Scandinavian dentist provides pointers to stem oral cancer

By: Mariecar Jara-Puyod | April 22, 2018 | Gulf Today

ABU DHABI: A Scandinavian second generation dentist based in Abu Dhabi has raised the alarm against oral cancer and has given tips to address this common but neglected disease since April is the Oral Cancer Awareness Month.

From the recent World Health Organisation (WHO) Global Oral Health Programme files, it was known that oral or mouth cancers are a “kind of head and neck cancer.”

One of these is the oropharyngeal cancer or throat cancer, the 11th most common cancer worldwide.

Signs and symptoms of oropharyngeal cancer, caused by the human papilloma virus, are sores or blisters at the back of the mouth; difficulty in speech, swallowing and breathing; neck swelling; loss of appetite and weight; and weakness.

According to the “Global Burden of Oral Cavity and Pharyngeal Cancers” paper, oral cancers include tumours located on and which affect the “mucosal surfaces of the mouth, salivary glands, oropharynx, nasopharynx, and hypopharynx (collectively the part of the throat behind the mouth).”

Estimated annual global deaths attributed to oral cancers are at over 520,000. 

As WHO noted that 90 per cent of oral cancers are a result of tobacco use including smoke-less and e-cigarettes as well as excessive alcohol consumption, experts who had researched on the global burden of oral cavity and pharyngeal cancers considered tobacco chewing and betel-quid chewing with or without the cigarette as risk factors as well.

“Other emerging factors include diet low in fruit and vegetable consumption and poor oral hygiene.”

The experts who analysed population-based cancer registry data in the Middle East and Africa found that the most common causes of oral cancers in the region are cigarette/toombak and khat smoking, mate and alcohol.

The predominantly affected organ for these oral cancers is the tongue. 

The highest incidence rates are in Djibouti, Somalia, Sudan, Madagascar, Mozambique, Mauritius and Botswana.

From Abu Dhabi, Sno Dental chief executive officer Dr Per Rehnberg said: “Oral health is important to overall health. We believe regular check-ups can help prevent oral cancer by helping detect it earlier than ever before.

“The best way to manage and treat an oral cancer diagnosis is by combining early detection of the disease with timely treatment.”

With over 30 years of work as a dentist in Norway, Sweden and Denmark, Rehnberg, who grew up with a dentist-father, added: “While oral cancer is not a rare disease, it is particularly dangerous because it tends to go unnoticed.

“The potential for death is significantly reduced if cancer is detected early, making treatment easier, less invasive and more than 90 per cent curable.”

Rehnberg who has followed his dentist-father’s approach that being the best dentist is to incorporate “one-third science, one-third craftsmanship and one-third patient care” has the following tips against all forms of oral/mouth cancers:

• Refrain from using tobacco products. Smoking has been linked to many types of cancer including that of the head, neck and oral cavity.

• Brush the teeth twice a day with a fluoride-based toothpaste. This will extricate cavities/gingivitis/halitosis-causing bacteria.

• Floss the teeth twice a day. Evening flossing will remove the bacteria that will feed on food particles. It will prevent bad breath.

• Check the mouth personally every month in good light for non-healing ulcers, bleeding, abnormal patches and swellings which are signs and symptoms of oral cancers.

• If the non-healing ulcers, bleeding, abnormal patches and swellings prevail and become unresponsive to treatments for over a month, go for the dental check-ups again.

• Go for bi-annual dental check-ups or every six months.

• Avoid too much exposure to sunlight or wear a protective lip balm with sun protection factor to prevent lip cancer.

• Consume lots of fruits, vegetables and nuts every day. Go for regular physical exercises.

• Limit or better yet cut out alcohol consumption.

Sno Dental in the capital is offering free screenings until April 26.



By Mariecar Jara-Puyod

April 22, 2018

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Doctors in UAE sound oral cancer alarm over use of qat, betel leaves

By: Jasmine Al Kuttab /Abu Dhabi | May 4, 2018 | Khaleej Times

Doctors in the UAE are warning against the illegal use of betel leaves (paan) and qat leaves, which they said are among the top causes of oral cancer.

"We have noticed people consuming these dangerous carcinogenic substances, mainly coming from South Asia and Yemen," Dr Norbert W. Dreier, consultant - oncology at Burjeel Hospital, told Khaleej Times.

According to the UAE law, qat leaves are banned. The trafficking, possession or consumption of the substance is a criminal offence.

Betel leaves, which are widely chewed in Asia as a stimulant substance, are also banned in the UAE and those caught trafficking or consuming the product will face penalties. 

Dr Dreier pointed out although oral cancer is not the leading cancer in the UAE, expats from South Asia, who have been using these substances are mostly at risk. "What we have noticed is patients from these areas who have a habit of chewing the betel and qat leaves are more prone to the disease.

"In Western countries, we see more people with oral cancer, which has been caused mainly by tobacco and alcohol consumption. However, here we see more cases among people chewing betel and qat leaves."

