Dr L (a senior consultant at a well known local hospital) and I were neighbours. We virtually grew up together in the old neighbourhood of Queenstown. We had a lot in common as our parents were neither well-educated nor wealthy. We were athletic, but unlike the other boys, the two of us just didn’t like football and marbles. Our folks were good friends, especially our mothers. Once, the two ladies travelled to Australia together. They visited the outback and some beautiful farms and vineyards. Mrs L’s impression of Australia?

“It’s such a backward country. You drive for miles and can’t even find a single NTUC. Trees, grass and sheep. So backward. Not like Singapore where everything you need is within a shuttle bus ride.”

At first glance, Mrs L’s remarks are laughable and perhaps not even worth mentioning. You may not believe me now, but there is actually a lot that we and our esteemed decision makers can learn from Mrs L’s remarks.

According to one CNA report:

Singapore has only 1,300 dentists in active practice and the Ministry of Health (MOH) wants to increase this number by between 60 and 80 per cent over the next 10 years.

It is studying a proposal to allow foreign dentists from the region to practise and train here under an accreditation scheme.

There is one dentist for every 3,400 people here in Singapore, a figure that has lagged far behind developed countries.

Singapore produces 40 dentists a year and MOH hopes to ramp this up. It is considering accrediting private training centres to allow registered foreign dentists to treat patients while undergoing training.

A dentist to population ratio of 1:3400 is too low for Singapore because developed countries have a “healthier” ratio?

First of all, let’s consider Mrs L’s remarks about Australia where you can drive for miles in the outback and not come across an NTUC, let alone a dentist. Can you drive for miles off the expressway from one housing estate to another in Singapore and not be able to find a single dentist with an empty waiting room? Is dentist to population ratio a good guideline for what is excess and what is deficient?

The logic behind looking at absolute numbers is obviously flawed. Many established dentists have more than 5000 patients on record, many of whom are seen once in 10 years. In the developed countries, old folks must have dentures. And they do change their dentures every now and then too. Over in the developed countries, it’s also not too difficult for dentists to convince their patients to do root canals and crowns. A lot of such treatment is considered basic necessities and are covered by insurance.

Over here, our thrifty old folks make one set of dentures and try to make them last a lifetime and many young, educated people have not heard of crowns and root canals. There are numerous indications for crowns, root canals and implants, but indications are just indications. What is the reason for all that undone dentistry which dental practitioners encounter on a daily basis? Not enough dentists? Or just a lack of interest and/or knowledge on the part of the patients?

Still trust the numbers?

Unlike mom and pop shops, solo dental clinics are still able to survive because as far as dentistry and hairdstyling go, many people still value that personal touch from someone familiar. Apart from that, the small practices have little advantage over the big boys who often get free publicity by making news. Many existing small practices are already facing great challenges against the big boys. Increasing the number of dentists will only shrink the pie further and make things worse for small practices which are already struggling regardless of the favourable theoretical conclusion that can be drawn from the 1:3400 ratio.