Oh the sleepless night...

REASONS FOR INTEREST IN THIS COURSE

I was exposed to orthodontic treatment since at a young age. Before I was orthodontically treated, I was lacking in self confidence and self esteem. I had a malocclusion with severe crowding which made me a social recluse. My orthodontist corrected my smile and I became less timid, more contented and confident. I presume that the feeling of giving people that much impact on improving their quality of life, whereby the ability to improve their self confidence and self esteem is extremely overwhelming, hence, me being in dentistry.

However, being in the dental world over the years and trained in Universiti Sains Malaysia (USM) under the philosophy of Professor Abdul Rani, a respected oral maxillofacial surgeon in the region and the founder dean, I was exposed to a more challenging and wider scope of dentistry and medicine. I was indulged in more serious matters of health affecting the head and neck region. I learned that there are more concerns regarding the oral cavity, head and neck that a dentist or an oral surgeon can do to help those in need. It is not merely drilling teeth, constructing dentures, and aligning the dentition.

In addition to that, being attached in the Oral Surgery Department, Sarawak General Hospital which is the hub for Oral Maxillofacial Surgery in Borneo, I was involved with a diversity of experiences that offered a very realistic and in-depth glimpse of life as an oral surgeon. During the short attachment, I had the opportunity to observe and get first-hand training by the oral surgeons in the management of various surgical cases, from biopsies and intermaxillary fixation in trauma cases, to more major surgeries such as segmental mandibulectomy and immediate reconstruction with free flaps. While the surgeries are tantalizing, the reviews and the follow-ups were remarkably challenging as to ensure both quality of life and aesthetics can still be maintained despite the possibility of a futile outcome.

One of the interesting cases that I get to experience is a case of Desmoplastic Amelobastoma affecting the symphysis of the mandible of a 19 year old female. Presenting to the outpatient clinic with just a gum swelling and a prognathic mandible, she was then diagnosed and planned for segmental mandibulectomy and reconstruction with free fibula flap. After long hours of operation and regular rounds in the ward, patient was finally discharged without complication. The regular follow ups and reviews were daunting but inspiring as I had the opportunity to witness the success of the flap. In spite of continuous care towards the reconstructive site, patient’s facial appearance showed near normal results. Additionally, upon issuing of denture, although not ideal, patient showed satisfaction and was pleased with the overall outcome. Ever since then, my interest in oral maxillofacial surgery has developed further. The change and improvement that I see in patients brings joy and gratification. It is exciting, expanding, and engaging that I am willing to take a leap of faith and commit myself in this field.

I believe that OMFS requires a unique surgical skillset that can only be acquired by hands on practical experience in the clinical and surgical management of patients. University of Hong Kong, being an international reputable university in the region with esteemed Professors, it is of great value to be able to study and expand my knowledge in the Faculty of Dentistry. Having very limited experience in a hospital-based dental setting, I believe, to have the opportunity to learn and getting first hand training by highly experienced and didactic lecturers and surgeons is a key to further discover my surgical proficiency. Apart from that, being the premier center of dental education, I would hope to carry back the surgical doctrine that the Faculty can offer to my recently established dental school and share the knowledge with my colleagues for the advancement of the OMFS Department. I am aware that the technical and aesthetic concerns of OMFS makes it a challenging field and a rewarding specialty and it pushed me beyond my limits every day. The yearning to expand my knowledge and learning the art and science of OMFS in a reputable faculty would be my privilege.

Would that suffice?

PS: Entry is copyrighted for my Masters application. Published for the purpose of inspiring others. So please, do not steal. Would appreciate it very much. Thanks.

Right in front of me.

I wanted to tell you. When you were right in front of me. But I have no strength. I'm a coward. How can I bear this feeling?

Can I just focus on my studies first please? Remember, be selfish for awhile!

I miss falling inlove..

Sent on Jan 13 2:48pm
"I had a great time with you. Dont have to be sorry. I jus wish i could hang out with u again without having to think about exams most of the time. InsyaAllah lepas exam, ill see you again. And InsyaAllah we'll have better time ahead. And InsyaAllah i can and hope ill pass my exams. Have safe journey home. Kirim salam to ur parents. Do msg me if ure bored. And do let me know once ure abt to board. I just got home nw. I wanna rest for awhile."