Dr Anoop Azad, specialist in prosthodontics at Universal Hospital, said betel nut (paan) chewing is popular among Asian people, and is a top risk factor for oral cancer.

However, oral cancer causes are not only related to the prohibited substances, but also to tobacco chewing or 'reverse smoking,' he warned.

"In India, many people smoke without filters," he said, adding that he had noticed that oral cancer cases are more common among Indian expats in the UAE, particularly the workers in camp sites.

"The expats are the major part of the volume, and when we ask about their history, they refer to such substance use."

He said the disease can be deadly because it can quickly spread to the neck and chest.

"The chances of oral cancer spreading to other areas is much faster, because of the extensive blood supply."

He stressed that early intervention is crucial, and urged the public to undergo regular screenings, warning that the disease is difficult to detect and can thus turn fatal.

"If people ignore the signs, it will not only get worse, but it can turn fatal very quickly."

"People tend to take this issue very light. They don't understand how important it is to have their screening done."

He said in the last two years, he has seen around 15 cases related to oral cancer, and the youngest patient was just 22 years old. He said he attends at least six cases of patients who have developed lesions and ulcers a month, which can develop into cancer.

Dr Per Rehnberg, CEO of Snö Dental, said the potential for death can significantly be reduced if the cancer is detected early, making treatment easier, less invasive and more than 90 per cent curable.

"The best way to manage and treat an oral cancer diagnosis is by combining early detection of the disease with timely treatment."


He urged people to regularly examine their mouth, to look for non-healing ulcers, areas of bleeding, abnormal patches and swellings.


Dr Rehnberg added that professional screening should be conducted every six months.

He also advised people to protect themselves from sun exposure, as lip cancer is directly related to ultraviolet radiation from sunlight.


"People who work outdoors and have prolonged exposure to the sun are more likely to develop lip cancer."


Top causes of oral cancer

>Chewing betel or qat leaves

>Around 50 per cent of the oral cancer cases are related to tobacco use

>Reverse smoking

>Human papilloma virus is another risk factor

>Those with a family history of cancer, and/or a weak immune system are at a greater risk



Jasmine Al Kuttab /Abu Dhabi

May 4, 2018

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Free screening and top prevention tips offered for Oral Cancer Awareness Month

April 20, 2018 | Health Magazine AE

In an effort to shed light on the importance of prevention when it comes to oral cancer, the Abu Dhabi based practice is offering the screening from April 19 to 26 and has identified eight top tips to avoid the disease – which is notoriously difficult to detect.

While oral cancer is not a rare disease, it is particularly dangerous because it tends to go unnoticed. The potential for death is significantly reduced if cancer is detected early, making treatment easier, less invasive and more than 90% curable.



Dr Per Rehnberg, CEO of Snö Dental said: “Oral health is important to overall health and we believe regular checkups can help prevent oral cancer by helping detect it earlier than ever before. The best way to manage and treat an oral cancer diagnosis is by combining early detection of the disease with timely treatment.

“This can affect all adults therefore we would urge people to get regular screenings and we are delighted to be in a position that we can offer this for free to the Abu Dhabi community.”

“At Snö Dental, we would like to take the opportunity to get involved and give back to our local community in hopes to raise oral cancer awareness and the need for early detection to save lives.”


Oral Cancer


Here are some simple tips from Dr Per Rehnberg, that can help prevent oral cancer.

Don’t use tobacco products

Smoking has been linked to many different types of cancer, including that of the head, neck and oral cavity. To greatly reduce your chance of developing oral or oropharyngeal cancer, stay away from tobacco in any form.

Maintain good oral hygiene

Brush and floss your teeth daily as bad oral hygiene is a known risk factor for oral cancer. Brushing twice a day with a fluoride-based toothpaste is critical in removing bacteria that causes cavities, gingivitis (inflammation in the gum) and bad breath. Flossing is often forgotten, however, if you don’t floss, you will miss cleaning 35 percent of your tooth surfaces. Flossing in the evening will remove bacteria that like to feed on food particles throughout the day and also prevent bad breath.

Regular self-oral examination

Examine your oral cavity (mouth) in good light once every month to look for non-healing ulcers, areas of bleeding, abnormal patches or any swellings, as these may be signs of cancer and early detection increases the chances of successful treatment.

Have regular professional screening

Scheduling six-month check-ups is a great way to keep a healthy mouth. Early detection and regular preventive examination are key to surviving oral cancer. Regular expert screening at a dental clinic can detect early warning signs, giving you your best chance at successful treatment. Make sure your clinic does this.

Protect yourself from sun exposure

Lip cancer is directly related to ultraviolet radiation from sunlight and people who work outdoors and have prolonged exposure to the sun are more likely to develop lip cancer. To reduce this risk, you must try to limit your exposure to sunlight and other sources of ultraviolet (UV) radiation. This does not mean you must avoid the sun altogether. Always wear a protective lip balm with SPF when you’re outside in the strong sun.

