5 reasons to say no to sugar from daddy this christmas

Father Christmas would be somewhat of a controversial figure these days. In this age of health and wellness, Daddy Nicholas would be classified as an “overweight endomorph”. If he were to walk into any clinic without his Christmas garb, he would have to be screened for diabetes, heart disease and high blood pressure simply because these diseases are associated with obesity.

I am sure Christmas must make them organic-eating-Lululemon-wearing moms go crazy. (Ok, sounds like a pretty good description of me.) Not only is Father Christmas telling your kid it’s ok to want that expensive Lego toy, it is also ok to go crazy on candy canes and treacle. Hey, shouldn’t kids be making lists for world peace and reducing our carbon footprint instead of wishing for excess material toys and junk food? Totally grates on those values and home rules, no?

Well, science shows these sugar-thrashing women may really know what they are talking about! In fact, The Guardian reports that the UK government is under pressure to impose a tax on sugar because it is so BAD!  Yes, it is really. There is so much scientific evidence that sugar is bad, I wonder why it hasn’t been labelled a ‘toxin” yet.

So why say no to sugar from Daddy Nicholas this Christmas?

#1 It Makes Your Teeth Rot

The refined sugar in cookies and sweet treats are bad for your teeth. The bacteria in your mouth digest these carbohydrates and produce acid. When this acid accumulates on your teeth, they start dissolving the top layer of your teeth (the enamel) and this action promotes the formation of cavities. If left unchecked, it could lead to a toothache and A LOT of pain! Jamie Oliver has even come up with a documentary that shows a five-year-old boy having his teeth extracted under general anesthesia. Really gory, but a smack to the face to watch what happens when you have an addiction to sweet treats.

#2 It Could Make Your Gum Disease Worse

To date, there is no evidence that there is a direct link between sugar and gum disease, but sugar can worsen gum disease symptoms indirectly by triggering increased inflammation in the body.

Gum disease occurs when bacteria in the mouth irritates the gum tissues surrounding the teeth. The body will try to wall off the bacteria and prevent the bacteria from going into the bloodstream by a process called inflammation. Inflammation calls the body’s protective cells to the area and when the cells are present in optimum numbers, inflammation is protective for the gums.

Inflammation is a double-edged sword though. When the soldiers (protective cells) in the body get too angry and crazy, they overreact and start damaging the body’s own cells. And refined sugar in large amounts is one of the biggest triggers of ‘bad” inflammation.

When you ingest sugar or high-glycemic foods like cake that rapidly convert to sugar, your body breaks down these carbohydrates into glucose, which raises your insulin levels. Simple carbohydrates, like refined sugar, rice, white bread and soft drinks, cause your insulin levels to spike, which leads to a spike of inflammation in the body.

It starts causing the protective cells to run amok and dump toxic substances around the teeth. And the bone around the teeth starts melting away. Serious. Not funny when you lose bone around your teeth and the teeth start to wobble. Ok if you are a five-year-old kid losing his first set of teeth. Not ok if you are 40 and about to lose that front tooth!

#3 It Makes You Fat

Have you gone on holiday and snacked all day, only to find fat rolls around your waistline? Excess consumption of sugar has a direct link with obesity. The results on sugar and health are pretty scary. Worse yet, gum disease has also been shown to be associated with obesity. Which means that if you are overweight, you might need your gums checked out too.

#4 It Makes You Age

You can really cause wrinkles to form by eating lots of cakes and sweets. Glucose in excess amounts causes collagen to clump together and bunch up by a process called glycation. This clumped up collagen shows up in your skin and makes it sag. So have your cake and eat it, and kiss that baby smooth skin goodbye! :(

#5 It Makes You…

Well, I could put in a whole list of diseases excess consumption of sugar is associated with…. like heart disease, diabetes, etc., but the above reasons are enough for me to really cut down on my sugar intake even during Christmas… or should I say especially during Christmas! Yeah, sorry to pop your Christmas bubble, but these are the facts on sugar.

