We'd like to introduce you to Dr Clara Gibson from Expat Dental. She is originally from Ireland where she qualified as a dentist from Trinity College Dublin with the highest exam results.
In addition to having experience in general dentistry, she received her Masters in Orthodontics and Membership in Orthodontics with The Royal College of Surgeons.
After practising in London for 10 years, she relocated to Singapore, bringing with her vast experience in all types of orthodontic treatments.
Thank you for agreeing to talk to us, Dr Gibson. Can you introduce yourself to our readers and tell us a little bit about yourself.
Dr Gibson: I would be happy to! I'm Clara and I'm originally from Ireland. After training as a dentist there, I moved to work in London. I then spent some more years training as an orthodontist in London and ended up staying there for 10 years. I moved to Singapore at the start of 2020 and have been really enjoying living and working here.
Why did you choose dentistry instead of other medical fields?
Dr Gibson: It was tricky making that decision at the end of high school and I was deliberating between medicine and dentistry. Ultimately I chose dentistry because I liked the balance between diagnosis/pathology and the hands-on clinical side. Also, dentistry offers great work flexibility and options straight out of training; you can join a large hospital team or be your own boss and set up your clinic.
What got you interested in orthodontics?
Dr Gibson: I had orthodontic treatment as a teenager and had a favourable memory of it - no needles or drilling and an outcome which I was pleased with!
I like that patients are not necessarily ill when they come to see me so it's enjoyable building a rapport as I get to know them over a 1-2 year treatment plan. And orthodontics fits well with my personality - I enjoy working with a high level of attention to detail.
For people who may not know, could you describe briefly what you do and what is the difference between an orthodontist and a general dentist?
Dr Gibson: A general dentist has a broader focus, and will carry out treatments such as fillings, crowns, root treatment - this is focused on keeping teeth healthy and free of disease. An orthodontist focuses on treatments that involve moving the position of the teeth for cosmetic straightening or to improve the bite or function of the teeth.
What do you like the most about what you do?
Dr Gibson: It is very satisfying when I see patients who are self-conscious and unhappy with their smiles and I get to correct this. I really enjoy seeing the transformation throughout, and at the end of brace treatment.
Why did you choose to move to Singapore?
Dr Gibson: After 10 years in London, I knew I was ready for a change and the next challenge... and most definitely ready for some warm weather! I had some ties with Singapore and have always really liked it here.
The team at Expat Dental were very dynamic and progressive and the standard of dentistry was extremely high - I knew it was a team that I would like to get involved with so it was an easy decision to join them.
What are the differences between working here and in the UK?
Dr Gibson: Actually, there are not too many differences. Singapore healthcare is of a very high standard and I see lots of similarities with Europe.
I was based in a busy hospital in London, UK whereas I am working in a private setting in Singapore so I am enjoying having more time to spend with each patient.
Things are changing, but most dentists, especially specialists like orthodontists and oral surgeons are still male, or at least the public perception is such. What are your thoughts on this?
Dr Gibson: I am pleased to say that I think gender divisions are becoming more balanced throughout the dental industry. I have never encountered any issues in this regard and have always felt very respected here in Singapore as a female in the healthcare field.
Certainly in the UK, I used to lecture to undergraduate students and the trend would appear to indicate an increasing number of female students these days so I hope that there is a nicely balanced dental workforce in years to come.
People still have the habit of going to the dentist only when there is pain involved. Which oral health symptoms should not be ignored and outside of regular check-ups, at what point should they absolutely schedule an appointment?
Dr Gibson: It is indeed true that a lot of patients do postpone dental visits until symptomatic with pain, at which point the required treatment is often more complex than it could have been if treated earlier.
Any soreness in the mouth warrants a dental visit - routinely it is sensitivity or tooth wear and can be easily managed. If decay is detected, then it is preferable to catch it early when a small filling will suffice.
Ulcers in the mouth that don't show signs of healing after 3 weeks should always be checked by your dentist. It routinely is nothing sinister but it can provide clues as to some medical conditions which otherwise goes undetected.
Transitioning into orthodontics for a bit, what are the most common orthodontic problems treated in Singapore and do those differ from those in the UK?