When all I wanted to say is
"Dear, I had a great time with you. I should be the one to say sorry because i cannot spend time with you more. I just wish i could hang out with u again without having to think abt exams most of the time. InsyaAllah lepas exam, we'll have better times ahead. Because i really do miss you. Pray for my success in my exam k. Have a safe journey home. Kirim salam to your parents. Do msg me anytime. And do let me know once ure abt to board. I just got home nw. I really miss you, and i wish we could be as before. Take care, i love you."

But im too afraid to say it out.

Much love,
I.

Dear Friend,

I don't know why we still fight when all I ever wanted is to keep you. I have known you for so long and so deep that you have become a part of me. I was lost and alone and frustrated and down. Part of me is telling me that what I did to you was to test you. To test how much you would go to still be with me. But I don't know anymore. I don't know who is the other part of me. I don't know where you have gone. And I don't know what I want right now. All I need is for you to help me find myself back. The way we found each other. I need you to pull me back up so I can walk side-by-side with you. I need you because you need me through all the heartaches that we've been through.

You're my side-kick remember? Of course, you remember.

But I forgot. I forgot because I was lost. I forgot because I am careless. I forgot because I am lonely. I forgot because I was selfish. But I am here. And I will be here. Even if you go astray, I will chase after you.

This is a promise i made to my heart. A promise that I once broke. A promise that breaks us apart. One day, you will know.

See see see!

My kinda guy!

Like you, you know who you are.

New Years Resolution Much?

I figured it out. I figured out our relationship. We are the happiest together when we are apart. Together we are detrimental to one another. It took me some time to get here and I don't know how I did it but I figured out you and me.

It goes to the basics. You and I are motivated by one thing in life, that is success. You and I both live for our dreams and passions. We have strong urge to follow what is in our desired dreams. When we met each other, our universes collided. The attraction, the powerlessness, the paralysis, the desire, the pain, the lust, the need was there yet it was hopelessly unworkable. To pursue that desire would translate to giving up part of our devotion to what we do in real life. The harder we would try to pursue one another the more we would get lost and disappointed in each other and in ourselves. Each one of us would hate to see the other give up the devotion to what we do. Because one would know how much the one valued it. We loved watching each other succeed yet the more we would succeed the more we would get separated from each other...

You were strong, I was weak. You made me feel completely weak... The more we would try to fit in and try to get together, the more each one of us would get disappointed and sad that the other one wasn't real. And it drove us to insanity, to bully each other, to close up, to lose sight of reality and we were disintegrating as people. The environments we grew up in planted different dreams in us and we were deeply devoted to them.

Although you have been faithful to me, I have betrayed you. I have broken promises. I don't know what I see in life anymore. One year apart, grew us apart. And I am becoming a person you no longer know. Our efforts became meaningless, our hopes and dreams went down the drain. But yet we are still here.

To see you with someone who can make you happy and would put a smile on your face and help you fulfil all your dreams would give me a sense of unbearable lightness. I was never big enough to fill your shoes and may be yours were just too big to fit into mine, but i have come to a realization that no matter how big your shoes are, your happiness is key to mine. I swear I still love you, you Joker. You are my new year's resolution and life-long happiness, know that! Happy New Year.

One week Holiday!

Thank gawd I took a whole week of holiday. A tiring week of basic medical sciences course in UM. Gosh, only if anyone can understand how stressed I am about the course and the exam that is coming up in a few months. A really tiring week full of ups and downs.

The heart desires to be a specialist so badly. Especially after finding out someone i idolize was in the TV discussing about an awesome surgical case. I really wanna be somebody someday. I really do.

Also, the heart is split now. I dont know what happened to me. Had a big fight with my bestfriend. A bestfriend that I have been dedicating this blog to all this while. The bestfriend that encourages me to write a blog whenever I am lonely and lost. The bestfriend that I wanted to tell all my secrets to. But I doubt he reads it now. I doubt he remembers this. But thats not the point.

