Dr.Tan Wee Han - Tan Dental Surgery

Teeth whitening is now the most commonly requested cosmetic dental procedure¹. With greater demand for cheaper and more convenient teeth whitening products, many have resorted to buying teeth whitening products online as well as trying numerous do-it-yourself (DIY) methods using natural ingredients like strawberry puree, etc.

There are 4 options for teeth whitening:

In-office whitening
Take-home whitening
Over-the-counter (OTC)
Non-dental options

1. In-office whitening

In-office teeth whitening is done by the dentist in the clinic and this involves the application of a hydrogen peroxide bleaching gel. These whitening agents penetrate your teeth to break down the discoloured molecules deep down in your teeth and whitening your smile.

2. Take-home whitening kit

Take-home whitening kits are used at home. The home whitening kit can be used on its own or in combination with in-office whitening, to maintain or improve whitening results. This usually involves taking impressions of your upper and lower teeth to fabricate custom bleaching trays. At home, you will fill each tray with a whitening gel (usually carbamide peroxide) your dentist provides. You will wear the trays for several hours every day, according to your dentist’s advice. Carbamide peroxide gel will break down into hydrogen peroxide which whitens the teeth.

3. Over-the-counter (OTC)

Over-the-counter (OTC) whitening products include gels, rinses, chewing gums, toothpastes, paint-on films and strips, which are readily available at pharmacies and your local supermarket. The problem with these products is that they do not offer any protection to the gums during bleaching and therefore causes more discomfort.

Whitening strips

4. Non-dental options

The latest teeth whitening trend is the availability of whitening treatments or kits in non-dental retail settings, such as mall kiosks, salons, spas and, more recently, aboard passenger cruise ships. Non-dental whitening venues have come under scrutiny because the involved personnel are not educated in the use of disease screening or diagnostic tests (such as radiographs), and are not licensed or qualified to provide dental examinations. Additionally, their level of education and training in infection control is unknown (infectious diseases such as COVID-19 can spread via contact with saliva).

Teeth whitening at salon

Comparison of different teeth whitening techniques²

	In-office whitening	Take-home whitening	Over-the-counter (OTC)	Non-dental
Active ingredient	HP	HP or CP	HP, natural ingredients	HP
Concentration	≤ 40% HP	7-35% CP	≤ 12% HP	?
Activator	Chemical, LED, laser	Chemical	Chemical, light	Chemical, light
Effectiveness	Very good	Very good	Moderate	Questionable
Safety	Safe	Safe	Moderate	Questionable
Cost	$$$	$$	$	$$
Treatment time	~1 hour	A few weeks	A few weeks	1 hour or more

*HP – hydrogen peroxide, *CP – carbamide peroxide

So, what’s the best option among the 4 choices of teeth whitening?

The safest and most effective teeth whitening methods are still in-office and take-home whitening. Both work equally well. However, in-office whitening produces the fastest results.

Here at Tan Dental Surgery, we offer both options for teeth whitening:

Most patients would opt for a combination treatment, whereby after a session of in-office teeth whitening, they will get a take-home whitening kit to whiten the teeth further or for maintenance.

Is it safe to buy whitening products online? They are so cheap!

The most effective whitening agent is still hydrogen peroxide. However, only dentists can prescribe hydrogen peroxide-based products for teeth whitening.

Most of the teeth whitening products sold online do not contain hydrogen peroxide. For products which contain hydrogen peroxide, the concentration and safety as well as effectiveness of the products are unknown.

So, the bottom line is that it is best to avoid online teeth whitening products. They might cause more harm than good. We are very excited to help brighten your smile. Don’t hesitate to contact us for a teeth whitening session.

Interested in other options to improve your smile? You can check out our braces related posts by clicking here. Feel free to contact us for a no obligation braces consultation.

Reference:
1. Higher-order needs drive new growth in mature consumer markets (Journal of Business Strategy)
2. Tooth Whitening – An Evidence-Based Perspective (Springer)

Updated: 2 Oct 2021

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Teeth whitening

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Will the wisdom teeth “push” my other teeth to become crooked again? This is a common concern amongst orthodontic patients. We get asked about this a lot. Many patients are worried that the wisdom teeth will exert pressure on the front teeth causing the teeth to become crooked.

Studies have shown that patients who do not have wisdom teeth (congenitally missing) or already had the wisdom teeth removed still had teeth which became crooked later¹. This means that the wisdom teeth do not cause the teeth to become crooked after braces.

The reason teeth become crooked again after braces is because of the natural movement of the teeth as the patient grows older. Therefore, retainer wear is especially important to maintain the alignment of the teeth after braces.

When should wisdom teeth be removed then?
You should consider having your wisdom tooth/teeth removed in the following conditions²:

Recurrent pericoronitis. Repeated episodes of gum swelling around the wisdom tooth.

Decay (caries) of the wisdom tooth. If it is difficult to clean the area surrounding the wisdom tooth, it might be preferable to extract the wisdom tooth. (Figure 1)

Decay (caries) of adjacent tooth. If the adjacent tooth is decayed, then removal of the wisdom tooth is necessary to allow filling to be done. (Figure 1)

Infection. Pericoronitis or decayed wisdom tooth can cause infection of the area around the wisdom tooth.

