Dentistry Uncensored with Howard Farran
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366 Orthodontics in Singapore with Loh Kai Woh : Dentistry Uncensored with Howard Farran

366 Orthodontics in Singapore with Loh Kai Woh : Dentistry Uncensored with Howard Farran

4/16/2016 3:24:43 PM   |   Comments: 0   |   Views: 525

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Dr. Loh graduated from the University of Singapore in 1976 and obtained his Master of Dental Science from the University of Pittsburgh in 1982 through a scholarship awarded by the National University of Singapore. He was a full time instructor in the National University of Singapore until 1986. He is a visiting professor at the department of orthodontics, Wenzhou Medical College, China.

He was the Honorary General Secretary of the Singapore Dental Association in 1986-1988. He founded the Association of Orthodontists, Singapore in 1991 and was the President for the first 2 years. He was the President of the Asian Pacific Orthodontic Society 2010-2012.

Dr. Loh has given presentations in Australia, Bangladesh, China, India, Indonesia, Japan, Macau, Malaysia, Nepal, Pakistan, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam.

www.AlohaDental.sg

Howard Farran:

It is a huge honor today. I am in Singapore with one of the most famous orthodontists in Singapore who lectures around the world. He actually got out of dental school in Singapore in 1976. Then to become an orthodontist, you went all the way to Pittsburgh.

 

Dr. Loh Kai Woh:

Yes. That's correct.

 

Howard Farran:

Which is why I found a Pittsburgh Steelers football fan all the way in Singapore. We are both reminiscing about the glory days of Terry Bradshaw and Lynn Swann. That was as good as the NFL ever got. I don't think it can ever get that good again.

 

Dr. Loh Kai Woh:

They won so many Superbowls.

 

Howard Farran:

Oh, my gosh.

 

Dr. Loh Kai Woh:

I think five at the time.

 

Howard Farran:

Yeah. They were an amazing team.

 

 

You've been doing orthodontics for years and years and years. What's new in orthodontics?

 

Dr. Loh Kai Woh:

Well, I think orthodontic has moved along really well. The things that I learned from then and now is quite different. For example, the computer came in, in the sense that Invisalign is here. All this computer guided treatment. Then you have self-ligating brackets which are moving teeth faster, more comfortable, less pain. And the latest is you have micro-osteoperforation in term of Propel that is using little tiny screws to puncture holes in the bone that allow the teeth to move faster. These are very exciting development in orthodontics.

 

Howard Farran:

Are you using Propel?

 

Dr. Loh Kai Woh:

Not at the present moment.

 

Howard Farran:

You're not using it?

 

Dr. Loh Kai Woh:

But I'm using mini-screws. You must remember that the Propel was not sold in Singapore at that time. Propel has just come into Singapore. So when I read the article in AJO, what I did was I used mini orthodontic implants, the TADs, to screw into the bone and and then just removed the TADs and threw it away. So the principle is the same. Of course, Propel is much safer and easier to do.

 

Howard Farran:

So Propel, it's an interesting surgery, but it would kind of be a strange business model because you could do the micro-perforation with about anything. And you are saying you're using TADs?

 

Dr. Loh Kai Woh:

Yes, of course.

 

Howard Farran:

And what does TADs stand for?

 

Dr. Loh Kai Woh:

Temporary anchorage device. These are little screws that we put into the bone for anchor, skeletal anchorage and, of course, the Americans in the United States say that we shouldn't call it a screw. It's too traumatic to the patient. They call it temporary anchorage device. It's nice name for the patient to receive.

 

Howard Farran:

So on the self-ligating brackets. What brand do you like, or what are you using?

 

Dr. Loh Kai Woh:

As you all noted, the pioneer of [inaudible 00:03:04] the Damon system. Before Damon system was famous, I was given some of their brackets in Singapore. In fact, I was one of the very first few to use the Damon system in Asia, so I'm stuck with that system. Of course, now, a lot of development in the new type of self-ligating braces from many other companies.

 

Howard Farran:

And why are a fan of self-ligating? Just because you don't have to have the rubber bands?

 

Dr. Loh Kai Woh:

First of all, it's easier to use the system. You don't have to ligate the rubber band. You don't have to take it out every time the patient change a wire. Remember the fact that the practice of dentistry in this part of the world could be very different from US. For example, in Singapore, only the orthodontist can touch the patient, can change the wire. We cannot use auxiliaries. So every minute that we save on, let's say for example, removing the ligature, is very important to us. So time is a factor.