Don’t ignore any ulcer / bleeding / pain

If you spot any ulcers or bleeding that do not respond to treatment for over a month, please get it checked out as it could be something much more serious.

Proper diet and a healthy lifestyle

A diet rich in vegetables, fruits and nuts with regular exercise is known to protect from oral cancer. Most of us have sedentary lifestyles and we must try and balance this by doing some form of regular exercise.

Cut out alcohol

Alcohol is known to be a big risk factor for oral and oropharyngeal cancer, particularly when used along with tobacco. It is advisable to limit your alcohol intake to a minimal level. Not only will this prove to be good for your liver and heart, but it also reduces your risk of oral cancer. Latest general recommendation says no more than 5 glasses of wine or 5 pints of beer per week.

To schedule your oral cancer screening, contact Snö Dental today at 800 DENTIST (800 3368478).


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Do not neglect dental hygiene when fasting

By: Samihah Zaman | May 23, 2018 | Gulf News

Common issue like bad breath can be easily prevented with proper care, dentists say

Abu Dhabi: Overindulging in sweets coupled with lack of hydration during Ramadan leaves many residents with bad breath, or worsens dental problems, dentists warned.

“Many people believe that bad breath cannot be avoided while fasting. They also put off dental treatment during Ramadan, but this can make existing tooth cavities bigger,” Dr Nasser Fouda, gum specialist at Sno Dental Clinic in Abu Dhabi, said. “Simple steps like rinsing the mouth frequently and brushing and flossing properly will ensure dental hygiene, even while fasting

According to Dr Fouda, bad breath, or halitosis, is often the result of a dry mouth. The lack of saliva causes bacteria in the mouth to act upon food remnants between the teeth and on the coating of the tongue, releasing unpleasant gases.

“It doesn’t help either that people eat a lot more sugary food and meat, then go to bed without brushing their teeth,” added Dr Sujay Mohan Rai, specialist prosthodontics at NMC Specialty Hospital.

“Dental prostheses like dentures, bridges and retainers should not be ignored, and should be cleaned frequently while fasting, as they too can harbour food particles,” he added.

In addition, it is a good idea to rinse frequently with mouthwash or just water.

“We also advise residents not to put off dental treatment till after Ramadan. Even if you are worried that the treatments will affect the fast, most dental clinics are open till very late to accommodate patients after iftar. So if you were getting treatment for gum disease or cavities before Ramadan, make sure you continue to visit the dentist,” Dr Fouda said.

Dr Rai also cautioned against ignoring dental problems.

“If you are facing bleeding gums or pain, do see a dentist immediately. Not doing so can cause the problem to worsen, and make the eventual treatment lengthy and painful,” he said.

Although awareness about dental health is improving, the doctors added that they still see a significant increase in the number of patients after Ramadan, with many of them requiring major dental work.


Dentists say...

■ Rinse frequently while fasting to prevent bad breath.
■ Drink enough water after iftar.
■ Brush as well as floss before going to bed.
■ Use a tongue scraper as bacteria multiplies on the tongue coating.
■ Clean dentures, bridges and retainers through the day.
■ Avoid too much sugary and fatty food.
■ Do not put off dental treatment till after Ramadan.



Samihah Zaman

May 23, 2018


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Everything you need to know about finding a dentist

By: Camille Hogg | December 20, 2017 | Abu Dhabi World Online
From cavities to consultations, we find out about the main dental issues in Abu Dhabi and how to pick a good dentist.

  Your smile says a lot about you, and that’s especially true when it comes to your teeth.
With cavities and gum disease on the rise, we consult the experts on maintaining good hygiene, dealing with dental emergencies and knowing what to look for in a clinician.

The root of the problem

“The two biggest diseases in dentistry are caries – or cavities – and periodontitis,” explains Dr Per Rehnberg, CEO at Snö Clinics.

Caused by factors including poor oral hygiene and diet, cavities are common in children and adults, and occur when your tooth enamel begins to erode due to acids caused by bacteria.

With a particularly high prevalence of decay in the region among children, Dr Per is keen to emphasise that more awareness is needed of the detrimental effects our sugary habits have on our teeth.

“In this region, the caries in kids are so much worse. Kids drink a lot of juice and soda, and the low pH means that the soda is acidic as well as sugary, so we see a lot of eroded teeth,” says Dr Per.

Dr Heba Aboushady, general dentist at the Boston Dental Center, agrees.

“Adults misunderstand the right diet for the teeth and switch from milk to fruit juices; these are actually very high in sugar and acids,” she emphasises. “We need more education on healthy diets and how to follow basic oral hygiene instructions.”

But with pain, sensitivity to cold and, in severe cases, visible holes as key symptoms of caries in children and adults, the solution isn’t always drilling.

“Small caries can be healed without drilling,” Dr Per clarifies. “If you do flossing and fluoride treatments, we can check in three to six months and you may not need a filling, so [the tooth] will have much better longevity.”

