, these wear down rapidly. In your case, I can see that your lower teeth are in front of your upper teeth when you are biting together.