https://www.etmh.com.sg/calendar daily 0.75 2022-09-12 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1480060620841-KRLUD7UCV14N1QKYFGM2/Singapore-Skyline.jpg Events/Courses https://www.etmh.com.sg/calendar/2022/9/13/marpe-mini-screw-assisted-rapid-palatal-expander-workshop-and-marpe-complications-what-to-do-and-what-not-to-do monthly 0.5 2022-09-12 https://www.etmh.com.sg/calendar/2022/11/28/dentists-role-for-children-with-sleep-disordered-breathing monthly 0.5 2022-09-12 https://www.etmh.com.sg/calendar/2022/11/27/designing-the-airway-for-better-sleep-from-infants-to-adults monthly 0.5 2022-11-10 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/27844699-d0ea-4946-88b7-97e3cbea1dc3/ETMBanner+AY.jpg Events/Courses - Designing the Airway for better sleep: from infants to adults https://www.etmh.com.sg/calendar/2019/1/sleep-medicine-the-role-of-the-oral-healthcare-professional-making-a-difference monthly 0.5 2022-09-12 https://www.etmh.com.sg/calendar/2018/12/4/sleep-medicine-the-role-of-the-oral-healthcare-professional-making-a-difference monthly 0.5 2022-09-12 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1543935786525-WADYAJ0J2QM75URZM2JX/ETMBannerDS.jpg Events/Courses - Sleep Medicine - The Role of the Oral Healthcare Professional: Making a Difference https://www.etmh.com.sg/calendar/2018/7/9/sleep-bruxism-and-apnea-an-association monthly 0.5 2018-06-15 https://www.etmh.com.sg/calendar/2017/8/25/sleep-medicine-for-physician-and-dentist-interdisciplinary-clinical-sciences monthly 0.5 2019-12-04 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1503630913546-GG4LN7YKBTF8946J0XRO/ETMHBanner.jpg Events/Courses - Sleep Medicine for Physician and Dentist: Interdisciplinary Clinical Sciences https://www.etmh.com.sg/calendar/2017/3/26/multidisciplinary-perspective-on-sleep-disordered-breathing-state-of-the-art monthly 0.5 2017-02-23 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1485015638531-WAXNLOWJVDZJUVREC2IA/image-asset.jpeg Events/Courses - Multidisciplinary Perspective on Sleep Disordered Breathing - State of the Art https://www.etmh.com.sg/calendar/2017/3/27/sleep-the-new-health-frontier monthly 0.5 2017-01-21 https://www.etmh.com.sg/calendar/etmh-distinguished-speaker-programme monthly 0.5 2017-02-23 https://www.etmh.com.sg/calendar/2016/9/17/sleep-medicine-for-the-dentist monthly 0.5 2017-01-22 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1478192301873-0L51ANM5ZCO2771ILSMN/NUS.png Events/Courses - Sleep Medicine for the Dentist https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1478192337565-7TAL9ZE9RPFUNHSWKCOC/logo.png Events/Courses - Sleep Medicine for the Dentist https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1478192314766-JTI9ZQI3KFB364EF5Y9M/fondaco.png Events/Courses - Sleep Medicine for the Dentist https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1479390971255-4VB74JQECC8XR0KXG4H6/ortho.png Events/Courses - Sleep Medicine for the Dentist https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1479390971298-1ZHE7695NGH5F5AKZZCP/sunny.png Events/Courses - Sleep Medicine for the Dentist https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1485098050477-Q2BSJVN5RSE4VJK893KW/image-asset.jpeg Events/Courses - Sleep Medicine for the Dentist Dr. David Tay and Dr. Kenny Pang https://www.etmh.com.sg/blog daily 0.75 2018-06-08 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1524756595013-7N6QU57IVMEXNP41JNCY/edmundblur.jpg My Clinical Insights https://www.etmh.com.sg/blog/2018/6/8/188qapd6gtryb9d576kc2k6e3p8m1x monthly 0.5 2019-09-14 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1528462651010-GFBM1UBUUF8PU61T9RO3/Fig21b.png My Clinical Insights - Dentists must learn to look beyond the molars! Fig. 21B CBCT scan of the same patient wearing a Mandibular Advancement Splint (set at 75% of his maximum protrusive range) for the management of his UARS. Notice the significant dimensional improvement in his pharynx especially at the retro-glossal and retro-velar regions. https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1528462608778-TO03EFBEBOWOQWRCML3V/Fig21a.png My Clinical Insights - Dentists must learn to look beyond the molars! Fig. 21A The CBCT scan when the patient was biting at maximum intercsupation. His severely compromised upper airway (in black) can be clearly seen despite the fact that the patient was awake and seated upright. His worn occlusion had been Gnathologically reorganized at centric relation. https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1528465439356-166B97AL41D0RVYCAUJX/Fig22.png My Clinical Insights - Dentists must learn to look beyond the molars! Fig. 22 Our postulate on how the TMD-UARS phenotype may have originally developed as an adaptive response to ‘awake’ disordered breathing [2]. The Southern Chinese craniofacial morphology has been previously implicated in sleep disordered breathing but uninformed dentists may further exacerbate the ‘Restricted Box’ by inappropriate treatment (e.g. retractive orthodontics