Even with larger cavities, there are still options before you need to undergo a root canal, where the infected pulp from inside the tooth is removed and the tooth sealed.

“The root has a function, so once you replace it with a root filling, it shortens the lifespan of the tooth,” Dr Per explains.

“When [the cavity] is middle-big and gets closer to the nerve, you can still do a filling in that case without a root canal treatment.

“If you have a cavity that is close to the pulp, one way of treating it is to have a special kind of dressing and calming filling on top of that in order to save the root,” he adds.

Periodontitis is another common disease in the region, but unlike cavities, pain is not a common symptom until more advanced stages.

“Many people in this region are under-diagnosed with periodontitis,” says Dr Per. “It’s not usually painful for the first ten to 15 years, but then it’s often too late to save the teeth.

“It generally starts with bleeding gums. Bad breath could also be a factor. When you eat, food gets stuck between your teeth and causes inflammation as it rots; this causes tooth loss. We also associate calculus (plaque that has hardened and cannot be removed by brushing) with the disease, which can be removed at the hygienist.”

One key way to slow the disease down is flossing, and Dr Per recommends a once-a-day regimen.

However, whatever your problem, acting early is key, as regular check-ups can prevent problems from escalating.

Things you should look out for include pain or sensation when you consume something cold, as well as bridges, crowns or problematic wisdom teeth – and any jaw joint issues should be dealt with by your dentist, too.

Dental emergencies

With many of us harbouring a deep fear of the dentist, we often ignore our problems before it becomes an emergency – and that’s not a good idea.

“There’s often a difference in opinion between the dentist and their patient as to what constitutes an emergency,” Dr Heba chuckles wryly.

“When there’s a cosmetic problem, like a tooth has fallen out or a filling has broken, I find that patients come in quite quickly, but with pain or infection, it’s not always the case.

“As a dentist, things like swelling on one side of your face, fever and difficulty swallowing can indicate a life-threatening infection,” Dr Heba states.

“Things like accidents involving knocked-out teeth also need quick intervention, and constant pain might be an abscess or deep cavity. One thing people don’t know too much about is that if you have red patches or ulcers in the mouth, you need to take instant action.”

Dr Per agrees, noting the location of the pain or problem: “Go quickly to the dentist, especially if the infection is in the lower jaw.”


Which dentist?

With so many options on the market, it can be hard to know what to look for when picking your dentist.

“That’s the hard thing about being the patient,” agrees Dr Per. “You just don’t know. We have a transitory community here and people don’t tend to get that long bond with their dentist that they might get in their home country.

“One way is to make sure you can audit what the clinic has done,” he adds. “You need to ask to see the documentation, diagnosis, x-rays, printouts and treatment plans so that if needed, you can get a second opinion.”

While many dentists may offer deals for free consultations, Dr Per recommends knowing what you’re getting from the experience.

“It’s very important to have a proper exam,” Dr Per advises. “If you don’t have all the data on the patient’s specific conditions, it’s very hard to suggest the right treatment – it’s like building a house without having a f  

“Many dentists might offer a free exam, but these may not be full exams – a proper one would usually take at least 45 minutes and will detail the status today, risk calculation and a prevention plan.

“Patients also need to be informed about problems that might happen,” Dr Per adds. “Many dentists are reactive; they might only treat symptoms like tooth pain, but a good dentist would look at underlying causes.”

For Dr Heba, communication is a huge factor.

“A good dentist will explain everything to the patient, including treatment options, the procedures involved, the expected outcome and, of course, involve the patient in any decision making,” she says.

“Going to the dentist can be scary – I was that child and I had a bad experience,” she laughs. “These days, it’s very different: there are new techniques, technologies and types of anaesthetic.

“We don’t want you to have more pain; we want you to be rid of it, and a good dentist will explain what they’re doing.”

At the end of the day, make sure you feel confident before you put your money where your mouth is, says Dr Per.

“Establishing trust with your dentist is very important, and if you don’t like the clinic or clinician, then close your mouth and get a second opinion.”

Word of mouth

Good oral hygiene takes some effort, so here are our experts’ top tips.

Have regular check-ups: Scheduling a check-up depends on your oral health, says Dr Per. If you have ongoing conditions such as periodontitis or you’re at increased risk of cavities, you’ll need them more frequently, but between six months and one year is common in the UAE.

Get a fresh brush: “You need to change your brush every three months – and use a soft one,” Dr Heba says.

Don’t forget to floss: “Use floss or interdental brushes if you have a brace, crowns or bridges. They have tighter contact than air flossers,” Dr Heba says.

Supplement with fluoride: “Water here has no fluoride,” says Dr Heba. “Fluoride application for children can help reverse early signs of decay.”

By Camille Hogg
December 20, 2017
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Most root canal treatments not needed, warn UAE dentists

By: Jasmine Al Kuttab/ Abu Dhabi | May 7, 2018 | Khaleej Times

Dental experts say root canal is the last treatment to be considered and 9 out of 10 patients do not need a root filling. Much less invasive and cheaper options can be carried out in most cases.