Periodontitis. Gum disease (periodontitis) can occur around wisdom tooth. A study showed that 1 in 4 person with non-problematic wisdom teeth had gum disease around the wisdom teeth area³.

Non-functional wisdom tooth. If the opposing wisdom tooth is missing (either extracted or congenitally missing), then the wisdom tooth may need to be removed. This is to prevent trauma of the gums on the opposing side due to elongation of the tooth (supraeruption). Figure 2.

Denture covering buried (impacted) wisdom tooth. If the buried wisdom tooth is very near the gums, then the tooth might need to be removed to prevent irritation from the denture.

Obstruction of adjacent tooth. If both the wisdom tooth and the adjacent tooth (second molar) are buried, then the wisdom tooth might need to be removed to allow the second molar to be straightened. (Figure 3)

Jaw surgery with braces. If jaw surgery is planned for the lower jaw, then the lower wisdom teeth would need to be removed at least 6 months before surgery to facilitate the jaw surgery procedure.

Figure 1. Decay (caries) of lower right wisdom tooth and adjacent tooth (second molar) (red circle). Decay of lower left wisdom tooth (yellow circle).

Figure 2. Elongation (supraeruption) of upper right wisdom tooth due to missing lower right wisdom tooth (red circle). Possible trauma to gums (red arrow).

Figure 3. Lower left wisdom tooth obstructing impacted adjacent tooth (second molar) (red circle). If the adjacent tooth is going to be uprighted, then the wisdom tooth will need to be removed.

In conclusion, wisdom teeth do not cause the other teeth to become crooked. However, the wisdom teeth can cause some other problems even if you do not experience any pain or discomfort. Therefore, it is important to go for regular check-ups to ensure the wisdom teeth are problem-free.

Don’t worry, you will not lose your “wisdom” after removal of your wisdom teeth. If you are unsure about the condition of your wisdom teeth, contact us to schedule an appointment for a check-up.

Also wondering if something can be done to correct crooked teeth? Do check out our braces related posts by clicking here. Feel free to contact us for a no obligation braces consultation.

References:
1. The role of mandibularl third molars on lower anterior teeth crowding and relapse after orthodontic treatment: A systematic review (The Scientific World Journal)
2. The indications for third-molar extractions (Journal of the American Dental Association)
3. Periodontal pathology associated with asymptomatic third molars (Journal of Oral and Maxillofacial Surgery)

Updated: 21 Sept 2021

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Comparison between vacuum-formed, acrylic and fixed retainers

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Now that you have completed braces treatment, the next important step is to keep your teeth straight. For that, you will need to wear retainers.

This is because as we grow older, there will be natural movement of the teeth which can cause the teeth to become crooked again. That’s why some Orthodontists have advocated lifelong wear of retainers to maintain the teeth alignment.

There are basically 3 types of retainers: vacuum-formed retainers, acrylic/Hawley retainers and fixed retainers.

1. Vacuum-formed retainers

These are clear plastic splints which can function as mouth guards if patients grind their teeth during sleep. These retainers can be used as teeth whitening trays as well (part of the take-home whitening kit).

2. Acrylic retainers (e.g. Hawley retainers)

These are made of acrylic/plastic and metal wires. There are many different designs for these retainers.
The wires can be adjusted to move teeth.

3. Fixed retainer

These are wires glued to the back of teeth. Periodic check-ups (every 6-12 months) are necessary in case the wire detaches from the teeth or if there is distortion in the wire. These can cause the teeth to become crooked again (see below).

Oral hygiene must be excellent to prevent tooth decay and gum problems.

Breakage of fixed retainer causing teeth movement.

The choice of retainers is dependent on your Orthodontist and your teeth condition. Below is a comparison of the different types of retainers.

	Vacuum-formed retainers	Acrylic retainers (e.g. Hawley retainer)	Fixed retainers
Fixed or removable	Removable	Removable	Fixed
Oral hygiene	Easy maintenance	Easy maintenance	Harder to clean between teeth
Fabrication	Can be made in-house	Usually made in dental labs	Can be done chairside
Durability	Moderate	Good	Moderate
Adjustability	Not adjustable	Wires are adjustable	Not adjustable
Effectiveness	Effective	Effective	Effective only if there is no wire distortion/breakage
Protection for teeth	Protective function	No protective function	No protective function
Can be used as whitening trays	Yes	No	No
Compliance	Requires compliance with regular wear	Requires compliance with regular wear	No compliance with wear required as retainer is fixed

*Vacuum-formed and fixed retainers can be worn simultaneously to maintain/improve stability of teeth alignment.

All three types of retainers work well. Most of our patients (>90%) here are given vacuum-formed retainers as they can be made in-house within 2-3 days.

The most important thing to remember is to wear the retainers regularly (for removable retainers) and to go for periodic check-ups (at least once a year) to ensure the retainers are fitting well.

Did you know?