with 4 bicuspid extractions and/or rigid adherence to Gnathologic dogma) of these morpho-functional adaptations (including dental malocclusion) to the patient’s pre-existing awake disordered breathing. An interdisciplinary team approach is advocated. https://www.etmh.com.sg/blog/2018/3/4/establishing-a-putative-diagnosis-of-bruxism-in-daily-practice-using-a-6-week-nti-trial monthly 0.5 2019-09-27 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520158702703-QINAHGLEV0UELBK9J8U5/Fig13b My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 13A Typical NREM SB wear patterns on the sleep NTI https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520158970222-JTHQXVOS7JVSKR4C1G87/Fig16 My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 16 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520159204824-3SP8SFGJYEG6KCUURR19/Fig4 My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 4 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520158448836-MZ8K6BGREQ3D9N2E7DPT/Fig12 My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 12A Sleep NTI - Usually made on the upper arch. Fig. 12B Always ensure that the discluding element is perpendicular to the opposing incisor. Fig. 12C Awake NTI - Usually made on the lower arch as it interferes less with speech. Notice also the cervical abfraction lesions and the bony exostoses related to Awake Bruxism in this patient. Fig. 12D There must be no posterior tooth contacts in centric and eccentric mandibular excursions. https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520158754861-WD7DU6SZFZAS9BXV1SU1/Fig15.png My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 15 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520159035637-IFJB07AUS4M7GI30FXZN/Fig18 My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 18 REM Sleep Bruxism https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520159237150-FAPKG58KBA0M3BEGNZXC/Fig20 My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 20 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520158996924-HF24F7INV1H3IRY53QKY/Fig17 My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 17 NREM Sleep Bruxism https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520183796786-QHPVIXY4CFHIKLGXXARS/Fig13b My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 13B Characteristic REM SB wear pattern on the sleep NTI https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520158630224-KK0XJ74PPYEIJMAZ1NX1/Fig14 My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 14A & B REM SB wear on sleep NTIs Fig. 14C Patient exhibiting both NREM & REM SB https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520159089081-2TKS8TQ89I7JE28SHHTI/Fig19 My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. Fig. 19 Awake Bruxism https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520214803037-OTIJHLWX9RCRCUNVXGTX/Table1_edited.png My Clinical Insights - Establishing a putative diagnosis of bruxism in daily practice using a 6-week NTI trial. https://www.etmh.com.sg/blog/2018/3/4/awake-bruxism-ab-and-the-masseter-muscle-hypertrophy-controversy monthly 0.5 2025-08-09 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520156792768-37PI3Z47CCYBH64985AD/Fig9 My Clinical Insights - Awake Bruxism (AB) and the Masseter Muscle Hypertrophy Controversy; Secondary vs Primary(or Idiopathic) Bruxism Fig. 9 Pathognomonic occlusal wear pattern related to lateral mandibular flexure associated with habitual (awake) parafunctional clenching https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520156999256-RVQPCUZDU2YK1PIDPMTV/Fig11 My Clinical Insights - Awake Bruxism (AB) and the Masseter Muscle Hypertrophy Controversy; Secondary vs Primary(or Idiopathic) Bruxism Fig. 11 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520156703934-5UURXN0R6723PSN7D1P1/Fig7 My Clinical Insights - Awake Bruxism (AB) and the Masseter Muscle Hypertrophy Controversy; Secondary vs Primary(or Idiopathic) Bruxism Fig. 7 Awake Bruxism https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520156745246-DP39IETT4WPRGNOSM9IU/Fig8 My Clinical Insights - Awake Bruxism (AB) and the Masseter Muscle Hypertrophy Controversy; Secondary vs Primary(or Idiopathic) Bruxism Fig. 8 Awake Bruxism https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520156895534-JLX4I3JYL1NZIJ8PRV3Y/Fig10 My Clinical Insights - Awake Bruxism (AB) and the Masseter Muscle Hypertrophy Controversy; Secondary vs Primary(or Idiopathic) Bruxism Fig. 10A Increase in mandibular width during clenching Coactivation of bilateral hypertrophied temporalis and the pterygo-masseteric slings can cause intermolar distance increases during heavy clenching. The mandibular molar is carried buccally, repeatedly rubbing against opposing surfaces. Maximum lateral mandibular flexure occurring in the horizontal plane as reflected by a 0.5-0.6 mm increase in the intermolar distance has been estimated in chronic habitual clenchers. Fig. 10B Pathognomonic mandibular flexural occlusal wear pattern Involving the buccal facing