The point is:
This time its about what I did wrong.
Its about broken promises.
Its about betrayal.
Im afraid of losing him.
Im afraid he wouldnt want me anymore.

And the whole conclusion to this all:
I've go one week holiday to figure this all out. Thank gawd.

English?

IELTS? TOEFL? MUET? Whats the point of this all.
Cant wait to get this over with.

Woot woot

My lappie is back on track. Yay!!! The joy of replacing that crooked old cable is just like I got myself a brand new Macbook. Pffft. But still weee. Now I can go online in my lonely cold office and start blogging again.

Say hello again to thisisizzy!

Read this.

You cried and I dont know what to do. But I know one thing is sure,
I never want to lose you.

... i just want you to know.

Dear stranger,

I have been staring at you without you even realizing it. I looked away when you look back. But, no. You don't notice it. You see me but you weren't looking at me.
I would have maximize every communication we have with each other. But I was too shy that i walked away too fast, letting the only opportunity goes to waste.
I could tell you how awesome you are, but who am I to you.
I want to talk to you. But I don't know how. You were always around people and I just don't seem to stand out.
You are too perfect. You are fun to be around. Your every move makes me smile.
Look at me. Talk to me. Smile at me. Cause I so longed for it.
Please, read this.

Oh dear. I think I'm falling again. But to a stranger I have known all along.

KAFTANS FOR RAYA: anyone?

Hello & Good Day.

A week of Ramadan has gone by, and I am sure everyone is all hyped up for Aidilfitri preparation. I know what goes into deciding to wear what where & when for this upcoming Eid, and all the hassle you have to go through during this fasting Festive season. Which is why I want to take up some of my precious time, and yours too, to ease the process by providing you with the latest trend for this year's Eid: Kaftans! ; and the opportunity for you to browse through these beautiful kaftans, and after some clicks here and there, the next thing you know, your outfit for Eid will be ready at your doorstep. So, make a date with these kaftans and look stunningly classy on this Aidilfitri :)

The kaftans’ sleek silhouette and intricate detailing display classic sophistication that is perfect for those who want to retain a sense of tradition with a dose of contemporary style.

They are guaranteed of the highest quality with affordable prices. Fabric of Kaftan is the finest chiffon; soft, breezy and elite. Fret not about the sizes, because it fits ALL sizes. They have an inner string tie inside that you can shape according to your silhouette.

Kaftan Agnes

Agnes (purple)

Agnes (white)

Kaftan Agnes available in purple and white. 

Exclusive chiffon. 

Inner not included.

Fits UK6-UK14. 

RM 180

Kaftan Melati

Melati (black)

Melati (fuschia) 

Melati (red)

Melati (white)

Kaftan Melati is available in black, fuschia, red and white.

Soft chiffon. 

Inner not included.

Fits UK6-UK14. 

RM 180

Kaftan Salsa Manset

Salsa manset (purple)

Salsa manset (turqoise) 

Salsa manset (yellow)

Salsa manset (maroon)

Kaftan Salsa Manset is available in purple, turqoise, yellow, maroon.

Soft chiffon. 

Inner IS included.

Fits UK6-UK14. 

RM 190

These kaftans are brand new. They are ready stock and very limited. So, be the first to grab them and stand out & be classy this Aidilfitri.

Price does not include postage and additional RM7 is required for poslaju. We provide COD at certain areas. Do inform us if you have any preference and meet-up can be discussed. 

Below are the details of contact person for order and inquiries. 

General inquiry    - syahirawrrr@gmail.com
Klang valley area - Syahirah 0127045514 (owner)

Melaka area        - Diyana 0122879505

Kuantan area      - Izzati 0127825313 (thats me)

Kuching, Sarawak - Fadzily 0168903608

Otherwise, drop me a comment with your name & contact no, and i will get back to you as soon as I can. Or better, visit the facebook page. :)

Happy shopping.

Those who teach, do better!

Most people believe with the saying that those who cant do, teach. That, to be frank, is totally ridiculous! At least in medical and dentistry. Or health for that matter.