Here at Tan Dental Surgery, we keep your retainer working models. If you lose your retainers, fret not. Just give us a call and we can fabricate the retainers immediately without you coming in for impressions/moulds.

And if your teeth have moved a little after you lose your retainers, the new set of retainers can help move the teeth back to their straight position. This is because the retainers are made using the original working models after braces (see below).

If you need any additional information regarding retainers or braces, just drop us a line through WhatsApp, e-mail or phone.

Updated: 18 Oct 2021

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A common question that we get regarding braces is: what is the best type of braces?

Well, the short answer to that is, it depends. The most suitable braces for you would be one which fits your budget, personal preference, job (e.g. some airlines do not allow visible braces for flight attendants), etc.

Below is an overview of different types of braces:

In this blog, we will only be comparing metal and clear braces with clear aligners. Plates (removable and functional appliances) are normally reserved for simpler cases and will be discussed in another blog.

Metal braces

Brackets are braces attachments which are glued to the teeth. Brackets can be made of metal (e.g. stainless steel, titanium) or clear materials (e.g. plastic, ceramic or composite).

Stainless steel is the most common material for metal braces. Titanium brackets can be used for patients who are allergic to stainless steel brackets.

Metal braces can be fitted in front (labial), or behind the teeth (lingual).

Lingual braces are invisible but because they are fitted behind the teeth, they tend to cause more discomfort to the tongue. Lingual braces are technically more challenging to manage for the dentist/ Orthodontist.

Lingual Braces

Clear braces

As the name suggests, clear braces are tooth-coloured which makes them less conspicuous than metal braces. Earliest version (1970s) of clear brackets was made of plastic but had problems like staining, poor strength, poor stability and high friction¹.

Currently, ceramic brackets are the main option for clear braces. However, ceramic brackets are not suitable for patients with deep bite as the brackets can cause wear to the opposing teeth.

Newer clear brackets are made of composite which is the same material used for tooth fillings. These brackets are highly aesthetic.

Clear braces are very popular among patients here at Tan Dental Surgery.

Clear aligners (e.g. Invisalign®)

Clear aligners are transparent plastics which cover the teeth. They are almost invisible when worn and look like vacuum-formed retainers. In fact, the material used to produce clear aligners is almost similar to retainers and the fabrication process is also similar. One could even say clear aligners are “active” forms of retainers which can move teeth.

Invisalign® was the first commercial clear aligner system introduced in 1998 by Align Technology (Santa Clara, California). The idea was to use a series of clear plastics to move teeth little by little. Each aligner has to be worn for 2 weeks and after that, the patient proceeds with the next aligner in sequence.

More affordable brands of clear aligners are starting to become available now. The differences between the different brands are the material used, cost and manufacturing location.

Clear aligners are gaining popularity now due to the invisible appearance and increased comfort compared to metal/clear braces. And because the aligners can be removed, tooth brushing is made easier.

However, disadvantages with clear aligners include possible longer total treatment time than normal braces² and difficulty in moving teeth in certain directions.

Table of comparison between metal braces, clear braces and clear aligners

	Metal braces	Clear braces	Clear aligners
Material	Stainless steel Titanium	Plastic Ceramic Composite	Elastic thermoplastic material
Durability	Very strong	Brittle and bulkier than metal brackets	Aligners can break if not handled well
Appearance	Silver-coloured	Tooth-coloured	Transparent
Comfort	Might cause discomfort	Might cause discomfort	More comfortable
Oral hygiene care	More difficult to clean	More difficult to clean	Easier to clean teeth as aligners are removable
Types of cases	Suitable for all cases	Not suitable for deep bite cases	More suitable for mild to moderate cases
Cost	$ ($$$ for lingual braces)	$$	$$$
Compliance	No compliance with wear required as brackets are fixed	No compliance with wear required as brackets are fixed	Compliance with aligner wear required (20-22 hours per day)

In summary, if you are on a tight budget, then metal braces, specifically labial ones (fitted in front) is the most cost-effective option.

If you do not like the “metal mouth” look and budget is not a concern, then your options are clear braces, lingual braces or clear aligners. Of these 3 options, clear braces are the cheapest. Clear aligners are definitely more comfortable than clear and lingual braces. However, clear aligners might not be suitable for cases that are more complex.

We offer all types of braces at Tan Dental Surgery. In our opinion, the metal and clear braces are still the best options for the majority of patients as they are more affordable and produce predictable results.

If you are thinking of having braces, be sure to check out our other braces related posts here.

Did you know?

Prior to the 1970s, brackets were welded to metal bands/rings. The bands were custom-made and fitted around each tooth individually (see below). The fitting process was arduous, time-consuming and uncomfortable. In fact, the entire process could take an entire day!

Full mouth banding

References:
1. Contemporary Orthodontics (Elsevier)
2. Activation time and material stiffness of sequential removable orthodontic appliances. Part 3: premolar extraction patients (American Journal of Orthodontics and Dentofacial Orthopedics)

Updated: 20 Sept 2021

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Periodontitis is an inflammatory disease that affects both the soft (gum) and hard tissues (bone) that support the teeth. It is caused by the build-up of bacterial plaque, leading to the detachment of your gums from the roots of your teeth. This will result in the formation of a gap between your gums and your teeth, which is known as the periodontal pocket.