Dentists must inform their patients that only 10 per cent of the cases need a root canal.

Almost nine out of 10 patients never required root canal treatment but most were unnecessarily lured into the invasive treatment, an Abu Dhabi doctor has said.

As Root Canal Awareness Week gets under way across the globe, Dr Per Rehnberg, CEO of Snö Dental, is warning against the over-use of the treatment. He urged patients to obtain all the facts before proceeding with it. "Root canal is the absolute last thing you should consider for your teeth; everything should be done to ensure natural teeth are kept vital."

He stressed that patients who often complain about tooth ache, which can be caused by a cavity, can usually have a much less invasive and cheaper option done than the root canal treatment.

"The problem is that around 10 per cent of the band aid cases (traditional filling) will need a root filling, that is why many dentists are often quick to suggest a root canal. But nine out of 10 patients do not actually need a root filling."

He pointed out that dentists must inform their patients that only 10 per cent of the cases  need a root canal and share with them the other available options.

Moreover, Dr Rehnberg exp-lained that health insurance companies pay much more for a root canal treatment than the traditional filling, which could be why many dental clinics lure patients into getting the costly treatment.

He added that the band aid treatment costs around Dh500, whereas a root canal treatment is usually around Dh3,000, and will also require extra procedures, including placing a crown on top of the tooth, which costs another Dh2,000.

"What we have seen is that the root canal treatment has become a common option, or even a first-time option when the pat-ient only has slight tooth ache."

In fact, Dr Rehnberg and his team conducted a mystery shopping survey around the UAE to identify the clinics that provide thorough information to the patients, and those that recommend invasive, costly and unnecessary treatments. "We wanted to look at the diagnoses and suggestions for treatment, and we found that it is very common to suggest the root canal treatment before they even knew what to do.

"We took 15 people from our company and sent them out for the mystery shopping in Abu Dhabi and Dubai and found that most dentists showed a lack of proper documentation. Many patients were also suggested the root can-als, which we later treated with simpler and more affordable treatments."

He said that it is important for patients to trust their dentists; however, it is also important to receive transparent information about the alternatives.

Dr Rehnberg added that people are more prone to having dental cavities in the UAE, for various reasons that are often related to their lifestyle choices, including smoking and eating sugary and processed foods.

However, having cavities does not necessarily mean patients have to turn to the invasive treatment.  "I've seen people who had low risk and still had root canals. This is a sign of possible over-treatment."

He also noted that official documentation is necessary for the pat-ient in order to be able to receive second opinions.

"If a dentist is reluctant to allow the patients to keep their documents, then this is a concern, because it's a matter of trust."

Dr Gun Norell of Snö Dental, who has worked in dentistry in various parts of the world for over 30 years, said raising awareness on the matter is key.

"We urge people to seek a second opinion before having invasive treatments carried out, and advise that they think about root canal as the last option rather than the first."

Free second opinions for patients

To help support patients with their decision, Snö Dental is offering free second opinions on root canal treatments for all residents of Abu Dhabi, during Root Canal Awareness Week from May 6-12.

"We always evaluate the teeth and if we can avoid over treatment by providing a less invasive option for the tooth to recover, we will do that," said Dr Per Rehnberg, CEO of Snö Dental.

Jasmine Al Kuttab/ Abu Dhabi

May 7, 2018

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Some UAE dentists caught out for grossly over-treating patients

By: Nick Webster | May 12, 2018 | The National

Dubai Health Authority handed out 25 fines for fraud, waste and abuse cases.

From left, Dr Per Rehnberg, chief executive of Snö Dental Clinics, and dentist Dr Nasser Fouda, say dentists can often view their practice as a business rather than as providing healthcare. Pawan Singh / The National

Expensive and pointless dental treatments offered to patients to boost profits have been exposed in a mystery shopping exercise at practices in Abu Dhabi and Dubai.

Fifteen clinics were checked by dentists posing as patients to assess how common over-treatment is in the industry.

One patient was offered unnecessary root canal treatment, crowns and fillings at a total cost of Dh26,200, when all that was required was two fillings and a visit to a hygienist.

The case was just one example highlighted by Scandinavian dentists in Abu Dhabi.

Regulators said they were stepping up inspections, and would only recommend providers based on a positive history of care.

Dr Per Rehnberg, chief executive of Snö Dental Clinics, who has been working in Sweden, Norway and Denmark before running a dentist practice in Abu Dhabi, was shocked at the high level of treatments being offered to patients, with insurers often picking up the costs.

“Root canal treatment is often suggested and is very common here.” he said.

“After my experience, I sent staff out to several other clinics and they found the same thing.

“There was a lack of documentation. Clinics take x-rays but it is very important for patients to get a proper status so they know what is being included in an exam.”

One clinic suggested a patient had a root canal, 3 crowns fitted and 4 fillings amongst other minor treatments costing Dh26,200.Caries - decaying teeth - were removed by another dentist to avoid the need for fillings, root canal work or crown fittings, at a cost of just Dh3,000.