Do enjoy the festivities though! without going overboard with the sugars. And if Father Christmas looked like this…

healthy santa

…perhaps we would enjoy the holidays even more! ;)

My creepy new electric toothbrush: a leap towards technology

I admit that I am one of those old peeps that don’t like change. I feel safe and familiar with routine and new phones and new technology scare me. Seriously. Even Facebook scares me. But now that I have figured out how to post articles, it is a lot less creepy than it seems!

So I was left with mixed feelings when I was invited to be a key opinion leader at a leading toothbrush manufacturer’s launch of their new electric toothbrush. I couldn’t just diss the toothbrush because it is (gasp!) powered by electricity and works at the touch of a button. Plus I am such a stickler for hard work, it actually feels weird that I don’t have to do much work to brush my teeth. Like… the electric toothbrush is for lazy people, right?

So it was with trepidation when I first used that darn electric toothbrush I was supposed to evaluate to brush my teeth. I cringed when I turned it on. Then I realised that it was actually really, really comfortable! The oscillating action was a lot gentler than I thought and my teeth felt really clean afterwards. Can I say that it’s almost idiot-proof and so easy to use?

The brush even has a cool Bluetooth function that connects with your smartphone which then tells you which part of your mouth still needs brushing so you don’t miss a spot! Something that would totally appeal to techies out there.

But enough of what I think. What does science say about brushing with a manual toothbrush vs an electric one? In 2014, the Cochrane Oral Health Group — a group of dentists charged with publishing summaries of the best available evidence – looked at this issue. It concluded that, over three months, using an electric brush was associated with a 21% reduction in plaque and an 11% reduction in gum inflammation compared with manual brushing. Good news for lazy people out there!

One note of caution though: Most Asians have really thin gums so be careful about brushing too rigorously. I personally use the sensitive brush head range when I use the electric toothbrush to prevent gum recession. I don’t want brush my precious gums away!

That is not to say manual toothbrushes don’t work. They work very well — when used properly. They can also remove plaque readily when the technique is right. I personally recommend the Bass technique as it is really easy to follow and cleans both the teeth and gum margins at the same time.

Choose a toothbrush with a small head and super soft bristles and hold the toothbrush bristles against your gum line at a 45-degree angle towards your gums. For the upper teeth, this means pointing it 45 degrees upwards and for the lower teeth, 45 degrees downwards. Using short horizontal strokes or tiny circular movements, “jiggle” the brush against the teeth you are cleaning. Do this for about 20 strokes and then move on to the next tooth. Do this for both the inner and outer surfaces of the teeth. This technique is really easy once you get used to it.

So the verdict? I would take that great leap forward and start brushing with an electric toothbrush if you feel like being lazy and want to put in minimal effort while having clean teeth! Otherwise, just stick to your good ole’ manual toothbrush and brush the right way!

Brush your bleeding gums away!

Yes, I know it is ABSOLUTELY counter-intuitive, but you sooo need to brush those parts of your gums that bleed.

When I tell my patients or friends that they need to brush their gums, their reaction usually goes along the lines of, “Must brush gums one meh?”

The answer to that question is ABSOLUTELY! YES! We must brush along our gum line with a soft tooth brush at a 45-degree angle. Otherwise, bacteria and food will accumulate along the gum line and inflammation will happen. Once inflamed, the gums will become swollen and red and may even bleed spontaneously. Its a great Halloween fix, but try that at Thanksgiving or Christmas… trust me, you might never be invited to that important dinner again.

Worst yet, if the bacteria is not brushed off or cleaned off by your dentist for the next few months or years, Periodontitis can develop. Periodontitis is a form of gum disease, more severe than gingivitis that is characterised by bone loss around a tooth, In the worst scenario, your teeth could start shaking and even fall out. No, I am really not kidding here.

However, if you brush your gums for a week and they still bleed, please go to your dentist for a check up! Bleeding gums is usually a sign of gum disease, but it could also be an indicator for high stress levels, diabetes, hormonal imbalance, poor nutrition, or get this, even pregnancy! In some rare (and I repeat RARE) cases, it could also be a sign of leukaemia.