The periodontal pocket is an area where your toothbrush cannot access. Therefore, bacterial plaque (from your food debris) will continually deposit below your gum line onto the roots of your teeth. Over time, the build-up will harden and become tartar, and attract even more plaque. Multiple studies have shown that the subgingival plaque (plaque beneath the gums) harbours large amounts of bacteria.

Early stages of periodontitis are often pain-less. As a result, many patients only seek “symptom-driven” care when their disease is at the advanced stage. Once a considerable amount of gum and bone has been lost, tooth migration (change in tooth position), tooth mobility (loose tooth) and tooth loss follow.

Poor chewing function, as the terminal stage of periodontitis, compromises your digestion, as well as your nutrition, often leading to poorer general health.

How Chewing Affects Digestion

Did you know that the food that you eat is digested in your mouth first before it enters your stomach? What?! Your saliva contains digestive enzymes (called amylase) which break down starches into simple sugars. So by chewing for one minute, up to half of the starch may be digested before you even swallow!

Your saliva also contains some fat digesting enzymes (called lipase) that help begin the process of breaking down the fats in your food. The act of chewing food triggers the production of your stomach acid and pancreatic juices further along the digestive tract, so that the system is primed for the whole digestive sequence.

Chewing well also breaks the food down into smaller pieces, so when you swallow the food, it mixes more thoroughly with your stomach acid. The more surface area is exposed to stomach acid, the more effectively it can do its job. Good chewing function also comes in handy further down the digestive tract. Thorough chewing means that less un- or partially-digested food matter enters your colon and that translates into less intestinal gas.

How Chewing Affects Nutrition

If you’re digesting your food better, does that mean that you get more nutrition from it? Yes! Longer chewing has been shown to increase the amount of protein your body can absorb from foods and put to use building muscle. It also makes some vitamins and minerals more available for absorption, especially from fresh fruits and vegetables.

In summary, chewing your food more thoroughly can improve your digestion and nutrition. And in order to chew your food well, you need a healthy set of pearly whites.

How Does Periodontitis Affect Your Overall Health

Over the last 20 years, there has been a large increase in the literature reporting on increasing number & variety of conditions linked with periodontitis:

Cardiovascular disease

Diabetes mellitus

Pre-term/ low birth weight

Pneumonia

Rheumatoid arthritis

Metabolic syndrome

Cancer

Chronic kidney disease etc.

Substantial evidence points to the fact that periodontitis affects the body by haematogenous dissemination (spread via the bloodstream) of both bacteria and bacterial products (from the dental plaque), and inflammatory mediators (from the inflamed gum and bone). Say what?!

An easy way to understand this is to quantify the size of the periodontal wound in your mouth, and compare that to the size of a skin wound, say on your knee. An abrasion wound on your knee (say 30x30mm) would equate to an area of 900mm². One recent study showed that individuals with severe periodontitis have an average periodontal inflamed surface area (PISA) of approximately 2300mm² – 2.5 times wider!

An untreated periodontal wound forms an easy portal of entry for oral bacteria into your circulation, to your heart, lungs, joints etc. Several studies found the presence of oral bacteria in atherosclerotic plaque (the stuff that is responsible for narrowing your blood vessels).

Furthermore, as your body tries to get rid of these bacteria, it releases chemicals (called pro-inflammatory mediators) which may cause collateral damage to your organs. There is strong evidence that individuals with periodontitis have higher levels of C-reactive protein (CRP), a pro-inflammatory mediator (easily measured from a blood sample) compared to periodontally healthy individuals.

Harmful bacteria can enter your bloodstream through the gums (Dentistry and Oral Health)

The Role of Periodontal Therapy

So if periodontitis affects your general health, can treating periodontitis reverse your fate?

There is evidence on the effect of periodontal therapy in lowering the levels of CRP in cardiovascular disease. Periodontal therapy has also been shown to reduce the level of glycated haemoglobin, HbA1c (0.4-0.7%) in diabetic patients, and erythrocyte sedimentation rate, ESR in rheumatoid arthritis patients.

Therefore, periodontal therapy may not only help achieve and maintain a healthy smile into your twilight years, but may also help with the management of other chronic inflammatory conditions.

What Can You Do

Here’s what you can do to improve your periodontal health:

Practice good oral hygiene

Aware of common signs of gum disease

See your dentist regularly

Quit smoking

Healthy diet

Exercise regularly

With proper management, many systemic diseases can be well controlled – even if they can’t be fully cured. Likewise, periodontal disease deserves consistent attention and appropriate care. If you have questions or concerns about periodontal disease, your dentist can be a great source of information and help. You may also click here to find out more about the types of periodontal services available at Tan Dental Surgery.

