Somjot

Honestly, since I passed the Thai dental board exam as the first and afaik until now only foreigner, I wasn't much interested in that matter. All I know, is that there used to be a few government universities, but later private universities opened, which caused huge problems, as the government universities said, they wouldn't accept the exam from the private ones. But all this has been resolved by now. The private universities are quite expensive and there have been rumors, that the government universities, which are much cheaper and officially only accept new students depending on their grades, were also quite expensive, the difference being the method of payment: on the table or under it. But of course those were only rumors.

The world`s leading company for dental whitening is Ultradent and the product`s name is Opalescence. We normally use the 20% concentration as I have seen many times that higher concentrations can cause extreme tooth sensibility with some patients, not all of them of course. I found a 35% concentration on Lazada but the whole thing is a bit funny. They also write “no brand” but what really worries me, is that they give you 2 trays for free. For home bleaching we take impressions of your upper and lower jaws and our technician casts models on which he manufactures individual trays which have a very tight contact to the gingiva but about 1 millimeter space to the teeth to protect all the surrounding tissues while the teeth are exposed to the bleaching material. If you use those trays you can see on the picture, the bleaching material will be just floating around in your mouth and lead to severe destruction.

Apologies if my writings were difficult to understand. I tried to use as many layman words as possible. Please understand, I am not a native speaker, so I have to translate the medical words into English first and then try to find the correct layman words. Takes some time to do it, but I am always happy to help.

I will ask my clinic manager tomorrow, which concentrations we have. If you could tell me the peroxide percentage of the bleach you would like to have, I can check for it.

Now you are getting more precise. You are clearly speaking about the upper molar area and yes, what often happens after tooth extraction, is that the sinuses move downwards so that in some cases the thickness of the bone on the alveolar ridge is only one millimetre. In that case an external sinus lift is required and quite some amount of bone granulate, I'd say the size of a walnut for each side. If there are maybe five to seven millimeters left an internal sinus lift might solve the problem. It would be easier if you would send me your panoramic X-ray.

What I wrote was, that bone actually DOES grow, but bone grafts are not necessary after every extraction. I never said they're useless - I even wrote, that I have made hundreds of them - but I always try to keep the surgery small. For example in many cases, if the bone is too thin, bone spreading might solve the problem and the bone graft can be avoided. But to go into all details would be too complicated.

Honestly, pulling your own teeth is not such a good idea. In case you have an advanced periodontal disease, as a result your teeth are only sticking in the gum and can easily be moved in any direction, then maybe self-extraction is possible. In any other case I would not do it. You could hurt yourself; the bleeding might not stop or some parts of the route might break off and stick in the bone without you noticing it, which can lead to severe infections later.

Phantastic thread by the way. I've been thinking about Thai citizenship for quite some time now. I have permanent residency since 2006, as it was mandatory to get a blue tabien baan, which again was one of many requirements to be allowed to certain exams. To pass them, which I finally managed 2010, would allow me to work in my profession in Thailand. I do see the advantages of Thai citizenship, but I am not much interested in buying land or a house as I live in a beautiful one already, perfectly located for my needs, with a 30-year lease. The residency is very comfortable and as all I must do, is getting my multiple re-entry permit, in case I want to travel abroad, which is not a big deal. The advantage is, that I am 100% legal. Thai citizenship requires to surrender the original one, mine being German, which I definitely don't want to. I have read in here, that it only requires “the intention to surrender the original citizenship”, but despite not having any experience with that, I doubt, the officials would accept any excuse like: “of course I intended to give back my citizenship but later I changed my intentions which is only human.” I'm pretty much sure the reason why they did not write “MUST give back the original citizenship” is, that many countries simply do not allow it and you just can`t give it back. But the German one can be given back, even worse, if you successfully apply for a new citizenship without asking for permission in advance, your German one is automatically revoked, once they find out. Any suggestions? And apologies, I did not read the entire thread, but I will do as soon as I have the time.

That is not entirely correct. Germany allows citizens of certain countries to keep their citizenship, while getting the German one. Thailand was added 2012.