Dr Gibson: Here in Singapore, there is a nice mix of both adult and child patients. There are many adults who had treatment as a child and now have some relapse or age-related dental tooth movement. Often these patients just require a short course of treatment to correct their concern, so this is quite a straight-forward and satisfying treatment for the patient.
In the UK, I treated many patients with cleft orthodontics and orthognathic surgery - so mainly treating children with facial deformities who required orthodontic work combined with jaw or facial surgery to correct their concerns.
This is one of the things which I like about dentistry - there are many different facets to it and you can tailor your work to whichever aspect you prefer.
Is orthodontics a field that develops fast? How do you stay up-to-date on the latest updates in treatment methods and technologies?
Dr Gibson: Yes indeed, orthodontics is rapidly developing with digital workflows and remote monitoring using A.I. becoming more and more popular. But what that all means for the patient however is that treatment is often faster, without the need for as many in-clinic appointments.
At Expat Dental, we fully embrace digital advancements and it is one of the reasons I was eager to join the team. Digital smile designs and 3D simulations help both us and the patient ensure the result is exactly what we both want before we even touch a tooth. And orthodontic patients are always very grateful to avoid us having to take putty impression moulds by instead using our 3D scanner!
During the pandemic, many of us were attending online webinars to get fully up to date on the latest dental tech.
Obviously, getting treatment as early as possible is important. At what age should people start orthodontic treatment?
Dr Gibson: It is beneficial to have an orthodontic consultation quite early on - around the age of 7 or 8 years. Occasionally, some treatment at age 9 is recommended and it's always nice for your child to be familiar with the orthodontic setting. Generally, though, most treatment is carried out when the patient has all their adult teeth, which is usually 11-12 years onwards.
Is it always best to start treatments as children or teens, or are there cases where the best time to start is once our bodies have fully developed and stopped growing?
Dr Gibson: This depends on the type of bite issue that the patient has, therefore an early consultation can help guide treatment. It is always disappointing when I see a patient too late (after they have stopped growing) as it can make treatment more complex and we may even have to accept a less-than-perfect result.
There are some types of bite conditions that do require a monitoring until after the patient has stopped growing, and only then we begin treatment. Therefore, seeing the patient early is always advised and the dentist will then recommend the best approach. I am always happy to monitor patients until the right age for treatment; this is always preferable to seeing them too late.
We receive a lot of questions starting with “Is it too late for me to…" Early treatment is vital, but is there such a thing as being too late in order to have satisfying results from the treatment?
Dr Gibson: There is no such thing as being too late, I treat patients in their late 60s! Treatment is often more predictable and straightforward when the patient is growing but that does not preclude treatment at any age. I have lots of adult patients with lingual braces (braces on the inside of their teeth instead of the outside) and this is a great option for adults who want discreet treatment at any age.
Pregnancy can put additional strain on women’s oral health. Do orthodontic treatments differ for patients who are pregnant?
Dr Gibson: The treatment itself doesn't differ but pregnant ladies may experience more gum symptoms and swollen gums. Therefore more frequent hygiene appointments for cleaning and maintenance is the best approach.
Can a child’s teeth straighten themselves naturally or do parents need to seek help as soon as they notice anything out of order?
Dr Gibson: As the child grows and develops their adult teeth, the bite and appearance of the teeth will change. Sometimes gaps between the front teeth will spontaneously close during this time. However, it would be unusual to see a patient's teeth straighten themselves naturally. If I see a young patient with quite a lot of crowding (not enough space for their teeth), I know that this won't improve by itself without some help from us.
What is orthodontic relapse and what causes it?
Dr Gibson: Orthodontic relapse is when teeth start to drift back to their original position after the treatment has finished.
How common is it and what steps can people take to minimize or prevent it?
Dr Gibson: Unfortunately, quite common. We recommend retainers at night after treatment has finished. This doesn't mean every night for the rest of a patient's life, but occasional nightwear to maintain the result.
As we age and change throughout life, our faces and bones change and skin lose elasticity - we now know that these subtle changes can coincide with teeth also changing in position. Some adults notice teeth becoming more overlapped, others see gaps opening between teeth. I recommend to my patients to wear a night retainer occasionally to help maintain their straight teeth and smile.