So brush your gums, and don’t stop brushing them even when they bleed. If they bleed, it is usually not because you have traumatised them, but because they are injured and sick already. You need to massage and brush them well to get them better!

The men don’t get it: how female hormones affect your gum health!

It’s kinda unfair, eh? Besides having to bear babies and deal with those dreaded PMS days (when everyone is just plain old irritating) we also have to deal with female hormones affecting our gum health.

“Say what?”

Yup. Yes. You heard me right! The same hormones that keep our skin glowy, our moods happy, and help us carry a baby to term can also wreak havoc on our body and minds by giving us depression, make us serial stalk that cute guy next door, or exacerbate that gum problem we already have.

So How Do Female Hormones Play a Part in Gum Disease?

Professor Krejci from Case Western Reserve University published a landmark study in 2012 where she reviewed journal articles and arrived at a conclusion that the fluctuation of female hormones are associated with gum disease. These hormones can change conditions in the mouth, promote bacterial growth and thus possibly enhance the breakdown of bone and worsen gum disease.

“Although women tend to take better care of their oral health than men, the main message is women need to be even more vigilant about maintaining healthy teeth and gums to prevent or lessen the severity of some of women-specific health issues.” – Professor Krejci

When Must Women Pay Special Attention to Their Gums?


During puberty, your body forms sex hormones such as progesterone and estrogen. There is increased blood flow to the gums and they are more reactive towards bacteria and food. So don’t be surprised to see some bright red gums that bleed more, together with the appearance of acne on your face! Some women can also get menstruation gingivitis. The gums get bright red just before menstruation and subside once menstruation starts.


Hormonal changes again make the gums more sensitive to bacteria in plaque and gums can swell and turn bright red. Some poor women even report spontaneous bleeding of the gums. This can be really embarrassing when the gums bleed when you are talking to someone! This is termed pregnancy gingivitis and this condition should resolve with good brushing and when the pregnancy is over.

There is another point to note though: Studies have also linked severe gum disease in pregnant to pre-term low-birth-weight babies. These women tend to have kids that are small with weak immunity. And if born too soon, these little ones have to be incubated, away from their moms!

So please get your gums checked out by a dentist or periodontist before you get pregnant. A mom needs her body to be in tip-top shape to support a healthy baby. If it is a little too late and you are already pregnant, experts recommend a check up during the second trimester when cleaning of the gums can be carried out safely.

Menopause & Post-menopause

Women who are menopausal or post-menopausal may experience changes in their mouths. They may notice discomfort in the mouth, including dry mouth and gums due to those pesky hormones (or rather the lack of). There is less saliva and you are less able to flush away bacteria in the mouth. The bacteria take this opportunity to grow and can worsen gum disease.

So we can see that as women, we need to pay more attention to the gums than men! In addition to brushing and flossing daily, please do get a check up once every six months or when you intend to get pregnant or are undergoing menopause. It can really help keep your baby safe, or prevent you from losing your teeth when you age. Your periodontist can help you through these tricky phases and teach you how to care for your gums.

Your gums reveal everything about you (well… almost!)

Some of my patients say I’m psychic. I take it as a compliment.

I can mostly tell if you are happy and healthy, stressed, not been sleeping well, or if your body is completely out of sync with your biological clock.

I’m not the only ‘psychic’ dentist in Singapore though. Most periodontists are! Since the gums are a reflection of your general health, we are able to spot trouble sometimes even before your medical provider is able to do so.

So what do your gums tell me when I examine your gums and teeth?

Pink and Firm

Oh, I love seeing this! Gums that don’t bleed easily and are a nice baby pink with a firm texture are very rare. I usually shower these people with compliments as it usually means these people look after themselves. In general, good gums usually reflect good health.

Red and Puffy

When gums are red and puffy and oral hygiene is poor, it means that the patient has good old gingivitis. A good cleaning to remove bacterial plaque and oral hygiene instructions usually clears this condition up rapidly.