You see, after graduating about 2 years ago, i was immediately registered as a dentist under a registered body and was posted to Kuching for specialty rotation. Well, being a first year dental officer, of course I thought I learned a lot during my specialty postings. And i did, actually. Especially in hospital attachment. Getting first-hand training in OTs, something that, to some grad dentists, would find a little bit alien because lack of exposure during the first year attachment because of discrimination and inadequate confidence of specialists towards them. I, however, enjoyed handling trauma cases, toileting and suturing wounds, stabilize fractured bones, learning about cancer and tumours in moutn. Because of the wide variety of cases i saw during my rotation in Sarawak gen hospital. And of course not forgetting these very helpful and supportive specialists who are not so stingy about sharing experience and knowledge. Unlike other specialists in other parts of the country. I love and enjoyed every minute and second of my specialty rotation. Ive got my doubts and worries and recklessness during my oncalls but I managed well. Many thanks again to a very good support system from colleagues, staffs and friends back in Kuching.

After a year of completing specialty postings, i was sent out for general dental practice. Out, in a district, 3 hours drive away from Kuching. Needless to go back to the timeline again, cutting the story short, i was unhappy in Betong. Discrimination by the superiors, and the feeling like i dont belong there because I cant speak Iban (thats a funny reason to go, i might say). It was depressing that it strikes to me that I need to get away to improve myself in the field of dentistry. Of course the other reason for my leaving is because there is no development. I felt static and I dont learn that much because the other superiors are being too competitive, when they shouldnt, actually. So, I thought to myself, its now or I'll suffer these doom.

Way back then, before I even decided to explore Sarawak, i had my plans of joining the university healthcare setting as an academician. I cant quite clarify the reason why I wanted to join the university. But to some people, those who become academicians, chose that because they cant perform clinically. Obviously there are totally wrong about it. You cant be an academician if you cant perform in the first place. Because to become an academician in health, means you have to be the pioneer. Academicians are the reference point to future health delivery. Every knowledge has to be tip top. Every clinical performance, judgement, decision, is being watched and learned by fellow students. And that is not something that is easy to maintain. Mentally, spiritually, physically, emotionally, you've got to be ready. The main responsibility of a healthcare academician is guiding newbies, making sure that they are to be release with sound knowledge and a good practice. It seems no biggie. But, that is only easier said than done. And I think, after writing this blog down, that is the reason i chose and decided to join university, to become an academician. To challenge myself. Not to run away from the district, but rather running away from ignorance & injudiciousness.

So, now, here I am, in school of dentistry, iium, as a trainee lecturer. Aimed and dream big of becoming oral maxfac surgeon. Because my surgeon back then, said so. Thanks, Dr Lani.

Now, dont be scared. Dentistry is painless. Er, rephrasing, Surgery is painless! :)

I cant remember what case this was, and who captured it.

And this is me and colleagues just doing nothing in the surgery.

Photos from when I was in Kuching. A one year++ exciting journey that was cut short. I miss Kuching!

Nonetheless,

We invariably tell each other, and our students, that the academic tripod consists of patient care, teaching and research. In fact, in the real world where science is performed and medicine is practised, a better understanding of the academic tripod might be: "If its new, its not true; if its true, its not important; but if its new and its true and its important, then we knew it all along." - Phil Gold, 1995

Dulang girls is a must in every girls dream wedding. Or is it?

"why not? your wedding will end up dull and will seem like you don't have friends" - was my sister's respond when i told her i don't intend or wish to have dulang girls on my wedding.

The conversation begins when we were on our way back home from visiting her friend's newborn baby. I started asking her when her turn to get hitched is. Somehow, that short conversation deviates to about bridesmaids in weddings. She mentioned that few names are already in mind to be her dulang girls. 

Dulang girls for Awal Ashaari and Scha Al-Yahya Reception

Bridesmaids, a.k.a dulang girls, or sometimes we can call them flower girls, are just young pretty girls solely selected by the bride herself, typically her special friends or sisters, to be a part of the wedding party. Bridesmaids are thought to be responsible in attending the wedding ceremony and to assist the bride on the day of the wedding. They dress in unison, they held flowers or dulang, and most often, they had to pose with the married couple in the bridal photos. The more bridesmaids you have in a wedding signifies a family’s social status and wealth, and how grand the wedding party would be. For some, it is a pleasure to be called for a bridesmaid in a friend's wedding.