References:
1. The Effect of Periodontal Therapy on the Composition of the Subgingival Microbiota (Periodontology 2000)
2. Protein Metabolism After a Meat Meal Is Influenced by Chewing Efficiency in Elderly Subjects (American Journal of Clinical Nutrition)
3. Particle size and nutrient bioavailability (Journal of Agricultural and Food Chemistry)
4. Effect of Bite Size and Oral Processing Time of a Semisolid Food on Satiation (American Journal of Clinical Nutrition)
5. Periodontal Inflamed Surface Area: Quantifying Inflammatory Burden (Journal of Clinical Periodontology)
6. Periodontal Inflamed Surface Area and Periodontal Case Definition Classification (Acta Odontologica Scandinavica)
7. Periodontal Pathogens in Atheromatous Plaques Isolated From Patients With Chronic Periodontitis (Journal of Periodontal Research)
8. Harmful bacteria can enter your bloodstream through the gums (Dentistry and Oral Health)
9. A Systematic Review and Meta-Analyses on C-reactive Protein in Relation to Periodontitis (Journal of Clinical Periodontology)

Updated: 2 Aug 2021

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Now that you have decided to take the plunge and have braces, the next step is to determine where to get the braces done.

The decision depends on many factors:

1. Convenient location and opening hours

This is a very important point to consider because the entire treatment might take at least 1 year and you would need to see the dentist/Orthodontist every 4-6 weeks. Do make sure you are able to travel to the clinic every month for check-up. In fact, if you are travelling from another state/country (e.g. Singapore) for your braces check-up, it is usually advisable to book your appointment 2-3 months ahead. That way, you are almost assured of an appointment slot.

2. Cost and payment plan

Your choice of clinic is also dependent on the cost of braces and payment plan offered. Is the treatment affordable given your current expenditure and lifestyle? If not, there is no harm (for most cases) in delaying treatment until you have saved up enough money.

3. Availability of specialist (Orthodontist) at the clinic

Both dentists and Orthodontists can provide braces treatment. However, some may choose to see an Orthodontist for a more specialised care as they are better trained to handle a wider range of orthodontic problems.

4. Types of braces offered

Your choice of braces (e.g. metal braces, clear braces, lingual braces or clear aligners) would also determine where you choose to have braces done. For example, most government dental clinics only offer metal braces whereas private dental clinics usually have more options.

5. Rapport with the dentist/Orthodontist

It is a good idea to have consultation with a few dentists/Orthodontists to find someone you are comfortable with. After all, you will be seeing the same person every month for the next year or so (Hint: find a dentist/Orthodontist who is willing to explain the procedures and answer all questions patiently).

6. Recommendation from others

With so many dental clinics to choose from, it can be a little overwhelming to decide on one. The easiest way would be to ask family members and friends for personal recommendation. Get their feedback and ask them about the entire braces experience and what they like or don’t like about the clinic. You could also look up online reviews of the clinics.

Most private and some government dental clinics offer braces treatment. We have compiled a list of government, military and university dental clinics in Malaysia offering braces treatment.