“It is a competitive business, we know that, but none of the mystery shoppers were given any documents and the majority of clinics recommended over treatment,” Dr Rehnberg said.

“The science has gone so far forward. We know there are many alternatives that are cheaper and less invasive than a root canal.

“We earn less money as dentists, as insurance companies do not always pay for these kind of alternative treatments, but they are usually better for the patient.”

Dentists said nine out of ten patients in pain did not need a root canal treatment, yet the procedure was still offered.

“The Hollywood smile is big business; it looks good but many patients I see for follow up work it is clear it has been done in a hurry,” Dr Rehnberg said.

“Cosmetics are very popular, but many dentists are not describing the pros and cons to patients. “There is always risk.”

Veneers at a cost of between Dh2,000 to Dh4,000 per tooth were commonly prescribed, instead of a cheaper option of bleaching.

To achieve the perfect smile, patients can expect to pay anything from Dh12,000 to Dh40,000 for veneers, whereas bleaching can cost just Dh2,000.

Dentists have said proper record keeping is crucial to maintain a transparent industry.

Dr Nasser Fouda has been in the UAE since 1996 and said a common trend is dentists viewing their practice as more of a business than providing healthcare.

“Many dentists call people clients, rather than patients and want to make money – they are more like teeth mechanics, and are happy to drill, screw or carry out a root canal,” he said.

“Patients may go in for a simple filling, and end up with a crown - that’s not always the best option.

“Dentistry teams often want to do everything themselves, rather than call in specialists to maximise their profits. This is not always the best option.

“It’s preferable to preserve natural teeth for as long as possible, as the structure is much better and artificial products will never be as good as enamel and dentine.”

There are clear rules and regulations for dentistry to follow, and clinics must adhere to a strict operating policy imposed by regulators – either the Dubai Health Authority or Department of Health.

DHA has said its regulators inspected 59 clinics in Dubai in 2017, issuing seven warnings and handing out 25 fines for misdemeanors around fraud, waste and abuse.

“At the Health Funding Department we do not directly regulate provider service pricing at this time,” said Ali Lutfi, Head of Insurance Permit at Health Funding at the DHA.

“However, we do conduct inspections across all medical providers in the Emirate from a financial aspect – including hospitals, medical centers, dental clinics and pharmacies. Our inspections mainly look for fraud, waste and abuse (FWA).

“Part of our licensing requirements for insurance companies and third party administrators is for them to provide us with quarterly FWA reports, highlighting any providers with suspected FWA.

“We select providers to inspect based on these reports and feedback from members via our various complaints channels.”

The Department of Health did not respond to a comment request in time for publication.

By Nick Webster
May 12, 2018
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Sometimes, the best treatment is no treatment

Why less is  often more.

No matter the clinic, trust, openness, and transparency should be at the core of the services provided. At Snö, we pride ourselves in being Superior, Gentle and Trusted,  in our approach to modern dentistry.  And, as part of our core values, we believe that sometimes, the best treatment is no treatment at all – something we are not afraid to tell our patients. When treatment is required, we will always choose to save as much of the healthy tooth and tissues as possible to ensure good long-term dental health, instead of drilling and damaging the tooth for short-term symptomatic relief.

Here, you will never be over-treated or overcharged. You will always get the dental care you need and deserve.

The wisdom to say no

Take the case of nine-year-old Sara, who had crowded teeth. After a consultation with a dentist, orthodontic braces was suggested. However, at Snö, we gave her a second, much less invasive and practically free alternative. To wait.

We were able to ascertain that with time, Sara’s natural bone growth would set her teeth, without the need for orthodontics or expensive treatments.

Sure enough, in a year, Sara’s teeth aligned themselves without the need for any treatment. With the right prophylactic care and proper brushing and flossing techniques, she will have strong, healthy teeth in the future (images above are for illustrative purposes).

Modern dentistry allows us to treat such cases in many ways, but with the proper examination, the right diagnosis and thorough documentation, it is possible to avoid expensive short-term treatments and provide long-term  health benefits.

But what about cavities?

Caries (cavities) affect many people. A usual practice is to "drill, fill and bill” as soon as caries is spotted, which could be just the beginning of a cavity. But at Snö, we know that this approach does not always yield the best results. The best tooth is one we do not have to drill.

We believe that it is better, whenever possible, to heal the caries lesion, which can be achieved through prophylaxis – simple things like improved oral hygiene, fluoride treatment and changes in diet. Unfortunately, the alternative of drilling and filling the  tooth is a common practice in the region, and around the world. But with our superior, gentle and trusted service, you can be rest assured we will not take the easy way out when it comes to your dental health. We also use a specific method for improving your diagnosis in order to drill less – an infrared camera that can spot caries without radiation.

How can I trust that this is the treatment that I need?