However, sometimes people can have red inflamed gums that bleed easily even though they have fantastic oral hygiene.  So what’s up with that?

Actually, sometimes moms know best and your mom might be smarter than you think! Remember the time when your mom nagged you and told you that your red puffy gums are caused by you eating ‘heaty’ foods, that you should sleep earlier, and that gum boils are caused by you having too much ‘heat’ in your body — blah, blah, blah? And remember the time you rolled your eyes when she tried to offer you ginseng and chrysanthemum tea to ‘cool’ your body because you were stressed at work?

Well, she is not that crazy you know… There is some truth that high stress levels, not sleeping, and not eating healthily can cause more inflammation. Traditional Chinese medicine believes that heat in the body can be generated by fiery emotions. So in this case, ‘heat’ is almost equivalent to inflammation.

So a high inflammatory load in the body, which is characterized by bleeding, red and puffy gums in a generally clean mouth usually mean that you need to slow down at work,  sleep more, and eat more healthy foods to boost your immunity!

Red and Puffy with Lots of Pus and Loose Teeth

Sometime I can smell diabetes even before the patient opens his or her mouth. When patients have a really high sugar level and diabetes is not under control, inflammation in the body is sky high and the immune system creates havoc in the body. The body is unable to cope with common pathogens and abscesses pop out especially in the mouth. The pus gives off a bad smell and this can cause really bad breath too!

This bad smell, combined with lots of pus in the mouth and loose teeth will prompt me to send the patient for a diabetes check immediately. I’ve picked up diabetes in some patients this way. Diabetes and gum disease are intimately connected by the way.

White, Dehydrated, and Crinkly

Ok, this is dedicated to you closet smokers out there. I CAN TELL WHEN YOU’VE BEEN SMOKING. There have been times when I look at those shrivelled up gums on the palate and those stained teeth and I ask: “Have you have been smoking?”

Very often, I get the wounded Bambi-eyed “Who me? Nooo…” look. “I just love coffee” is the next favourite line.

Well, its ok if you don’t admit to smoking, but check your gums and under your own tongue. If you see white patches that cannot be wiped off, go see your dentist immediately and it’s a good idea to tell him or her that you smoke. These patches are called oral leukoplakia and 15.6-39.2% of these lesions can turn into pre-cancer or cancer.

Yup. It’s scary. Better go get that white patch checked out.

Of course, I must qualify that nothing can or should be diagnosed just by looking at your gums. The gums suggest trouble when they don’t look healthy. Sometimes, red and bleeding gums is merely caused by having poor oral hygiene and never having been taught the correct way to brush! If you need more advice, do contact your periodontist or dentist for a check-up, and they will teach you how to clean your teeth specifically tailored to your needs!

5 ways to fix a gummy smile

I don’t get it. I really don’t.

I don’t understand why girls would go for plastic surgery to raise their nose bridge and cut double eyelids but walk around with a really gummy smile. Or flip a switch over a single freckle or zit, and be ok about uneven gum margins and a totally lopsided smile?

I mean, let’s take a poll here guys. Which is more unattractive? A single zit or an ugly smile? OK, I just asked my five-year-old son and he said: “Ugly smile is uglier.” Not the best way to take a poll, but you catch my drift.

So perhaps, I tell myself, maybe it’s because the girls think gummy smiles cannot be fixed! Studies show that gummy smiles become noticeable when 3mm or more of gums show when smiling. The two ways to fix this is to prevent the upper lip from moving too far upwards or increase the length of the teeth to reduce the amount of gum shown.

There are many factors that cause a gummy smile like an over-active upper lip or excessive gums that cover too much of your teeth.

So the treatment is based on the diagnosis and what is causing you to look too ‘gummy’. Here are some ways to get a better smile!


If the Gummy Smile is Due to an Over-active Upper Lip:


Lip repositioning surgery

The lip is cut from the inside and stitched closer to the teeth so the lip cannot retract as much. (Ouch.)