inclines of the mandibular buccal cusps vs the lingual facing inclines of the maxillary buccal cusps & buccal facing inclines of the mandibular lingual cusps vs the lingual facing inclines of the maxillary palatal cusps.This hollowing out of the mandibular and maxillary occusal tables weakens the antagonists, leaves the unsupported enamel in the mandibular lingual cusps, and sharp edges all around. Prophylactic coronoplasty (e.g. creating more rounded cuspal morphology and reducing the tight grasping mortar-pestal intercuspation) will render the affected teeth less vulnerable to frictional wear/cracks/fractures and plastic restorations less prone to dislodgement and microleakage. The mandibular lingual cusps characteristically end up higher than the buccal in those engaging in severe habitual awake clenching. Fig. 10C Compensatory eruption and formation of non-carious cervical abfraction lesion As tooth surfaces wear, compensatory eruption will progressively ‘deepen’ intercuspation and the increased surface contact area during consequent function and parafunction leads to even greater frictional attrition and unfavorable stress concentration. The parafunctional forces repetitively generated during centric clenching create distinct stress shielding patterns that adversely affect enamel prism integrity at vulnerable cervical regions where prism orientation is different and the amelodentinal junction less scalloped. Notice the morphology of the mandibular cervical abfraction lesion is distinct from those found in the maxillary arch. https://www.etmh.com.sg/blog/2018/3/4/bruxism-phenotypes-one-size-does-not-fit-all monthly 0.5 2021-08-03 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520156183333-ZZOK2X5KH3PMARF5X4HJ/Fig5 My Clinical Insights - Bruxism phenotypes – One size does not fit all! Fig. 5 Orthotic therapy for REM SB The modified SomnoDent Fusion is a Mandibular Advancement Splint (MAS) that could be considered in the management of SB when there is comorbid SDB. It is ideal in the management of these ‘destructive’ REM sleep bruxers as the lateral wings are metal reinforced and replaceable. Tying the maxillary and mandibular plates together with orthodontic power chains prevents injurious mandibular torqueing that not uncommonly occur during REM SB episodes. https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520156236644-K06ZQ5G3WV97VIZCSQWK/Fig6 My Clinical Insights - Bruxism phenotypes – One size does not fit all! Fig. 6A Hypnogram representing the schematic distribution of RMMA episodes over the sleep cycles. RMMA episodes are more frequently observed during NREM stage 1 & 2, sleep stage shift, and pre-REM sleep periods. RMMA episodes in REM stage occur less frequently. The latter, however, have greater potential to cause stomatognathic damage and we’ve had patients who only exhibited REM SB without the NREM variety. Fig. 6B Example of an RMMA episode Defined on the masseter electromyographic channel as an activity of at least 3 consecutive EMG bursts (frequency 1Hz) lasting greater or equal to 0.25 sec. https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520156014320-FVU9CDNN39N87VPYW0I6/Fig3 My Clinical Insights - Bruxism phenotypes – One size does not fit all! Fig. 3 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520156103490-7HOP3NU5WDJG107AGA67/Fig4 My Clinical Insights - Bruxism phenotypes – One size does not fit all! Fig. 4 Phasic NREM SLEEP BRUXISM with comorbid UARS and GERD https://www.etmh.com.sg/blog/2018/3/4/the-demystification-of-sleep-bruxism-is-what-measured-necessarily-a-fact monthly 0.5 2019-09-14 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520155256156-0SE1WYP52UFB3DCOEMLW/Fig1 My Clinical Insights - The Demystification of Sleep Bruxism – Is what's measured necessarily fact? Fig. 1 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1520155540988-95TAQ6ESKFZSL97XZA2B/Fig+2 My Clinical Insights - The Demystification of Sleep Bruxism – Is what's measured necessarily fact? Fig. 2 https://www.etmh.com.sg/blog/2018/3/3/introduction monthly 0.5 2018-04-26 https://www.etmh.com.sg/edmund-tay-mai-hiong daily 0.75 2021-05-29 https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1470817309642-I4XHS3CV6MKFLLDKD3EC/image-asset.png Edmund Tay Mai Hiong Professor Tay (extreme left) with our First President Yusof Ishak and the First Lady, Puan Noor Aishah, at the Istana https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1470818680795-DFBKE09Z84IAKWTROINO/Kid.png Edmund Tay Mai Hiong https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1470817773624-4ZR3UZ51UW0LU0RZFWYJ/image-asset.png Edmund Tay Mai Hiong My father (extreme right) when he was a King Scout with other patrol leaders and the legendary Black Bear (third from left) https://images.squarespace-cdn.com/content/v1/579eebd42e69cf81541e8395/1470818107426-O6CBHXZS5A01E9RZ4XS8/image-asset.png Edmund Tay Mai Hiong Inaugural opening of the Faculty of Dentistry (1966). 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