General Topic : Dental Examination

“Doctor, I brush my teeth twice a day. Why do I still get problem with my teeth?”

Does this sound familiar to you? Is this one of your doubts as well?

Most of us in Malaysia have the habit of brushing twice per day.

However, how effective is your brushing?

Are you brushing using the right tool?

Are you brushing using the right way?

How do you know if you are brushing well?

Chances are you won’t know until a dentist examine you and tell you about it.


Whenever patient come for dental check up, I like to examine the teeth, the gum, the arrangement of their teeth and any other potential problem that is present.

Let’s look at this patient teeth together.


Case Study: a lower tooth that is difficult to clean

This young gentleman came requested for a scaling.

Interestingly, all the teeth in general are very clean; except for one tooth that was totally covered by calculus.

Immediately, I knew that something wasn’t quite right there.

When I looked again, I realised that the teeth next to it are not align with it.

It means that when he place his tooth brush there, the bristle of the tooth brush won’t be touching this tooth. No matter how hard he tried, he won’t be able to clean the tooth.

I discussed with him what is the challenge, and taught him how to angle his tooth brush in brushing this tooth.

Also, I suggested other tools that could help him in cleaning this particular tooth.

He was delighted to learn about the way of cleaning his teeth as he was always troubled by a rough feeling over this tooth.

Before he left, of course I cleaned his teeth so that he could start fresh from there.


In a nutshell, everyone has different teeth.

There is no one size fits all method of cleaning teeth.

If you have trouble cleaning your teeth, or you would like to know how to clean your teeth effectively, feel free to contact me for a personalised plan for you.

Thank you.


Dr Gwen Gan

Mandibular Tori (Torus Mandibularis)


Mandibular tori or torus (plural)  is a common harmless bone growth that develops at the lower jaw, at the side near to the tongue.

This condition normally does not have any significant impact to life as it does not disturb speech, eating or how the person looks.

Hence, most people never realise they have this excessive bone growth in their mouth until they were pointed out; or they just never know its existence.


Clinical Features

The mandibular torus present as a bony structure along the inner aspect of the lower jaw near to the premolar region.

It can be either  a single nodule or a bilateral growth (growing on both left and right side of the jaw)

The color of the tissue covering the bony structure is of the same color like the gum, and the surface feel smooth.

In rare circumstances, the bilateral tori can grow so big that the almost meet in the midline.



No treatment is necessary generally.

The only time that a treatment is considered is when a denture is required at the site, and the presence of tori makes it hard for a denture to be placed.

In such a case, a surgical removal is required to accomodate the denture.


My Experience With Mandibular Tori

It is a very common condition among Asian and I see it quite often in my practice.

Recently I was approached  by my patients raising concern about this as they were worried that it is something cancerous.

The first lady was a 80-ish lady and she was very concerned since she had lived so long and she never realised of its existence. I assured her that this is a harmless condition and we took photos to record it in case it grows bigger.

Another patient rushed in with a sudden panic attack worrying that her torus had grown. (We have discussed about her torus two years ago, radiograph and record was taken). This is a very young lady at her twenties. For her, I too make sure that the record is well taken and we measured it so that we can be sure if it grows.

The experience with these two ladies actually made me reflect on myself that something that is common in a dentist eyes, may not be something that patient is cool about.

The best is to inform patient whenever I see such condition and make sure they understand about it.

If you have a similar condition and you are wondering what is this, the best thing is to schedule and appointment with a dentist for a check up.

Else, you can send me a picture and if it is clear enough, I am happy to help diagnosing it.

Hope you learn somethin from this post.

Have a good day.


Thank you.

With Love,

Dr Gwen Gan

Smile Makeover For Lily – Part 1


This blog post is specially dedicated for Lily – a girl who is happy, determined and never give up.

How we met was nothing special, she is a patient and I am a dentist.

She came for dental check up and I was her dentist.

She probably did not expect that our meet up would change her smile and life; and I definitely would not expect that her story would remind me once again how my job could impact someone life.

I want to write this down to remind myself never to forget to be a kind dentist.


Lily had been to many different dentists before seeing me. Her appointment with me was an appointment for scaling.

She is a regular patient in the clinic that I work for but we have never met, she was seeing other dentist all the while.

Looking at her appointment, I did not have a second thought and thought that this is just another patient coming for a regular dental check up and scaling.

However, when I looked into her mouth, I started to frown.

She is a pretty and young lady, and it was very obvious that she had some dental problem but why nothing had been treated despite being a regular patient to the dental clinic. I felt sorry for her.

After the scaling, I sat her down and explain her about her oral condition.

I prepared a long list of what were the problems, what were the treatments required, what are the prices and how long she would need to complete all these.

I reassure her that she would be fine as what she was lacking is someone to guide her and do a good treatment plan for her.

I was running out of time that day, in fact I was overtime as I was only given half an hour with her, but I felt the duty to make sure she understood what is her oral condition and what types of treatment she needed. Hence, I kept her longer to feed her with as much information as I could.

Before she left, I told her that she must make an appointment to come for a discussion again and I did not really have faith that she would return as she was quiet and did not show much interest.

At least I did my part. That was what I thought.



Little did I know that, that time she was actually frustrated looking for a dentist.

She had been to many dentists hoping someone could help her, but all she got was blaming her for such bad teeth and never told her what to do.

After we completed everything only she told me that she was taking me as her last chance to fix her teeth.

If I failed her as everyone else, she was ready to give up already.

I am really glad that I took the initiative to explain her oral condition and the treatments that she needed even though she did not ask actively.

I am really grateful that I could be there to help her in making a decision that would impact her life.

I am glad that I still keep my pure heart being a dentist to help people in need. =)


to be continued…..