If you are doubtful of a treatment suggested by your dentist, do not be afraid to ask questions. They should be able to explain the treatment and how it will be done. Often, this is not the case and results in unrequired treatments that cause more damage than good, in the long run.

Take the case of this patient, whose x-ray shows a caries lesion (dark zone indicated by the arrow).

The treatment option suggested to this patient was a root filling, a post and a crown, which is common in this region. The total cost of the treatment was AED 9,800. At Snö, we were able to save the root and do a composite filling  instead. The nerve is alive inside the tooth, the treatment was much less invasive and less painful, and cost the patient only AED1,500.

All our treatments and examinations are thoroughly documented and yours to keep. You are encouraged to get a second opinion. But most importantly, you are able to audit all treatments at Snö, which gives you the guarantee that you are getting only the highest quality care that you need and deserve.


What makes the Snö Exam Superior, Gentle and Trusted?

For many people, a visit to the dentist often starts with a toothache. As a result, many dental clinics in the region, and around the world, have been geared to treat symptoms and not put the patients’ holistic dental health first. The result is often a prescription and an unrequired treatment, as opposed to an informative and informed discussion on what your dental care should be. Many people are happy to leave the decision to their dentist and not get a second opinion.
At Snö, we believe that your holistic and long-term dental health begins with a simple, yet thorough examination. We also believe that our patients have the right to know what treatments are best for them – and sometimes, the best treatment is no treatment at all – and as dentists, we have an obligation to ensure that our patients are always informed of these alternatives. You should not feel apprehensive about getting a second opinion; in fact, we encourage it. This is why the Snö Exam embodies our core values of Superior, Gentle and Trusted, and why it is necessary for your long-term dental health.
Contrary to popular belief, there’s so much more to dental exams than just finding a problem to fix. Here are five ways that the Snö Exam lives up to its reputation and why it ensures you always get the best treatment options for your dental health.

1. Digital or printed copy of your entire exam package

Our latest digital equipment not only allows our dentists to carefully document every x-ray and 3D scan, but also share that information with our patients. The results are quick and easy. What’s more, we will hand you a digital (USB or via our App) and printed record of your full Snö exam for you to keep. This is your right.
2. Updated information at least every year

The Snö Exam is not just for spotting cavities or finding the cause of a toothache. It is an important record of your dental health so your dentist can spot problems early and prevent them from getting worse. It is also the best way to keep track of your dental health, the progress of treatments, fillings, veneers, crowns, implants, orthodontics etc.

3. All your x-rays and 3D scans, yours to keep

X-rays are a very important tool for us to discover diseases early. In keeping with our minimally invasive philosophy, we use the latest digital equipment ranging from intraoral x-rays, in all treatment rooms, to full 3D face scanners (cone beam). We also save a 3D model in full colour of your teeth and gums. This means better, more accurate results, and more importantly, a through record of your dental health. This helps us model treatments (braces, guards, guided implant surgery, crowns, bridges and veneers), track changes on a microscopic level and perform any replacements, if necessary, keeping your original tooth anatomy. Best of all, the records are yours to keep.

3D scanned full color model with microscopic precision – included in all Snö exams.
4. Properly documented treatments

Documentation is VERY important. Not just for your case history, but also for rebuilding damaged teeth, to track wear and changes in your dental health over a period of time with highest accuracy. It is also crucial if you want to get a second opinion or if you want to audit any or all of your treatments. These are just some of the ways we offer a superior exam and security for you at Snö.

Whether you move to another country, your dentist at home is unavailable or you have an emergency while on holiday, your Snö exam and treatment records will always be with you. This could prevent other dentists from having to start from scratch and prescribe incorrect treatments.

5. Risk assessment and results

At the end of the exam you should also get a risk assessment which classifies your risk for conditions like caries, periodontitis, and other general and technical risks. This helps dentists (and you) better understand and focus on the right kind of prophylactic treatment and maintenance. If treatment is suggested, you have the right to know all the alternatives, risks, prognoses, costs, and guarantees.

For a trained dental team this whole process only takes 30-60 minutes. Follow-up exams are usually much quicker.

There are many good dentists out there, but great dentists give their patients superior, trusted and gentle dental care they deserve and need, without over-treating or overcharging. If your dentist doesn’t provide you with this information or kind of treatment you should be concerned.

Getting to know Per Rehnberg

One of the essential things to develop between a doctor and their client is trust, and what better way to develop that trust than to get to know the man underneath the white coat-Snö’s CEO, Per Rehnberg.

The man behind it all

Meet Per, at the age of 55, he has clocked thirty-two years in the dental industry under his belt. Having worked in Sweden, Norway, Denmark and UAE, his expertise has been tested and strengthened with time and practice.  Per describes himself as someone who has a positive attitude not only towards his profession but towards life as well. He also likes gets things done and strives to obtain the best results possible, and of course, being awesome while doing it.
According to him, he is not your typical dentist, and being a bit talkative, he loves to interact with his patients. Despite being in the same profession for 32 years, his passion and his dedication towards his craft remain strong and unparalleled. His philosophy: do not over treat or overcharge, has given him not only a great number of clients and success but loyalty and trust as well - which is for him, the things that truly hold value.

