Dr. Kuok Yew Jhin
“What made you choose periodontics as your career path?”
I'd like to believe that most specialists or all specialists, at some point, started off as maybe being selected to be attached to a specialist, or even to be hand selected by a specialist, to be guided by one or inspired by one and I’m no different. I was inspired by a periodontist, actually, and it all started when I was a dental student in my third year. My mom was a patient of Dr. Jeanette and simply because of that, she invited me to come every time I had term breaks. I would have to spend the whole week observing. I didn’t like it not because I wasn’t interested but because I didn’t know what was going on. I didn’t understand and I saw procedures I have never heard of, or even looking back at the textbooks, they are either really small chapters with no photos. I felt like this wasn’t dentistry but that ticked a little bit because I knew that what I learned in 5 years is not enough. I knew my learning had to continue after this and that planted the seed of me wanting to specialize to begin with. When I started my career as a young dental officer in my first year, I was actually very obsessed with Oral Surgery. In fact, I almost wanted to do Oral Surgery; from doing on-call emergency cases, ward rounds, and even once I had no sleep, minimal food and water for almost 48 hours straight. Somehow, I still had a sense of fulfillment. To cut the story short, I was offered a job with Dr. Jeanette and I immediately accepted the offer. I saw things from a very different perspective, a very perio-based perspective. Life got easier eventually as I started private practice, I realized not what I really liked, but what I didn’t like. I wasn't good at root canal treatments, naturally. I didn't really like fillings and I don't believe I was good at handling children. Through the process of elimination, I found Periodontics.
“During your journey, I am pretty sure you faced a lot of challenges. Can you brief us on what challenges you have faced and how did you overcome them?”
Due to MCO, this poses the difficulty of me establishing a presence as a young periodontist in Kuala Lumpur. I was also fortunate as the beginning of the pandemic was towards the end of my program. While I was quite free during the lockdown, I started this online kind of teaching under my alumni. I think within two to three months, we organized about 27 lectures and it was only open to my alumni group. So myself included and I've got some of my friends to share and teach. I have also given online lectures back at my university in PIDC and also to MDSA UK, 3 years in a row now. This may have helped me establish a presence. The second thing is that I get a lot of patients telling me I look very young. I would say how I overcome this issue is that I adapt what I've learned from the UK, whereby the UK style is very much based on communication. I think that's something that maybe I didn't learn very much while I was an undergraduate, but it is very important ; how to listen, how to get to the point and how to instill confidence in your patients. The third one that I found challenging is that, I think the awareness of periodontal disease among both dentists and the public in Malaysia is quite low. I feel that all dentists and us as dentists, we are all ambassadors of our profession to promote oral health and gum health. It starts from us. Following from the UK for example, all general dentists are required to do something called the BPE or Basic Periodontal Examination and this will take around two to three minutes to perform. This serves as a guide to refer patients. It is not an assessment of the severity of the disease. Now, this is significant because in the UK, the litigation cases, more than 50% of it, or just over 50% meaning a majority of the cases are from patients suing the dentists for not detecting gum disease. That's what I think some of the challenges that I faced and I think one way to overcome this is for us to really promote periodontal health and one simple way you can do it is through the BPE.
“In your biography, it is stated that you have completed your specialist training in the UK. Many students out there like myself are very interested to pursue our studies in the UK. Can you share with us your experience on how your Postgraduate years have been like in the UK? “
It is the best time of my life, but it is also the worst time of my life. I deliberately chose London for various reasons, but one of them was because London, to me, is a truly multicultural city. From eating Ethiopian food all the way to being in a small little Spanish bar where everybody is Spanish and was speaking Spanish and they even spoke Spanish to me. These are the kinds of experiences that are truly worthwhile. Within the program itself, I was lucky to have been able to travel to, at least three times a year to different countries to go for perio conferences and symposiums of the best quality. The exposure itself was just fantastic. I've been to places such as Amsterdam, Valencia, Sevilla and Gothenburg, where it is the birthplace of perio. This is actually the strength I believe, in pursuing your postgraduate overseas, is that we don't use textbooks anymore. We use articles and journals. Coming to the bad side now, the program was really tough. You're alone and you're in a foreign country, you will have to plow through. It is really different from the challenges that you will face as an undergraduate and it is more lonely, I would say. Unfortunately, something happened internally within the department towards the end of second year and that really affected my batchmates and myself, which at one point I wanted to give up. Despite my parents spending so much money, I got to that point, that dark point. However, I have no regrets and if I could do it again, I would do it again in a heartbeat because I made lifelong friends and I traveled the beautiful country. That is the highs and lows of my experience.