Botox the upper lip

Luckily, nowadays, it’s easier to get that stiff upper lip. No need to smile in a certain way or stifle your laughter! You can just get that upper lip botoxed! Only thing is, botox wears out after a few months and you will need to get another botox injection to keep that lip in its place.


If the Gummy Smile is Due to Excessive Gums:


Laser or scalpel gum gingivectomy

Your periodontist can trim your excessive gums using a laser or a scalpel. It’s a very comfortable procedure and the results are immediate. Be warned though. If there is still too much bone underneath the gums in some patients, the gums will regrow back to it’s original position and the gingivectomy procedure will have to be repeated a few months later. Much like botox.

Crown lengthening with osseous surgery

This procedure basically means having your gums and bone trimmed to lengthen your teeth permanently. Some patients have excessive bone which causes excessive gums to form. So when we trim that bone away together with the gums, the final look is, well… final! You get nicely shaped teeth and less gums without having to repeat any procedures.


If the Gummy Smile is Due to a Long Mid-Face:


Vertical maxillary impaction

The surgeon will need to embark on corrective jaw surgery, where the whole upper jaw is repositioned upwards. Needless to say, this procedure is much more invasive and you will need much more time to heal!

So there you go.

So many ways to fix a gummy smile, ranging from something temporary to “test the look” to see if you like it (kind of like getting your hair waved with a curler at the salon before you commit to a perm) to getting the gums fixed permanently in that position so it doesn’t become a hassle to go back to your periodontist for repeat procedures.

So remember, before going for that second nose job, why not fix your smile first?

3 lifestyle tips for healthier, better-looking gums

It’s kinda weird to go to a periodontist (this one) and have her nag you about changing your lifestyle, but if you do ever come for a consultation with me, be prepared for a lifestyle reboot too!

The major cause of gum disease is bacterial plaque, a sticky white film composed of food debris and bacteria that forms on the teeth. If the plaque is not removed, it can turn into a hard substance called calculus or tartar in less than two days. Tartar then acts as a further bacteria trap due to its rough surface.

The bacteria in plaque infects the gums and releases toxins that cause redness and irritation.

If the body is healthy, it is able to fight off the bacteria and the disease remains as gingivitis or localized inflammation of the gums. It doesn’t progress.

However once your immunity is weakened from smoking, stress, or a systemic disease, the bacteria wins and the bone and gums surrounding the teeth dissolve due to chemicals released by the body as it desperately tries to wall off the bacteria. This over-active inflammatory process is needs to be dampened, otherwise this excessive dumping of chemicals (catabolic cytokines) leads to progressive tissue destruction!

Treatment for gum disease will always require a good diagnosis, conventional cleaning of your gums and teeth by a professional, and good home-care.

But if you really want your gums to get truly better, you are going to have to kick some habits (like smoking),  decrease your stress levels, and put in some effort to boost your immunity. Research continues to demonstrate that our overall health and oral health are intimately connected. So your gums are as healthy as you are!

Since uncontrolled inflammation is so destructive to our body, here are 3 main ways to decrease inflammation.


There are more studies that show we  really are what we eat. In general, a diet rich with fresh fruits and vegetables and low in sugar and processed foods will lower the inflammatory load in the body.

Green tea, foods rich in Omega 3, and DHA supplements have also been shown to help prevent or reduce the severity of gum disease.


Research shows that subjects with a healthy weight and high physical fitness have a lower incidence of severe gum disease. Anyway, exercise is always good. Who doesn’t want to stay in shape, free from halitosis and gum disease, AND look great?


Apparently, getting that good night’s sleep is so important to the body! So stop watching those Korean drama serials and playing those video games and bunker down to bed.

It shows that psychotherapy helps improve sleep, which in turn reduces the amount of inflammation in the body! Isn’t that cool? The researchers are basically telling you to be lazy and rest in bed so you can heal and feel better. Pretty good way to get back to health, methinks.

So there you go. Eat well, sleep well, exercise well. All that will help you in your journey to better gum health!