Personally, I regard bridesmaids, a.k.a dulang girls, as just another unnecessary minor element in a wedding, apart from the principal constituent of a wedding itself: wedding dress, wedding ring, and the whole wedding reception. It seems to just be another opportunity to show off the family’s social status and wealth, and partly, how famous and likeable the bride is to have a lot of friends supporting her wedding. 


I dont intend on having a huge wedding reception, and bridesmaids are not even an exclusive. Reason no. 1, wedding reception itself is already financially exhausting. To sponsor for their unison dresses is overwhelming. No one should look fancier or as fancy as you at the wedding. They should not be treated like a queen. They should not be the attention. Because, seriously, when you portray your wedding photos surrounded by beautiful bridesmaids, people don't look at how pretty the bride is. They look at the next potential bride-to-be among the bridesmaids. And in the end, wedding is about the bride and groom. Not bridesmaids. 


But, the choice is yours. 

I just love you.

Words demand explanation. They require analysis. They are the construction and expression of my thoughts. Of my heart. But they can't describe it. They can't describe any of it. They can't tell you how deep the memories are, or how often I think of them. They can't scream what I really want to say. They are the mask of how I really feel and they try to disguise the pain. But somehow, someone will strip it away. And someone will make those words worthless.

So what is a word worth? Nothing. What are three words worth? Nothing. But we say them anyway, because you know! You know more than anyone what they mean. You know when I say I love you, I really mean that those three words can't describe what it is we have. When I say you're amazing, I know the word is just a cover; a quick way for me to remember all the things that amaze me about you, a mask for the memories we share, a disguised version of our adventures together. And I really believe that you know, when I say I miss you, it's not just that. I miss you every moment, and I miss just what your name means to me. It means an alphabet of sounds and letters and words. But none of them really mean anything, because words are based on trust, they rely on how truly and deeply we feel.

Remember, always, that they don't mean anything, they are letters and they are constructions, but we deconstruct them every day and we twist them; we manipulate them so that they say what we want them to. But no word, no shape, no photograph could ever begin to explain even a little bit of how I feel.

Much love.

Speaking of unhealthy lifestyle...

Well, yesterday, I began blogging again. And it strikes to me that i havent been living a healthy lifestyle since I moved out from Kuching. I havent been regularly jogging. In fact, last i remembered, I only jogged once since I really moved out from Kuching and that was one lonely stressful night, exactly a week before my Royal college of surgeons exam. I flunked, by the way. Hope I can retake and pass the exam. I have been continuing the revision.

Speaking of living life unhealthily, I have been eating foods that are too sweet for my bloodstream, and too fattening fod my tummy and hips. Junk foods and fast foods are becoming a regular meal. And i vow to myself I will restrain from all these things that are corrupting my life. I am planning to get myself a real weight scale, but i havent really got the chance to get it.

Anyway, i jogged this morning. While everyone in the city being overly ambitious, rushing to work, here i am in this small town called Indera Mahkota, having a nice stroll of morning fresh air. Ahh, so serene! Well, after a reckless weekend with eating, restless nights thinking that my tummy are getting flabbier, I finally am able to force myself to get up at 6, to prepare myself for a freshful morning jog. I forgot how great it feels like to be doing this, once upon a time. Im planning to get myself some breakfast, before i really starve for lunch. And hopefully, with this blogspot standing by me, I keep myself straight, forward, and positive towards aiming my 30 wishlists.

30 before 30

I recently found this blog post entitled 30 before 30 while I was blog-hopping on a boring Sunday. It speaks of accomplishments, inspiration, just the will to live. It inspires me to write again, after so many months of abandoning the blogging world.

On a typical Sunday noon, I would be reading, focusing on my studies. But not today. As of today, I'm blog hopping as i happily would, googling the images of twinkle twinkle little lights. I have always loved colorful, twinkling lights at night. I remember I would get really excited when my parents would bring us out at night for a drive to the city, to look at the lights hanging on the trees & roadsides, and the tall buildings with lights. I friggin love them. 