Types of Dental Clinics	State	Location
Government – Northern Region	Perlis	Klinik Pergigian Pakar Ortodontik Kampung Gial 02500 Mata Ayer, Perlis
	Kedah	Klinik Pakar Pergigian Kota Setar Lot 894, Lebuhraya Darul Aman 05100 Alor Setar	Unit Ortodontik Klinik Pergigian Changlun 06010 Changlun
		Unit Ortodontik Klinik Pergigian Kulim Jalan Hospital Lama 09000 Kulim	Klinik Pergigian Sungai Petani Jalan Kapal Terbang 08000 Sungai Petani
	Penang	Klinik Pergigian Jalan Perak 11600 Pulau Pinang	Klinik Pergigian Bukit Minyak Klinik Kesihatan Bukit Minyak 14000 Bukit Mertajam
		Klinik Pergigian Mak Mandin Poliklinik Komuniti Mak Mandin 13400 Butterworth	Klinik Pergigian Kepala Batas Lot 1466, Mukim 6, Kepala Batas 13200 Seberang Perai Utara
		Pusat Pergigian Kanak-Kanak & Kolej Latihan Pergigian Malaysia No. 3, Jalan Sepoy Lines 10450 Pulau Pinang	Klinik Pergigian Bayan Lepas Jalan Dato' Ismail Hashim 11900 Bayan Lepas Pulau Pinang
	Perak	Klinik Pergigian Ipoh Jalan Panglima Bukit Gantang Wahab 30590 Ipoh	Klinik Pergigian Buntong Taman Desa Rishah 30100 Ipoh
		Klinik Pergigian Taiping Jalan Tupai 34000 Taiping	Klinik Pergigian Seri Manjung Jalan Lumut 32000 Sitiawan
		Klinik Pergigian Parit Buntar Jalan Sempadan 34200 Parit Buntar	Klinik Pakar Pergigian Jalan Putra 36000 Teluk Intan
Government – Central Region	Kuala Lumpur	Klinik Pergigian Cahaya Suria, Tingkat 1 Bangunan Pudu Sentral,Jalan Pudu 55100 Kuala Lumpur	Klinik Pergigian Setapak Jalan 9/23A, Medan Makmur Off Jalan Usahawan 53200 Setapak
		Klinik Pergigian Bangsar Jalan Bangsar 59200 Kuala Lumpur	Klinik Kesihatan Kuala Lumpur, Jalan Temerloh, Taman Tasik Titiwangsa, 53200 Kuala Lumpur
	Putrajaya	Klinik Pergigian Putrajaya Presint 18 Jalan P18C1, Presint 18 62602 Putrajaya
	Selangor	Klinik Pergigian Shah Alam Seksyen 19, Jalan Gelora 19/46 40300 Shah Alam	Klinik Pergigian Seri Kembangan 1, Jalan Besar 43300 Seri Kembangan
		Klinik Pergigian Sungai Chua Kawasan Perindustrian Sungai Chua 43000 Kajang	Klinik Pergigian Bandar Botanik Blok A, Jalan Langat, Bandar Botanic 41200 Klang
		Klinik Pergigian Rawang Jalan Bukit Kelab 48000 Rawang	Klinik Pergigian Tanjung Karang 45500 Tanjung Karang
		Klinik Pergigian Besar Jalan Tengku Kelana 41000 Klang
Government – Southern Region	Melaka	Klinik Pergigian Besar Jalan Tun Sri Lanang 75100 Melaka	Klinik Pergigian Alor Gajah Jalan Hospital Lama 78000 Alor Gajah
		Klinik Pergigian Batu Berendam Batu Berendam 75350 Melaka
	Negeri Sembilan	Pusat Pakar Pergigian Seremban Jalan Zaaba 70100 Seremban	Klinik Pergigian Senawang Persiaran Senawang 2 70450 Senawang
		Klinik Pakar Ortodontik Tampin Jalan Cantik 73000 Tampin	Klinik Pergigian Besar Kuala Pilah 72000 Kuala Pilah
		Klinik Pergigian Seremban 2 Jalan S2A2 70300 Seremban	Klinik Pergigian Port Dickson 71000 Port Dickson
	Johor	Klinik Pergigian Besar Muar Jalan Meriam 84000 Muar	Klinik Pergigian Besar Jalan Abdul Samad 80100 Johor Bahru
		Klinik Pergigian Taman University Jalan Kebudayaan 28, Taman University Skudai 81300 Johor Bahru	Klinik Pergigian Pekan Nenas Jalan Sawah 81500 Pekan Nenas, Pontian
		Klinik Pergigian Senggarang Klinik Kesihatan Senggarang 83000 Batu Pahat	Klinik Pergigian Kluang Hospital Kluang 86000 Kluang
		Klinik Pergigian Besar Segamat Jalan Muar 85000 Segamat
Government – East Coast Region	Pahang	Klinik Pergigian Jalan Gambut 25000 Kuantan	Klinik Pakar Pergigian Klinik Kesihatan Bandar Mentakab 28400 Mentakab
		Klinik Pergigian Indera Mahkota Jalan IM4 Bandar Indera Mahkota 25582 Kuantan	Klinik Pergigian Raub 27600 Raub
		Klinik Pergigian Pekan 26600 Pekan
	Terengganu	Klinik Pergigian Jalan Sultan Mahmud 20400 Kuala Terengganu	Klinik Pergigian Batu 2 ½ Jalan Air Putih, Chukai 24000, Kemaman
		Klinik Pergigian Kuala Berang Jalan Kuala Berang 21700 Hulu Terengganu
	Kelantan	Klinik Pergigian Kota Bharu Jalan Mahmood, 15200 Kota Bharu	Klinik Pergigian Kuala Krai 18000 Kuala Krai
		Klinik Pergigian Meranti 17010 Meranti, Pasir Mas	Klinik Pergigian Pasir Puteh 16800 Pasir Puteh
		Klinik Pergigian Hospital Machang 18500 Machang, Kelantan
Government – East Malaysia	Sabah	Klinik Pergigian Sandakan KM 3.2 Jalan Labuk 90500 Sandakan	Hospital Queen Elizabeth II Aras 8, Jalan Damai 88200 Kota Kinabalu
		Klinik Pakar Ortodontik Hospital Keningau Peti Surat 11 89007 Keningau, Sabah	Unit Ortondontik Klinik Pergigian Klinik Kesihatan Jenis 2 Jalan Chong Thien Vun 91000 Tawau, Sabah
	Sarawak	Klinik Pergigian Petra Jaya Off Jln Siol Kanan, Petra Jaya 93050 Kuching	Klinik Pergigian Tanah Puteh Jalan Kwong Lee Bank 93450 Kuching
		Klinik Pergigian Tudan Jalan Tudan Permyjaya 98100 Lutong, Miri	Klinik Pergigian Lanang Jalan Lanang 96000 Sibu
Military (Hospital Angkatan Tentera)	Melaka	Hospital Angkatan Tentera Kem Terendak 76200 Sungai Udang
	Perak	Hospital Angkatan Tentera Pangkalan TLDM Lumut 32200 Lumut
	Kuala Lumpur	Hospital Angkatan Tentera Tuanku Mizan 3, Jalan 4/27a, Seksyen 2 Wangsa Maju, 53300 Kuala Lumpur
	Negeri Sembilan	Hospital Tentera Darat Kem Syed Sirajuddin Gemas 73400 Gemas
	Sabah	Hospital Angkatan Tentera Wilayah Kota Kinabalu Jalan Universiti, 89200 Kota Kinabalu
Public University	Kuala Lumpur	Universiti Malaya (UM) Jalan Universiti, 50603 Kuala Lumpur
	Selangor	Universiti Kebangsaan Malaysia (UKM) 43600 Bangi	Universiti Teknologi MARA (UiTM) 47000 Sungai Buloh
	Negeri Sembilan	Universiti Sains Islam Malaysia (USIM) Bandar Baru Nilai, 71800 Nilai
	Pahang	Universiti Islam Antarabangsa Malaysia (UIA), Bandar Indera Mahkota, 25200 Kuantan
	Kelantan	Universiti Sains Malaysia (USM) 16150 Kubang Kerian
Private University	Melaka	Melaka-Manipal Medical College (MMMC) Jalan Padang Jambu, 75150 Bukit Baru
	Kedah	AIMST University Batu 3 1/2, Bukit Air Nasi, Jalan Bedong—Semeling 08100 Bedong
	Penang	Penang International Dental College (PIDC) Level 19 -21, NB Tower, 5050, Jalan Bagan Luar, 12000, Butterworth
	Kuala Lumpur	International Medical University (IMU) No.126, Jalan Jalil Perkasa 19, 57000 Bukit Jalil
	Selangor	MAHSA University College 2, Jalan SP 4/4, Bandar Saujana Putra, 42610 Jenjarom	SEGi University Taman Sains Selangor, 47810 Petaling Jaya
		Lincoln University College Block A, Mayang Plaza, 1, Jalan SS 26/2, Taman Mayang Jaya, 47301 Petaling Jaya