Yep, that pretty much sums it up. ????

Thank you very much for your comment and luckily your assumption is wrong. Think about it, if bone could not regrow, how does a broken leg heal, how does an orthodontist move or turn teeth to the correct position? Same as muscle and skin bone is living tissue full of different cells, some of them called “Osteoblasts” which means nothing else than “bone builder”. The most important thing is a bone preserving extraction technique. The classic extraction technique says, extraction and after that compression. This means that after the tooth has been extracted the dentist would grab the extraction socket with his thumb and index finger and press it together forcefully, which leads to a smaller extraction wound, lesser bleeding and faster healing. The downside is that the depth of the bone will be reduced by half, so that in case, the patient would like to have an implant inserted in this area, his bone might have enough height and width but not enough depth. The bone preserving extraction technique does not include compression and tries to keep all the walls from the alveolar socket, especially the buccal ones, which are on the side of the cheeks and lips and very thin, which makes them fracture easily. This technique will lead to a preservation of the socket and almost no loss for the alveolar ridge so that there is no need for a bone graft in most cases. I don't know if you are familiar with bone grafts. They are harvested from the bone of different animals and can be equine (horse), bovine (cow), porcine (pork) or even from human bodies by eliminating the complete organic material from it. What is left is just minerals in a shape that reminds of bone. I never felt comfortable with any of them why I always used artificial bone made of Tricalcium Phosphate. The companies tell us, that once the bone graft is inside the extraction socket or the area, were you plan to insert an implant, the Osteoblasts and other cells will transform it into our own bone. I can confirm that this is not the truth. I have made hundreds if not thousands of bone graft surgeries in the last quarter century and every time I drilled into it to shape an implant site months later I could see rests of that bone graft in the drill cuttings. Don't get me wrong, bone grafts can be very helpful, for example when you do an external sinus lift, were you want to create an artificial space between the bony sinus floor and the so-called Schneider membrane and need a placeholder. But generally spoken my experience taught me, the smaller the wound, the lesser invasive the surgery, the fewer foreign material included, the higher the chance for success and of course the lesser the pain after the surgery. For example, the classical operation technique for an implant is a longitudinal incision on the alveolar Ridge followed by transverse relief incisions and then separation of the mucoperiosteal flaps from the bone with raspatories, which are repositioned and stitched together after the implant has been inserted. This facilitates the determination of the implant position but it's a huge trauma followed by severe pain. I don't do this anymore. I use a punch, a round knife, and cut out a circular piece of the gingiva, which is located exactly where I want to insert my implant and has the exact same diameter as my implant. As a result, at the end of the surgery there is no wound, no bleeding, no stitches and in most cases no pain but on the other hand a much faster healing and a higher success rate and not to forget – lesser costs for the patient. That is also a point, I have always on my mind: My patients trust me with their health. I could never take advantage of that trust by suggesting a bigger and more expensive surgery than needed and still be able to look at my face in the mirror. Since my first days as a doctor, I always and without exception advised and treated my patients as if I would sit in the dental chair myself. Feel free to ask any questions.

