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02 Sep 2009
By Health Minister Khaw Boon Wan
1. Thank you for inviting me to the FDI Annual World Dental Congress. Let me extend a warm welcome to all delegates, especially those coming from afar.
2. We last hosted the FDI World Dental Congress in 1990. Twenty years later, we are honoured to host again. FDI is the leading organisation for international dental practice standards and policies, and Singapore is proud to be an active member.
3. This is an important year for Singapore. It is our 50th anniversary of self-government. Much has changed during the past 50 years. The changing faces of dentistry here closely reflect the transformation that Singapore has gone through. At 56, I lived through and experienced personally this transformation. As a child, I grew up in a third world village with third world dentistry: we did not care much about preventive dental care, we had no regular dental check up, we feared the dentists and their drills, we did not know about flossing and thought that brushing had to be aggressive to be effective. No kid in my village had braces or knew of their existence. It would be many years later before my dentist got to work on my teeth and he had much to catch up on during the first sessions. But some of the damage of third world dentistry is irreversible and I live to show them, not with a lot of pride.
From Third World To First
4. My children and young Singaporeans, on the other hand, have benefited from the transformation that Singapore dentistry has gone through. They have beautiful teeth and healthy gum to show. These are the results of many efforts.
5. First: we provide a comprehensive school dental health programme. Our school dental service is universal, covering 100% of all primary and secondary schools. All students receive free preventive as well as basic dental care. Together with water fluoridation since the 1950s, our children enjoy excellent oral health, with a DMFT (decayed, missing, filled teeth) index of 0.54, among the lowest in the world.
6. Second: we have an established training and upgrading programme for our dental professionals. Our university dental faculty has a long history, dating back to 1929 and currently takes in 48 students per year. Competition for the places is extremely keen with many bright students vying for admission.
7. Third: we recruit dental professionals from the best dental schools elsewhere to augment our local graduates. The Singapore Dental Council now recognises 89 foreign dental degrees. This adds to our local talent pool, besides generating a vibrant exchange of ideas and practice standards. It also enables benchmarking with the best in class globally.
8 Fourth: our dental fraternity pursues excellence and specialisation to continuously raise the standards and delivery of dental care in Singapore. There is now specialist accreditation and we currently recognize 7 dental specialties, with 250 dentists on the Specialist Register. This is good for the professionals as it encourages them to upgrade and excel in their respective specialties. It is also good for consumers as it enables our patients to make informed choices of which dental professional to go to.
9. Fifth: our dental professionals subscribe actively to continuing professional education. Recently, for example, as a commitment to patients’ safety, compulsory Cardio-Pulmonary Resuscitation (CPR) recertification was implemented for all dentists. Dentists have to be regularly recertified in Basic Cardiac Life Support (BCLS) in order to continue with their dental practice.
10. Sixth: we make innovative use of well-trained auxiliary staff, such as oral health therapists, dental technicians and dental surgery assistants. They complement our dental team and help deliver affordable, accessible and competent dental care to the public. This has allowed us to achieve a high standard of dental care with relatively less resources than other developed countries. For instance, our dentist-to-population ratio is 1 to more than 3,000. Compare this with Australia and UK where the ratio is 1 to about 1000. This has saved our patients money without compromising their dental health outcome.
Meeting Expectations and Demographic Change
11. Overall, we believe we have not done too badly, over the past 50 years. But the next 50 years will pose new challenges. In particular, an ageing population is a major challenge already facing many developed countries. Singapore cannot escape this demographic change. We have been thinking and preparing ahead. We are investing in building up our support services and expertise in Geriatric Dentistry through upgrading the courses for all our dentists. We are also funding more scholarships to training more dental experts to cope with the future demand.
12. With rising expectation and operating cost, affordability will be an issue. We have so far ensured universal coverage and access through heavy government subsidy for the needy. We have done so without nationalising the dental sector but instead, allow a vibrant private sector to co-exist with a public sector. This offers consumers freedom of choice. Besides Government subsidy, insurance and employer benefits co-fund the dental services, with some co-payment by patients. This mixed system of dental services delivery has helped ensure that basic dental services are affordable to all Singaporeans. Subsidised basic dental services are provided in our polyclinics. Subsidised specialist dental care for needy patients is available in our National Dental Centre. For those who can afford and desire non-basic care, we ensure a competitive market of providers to keep charges reasonable. We regularly update and publish the dental bill sizes for the common dental procedures carried out at our public hospitals; this provides a useful reference point for our patients.
Matching Supply With Demand
13. With population expansion and ageing, demand will continue to grow. Our job is to match the supply of providers to demand. Our sense is that at the primary dental care level, our polyclinics and an island-wide network of private dentists offer sufficient competition to keep prices affordable to the masses. At the specialist level, the National Dental Centre has served its mission well, managing some 170 000 patient-attendances every year. It houses 60 dental specialists within one complex, the largest concentration of such expertise in this region. But it is reaching full capacity and demand will continue to grow for sure.
14 We have decided to grow a second dental specialist centre. Our plan is to expand the existing National University Hospital Dental Centre (NUHDC) to perform this role. It currently houses 35 dental specialists. One proposal is to expand it with new capacity to house up to 60 dental specialists. Being closely associated with the Dental Faculty, we expect this second specialist centre to further raise our standard of dental training and bring dental translational research to new heights.
15. Over the years, Singapore Dentistry has attracted large numbers of foreign patients coming here for service, and foreign dentists coming here for specialist training. We are honoured by their presence, as that is a good market test of our dental standard. These are globally mobile clientele who have many choices to fly to. To retain their trust, we must continue to strive for higher clinical and ethical standard of care, while innovating to keep prices competitive.
Conclusion
16. The challenge for both dentistry and medicine is the same. Raising clinical standard is a matter of recruiting and retaining talent and investing in new technology and research. But how to ensure that high clinical standard does not price services beyond the means of the common people will make a difference on whether essential dental services remain affordable and accessible to the public. Simply passing on rising costs to consumers cannot be a sustainable strategy. Our dental professionals have to continue to innovate and find new ways to deliver better and cheaper services. Prevention strategy and greater use of skilled auxiliary staff must be part of the solution. Sensible outsourcing to tap on lower cost inputs available in the region is another. The gathering of so many dental professionals from across the globe provides an ideal platform for the sharing and dissemination of useful experiences and practices. I hope it can lead to new initiatives to benefit our patients.
17. On this hopeful note, l wish you all a successful meeting. Thank you once again for choosing Singapore for your congress.