At this age (I’m 25 now, another 4 months to hit 26), I dreamed of having my own house, designing them as vintage as I could, and would love every angle of the house that I would live in with a person that I love, tolerable enough to live as modest as we want. There’s this lovely image that I have in my head that I can’t wait to let it out and make them a reality. I imagine my life beyond 30. I marvel a lot on what I could accomplish, what I wish to possess, how I fancy my life joyfully. I picture the serenity of the environment surrounding me, with a lovely husband, and children (in God’s will), a respected career. That’s where I want to be. Nowhere luxurious but nowhere deprived. Just somewhere in between, something humble.
But then again, I’m only 25. And I have a few wish lists: 30 before 30. 

Another 5 years to achieve these wish lists. Its quite impossible as I am an ambitious, dream big type of person, hence I decided to extend it till maybe 45.

1. Get a Master’s Degree in OMFS (hopefully by 32).
2. Bring Mama travel back to Edinburgh.
3. Buy a house and design it vintage.

4. Travel to Europe with a lover.

5. Be able to afford an awesome sports car, like the bimmers M series.
6. Be financially stable. 300K, health insurance, savings, all that jazz.
7. Marry the man I love and can’t see myself being with anyone else.
8. Have kids and teach them how to be awesome.

9. Run a successful business with a partner (aka husband).
10. Honeymooning at the Maldives island.
11. Build and design my own backyard garden with twinkling lights.
12. Run a marathon.
13. Make myself comfortable wearing the hijab.
14. Have a flat abs.
15. Throw an amazing dinner party at home, and have cooked all the food myself and design the theme myself.


16. Learn to love the hot weather. Or at least, not hate it.
17. Live in a town that I am happy to be a part of.
18. Have an awesome room all to myself to focus on myself.
19. Organize a family day by the beach.
20. Volunteer for a good cause.
21. Take one day and ride a bike to a fresh market, buy fresh food, cook it, and be happy I did so.
22. Become a full blown modern muslimah.
23. Be happy with the physical shape I’m in.



24. Live a healthy lifestyle.
25. Publish an article to an international publication.
26. Have happy, healthy children that don’t despise me. And be able to help them in college.
27. Become a successful respected surgeon.
28. Stop caring about what others think about me.
29. Live life making wise choices.
30. Not regret a single thing.

Will I be able to achieve these? Let us see. InsyaAllah.

Back for good.

Its been a while since I posted something here. I have been busy with transfering, from Kuching Sarawak, back to mainland, Subang Jaya. A place I call home. I spend almost RM4000 for my transfer, with my car shipping being the most super expensive. But to be honest, I havent felt like Subang is my home for the past few years. Eventhough family and friends are all here. I feel like i have no place i call home. Hmm.

I've only been home for a week, and this weekend i'll be moving to Kuantan. I'll start my new job as a lecturer trainee under IIUM in the oral surgery department next Monday. To be honest with you, im nervous. Especially the part where I have to wear a hijab to work. Im not used to it, plus I dont like the fact that it hides my elegance from my hair. But i believe that this is one step towards a rightful pathway back to Allah Almighty, and a successful one. Ive been blessed with oppurtunity and hidayah and I am accepting it with an open heart and will try my best to work hard for my excellence. InsyaAllah.

Guess now im back to searching for an apartment to rent at Kuantan for now. What. A. Life.

Beware of Guns.

Ever since I moved and start living in Betong, I have been actively reading articles online regarding dentistry and anything that has to do with it, which is surprisingly good since I have always pushed myself for so many times to be constantly updated with the latest knowledge and development in dentistry.

So recently, as I was browsing through Google to find an article about painless dental visit, I stumbled upon an article, a published letter to the Editor of The Star on February 2008 regarding dental visits in Malaysia. So here is how the letter goes;

Dental visits a pain in the pocket

ACCORDING to statistics, about 10% of people who are 55 years and older will begin to lose their teeth. Whatever the cause attributed to each individual, age is the single biggest factor. Because of our ageing population, the number of people who would become edentulous would be a substantial number. The market is huge.

Many old folks are at the mercy of dental surgeons, especially the ones who now describe themselves as implantologists. Many of them wear doctor’s coats, carry stethoscopes and insist on being called doctors.