When I made the decision to pursue a postgraduate degree, I did it for myself. I did it for the challenge. I didn't do it for fame, money or parents. I did it because I wanted to do it. This is really important because whoever is going to pursue a postgraduate degree, you will come to your lowest point and what really pulls you through is you, yourself. That’s what got me through.
“Now, coming to the topic of digital dentistry. “Digital dentistry is the future of dentistry.” Do you agree with this statement and why?”
Very much so and I'll go as far as to say that this is the next big leap in dentistry, I believe. In the last 50 years of dentistry, that major leap is probably the way we did research. We've had journals and in fact, the concept and the idea of systematic reviews, where we can then collate all these case studies and do it in a systematic manner to come up with a higher kind of evidence based approach. I think that was the major leap, but the next one now in my opinion, is digital dentistry. It is basically incorporating technology into our lives and technology is generally a good thing. It's like in Marvel movies where Tony Stark gives Spider-Man an upgrade. The costume doesn't make Spider-Man, Spider-Man. Spider-Man is still Spider-Man but with the upgrade, he becomes a better version. I think that's what digital dentistry is like. Is it really going to be the future? Again, I say yes, because it has not only permeated into implant dentistry. You will be surprised as to how Orthodontics and not just Invisalign are trying to incorporate digital dentistry. It is there whether you like it or not. Hence, yes, it is definitely the future.
“Doctor, I came across this article that talks of fabrication of implant reconstruction. Can you briefly explain to the audience what fabrication of implant reconstruction means? In your opinion, why is the use of digital technologies for fabrication of implant reconstruction said to be more effective than the conventional technique? “
Reconstruction means to build back what has been lost and in this term, we want to build back what is lost to restore function and aesthetics. We’ll be achieving that using dental implants.
More effective is a little bit questionable. If I were to be really pedantic, I can say how accurate digital dentistry is. You have examples from even the intraoral scanning, it may be about up to about 15 microns off and when we 3D print stuff, it may be up to 30 microns off. So, is this 15 and 30 microns significant? When we are planning for something, we typically need to superimpose the clinical scan and maybe a CBCT together and then you would have human error. It also depends on how accurate the CBCT was taken and what kind of brand of scanners that you use. All of these things are taken into consideration. There are many ways where we can make small little margins of errors. Will it be significant? Some may argue yes. Although it seems to be the beginning of digital dentistry in Malaysia, we are fortunate that other countries in Europe and the United States, have started this 15 to 20 years ago, and they have troubleshooted all the small problems to what it is today. It would be a fair statement for me to say that it is fairly more effective and accurate. So yes, definitely more effective overall.
“Digital dentistry is on the rise. How should dental students get more exposure to digital dentistry, since it has yet to be implemented in dental schools?”
That is certainly a problem. I definitely wasn't exposed to it when I was an undergraduate. I would even say I had minimal exposure when I was in London. Unfortunately, this is going to be a problem probably in the next 10 years. The top universities in the US and in Europe are starting to adopt this into their undergraduate program. So that to me, is fantastic. I think it has to come sooner rather than later. How should students get more exposure? That is a very tough question. Within the context of Malaysia, I think you would just have to grab whatever that is available. I do see a trend of lectures now shifting towards digital, which is great. Secondly, one of the good things that came out of this pandemic is that all these online lectures are all over the Internet so grab whatever you can. Google, go to YouTube or follow all these pages as they become more prominent over the last two years due to the pandemic. Grab whatever you can and learn it as it is only the beginning.
“To all the dental students out there who wish or choose to pursue digital dentistry, are there any advice that you would give them?”
Firstly, I think it should not be an option. Everybody must pursue it. I’ll tell you why this is not an option as you are going to come out and practice for the next 30 to 40 years. If you don’t start, you are going to lose out in 10 years and you are going to fall behind. If I put things into perspective, in 30 to 40 years, people are getting smarter. People are going to Google more and you will inevitably fall behind. I have a few pieces of advice. Firstly, keep an open mind and know that whatever you learn in 5 years is not enough. Learning never ends and I don’t use this word lightly, it never ends. I didn't learn much about digital and I still am learning every day by going to all these conferences and events whenever I can. If you have that attitude, that never-ending quest to understand things, you will be fine. Look out for courses online as well. Another piece of advice that I would like to give is that, just like all lectures, take it with a pinch of salt. Before you start flying in digital dentistry, you need to understand your basics very well. The last piece of advice is don’t work hard but work smart. However, I think that is insufficient. You have to work hard, smart, and be guided with a direction. You need to find the right mentor and to get good guidance. If you put all these four together, work hard, smart with a direction and a good mentor, that is probably the most complete way of engaging into what I believe is the next leap of dentistry.