His passion: customer centric service, always

Passion is something not many people have, and the few that are truly lucky take the greatest care to nurture it and grow with it.
Like the blessed few, Per has found his passion in his craft and practice-serving and caring for his clients spanning the world. In the 32 years, he has been in the industry, he has continued to grow and acquire knowledge that has allowed him to gain the success he has today - and he always thirsts for more.
Central to his care is his desire to put the patient first.  He believes that listening is crucial, care is about paying heed to his patients’ thoughts and feelings, not only of their reported pain or ills.  He had pursued minimally invasive care procedures due to the concerns and fears his patients have of dental treatments and the pain they might bring – add to that the scary set of tools and intimidating equipment at the dental clinic. Per has taken great care and effort into learning new dental techniques that are science-based and less painful without sacrificing the quality of his services, in order to provide a better episode of care, in his practice and the practice of his team and clinics.

His practice: transparent and excellent

 Per believes firmly that,
“Money is like oxygen, we need it to survive but it should not be our main reason for doing our mission. You do not wake in the morning saying; let’s get some oxygen”
We all know that money plays a big role in the kind of products and services we obtain, the better the quality, the higher the cost. But with Per, you get the best of both worlds, a reasonably priced yet very high-quality dental service.
He values the human body and believes that it should be treated with respect, thus, he does not destroy tissues in order to cut corners and performs his practice of minimally invasive treatments.
With dental work, he uses a prophylactic mindset, which means using the best method for treatment, even if that means no treatment is done.
Usually, clients are scared to ask about the procedures and equipment involved in treatment, but Per promotes transparency and believes that the patient deserves all the information, with an explanation provided as to what procedures will take place and documented.
If a client, for example, is unsure of whether or not they need or want the treatment, Per advises that dentists should patiently tell them why it's needed or necessary and gives them the freedom to take that information and documentation somewhere else, to seek a second opinion.
He also discusses all alternatives along with risks, prognosis, guarantees, and prices for various treatments. Giving the patient options allows them to feel more secure and comfortable with the treatment and the dental teams at Snö.
Documentation according to Per is essential. It allows you to audit the treatments and procedures, which not only gives the client more security but also helps the team, (and you as a reader, included) with more experience and knowledge.

His battles: dealing with difficult people

We all have at least one person in our lives that sticks to what they “know” and what works, and swear by it. You know those types that say, “this is the way we’ve always done it” or “in my 20 years of experience” (when it’s actually 20 years of repetition) and so on? Tough crowd, agree?
Though change is not impossible. Per would always good-naturedly say “Yes, a rooster can be taught to climb a tree, but it’s much easier to use a squirrel,” and wish that the difficult types of people he encounter in his profession would embrace the way the world has developed in many good ways and in dental care in particular.

His candor: The good, the bad, and the ordinary

When he’s not trying to save the world one tooth at a time, this CEO enjoys kite surfing, triathlon training at Yas racing track (he finished 6 Ironman competitions), and a nice dinner with his family and friends punctuated with stimulating conversations.
His hobby kite surfing started with a vacation to Hawaii and the rest as they say is history. Aside from kite surfing, he is also quite athletic and enjoys long swim-run races where there is usually a couple of hours spent swimming and terrain running in and out of the water that is done with a partner.
Per is a believer in hard work and perseverance as well as keeping calm and composed even in situations that would trigger anger in most people.  These traits always allowed him to manage the bad.
He also believes that one should have a positive attitude and an open mind in order to use their energy and create positive things for others.

His goal: build the best dental care in the world

Because of a great need for good, transparent, modern dental clinics in UAE, the concept to build a dental clinic that champions high-quality care had him at the first meeting and made the whole process of coming to the UAE to change the game of dentistry short. With his years in the Nordic countries as a dentist and CEO building dental chains, he had never seen a project with such a long time investment perspective and vision, thus, his decision to move to Abu Dhabi.
But aside from the great opportunities the country has to offer, the beautiful beaches, sports opportunities, excellent food, the mix of cultures, and the young enthusiastic population are also the things Per loves about the country.

His brand: #NotYourTypicalDentist

Unlike traditional dentists who stick to the norm and usual practice, Per believes in continuously improving oneself and the knowledge, skills, and talents one has. Being “not typical” for us means to always, with control, improve more than others. He believes that being #NotYourTypicalDentist does not necessarily equate to being extraordinary in every way possible, but to do everything, even the little things extraordinarily well. Be on time, be prepared, have a positive attitude, go the extra mile, and always, always be kind.

His plan: what’s next?

He plans to continue his advocacy and the brand-if possible forever! Since it is the only road to success, changing and improving with the times, other companies are most likely to copy their methods and practice. However, Per plans on being transparent and in sharing the know-hows of their methods with his dental colleagues and collectively change the game.