The International Dental Exhibition And Meeting

02 Apr 2004

By Mr Khaw Boon Wan

Venue: Suntec International Convention And Exhibition Centre

"FROM THIRD TO FIRST WORLD DENTISTRY"

Dr Yoon Heung-Ryul,

President, Federation Dentaire International,

Mr Oliver Kurt,

Executive Vice-President, Koelnmesse,

Dr Tang Kok Weng,

President, Singapore Dental Association,

Ladies and Gentlemen,

I grew up in the Third World, with Third World dental care, which practically meant "no care". My first visit to a dentist was shortly before I went to Australia for my university study. I was advised to do a thorough dental check up as Australian dental care would be too expensive for a poor foreign student.

It was a session I could still remember. My dentist was kept busy the whole morning. There was so much overdue work to be done. Many fillings had to be carried out; a couple of teeth had to be extracted. It was a traumatic experience, to say the least.

Years later, after I graduated and joined the Ministry of Health as a health administrator, I became involved in some public dental health study. When I first came across the concept of DMFT index for decayed, missing and filled teeth, I could not help being amused. I must have personally contributed a lot to the DMFT index of my hometown's population!

My daughters have fully benefited from First World dental care of modern Singapore. With school dental education and regular dental care from birth, their problem is no longer over decayed, missing or filled teeth.

Two of my 3 daughters have gone through orthodontic treatments. One of them even had her teeth bleached. They are now qualified to model for tooth-paste advertisers!

These vastly different experiences in one generation reflect the quiet transformation within the dental healthcare services in Singapore.

While we can all be proud of these achievements, continuing progress is possible given the evolving nature of medical science. Our job is to build on the strong foundation that we have inherited and to make it even better for future generations.

It is in this spirit that I choose to discuss two policy proposals this morning.

Continuing Professional Development (CPD)

First, how do we maintain high standard among our dental professionals, in a constantly evolving field?

Just eyeball the scientific programme in this year's dental meeting. It is a good indication of the speed in which advances in knowledge and clinical dental practice are being made.

How to keep up with such rapid developments? I think it is inevitable that all dentists must actively participate in continuing education. It is the only way to stay current and in tandem with global developments. You owe this to your patients.

That is why in 1991, we introduced Continuing Professional Development (CPD) for all dentists, though on a voluntary basis. It had a promising start. One in five dentists participated in CPD. However, participation soon dropped. Now, only one in 20 dentists is attending CPD, based on those registered with the SDA though the actual numbers could be more.

It is not a surprising outcome. There is a limit to voluntary CPD. That is why many countries have imposed compulsory CPD, where active participation in CPD is a requirement for the renewal of professional registration.

The Singapore Dental Council has therefore recommended that we make CPD compulsory for our dental professionals. They think that the dental profession will support this initiative.

This would also be a good development for our patients. In line with my preference for public consultation before a major policy decision is taken, I have asked the Singapore Dental Council to initiate a public consultation on this. A consultation paper spelling out the rationale and the details of the proposal is now in the Ministry website.

We welcome your comments on this proposal. If there is general support for this idea, we can work towards implementing it, perhaps by next year.

Dental Specialists Register

The second proposal concerns the establishment of a dental specialists register.

In medicine, specialisation has shown to be the way to achieve excellence. There are now many established medical specialties, from Anaesthesiology to Urology. In order to enable the patients and their GPs to distinguish one medical specialist from another, a register of medical specialists was introduced in 1997.

In dentistry, the same argument for specialisation can also be made. One key difference between medicine and dentistry, however, is that the extent of specialization is not as established.

Nevertheless, one in four of our dentists have undergone some form of specialist training. The question arises as to whether it is now timely to also introduce a Dental Specialists Register.

The answer is not immediately obvious.

What are the benefits? A register can better ensure that our dental specialists are well trained, competent and have the appropriate clinical experience. It will facilitate the growth and development of specialised dental practice to manage complex dental cases. It will allow patients to identify dentists who have specialised skills and expertise in specific areas of dentistry. This should improve the quality of care for Singaporeans, besides helping the foreign patients who come here to seek dental care.

On the flip side, some patients may worry that a register may lead to higher charges by those on the register. Even among the professionals, there is no consensus over this proposal. I understand that a key issue is whether dental specialists will confine themselves solely to clinical work in their own specialty or whether they should be permitted to also do some general dental work.

Practices in countries with such registers vary to different extent. For the majority, including the US and UK, their dental specialists are not restricted to practising in their specialty only. However, in practice, many specialists do spend the major part of their time doing work within their specialty with very little general work.

To obtain a broader picture of the ideas and concerns on the ground, my Ministry will also be releasing a separate public consultation paper on this proposal. Again, I look forward to your feedback and views.

However, regardless of how we eventually proceed on this, it seems to me that there are a number of things that must continue to be done.

General dental practitioners should remain the first line of care. They should be the first to be consulted by patients with any dental problem. By managing the bulk of dental problems at the primary care level, Dental GPs can help keep costs low. They have an especially important role to play in preventive dentistry.

However, all dentists should work within the limits of their professional training and competence. This means that patients with difficult dental problems or requiring complex treatment should be referred to specialists.

As for specialists, it seems reasonable to expect them to spend the bulk of their time doing clinical work within their specialty. Only by doing this can they keep up their skills and expertise, and keep overall dental costs at an appropriately low level.

Conclusion

In closing, let me commend the organizers for setting up this conference and exhibition. It reflects their commitment to providing dental professionals with high quality continuing education. I am certain that IDEM will grow from strength to strength to be a landmark event in the international dental calendar.

My best wishes to you for a successful conference and to the overseas speakers and participants, I wish you a pleasant and enjoyable stay in Singapore.

It is now my pleasure to declare IDEM 2004 open.