I have noticed that there seems to be confusion about dental treatment in Thailand or which kind of treatment is to be preferred, a root canal treatment or an implant. As I know a thing or two about these matters, I might be able to offer some clarity: the Tooth The visible part of our teeth is called crown; the rest of it, the root, is inside the jawbone, which again is covered by gum. The body of the tooth is made of Dentin. Is comparable to bone but much harder, 33% of it being organic and it is sensitive to temperature. In the crown area the dentin is completely covered by enamel. Enamel is 96% crystalline mineral, which makes it harder than steel but also susceptible to demineralization if exposed to acids. This might happen through ingestion of soft drinks and fruit juices or by bacteria, which digest the sugar in our food and produce lactic acid, which can lead to caries, aka as decay. As soon as the decay passes the enamel and reaches the dentin, the tooth starts reacting stronger to temperature, than the others. Up to this point it is possible to treat that tooth with a simple filling. If the decay reaches the pulp, that is where the fun begins. The pulp reacts to infections like any other part of the body: it starts swelling. We all know that no matter if you have an ingrown toenail or hurt your hand while fixing your car, it always starts swelling and as long as we do not touch the wound, it is not very painful. The problem with the pulp is its location in the pulp chamber, which is hard tissue. The pulp starts swelling, which causes pressure in the pulp chamber leading to more pain which again leads to more swelling and so on. So, if you have asked yourself, why toothache can be so severe. Now you know the answer. In such a case a root canal treatment might be a good choice. Root canal treatment Your dentist will use many different instruments, like Headstroem Files and Reamers to clean the pulp chamber and the root canals down to the little opening, the apex, where the small nerves and blood vessels leave the tooth. And he will repeatedly rinse the root canal to get all that infected material out, so that he can finally fill it. Now here is the catch: Nature does not always build straight things. Due to genetic reasons some people do not have root canals going straight down to the apex. Their root canals split (in most cases) in the last third into many accessory canals comparable to a river delta. There is no way to see those accessory canals on an X-ray let alone to correctly fill them. This can be quite frustrating, you just made a perfect root canal filling, the X-ray shows a beautifully shaped and perfectly filled root canal, but the patient keeps having symptoms. In that case there are two options: 1. you see a skilled maxillofacial surgeon, who will perform a so-called root resection, where he drills through the jaw bone and cuts off the bottom of the root, after which you have a 70 : 30 chance to keep that tooth for a while. 2. Extraction Generally spoken, if you have a history of failed root canal treatments or if the decay has reached areas beneath the bone already, extraction might be the right treatment. The question, which is the better treatment, a root canal treatment or an implant actually makes no sense. It is always better to keep your teeth, but only if this has a good prognosis. If not, an implant is a very good choice. Not only does it replace the tooth; it also preserves our ability in chewing, speaking and our aesthetics and it prevents atrophy, aka bone loss, which always occurs when a tooth is extracted. Implants The implant is basically just an artificial root in most cases made of titanium although there are also a few available made of zirconia. Some people prefer zirconia because of its white color assuming it is more natural and healthier. This is wrong as both are metals and have no natural occurrence in the human body. If the extracted tooth was infected, it is preferable to wait about three to six months before implantation, so that the cells in the bone can eliminate all remaining bacteria and regrow new bone into the extraction wound. After the insertion of the implant, the surrounding bone will need another two to three months to osseointegrate the implant, which means to grow on it giving it stability to withstand the chewing pressure. After that the dental technician will choose the right abutment, which connects the implant with the prosthetics and start with the production. His choice depends on the prosthetics planned for you, which could be a single crown, a bridge or some removable device. Now here's another catch: Worldwide there are more than 1000 implant manufacturers, many of them having different types of implants in their catalogues and all those implant systems are not compatible to each other, as they have different geometries and require a different set of tools. There is no EU DIN norm or US standard. The different implant types of one implant manufacturer (STRAUMANN) implants from different manufacturers It's the same with cars: you cannot put the generator of a BMW into an AUDI, although it is basically the same device. So if you don't know the manufacturer of your car, you don't know where to go, if anything has to be replaced. Luckily, when it comes to cars, name of the manufacturer is written somewhere on the car. Not so with implants. Interestingly most people with implants do not know their manufacturer. But one day you might lose a few more teeth and in order to connect the remaining teeth with the existing implant, for example to fix a bridge, all you need is a different abutment. Or let's say, that little screw which connects the abutment with the implant has loosened and just needs to be tightened a bit. If you don't know the manufacturer of your implant, you have a problem. different abutment types Even worse if your implant is from some no name cheap manufacturer, which has gone bankrupt and disappeared. Many cheap implants offered in Pattaya are from one of those many no name manufacturers so choose wisely. Apologies for my wrong spellings or grammar mistakes; I am not a native speaker. Feel free to ask me any question about dental treatment. Cheers Somjot