They charge by the tooth for every implant. Current prices range from RM7,000 to RM9,000 for the implantation of a tooth. This does not include the cost of the replacement parts, surgery, X-rays, etc. Hence, for about four to five teeth to be implanted in the average elderly person, the price can come up to RM45,000. This is more than the cost of a complex angioplasty, bypass operation, or a hip replacement.

There seems to be no regulation to control these prices. It is a free market, with dentists, specialists, as well as GPs competing and charging whatever the market can take. Most older people are poor and have to depend on their relatives. And few family members want to pay these exorbitant charges.

Government specialists, curiously, do not provide teeth implants for most of these unfortunate victims. If they do, it is to learn the technique before leaving government service. While the cost of private medical care is now regulated and there are guidelines provided by the MMA, implantology is a wide open field with no control. Even the Malaysian Dental council has not tried to exert any control. The patients who cannot afford implants are given cheap dentures or a mix of implant and a bridge (if they can afford the latter).

Having watched the implantation procedure, I think this is really a simple procedure, most of the time done under direct vision. There are no special tools required. Most surgically trained medical GPs should be able to learn this procedure very quickly. There will, of course, be some difficult cases which can be left to the specialists.

Dental surgeons, whether specialists or GPs, work in a very narrow field of the human body. From experience, I have learnt that they know little or nothing about the wider spectrum of medicine. The number of antibiotics they are familiar with is very few. They ask for a history of diseases that the patient may have but do not know how to assess how bad these diseases are or how they should be treated. They have no idea about emergencies that may occur with surgery or with drugs. They do not know anything about cardiopulmonary resuscitation.

Because of these weaknesses, I would suggest the following remedial actions:

> The Malaysian Dental Council should investigate and control prices in this dog-eat-dog business. They must impose some discipline to care for poor old people.

> The dental surgeon who calls himself an implantologist should give a written bill to the patient before he starts treatment. He should list all his immediate charges as well as charges for subsequent visits.

> It should be possible to train technicians to do single implants. These technicians should be licensed and also given guidelines on charges. Prices would come down in a free market once you increase the supply.

> Medical emergencies during a dental implant are rare but can happen. Hence it should be mandated that an anaesthetist should be on standby during any implant or surgical procedure done by a dentist.

> The dentist should buy and place in his clinic emergency equipment. This would include a defibrillator, a heart monitor, a pulse oxymetre and an ECG machine.

> The implantologist should be certified, which means going before a panel of peers who will verify if he has the knowledge and skills to perform large volume implantation.

MEDICAL DOCTOR,
Kuala Lumpur.

My first few words that came out after reading this was: Shame on you medical doctor! Obviously he knows nothing what a dentist can do. Clearly he knows nothing about general health. I was to a certain extent angry initially. But I seek to understand and acknowledge his needs to be emotional about the costly dental treatments. If I could write a personal letter back to this medical doctor, I would not explain or educate him a single thing about dentistry. With his appalling judgment about dentists, it is such a disgrace to have a colleague in the health sector with an attitude and mindset like this. I don’t intend on being emotional and biased. So, to other medical doctors out there, to friends, and colleagues, here is my respond on this atrocious accusation.

First and foremost, I would like readers to know that I have made a meticulous exploration on the latest development, guidelines and knowledge on topic above mentioned prior to making my comments and response.

It is true that edentulous people are becoming a substantial number. According to NOHSA 2000, more than one third of population in 65-74 years of age was edentulous; almost half of population was edentulous by the age of 75. From that, more than ¼ of population wore prostheses, removable or fixed, or both. Female population was in higher proportion than male, and the urban and rural population was equally same. With that being said, there is no need for discrimination of pooper population having no better teeth replacement, such as implants. People pay for what they can afford regardless of how they want the otherwise. That is just how life is. No poor people who work manual labor obtaining 50cents per hour dream of ever owning a brand new Honda City. While on the other hand, a medical doctor is able to afford that. Even though it is likely that they want a more luxurious sporty BMW M3 series instead. Point is, change only what you can, accept what you can’t!

