iCare Dental Review: Travelling From SG to KL for Root Canal Treatment + Crowning
Quick Note: If you are a parent and teacher reading this article, it’s prolly a good idea to get your kids to read this article or read it to them.
When I was young, my teachers and parents used to nag at me, about brushing my teeth regularly or you might end up “boh-gay” (no teeth in Hokkien). The threat is REAL and the repercussion is irreversible.
Story: We were all taught from young to brush our teeth the “dentist-way”, you know, 15 times each side, inside and outside up-down-left-right, plus flossing and gurgling with mouthwash. While I do brush my teeth twice daily, I guess I skipped quite a few steps, often enough for me to end up with huge cavities in my molars when I was in Primary School (think Primary 2 or 3?).
It took me quite a while before I realised that the affected teeth were not my milk teeth, which means they won’t be replaced with a new one and the huge-ass holes with ugly silver amalgam fillings are gonna stay with me for LIFE.
sings Carole King’s It’s Too Late
So for the next two decades, I tried my best to salvage the situation, but it could only be slowed down but not reversed. The gum around the affected teeth were receding and it often bled. I had the ostrich mentality and tried to ignore the aches (it’s a mistake!). The situation got so complicated that the dentists I went to for my braces and another for my teeth whitening did not try to address the problem and told me to return only if it started hurting again.
(Digressing a lil) I also recalled having nightmares about losing all my teeth and according to Dream Moods, it was associated that with feelings of powerlessness and loss of control. They can also mean that you’re worried about losing something, like a job or a relationship.
Visit 1: Consultation and Root Canal Treatment
So last year, my gum started swelling in an odd way. There were weird bubble-like painful swells along my teeth. After more than a week of attempt to ignore the problem, I went to a neighbourhood dental clinic in Singapore, and he recommended endodontic treatment at another affiliated endodontist. The cost was high enough for me to consider the option of getting the treatment in Malaysia. But is the time spent, and quality of treatment going to be worth it? So now, let me share with you my experience with iCare Dental as well as a summary of the time I spent, the(travelling + treatment) cost involved, and you can judge for yourself whether it’s worthwhile!Josh from LikeBeforeLove introduced me to Dr Beh Wee Ren, Director of iCare Dental and after delaying for almost 1 month (Yes, I have high tolerance for pain), I finally got my butt moving and head to KL by bus. A 5-6hour KKKL bus ride to TBS (Terminal Bersepadu Selatan), and then a 10 minute Grab car ride got me to iCare Dental @ Taman Connaught where Dr Beh is (on certain days).
Before the treatment, I had to undergo a diagnostic full mouth OPG X-ray. For clinics without the machine, this will be an additional trip to an X-Ray examination clinic. iCare Dental @ Taman Connaught has their own in-house X-Ray room, hence the scan was done and results received immediately.
Here’s the real reason why I stopped dragging my feet and arranged an appointment: the filling I had for ages dropped off one day when I was eating. Worried that it will worsen the cavity and that my worst nightmare (of turning boh-gay) coming true, I quickly went for the long overdue treatment.
The X-ray is used to see the shape of the root canals, the length of the root and determine if there are any signs of infection in a surrounding bone. As I was no longer in pain when I visited Dr Beh (nerve was dead), no anaesthesia was used.
During the consultation, Dr Beh explained the condition of my tooth and the procedures he will be doing. The bubble-like painful swells I experienced was an abscess – a pus-filled pocket that forms at the end of the roots of the tooth and the gum.
When there’s a deep decay, repeated dental procedures on a tooth, and/or large fillings, a crack or chip in the tooth, or trauma to the face, the tooth’s nerve tissue or pulp will be irritated, inflamed, and infected. The pulp then breaks down and bacteria begin to multiply within the pulp chamber. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth.
Here’s an interesting device I saw during the procedure. The electronic apex locator is an electronic device used to determine the position of the apical constriction and the length of the root canal space.
Root canal treatment saves teeth that would otherwise have been extracted. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed.
An access hole is drilled into the tooth. The pulp along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. Water or anti-bacterial solution is used periodically to flush away the debris.
Once the tooth is thoroughly cleaned, intracanal medication applied to clear up the infection. A temporary filling is then placed in the exterior hole in the tooth to keep out contaminants like saliva and food between appointments.
P.S. If you are wondering if the whole treatment is painful, I don’t know whether I should be happy or sad to tell you that it’s not painful at all (cuz my nerve’s dead and I can’t feel a thing). But as I have to keep my mouth open for an extended time, my jaw was pretty sore.
Visit 2: 1 week later…
The next appointment was a week after where Dr Beh had to check if there’s still infection or inflammation. This looks a little gross, but that’s how the affected tooth looked like when the temporary filling was being removed. There was no infection, hence, Dr Beh worked on the permanent filling (obturation) of root canals.
A rubber dam was used to helps isolate the tooth from the bacteria in the mouth – this is especially important in a root canal treatment and when restoring very large cavities that are close to the pulp. It also helps to keep the tooth dry while providing a clean and saliva-free environment.
The canals are finally filled or sealed with a sealer paste and a inert rubber compound called gutta percha.
After that, a customised mould was taken for the crown and sent overseas (in my case, Australia) to be made. A temporary dental crown was created to protect the tooth and to prevent further injury to gums until the final crown is ready to be fitted.
P.S. I had slight swelling around the temporary crown and the gums around it was slightly tender for several days. But other than that, all was normal and no medication was required.