It can be seen that there are many options for getting braces in Malaysia. Of course having too many options to choose from can be overwhelming so do take your time to decide.

If you have any questions, we at Tan Dental Surgery are more than happy to answer them. You can even send in your enquiries via WhatsApp if you prefer. In the meantime, do check out our other posts on braces by clicking here.

Updated: 11 Jul 2021

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Having braces done can be a big financial commitment. We understand that it can be quite daunting finding a clinic which fits your budget. Don’t worry, we have compiled and compared the braces fee between private, government, military and university dental clinics in Malaysia for your reference.

The tables below should serve as a good starting point for you to decide where to have braces and also for you to plan your budget for braces. It can be seen that the braces fee ranges from RM700 all the way to RM20000+. This means that there are options to suit all budgets.

Even though the cost of braces in private dental clinics are higher, most dental clinics offer an interest-free instalment payment plan. Do check with the clinic regarding the payment plan and whether there are any additional miscellaneous costs involved.

10 things to ask your dentist/Orthodontist about braces cost:

What is the estimated total fee for braces?
Is the braces fee fixed or is it pay as you go? (e.g. fixed amount regardless of treatment duration or continuous monthly payment until completion of treatment)
What is included in the fee?
What is not included in the fee?
How much is the initial deposit upon signing up for braces? Is the deposit refundable if you change your mind?
How much is the monthly payment? Is it interest-free?
What is the accepted mode of payment (e.g. cash, credit card, online transfer, eWallet)?
Is there discount for full upfront payment? Is there family/group discount?
Are there additional fees for broken braces?
What happens if midway through treatment, you decide to continue braces elsewhere?

The table below compares the braces fee between private, government, military and university dental clinics. Here are a few things to take note regarding the fees:

Metal braces are offered at all dental clinics. However, only private dental clinics and certain university dental clinics offer ceramic braces and clear aligners

The cost of X-rays, as well as other dental treatment you may need is usually not included in the braces fee (e.g. scaling, tooth extractions, treatment of existing gum disease)

Types of Dental Clinics		Metal Braces	Retainers
Private		RM4000-RM8000+ (metal braces)	RM500-RM1000+
	.	RM8000- RM10000 (ceramic braces)
		RM12000-RM20000 (clear aligners)
Government		RM1000 (free for children of civil servants)	RM200
Military Hospital (Hospital Angkatan Tentera)		RM700	RM200
Public University	Universiti Malaya (UM)	RM3700	RM400
	Universiti Kebangsaan Malaysia (UKM)	RM2000-RM3000 (treatment by postgraduate student)	RM400
		RM5000-RM6000 (treatment by Orthodontist)	RM400
	Universiti Sains Malaysia (USM)	RM1500	RM400
	Universiti Teknologi MARA (UiTM)	RM2000-RM3000	RM400
	Universiti Islam Antarabangsa Malaysia (UIA)	RM4630 (only for those aged 17 years and below)	Included
	Universiti Sains Islam Malaysia (USIM)	RM3000	RM400
Private University	AIMST University	RM2000+	RM100-RM200
	Penang International Dental College (PIDC)	RM4000	RM225
	MAHSA University College	RM5000	RM500
	International Medical University (IMU)	RM7000-RM10000	Included(?)
	Melaka-Manipal Medical College (MMMC)	RM5300 (metal braces)	Included
		RM8000 (self-ligating metal braces)
		RM10000 (ceramic braces)
	SEGi University	RM4500	RM200
	Lincoln University College	RM4000	?