In your experience, what is the best method for treating orthodontic relapse?
Dr Gibson: There are lots of options for this and all are equally effective. Traditional metal braces or white ceramic braces are reliable. Clear aligners have the advantage of being removable for eating and cleaning. My personal preference is a lingual brace on the inside of the teeth - completely invisible, very effective and there is no risk of the patient forgetting to wear it as it stays in situ during the whole treatment.
Do people have to wear retainers after braces or Invisalign treatment in order to maintain the results?
Dr Gibson: Yes. Regardless of the type of brace used, the risk of relapse remains the same.
However, the orthodontist can judge from the start certain types of bite issues that will be more prone to relapse and they will advise accordingly. Some patients benefit from having a thin fixed wire retainer placed on the back of the teeth.
Underbite and overbite are among the more common serious orthodontic conditions. What factors affect whether or not jaw surgery is the best approach?
Dr Gibson: Two main factors affect this: the severity of the bite issue and the patient's concerns.
The orthodontist will advise if braces alone will not be able to fully correct the problem and therefore, jaw surgery would be required for complete correction. Many patients choose not to have surgery though, and then it is possible to use braces to get an improved result for the patient, but accepting that it may not be perfect.
If the patient has concerns about their facial appearance, such as one or both jaws are not straight or too far in front/behind, too large/small, then jaw surgery combined with braces is the best way to correct this.
An orthodontist trained in orthognathic (jaw) surgery will be able to detect the subtleties of the bite and facial issues and discuss treatment options and provide advice.
You’ve had a lot of experience in dealing with complicated orthodontic cases overseas. What was the most challenging case you treated?
Dr Gibson: A few come to mind! I think reconstructive cases can be the most challenging but rewarding. For example, children who have had facial tumours removed and hence are missing some facial bone structures and missing jaw bone and teeth. In these cases, a bone and soft tissue foundation is first required before addressing the bite and creating a nice smile so these cases require a bit more planning in advance.
It must feel very rewarding for you personally, especially when it comes to successful treatments of more severe cases.
Dr Gibson: Yes, the outcomes can be life-changing for the patient and that makes all the years of studying and training worthwhile!
There are a lot of things that we can all do to maintain good oral hygiene and health. But when it comes to orthodontics, is there anyone specific thing that you think everyone should know, even before their first appointment with you?
Dr Gibson: I think dentistry still has a bit of a bad reputation and a lot of patients have some horror stories to recount from the past! So I would love for patients to know that dentistry and orthodontic treatment has changed so much and is now much less invasive, more flexible around people's lifestyles and more discreet. I like listening to what each individual patient's concern is about treatment and tailoring their plan specifically to suit them.
Those are all the questions we have when it comes to orthodontics. Is there anything that we missed which you think is important? Or any final piece of advice you’d like to leave for our readers?
Dr Gibson: It is always worth seeing a dentist or orthodontist for advice. Even if you decide not to go ahead with treatment, it is always better to have the correct advice and then decide from there. I have seen too many patients with incorrect information from unreliable sources being unnecessarily worried and it is such a pity.
I’d like to conclude this on a lighter, more personal note. We know you like to go for a run or horse riding in your spare time. Did you grow up with a love for horses or is that something that captivated you later in life?
Dr Gibson: I did love it from childhood but I had very reluctant parents so it was only in university that I started horse-riding frequently. I started playing polo at university and it is still the most exhilarating team sport that I have played but I am still getting used to playing in the Singapore humidity.
Any other hobbies or what else do you like to do to relax in your free time?
Dr Gibson: I like to keep active so outside of work I am mostly cycling, running or playing tennis. I've also played the piano since I was a child so that is the perfect way to relax at the end of a long workday.
I think this is all for now. Thank you for taking some of your precious time to talk with us. We appreciate it and I know our readers will as well.
I hope you found this interview as interesting and informative as we did. If you have more questions about your oral health and treatments, you can get in touch with Dr Gibson and Expat Dental at:
Address: 10 Sinaran Drive Unit 08-15/16 Novena Medical Centre, Singapore 307506 and 20 Malacca Street, Unit 01-00, Malacca Centre, Singapore 048979
Phone: 65 6397 6718 / 65 6816 5742