Specialist dental clinic for elderly with medical, cognitive conditions opens at Alexandra Hospital
Published on
05 Apr 2023
Published by
The Straits Times
SINGAPORE - Retired carpenter Lim Bok Sim, 66, was not keen on having his tooth removed despite it being badly decayed.
But he needed to have it treated as he suffers from osteoporosis, a medical condition where bones become brittle and fragile, putting him at a higher risk of tooth loss, and a poor long-term outcome should it be left untreated.
His fears were allayed at a new specialist geriatric dental clinic at Alexandra Hospital (AH) to manage and treat the dental issues of elderly patients with pre-existing or cognitive and other chronic conditions.
Set up by the National University Centre for Oral Health Singapore (NUCOHS), the $2 million satellite clinic at AH makes it convenient for these senior patients to seek preventive and restorative dental treatment.
It is the first such specialist clinic to treat the more than 159,000 adults above 65 years old living in western Singapore.
About 27.7 per cent, or 44,000, of these seniors have diabetes, hyperlipidemia and hypertension.
Siting the clinic at AH helps as the hospital already has a programme assisting seniors with age-related cognitive, functional and mobility challenges.
Basic non-surgical management and oral hygiene instruction, and minimally invasive procedures such as tooth decay management and extractions, will be provided to restore the oral health of elderly patients.
These are seniors who are not suitable to be seen by regular dentists because of existing medical conditions such as diabetes, dementia and cancer, which require special considerations and treatment plans.
It is a little-known fact that oral disease in seniors can increase the risk and worsen the control of common conditions like diabetes, hypertension, heart disease and chronic obstructive pulmonary disease, said AH chief executive Jason Phua.
This worsens their quality of life, he added.
“This is why we have built the NUCOHS Dental Clinic @ AH within our hospital, where dental professionals and other specialists and members of our team can work together as one to care for seniors, both hospitalised and from the community,” he said.
This is in line with AH’s identity as an integrated general hospital providing holistic care, where all the needs of a person are considered, and fighting against “fragmented care in which different professionals separately focus on different organs rather than the human being in front of them”, Dr Phua said.
About the size of two five-room Housing Board flats, the clinic has five treatment rooms equipped with specialised geriatric dental equipment such as a wheelchair-tilter to enable patients with mobility issues to remain in their wheelchairs during treatment.
Other facilities include en-suite radiographic equipment and hoists to safely transfer patients when needed. The clinic is able to accommodate bed-bound hospital patients taken down on trolley beds from their wards for treatment.
The specialist dentists at the clinic treat gum diseases, loose and missing teeth, and chewing difficulties, as well as deal with dentures and pain relief.
Operational since March and now seeing an average of about 80 patients a week, the specialist dental clinic was officially opened by Senior Parliamentary Secretary for Health Rahayu Mahzam on Monday.
“As we tackle the challenges of a rapidly ageing population, there is a need to place more emphasis on prevention and appropriate intervention,” she said at the opening.
One in four adults in Singapore will be 65 years old and above by 2030.
She cited Project Silver Screen and the National Dental Centre Singapore’s Oral Health Movement 8020 and Tele-Dentistry Oral Care for Seniors as examples of programmes aimed at improving the oral health of older adults and helping them retain at least 20 of their natural teeth beyond the age of 80.
Madam Rahayu added that it is crucial to increase access to dental care in the community for Singapore’s ageing population, especially those with multiple medical conditions, to facilitate their co-management across dental, medical and other allied healthcare professionals.
The NUCOHS Dental Clinic @ AH provides specialised geriatric dental treatments at subsidised rates when patients are referred by polyclinics.
In June 2016, Singapore’s first one-stop speciality dental clinic for geriatric and special needs patients was officially opened at the National Dental Centre within the Singapore General Hospital campus.
Called the Geriatric Special Care Dentistry Clinic (GSDC), it provides integrated oral care for patients with complex medical needs, geriatric conditions, and intellectual and physical disabilities, also at subsidised rates when they are referred by polyclinics or their clinicians.
GSDC has treated almost 9,000 patients in the last seven years.
The siting of the geriatric-dentistry specialist clinic at AH, staffed by dental surgeons and specialists from NUCOHS, is beneficial as it is in Queenstown, where about 20 per cent of the area’s 10,000 resident population is aged 65 and above.
Queenstown is slated to be Singapore’s first health district to support residents’ well-being across their life stages, and be a model of a healthy and active community. AH is redeveloping to provide more comprehensive facilities by 2030 to respond to the planned development and housing expansion in the area.
The NUS Faculty of Dentistry offers a graduate diploma in geriatric dentistry to train qualified dentists to manage the oral health of the elderly, especially those with complex needs.
“Through this new dental clinic, the faculty will be able to provide enhanced clinical training opportunities for qualified dentists pursuing the graduate diploma. In addition to postgraduate training, the faculty also incorporates the teaching of geriatric dentistry in its undergraduate curriculum. This ensures that newly qualified dentists are able to competently manage senior patients,” Madam Rahayu said.
As for Mr Lim, his treatment process was fast, painless and comfortable. His appointment was also scheduled just two weeks from his referral.
“Back in the day, (getting dental treatment) outside was faster and cheaper. But now, this hospital clinic makes it better and also more affordable for us,” said Mr Lim, adding that it was easy to travel to the hospital from his home in Choa Chu Kang.
Source: The Straits Times © Singapore Press Holdings Limited. Reproduced with permission.
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