Dr. Eugene Tang (right) helps an elderly patient put on her new set of dentures. (Photo by Pua Poo Toong)
The Ren Ci Nursing Home at Bukit Batok, which started operations in January 2015, is relatively spacious and equipped with modern amenities. Most of the elderly residents there are either bedridden or wheelchair-bound; as such, maintaining their dental hygiene is a challenge for the institution. As dental services in Singapore are rather expensive, and there are not many VWOs providing such services, the Tzu Chi Foundation (Singapore) signed a two-year Memorandum of Understanding with Ren Ci Hospital in April 2016, to provide free monthly dental services for residents at its nursing home in Bukit Batok.
On 29 October 2016, a team of seven Tzu Chi Singapore’s TIMA members and eight volunteers arrived at the Ren Ci Nursing Home to conduct another one of their monthly dental outreaches. The outreach included services, such as regular teeth check-up, cleaning, extraction, and fitting of dentures.
“Grandpa, your teeth are not in good shape. Do you want us to remove them for you? With dentures, eating will be easier.” TIMA dentist Dr. Chen Xian Li patiently said to Twan Kiat, a resident at the nursing home, after having checked his teeth.
Dr. Chen’s sincere and caring attitude eventually convinced the senior to undergo treatment. After seeking his approval, she started the process of extracting Twan Kiat’s teeth with the help of two other dentists. They discovered that he had many decayed teeth and decided to only remove the five that were in the worst state first, as there was a danger of blood loss if too many teeth were removed at the same time.
The dental team adjusted the height of the reclining chair and put a dental bib on him before anaesthetising him. Within half an hour, the simple surgery was successfully completed, with the support and loving care of accompanying volunteers.
Overcoming Space and resource Constraints
“At the nursing home, every resident is either in a wheelchair or bedridden. Often, the doctors need to bend over to conduct checks or carry out surgery, thus they easily suffer from backaches. In addition, the available facilities are not adequate. Hence, it takes a longer time to complete a surgical procedure,” said Dr. Lin Yuan Xu, a first-time participant of the dental outreach.
Dental assistant and Tzu Chi commissioner Jennifer Ee, too, explained the extra efforts to be taken for the dental outreach to proceed smoothly at the nursing home. “Here, it is not like our Tzu Chi Free Clinic, where the equipment and medicines are all ready for use. At the nursing home, we need prior preparation for tooth extractions and cleaning, as well as injections, and the equipment to be used.”
Ee is responsible for ensuring that all the required equipment are made available during every outreach. “If anything is lacking, we’ll need to go and buy it,” she added.
Over the last half a year, even though they faced many challenges, the team members were able to adapt and overcome the difficulties. For instance, as there was a fixed amount of equipment and medical supplies, the dental team had to be flexible with their scheduling of manpower and time. The team soon adapted to the constraints on-site, and whether it was serving a patient lying in bed or in the wheelchair, they would still be able to accomplish their task.
As there was an absence of the professional lighting facilities used by dentists, volunteers would chip in to assist with shining a light where it was needed. Equipment used in tooth extraction had to be immediately cleaned, and it was the volunteers who took on the task of sterilization. Others provided companionship to the residents and interacted with them; everyone had their own role, and this contributed to the success of the dental outreaches.
The Joyful Smiles of Patients
The visit to the Ren Ci Nursing Home was also the second time TIMA was giving out dentures as the first occasion had taken place the previous month. Residents who needed dentures were taken to the second floor, where they awaited their turn with the dentists.
“Many of the residents have gone without dentures for many years and wonder if they are suitable candidates for dentures, or even if they really need a pair. We will explain the reason to them, but most importantly, we have to respect their wishes,” said Ee.
Seasoned dentist Dr. Eugene Tang, who is also the TIMA dental team leader, related that at the beginning, some of the residents would be very uncooperative as they were afraid of pain. Some would even scold the dentists, and there were even those who would ask to stop the treatment halfway.
The Jing Si Aphorism, “be willing to give and happy to accept whatever comes our way”, is perhaps the best description for the TIMA members, who remain undaunted by the various issues that surface. They see every challenge as good training, and after holding many rounds of the monthly dental outreaches, they find the smiles of patients to be the biggest form of encouragement. As Ee said, “It is a special moment to see the smiles and joy of the residents when they receive their dentures. Their brilliant smiles give us great satisfaction. After we give them a pair of dentures, they can eat and chew properly, and it really makes us feel very happy.”
Venuza Lorenzo, a staff at the nursing home, also commented that many of the residents would feel very happy after their dental check-up, or after having their teeth cleaned or extracted. They would also feel much more comfortable after putting on their dentures.
After some 12 residents had been fitted with new dentures, another new group of residents arrived for their turn, accompanied by the nursing home’s staff. Dr. Tang smiled as he said that the residents have become familiar with him after receiving a few dental treatments. They would even greet him and were more accepting of receiving treatment. They would go back to their rooms and tell others about their experience, which in turn, encouraged their friends to sign up for the free dental services.
Empathy, the Best Type of Medicine
“The residents like to chat with other people so whenever TIMA conducts a dental outreach, they will eagerly enquire what type of treatment will be offered this time round. After treatment, they will ask when they can receive their dentures and the happiness evident on their faces makes us feel so warm inside,” shared Ee.
Apart from giving treatment, the dental team and volunteers also offer emotional support to bed-ridden residents, and this helps to mitigate their loneliness. Tzu Chi volunteer Xiao Hong Chang, who was participating in the dental outreach for the fourth time, commented that the residents are a special group of people who need much care from others, and a warm word of greeting can bring them some much-needed comfort.
He said, “Most of them here cannot articulate their feelings. We must empathise with them in order to understand their thoughts and feelings, so that they may feel our concern for them and know that we are here to help them regain the function of chewing food.”
Wu Tian Ming, an elderly volunteer who is about to turn 71, enjoys chatting with the residents, allaying any fears they may have. He has helped out three times so far, and expressed how blessed he was to be able to contribute even at his age. To him, serving the residents is a meaningful and inspiring experience that helps him learn to count his blessings.
When the elderly residents grinned with happiness, TIMA members and volunteers too, had smiles that shone through their tiredness.
Staff of the nursing home lending a comforting hand to a patient as the dental team checks his teeth (Photo by Pua Poo Toong)
Dentists Yang Li Ling (centre) and Chen Xian Li (right) carefully examining a resident’s teeth (Photo by Pua Poo Toong)
A Tzu Chi volunteer manually provides the lighting needed during a treatment session. (Photo by Fu Ya Tian)
Dental assistant Jennifer Ee (left) shared that the team derived great satisfaction from seeing the smiles of residents who received a new pair of dentures. (Photo by Fu Ya Tian)
Volunteer Xiao Hong Chang (left) feels that a few well-placed words of concern for residents in the nursing home can bring them familial warmth. (Photo by Fu Ya Tian)
A dentist makes use of a few spare moments to explain to the volunteers the procedure for fitting dentures. (Photo by Pua Poo Toong)
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