Singapore’s dental services and equipment and supplies market is expected to grow in tandem with the city state’s reputation as the region’s healthcare hub and center of healthcare excellence. Medical tourism is potentially big business in Asia and is forecast to grow from about US$500 million currently to US$4 billion by 2012. The Government of Singapore is targeting 1 million foreign patients a year by 2012, up from 400,000 in 2006. This is expected to contribute US$1.93 billion (S$2.6 billion) of value-added or 1% of GDP. Singapore’s dental practitioners have seen a steady demand for more complex and specialty dental procedures from foreign visitors who also come here for medical consultation. The country continues to strive to provide first class healthcare systems and facilities to its residents and the international patient market.
The U.S., Germany and Japan are the top three leading suppliers of dental equipment in Singapore. The U.S. enjoys a good reputation and is recognized by industry as technologically superior, providing high quality, advanced and reliable equipment. Imports from the U.S. have seen a gradual but steady increase over the last few years and the recent depreciation of the U.S. dollar has contributed to increased demand for American dental supplies and equipment. It is hoped that this will lead to greater exports of U.S. products into the region. Singapore serves as a showcase for medical and dental technology and gateway to the regional economies of South East Asia. Over 35% of medical equipment and over 50% of dental equipment and supplies imported is re-exported to the region.
The general status of dental and oral hygiene of Singaporeans is good. Attributed to this success is the Singapore’s government’s fluoridation of potable water initiative since 1958 and the widespread use of fluoridated toothpaste among the general population. As such, the dental work done by dental practitioners has shifted from the traditional “drill and fill” regime to one that focuses on enhancing the patient’s aesthetic appearance.
The emphasis of the public healthcare service is in preventive dentistry targeted at pupils in schools. Dental care begins with preventive dentistry promoted through the Singapore Health Promotion Board, a statutory board tasked to promote a good and healthy lifestyle among Singaporeans. The Board targets students through a network of 200 static clinics located in schools as well as 30 mobile dental clinics. This plus fluoridation of potable water and availability of fluoridated toothpaste has greatly diminished dental decay and tooth loss.
Singapore provides some of the most advanced dental care in the region. With the second highest per capita income in Asia, Singaporeans demand for the best and most sophisticated dental care is strong. According to a report that highlighted the results of a survey conducted by the Singapore Dental Association, nearly 45% of the population visits the dentist at least twice a year. They spend an average of only US$40 for a visit to the dentist.
As an affluent nation, more and more patients are seeking treatment for their children early in the hope of arresting any potential problems with their teeth. More parents are bringing their children to see orthodontists before they lose their baby teeth. Teenagers and adults too are seeking corrective treatments to improve the alignment of their teeth.
Designer and/or transparent braces are popular and appeal to the more aesthetically-conscious and affluent. Costs for such treatments are in the thousands of dollars.
There has also been an increased awareness of oral and dental hygiene. More Singaporeans have adopted a more rigorous regime to oral care by incorporating flossing and gargling with a mouthwash to their typical routine of twice-a-day brushing. Schools have been instrumental in reinforcing this to the children.
Besides serving a more affluent and demanding resident population, dental practitioners have also seen a marked increase in foreign patients seeking dental treatment Singapore. Wealthy patients from Indonesia, Brunei, Thailand, Malaysia, Philippines, Hong Kong, Cambodia, China and Vietnam began to visit Singapore for medical care in the 1980s. According to a news report, these patients are not looking for a quick clean or check-up, they come for treatments that include cosmetic dentistry that arrest problems of discolored teeth, gaps between teeth, unsightly old crowns and reconstructive work which can cost up to US$60,000.
What makes Singaporean dentists so appealing is that they come with good credentials. Singaporean dentists do a lot of overseas teaching and are involved in overseas conferences. They are increasingly seen as experts in their field and are sought after as panelists at dental conferences, to do product demonstrations and as key opinion leaders. According to leading implant suppliers, implants are the fast growing segment in the global dental market with an annual growth rate of 18-20 percent.
Many dental GPs are improving themselves through workshops and courses and the popular topics include implants and cosmetic dentistry. Dentists are now seen as the “plastic surgeons of the dental sector”.
As Singaporean dental practitioners strive to provide more value-added consultations, some are providing their patients more holistic medical care by offering the option for oral cancer screening. Oral cancer is ranked 11th in the list of most common cancers in Singapore, based on information available from the Ministry of Health. Due to the anxiety that may be experienced by patients, this test is conducted selectively only when the patient displays high-risk symptoms and after the dental practitioner provides the appropriate counseling.
A recent news report cited advances in dentistry which may see the demise of the dental drill as the majority of people are fearful of it. Dental researchers are using biotechnology to create a solution which mimics the way the body forms new teeth. Such a solution, which is meant to be painted in teeth while decay is in the early stages, contains a protein which creates a scaffold to attract minerals that form an enamel in a natural way, thus doing away with drilling and filling. This same technology can be applied to fill tiny holes and cavities in the teeth’s dentine, associated with the discomfort and intense sensitivity to hot and cold food and drinks.
Further Education Trends
In an effort to raise standards both locally and regionally, the Ministry of Health announced in November 2007 that dental specialists have to meet certain criteria in order to stay registered. They have to be recertified after eight to 10 years if they want to remain on a first-ever register which came into effect in January 2008. Under the new Dental Registration Act, the dentists have to clock 70 hours of continuing professional education over two years or they will be barred from practicing. The specialties include endodontics (root canal work), orthodontics (straightening of teeth) and prosthodontics (restorative work including crowns and implants).
In November 2005, a Memorandum of Understanding (MOU) was signed between the United Kingdom’s University of Warwick, the Global Implant Forum & Teaching UK and the Singapore Institute for Dental Education Advancement (IDEA) offering the MSc (Implantology) program in Singapore. The MOU aims to provide a structured implant training program in Singapore. It was only in the last 35 years that the concept of Osseointegration was accepted. In the past, dentists had to go overseas for training. Today, there is an increase in the demand for using implants to replace missing teeth and it is timely that new materials together with new treatment methods have been developed, making it less traumatic for patients with much more successful outcomes. The program has been very well received and has attracted many dental GPs, some of whom have committed to a full Masters course.
The T32 Institute for Advanced Continuing Education and the Prosthodontic Society of Singapore (PSS) also organizes ad-hoc dental training courses, the most popular ones are cosmetic dentistry and implants.
The National University of Singapore (NUS) also has a Graduate Diploma Course in dental implantology available for both full-time and part-time basis.
By Luanne Theseira