Visit 3: Crown Fitting (4 weeks later…)
The crown was ready in 2 weeks after my second appointment, but as it was the festive season, I was caught up with work and had to postpone my third appointment several times. When the mould was taken, Dr Beh recommended me the two most popular types of crowns used in his clinic.
The Porcelain fused to metal crowns (or PFM crowns) are natural looking, durable and stable. However, there’s the “dark line” phenomenon where you will see the unsightly grey metal that lies underneath the crown’s porcelain surface especially when the gum recedes. They are often recommended for the back teeth where the dark line is not as visible.
The other type is the zirconia crown which does not have the metal fuse. It is aesthetically more natural (translucent enough to be similar to natural teeth), biocompatible, long lasting and extremely tough. However, it’s more expensive than the PFM crowns.
My Choice: My sister did her crowning using the PFM crown and was unhappy with the black line which made her tooth seem like decaying. As I have a wide smile (or you can say big mouth :P), I went for the Zirconia crown.
The third appointment was a short one hour appointment, mainly to do crown fitting and adjust the crown to make sure it fits aesthetically and does not affect my chewing. Dr Beh also explained about warranty and maintenance of the crown.
Crowning Or Not?
Many people went for root canal treatment because of the toothaches, and often stopped after the treatment and tried to save money by skipping on the crowning (like my brother!). This is not advisable as having a temporary filling (which means they stop after the first visit) does not protect your teeth from decay. The removed nerve and root might have been removed and you no longer feel the pain, but our daily eating will still cause stress to the cavity, and the next time the filling breaks, the whole tooth might be beyond repair and will require extraction and implant/ denture.
If you are wondering what else can be done besides root canal treatment, the only alternative to a root canal procedure is having the tooth extracted and replaced with a bridge, implant, or removable partial denture to restore chewing function and prevent adjacent teeth from shifting. These alternatives not only are more expensive than a root canal procedure but require more treatment time and additional procedures to adjacent teeth and supporting tissues.
Cost and Savings: Singapore VS Malaysia
Here comes the most important part of the article! Is it worth it? The cost of a root canal treatment varies depending on how severe your problem is and the tooth affected.
The Ministry of Health has published a guide (Last updated on 20 Apr 2015) to the cost of several specialist treatments at Singapore’s private dental clinics.
Root Canal Treatment (Molar Tooth) – Per Tooth*
Public Institutions SGD $678 – $815
Private Dental Clinics SGD $400 – $1,605
Excludes consultation, x-ray, investigation and re-treatment fees.
Crowns (Capping) – Single Unit*
Public Institutions $650 – $786
Private Dental Clinics $400 – $2,140
PFM Crown ≈ SGD $690
Full Porcelain Crown ≈ SGD $820
Includes laboratory fee and GST. Excludes consultation, x-ray and investigation fees.
Last updated on 20 Apr 2015 on MOH website. Fees are correct at the point article was published.
The rates I’ve managed to get from a local private clinic was SGD$1400 for molar tooth root canal treatment and PFM crowning. A top-up of SGD $200-$300 is needed if you opt for Zirconia crown.
iCare Dental Malaysia Clinic
Root Canal Treatment RM 500 – RM 2500 (≈ SGD $160 – $800)
PFM Crown RM 900 (≈ SGD $300)
Zirconia (Full ceramic crown) RM 2000 (≈ SGD $667)
Includes consultation, x-ray and investigation fees IF treatment is agreed on first visit.
Travelling Cost: It took me 3 visits to complete the whole procedure. Each return bus trip (Singapore to Kuala Lumpur’s Terminal Bersepadu Selatan and back) cost approximately SGD$45 – $70 depending on the type of buses you booked. A 10 minute Grab car ride (RM 7-10) will bring me to the terminal to iCare Dental @ Taman Connaught. Besides getting my treatment and crowning done, I did teeth scaling and made my retainers at the clinic too.
I’d usually take the first bus from Singapore and purchase the earliest bus ticket back to Singapore (on the same day) when my appointment is completed.
Time Needed: Travelling time really depends on the period you travel. Each ride took me 5.5h – 6.5h.
Appointment 1 (Consultation, Examination, Root Canal Treatment) ≈ 2.5h – 4h
Appointment 2 (Follow-up appointment and Crown Moulding) ≈ 1h – 2h
Appointment 3 (Crown Fitting) ≈ 1h – 2h
So if you’ve been contemplating about getting your dental treatments done in Malaysia, hope this article has provided you with sufficient information! If you wish to get your teeth cared for by iCare Dental and need more information for other treatments, email Dr Beh (firstname.lastname@example.org) and quote “Tiffany Yong” for a friendly price!
iCare Dental @ Taman Connaught
Address: 108 Mezzanine Floor, Jalan Cerdas, Taman Connaught, 56000 Kuala Lumpur.
Opening hours: Monday – Saturday (10am – 6pm) | *Except for Wednesdays (10am -4pm)
Other locations: http://icaredental.com.my/our-centres/
Website: http://icaredental.com.my/ | Facebook Page: https://www.facebook.com/icaredental.com.my/
Dr Beh’s advice: A root-canal-treated tooth can function normally and can be maintained with routine dental care and oral hygiene measures. Many teeth fixed with a root canal can last a lifetime. Practise good oral hygiene, including brushing and flossing at all times as root-filled teeth are as prone to decay as natural teeth. Have your treated tooth reviewed regularly and take care of your teeth.