A lot of good advice here but a lot of BS as well. @thailand49 has written it all; he knows what he's talking about. They have a saying here in Thailand, which sounds like “leo gone, dai gone” and means: “be evil first, get it first.” Let's say your landlord forces you to pay him money, which due to the law and your rental contract you were not obliged to pay. Even if the court decides later that she must pay you back, you might never get it. I've heard many times from “wise” Farangs “if you need a lawyer in Thailand you have lost already” or “if your opponent is Thai and has connections to the police, just give up and pay him what he wants, as you might wake up one day wondering why you have wings” Due to personal experience, I can confirm, this is BS. The judges are fair but it is important to dress, talk and act properly when at court; if you can't speak Thai, you have the right - and I would strictly recommend that - to get yourself a translator, who knows his job - the girlfriend you met last week for the first time might not be the best idea even if she is from a gentleman club. I've seen Farangs attending the court in shorts and Chang Beer tank tops trying to compensate their lack of knowledge of the Thai Language by volume; needless to report the outcome. A friend of mine bought a nice house in the well-known way by using a company, where he has his 49% shares. One or two years later he met a nice girl and after a few weeks he asked her to move in. All went well but after a few months she started to get more and more demanding and about two years later, after he had tried everything to fight for the relationship, and finally found out that no matter how much he would pay her and no matter how many rules they would agree on about her expenses, she wanted only one thing: MORE. He left in the morning and told her, that he will be back in the afternoon and expects her to be gone by then. When he came back the only things that had changed, were the door locks. He shouted: “get out of my house” and she answered “this Thailand, I am Thai, this my house. Farang go back your country.” He knew a good lawyer, who got him a interlocutory injunction, but every time, he came near the house with his lawyer and a few policemen, she would threaten to commit suicide if anyone would try to get in. Months later he got his house back by paying a bunch of motorbike taxi drivers to observe that house 24/7. They found out, that she would sneak out late at night on certain days of the week to visit her Thai boyfriend and spend some quality time with him and buy groceries on her way back. One time after she had left, he broke in, changed all the locks, and got back his house. When she realized, she started screaming again threatening to kill himself and all he answered was “This Thailand, you are Thai, you can do, up to you but not in my house.” But before it gets that far, always keep one thing in mind: Always have a clean record. Do not intentionally damage any part of that house. Never get into a verbal or physical fight with your landlord or anyone else. Always be polite and reasonable. Any wrongdoings on your side are perfect weapons for your opponent. Those Farangs, who literally <deleted> themselves, when the other guy shows up with policemen, usually have some skeletons in their cupboard and the first thing those policemen will do, when a fellow countryman asks them for help against a foreigner, is checking his papers, work permit, visa status and so on although this has nothing to do with the actual dispute between the foreigner and the Thai guy. And if there are any inconsistencies, well, let's say, better if there aren't any. About 15 years ago I had paid a Farang, 70.000, - Baht in advance to advertise my business in his new magazine. Of course, we had a written contract which clearly stated the beginning and the ending of the deal but somehow, he never honored his part of that contract and came up with cheap excuses, like the printing house ran out of ink or things like that. I said I want my money back, which he refused, which again made me tell him that I will sue him. A few days later he walked into my place accompanied by a uniformed immigration officer, from a lower rank as far as I could see, and told me, I should have known better than to mess with him. A second later the officer started shouting at me with a very aggressive voice asking me for my passport, my visa, and all the permissions I needed for my business. What he didn't know, was that the elder brother of my father-in-law was working in the immigration in Bangkok, his rank being Police Major General, which probably made him the boss of his boss. I took my phone, called the Major General, explained him my situation and handed it to the officer. He got even more aggressive and hit my hand with the back of his hand which made it fall on the floor. I picked it up and wanted to check if we are still connected, when I heard the voice of the Major General, who probably realized what just had happened: “Put it on speaker.” A few seconds later everybody in the room could hear his deep voice: “Do you recognize my voice?” It took the officer a few seconds to realize, who was talking to him and his facial expression changed from arrogant and aggressive too desperate and suicidal. “Khrap” “GET OUT!” I got my money back within 24 hours. Generally spoken Thai people seem to have high respect for lawyers and uniformed people. Best thing you can do right now, is look for a good lawyer. Google them, read the reviews and choose one. I could recommend one but try it first by yourself and find one where the chemistry is OK. Get a consultation from him about your rights and your duties and report all the wrongdoings of your landlord. It is mandatory that the communication between you and your lawyer is perfect. For example, I don't think your lawyer wanted the 130.000,- for himself. I had 3 lawsuits, 2 at the civil court Pattaya and one at the family court and for each of them I had to pay for 50,000 baht deposit at the court, for the family court even 100.000,-. Depending on the outcome, you'll get your money back. But it has not to get that far because your situation is quite clear: they are wrong. Your landlord probably thinks you're just a stupid and helpless foreigner, easy to intimidate. Let your lawyer contact them by phone or letter and make it absolutely clear, that from now on every kind of communication between you and the landlord or the agency or any request to pay some bill or to inspect the house must be done with your lawyer. No exceptions. You will see, that will cool them down, because from then on, any wrongdoings on their side are registered it will have consequences.