In his emotional letter, he accused that dentists insist on being called doctors and wear doctor’s coats carrying stethoscopes and that we know little or nothing about the wider spectrum of medicine. Doctors make people healthier. When people get sick, or in pain, doctors figure out why, do tests to see what is wrong, and give them medicine and other kinds of treatment. Dentists are equally doctors; doctors of dental medicine, specializing in the region of head and neck. During undergrad, we were taught of all basic medical sciences, from anatomy to physiology, pharmacology and more. There is a need for dentists to know all that because the mouth has a connection to the guts through the esophagus, and to the lungs through the trachea. Whatever that is in the oral cavity has the likelihood of transferring to the whole gastrointestinal system. And subconsciously, people are at risk of inhaling bacteria into their lungs and that can bring to diseases if the bad things pass through. The neck connects the head to the body. Blood vessels in the head and neck drains directly to the heart. No dental patients coming in to dental clinic leaving their body and limbs at the medical clinic. Isn’t that common sense already? One a medical doctor should have known.

In addition, dentists are at a closer contact with patients because commonly, dentists treat diseases in their mouth, a very narrow part of the human body but the number one home of bacteria. Dentists wore white coats to protect themselves from this infectious air spray during treatment. With regards to carrying stethoscopes, dentists, usually those oral surgery specialists, they are usually involved in surgeries in the OTs, repairing clefts, fixing fractured facial skeleton, marsupalizing large cysts, sectioning bony tumors and reconstructing the face. And all these surgeries usually require an anesthetist and long hours in the OTs. It is the surgeon’s responsibility to ensure that the patient’s vital status is in good stable condition, hence the need to carry the stethoscopes. One is considered malpractice if did not ensure stable vital status. One is not proudly carrying stethoscope for the sake of respect.

With regards to implants, this particular treatment modality is well known to be expensive, not because a private general dentist blindly charges patients. The Malaysian Dental Council together with the Health Ministry have set the range of dental charges for basic dental treatment under the Private Healthcare Facilities and Services Act.  It is the nature of implantology itself. This treatment of replacing lost tooth is a new development founded early 20^th century but first successful implant dated end of the 1970s. Implants are expensive because of its technique sensitive to create a biological integration between metal and bone. Plus, titanium is the only metal that can produce integration between bone and implant. Therefore, the type of metal itself is already super expensive. Even then, the cost for dental implants in Malaysia is one of the lowest in Asean.

Implants in the government service are available but limited to specialists only. Even then, these treatments are still as expensive as private clinics. “Medical doctor” also stated that the implantation procedure is an easy procedure done under direct vision. Yes, looking at it in youtube looks easy. Something even a technician can do. Seeing is easier than done. Please Wikipedia this: dental technician. They are a member of the dental team who upon prescription from a dental clinician constructs custom made restorative and dental appliances in the lab. Work of place: lab. They do not have direct communication nor deals directly with patients. They deal with dental materials in the lab, constructing prosthesis. They are not trained to treat diseases in the mouth. Implants are not simply done by GPs. A certificate of Implantology is required for the practice. There are many factors to be considered in implants, the art and science of it. An oral surgeon has to undergo lengthy clinical and hands-on training to become an expert in the field. There are existing ethical bodies to regulate this practice and dentist’s competency.

With that being said, I feel the writer was wrong in all his statements and figures. He was too emotional in expressing his opinion and created an increase in dental phobia among dental patients. One important phenomenon that everyone must realize is that: “What a dentist can do only a dentist can do.”

Terms and conditions of trust.

I live and work in Betong. But life for me was never there. Despite trying to save teeth (which the community here so much refuses) and ensuring people's general health, my presence in Betong does not really mean much. Every weekend i would drive 3 and a half hours down to Kuching just to relax, enjoy the lights and sounds of noise for awhile, and be happy. In other direct words, i would drive 3 hours down to the city just to see someone i love. Yes, love! I certainly do not dare to say this 4 letter word but i did. I love, again. And to be honest, I'm not slightly scared about it. Because I'm happy. Truly happy. And I feel safe, even when we are distant. I feel like i can trust again, and i did. But is that the right thing to do?