#unless otherwise stated
* The above information was obtained through the respective dental clinic reception. The accuracy has not been verified and serves as a general guide only.
* In compliance with the Malaysian Dental Council’s “Guidelines and Provisions for Public Information 2014”, we are unable to publish our fees online.

Well there you have it. A general comparison of the braces cost in private and government clinics.

Apart from cost, you may also want to consider the waiting time for braces. As the cost of treatment is lower in government and university dental clinics, waiting time can range from a few weeks up to several years.

Do check out our other braces related posts by clicking here. Feel free to contact us for a no obligation braces consultation.

Updated: 12 Oct 2021

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One of the most common questions we get asked about braces is how much do they cost? Some have also asked why does the braces fee vary between clinics. After all, isn’t braces treatment the same at all clinics?

Just like many other products and services, there are multiple reasons why the braces fee is different between clinics. If you are “shopping around” for braces, take a look below at some of the factors that affect the cost of braces before you plonk down your hard-earned cash (or your parents’) :

1. Treatment by General Dentist or Specialist (Orthodontist)

Braces (orthodontic) treatment is provided by general dentists and specialists (Orthodontists).

What is an Orthodontist? A degree in Dentistry is typically 5 years long. However, just like doctors, a dental graduate will need to complete at least 1 year of compulsory service with the government before he or she can become a registered dentist and practise dentistry in Malaysia. After that, there is an option to choose to specialise in fields such as orthodontics, periodontics etc. The process of specialisation is usually 3 years long.

In short, it generally takes about 6 years to be a fully registered dentist and another 3 years to become a specialist!

Education pathway to becoming a dentist and dental specialist (EduAdvisor)

Generally, braces treatment carried out by Orthodontists cost more but there are always exceptions. Here at Tan Dental Surgery, our resident Orthodontist, Dr. Tan Wee Han is registered as a dental specialist with the National Specialist Register as well as the Australian Health Practitioner Regulation Agency (AHPRA)

2. Private, government, university or military (Hospital Angkatan Tentera) dental clinics

The cost of braces is also influenced by where you get the braces done. Naturally, the cost of braces treatment is highest in private clinics compared to government clinics.

Most people assume that braces can only be done in private or government dental clinics. However, there are a number of university and military dental clinics offering braces as well. For a full list, click here.

3. Types of braces

When it comes to braces, there are a few options available to suit your budget and needs. For instance, if your job (e.g. flight attendant) does not permit visible braces on your teeth, then you have the option of either lingual braces (braces behind the teeth) or clear aligners (e.g. Invisalign®). Other types of braces include metal braces as well as clear braces.

In terms of cost, metal braces are the most affordable followed by clear braces. Clear aligners (e.g. Invisalign®) and lingual braces cost the most.

Another subtype of braces known as self-ligating braces (e.g. Damon®) is available in metal or clear form. These cost more than conventional braces. Self-ligating braces are different from conventional braces as they have clips to hold the wires whereas conventional braces require rubber rings to secure the wires.

There are also removable plastic plates. Plates which move teeth are called removable appliances and plates which change the position of the lower jaw (mandible) are called functional appliances. Removable appliances are normally used in children and some adults. Functional appliances are normally used in children.

We offer all types of braces here at Tan Dental Surgery. Do check with our Orthodontist if your choice of braces is right for you.

4. Scaling, X-rays and extractions of teeth

Here at Tan Dental Surgery, we normally advise patients who have signed up for braces to have gum evaluation (periodontal screening) and scaling done first. This is an important first step to ensure the teeth and gums are healthy prior to starting braces. If gum problem (periodontitis) is detected, then gum treatment is necessary before braces.

X-rays are also required before starting braces to assess the general condition of the teeth and jaw bones.

Some patients require extractions of teeth for braces. The reasons for extractions could be to make room to straighten the teeth or maybe because the tooth/teeth are in poor condition.

All of the above procedures are usually not included in the braces fee so do take that into account when calculating the total cost of braces.

5. Braces accessories and retainers

For some patients, additional components like orthodontic miniscrews, expanders, etc. are necessary to help move the teeth and jaws. These extra accessories are normally not included in the total fee for braces.

After completion of braces treatment, you would need to wear retainers to maintain the straight alignment of teeth. Some practices include the cost of retainers in the total fee and some do not. Do make sure you find out first before signing up for treatment (FYI, retainers are included in the fee here at Tan Dental Surgery).

Orthodontic miniscrew

Hopefully the above information has been helpful in providing you with a better idea of the factors determining the braces cost. Feel free to contact us (via WhatsApp, phone or email) if you have any enquiries about braces. We’ll be more than happy to answer them!

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1. Treatment by General Dentist or Specialist (Orthodontist)

2. Private, government, university or military (Hospital Angkatan Tentera) dental clinics

3. Types of braces

4. Scaling, X-rays and extractions of teeth

5. Braces accessories and retainers

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