She must clearly be using growth hormones in her anti aging regimens. Her husband is 192 cm tall - and he is Thai.

Yesterday I sent you a personal message. Yet since then, you've been visiting this forum a few times but did not read your messages. You might find the answer to your question in there.

One of the most important factors for a successful dental treatment is a perfect communication between dentist and patient. That might not be that important when it comes to a cleaning or a small filling but if the dentist plans a bridge, an implant or even a removeable prosthetics for his patient and fails to explain him exactly what he has to expect, problems are almost guaranteed. Another very important factor, especially in a tropical country like Thailand, is disinfection and sterilization. The regular control and calibration of your X-ray devices is another important point, in order to protect your patient, your staff and yourself. I've seen guys going from clinic to clinic, up to 20 different places, to find the cheapest place. That might not be the best idea. When you open a dental clinic in Thailand, you must apply for the licence in the local health authority. If your paperwork is OK, they will make an appointment with you, to check your place. Trust me, the regulations are very strict and there are many of them. But they come only one time and then never again. In Western countries you must test your X-ray machines and your autoclave (a machine that sterilises the instruments with temperatures between 110 and 140 degrees Celsius) on a daily base and keep all the reports. Not in Thailand. That is not entirely correct: It makes no difference if your implant is in the molar or in the front area. It will need about 3 months to completely heal in and be able to take the load of any kind of supraconstruction, no matter if this is a crown, a bridge or something different. And you definitely do not need to stay for that period of time. A brief check or, if required, the removal of the stitches one week after the surgery and you're good to go home. But then you have to come back after 3 months (or later, as once those implants have grown in, it doesn't matter, if you put the supraconstruction on them 3 or 6 or 24 months later) to get your final dental work. Very well explained. If I may add 1 very important point: the manufacturer of your implants. Please understand, that the implant is basically the artificial root made of titanium or ceramics, which is inserted in the bone. After the healing period the so-called abutment will be put on the implant, which connects the implant with the denture. Now there is no such thing like US standard or EU DIN norm when it comes to implants. The implants of every different manufacturer have a different geometry, that might be an inner octagon or an outer hexagon, which requires a different set of tools. It is comparable to cars: you cannot put the spare part of a Ford into a BMW, even if it is the same device. So it is mandatory to get implants from one of the leading companies and the surgeon must inform you about the manufacturer and the type of implant you got. To not know your implant type is like not knowing your automobile manufacturer. What are you going to do if something must be replaced? Well, when it comes to cars, it shouldn't be such a big problem to find out, which company produced it. Normally it's written somewhere on the car. Not so, when it comes to implants. And if your implant is from some cheap no name company and you need a spare part for it after a few years or maybe you have lost some more teeth and want to use this implant, which was carrying a crown, to insert a bridge, there is a high chance, this company does not exist anymore, and then good luck.

That is confusing. In fact in 26 years I never met a farang, who did NOT play around behind his lady. Even those, who live in the countryside, would visit the bigger cities once in a while. Compared to me, you`re clearly living in the better social environment.