 

 

So that is one. That means we shorten the visit time. Two, there's less pain because we're using lighter forces. So my patient will tell me that, hey, I have discomfort for one or two days, but my classmate is sore. They have pain for two weeks. So that is a big plus, the pain factor.

 

 

Three, we can do more non-extraction cases. In fact, I have put my case in Facebook. Not Facebook, sorry, in YouTube. Some of these cases that in the past we felt you had to extract four teeth, but it can be done nicely without extraction. So these are the things that really encourage me to use more of the self-ligating brackets.

 

Howard Farran:

What countries have you lectured in?

 

Dr. Loh Kai Woh:

I have lectured in twenty countries.

 

Howard Farran:

Twenty countries?

 

Dr. Loh Kai Woh:

Yeah, so to name them all could be quite long. Asia Pacific countries

 

Howard Farran:

Asia Pacific?

 

Dr. Loh Kai Woh:

Yeah. US, I've been to lecture there, too.

 

Howard Farran:

And you lectured in Moscow?

 

Dr. Loh Kai Woh:

I'm going to Moscow in April. Moscow and St. Petersburg, so that's exciting to me. New frontiers.

 

Howard Farran:

I love St. Petersburg. That is so interesting, but you've got to go there the right time of year. You can't go lecture there in January or February.

 

Dr. Loh Kai Woh:

Oh, yeah. That's too cold. That's too cold.

 

Howard Farran:

It's key to visit St. Petersburg in May, June, or July, or August.

 

Dr. Loh Kai Woh:

Yes. That's the peak period.

 

Howard Farran:

When you talk about using clear retainers like Invisalign, that gets very cost prohibitive in a more poor country, say, Indonesia than it does in a rich country like Singapore or Japan or Hong Kong.

 

Dr. Loh Kai Woh:

That is absolutely correct. One of the reasons why this kind of technology is not adopted so quickly in Asia is because of the cost. I understand it. For example, in India, a case may only cost $500 US to complete the case, and we pay about $2000 US for Invisalign. So it is quite prohibitive. But right now, as we all know, there are many other compatible systems. Other aligners is coming out from all over the world, and they are not so popular now because they are a lot of patients that are still being helped by Invisalign, but as the patients move away, I can foresee that more of these regional aligners company will push their product to the market and bring the price down.

 

 

In fact, I realized that Invisalign is trying to bring the price down, too. Recently, I received an email that say that if we can send maximum of four cases for the next few months, they will reduce the price by 25%. I think Invisalign is receptive that they have to drop the price in this region.

 

Howard Farran:

Any lower cost competitors to Invisalign that you can think of now? Have you heard of Clear Connect out of ...

 

Dr. Loh Kai Woh:

Yeah. Clear Connect. Clear Sure.

 

Howard Farran:

What are the other ones? Clear what?

 

Dr. Loh Kai Woh:

Clear Connect.

 

Howard Farran:

Clear Connect.

 

Dr. Loh Kai Woh:

Is it Sure Clear or Clear Sure? I can't remember that. There is iROK.

 

Howard Farran:

Clear Sure and iROK?

 

Dr. Loh Kai Woh:

iROK. There's many more, you know. Koreans company, Middle Eastern companies. There are much more.

 

Howard Farran:

I haven't heard of Clear Sure, and I haven't heard of ...

 

Dr. Loh Kai Woh:

iROK?

 

Howard Farran:

iROK. iROK. That's an interesting name. Do they rock?

 

Dr. Loh Kai Woh:

They perform quite good, I must say. I've tried iROK, and I've tried Invisalign. Just two.

 

Howard Farran:

So tell me, in your practice in Singapore, what percent is fixed bracket, what percent is Invisalign? Is it different mix for adults versus children.

 

Dr. Loh Kai Woh:

I think there's no difference between adult and children, but I must say that I am quite slowly adopting the technology because of the price. I would say maybe ten percent of my cases are using the aligners. I should use more because the technology has improved tremendously, and they can actually produce quite good results. Of course, case selection is very important. You have to select the right case for aligner treatment. They are not 100% efficient.

 

Howard Farran:

Go back to that question? You are using more fixed bracket?

 

Dr. Loh Kai Woh:

Yeah. I'm using more fixed bracket, but I would love to move to the aligners system because I think the potential of aligners system is quite good because of the technology improvement. And, hopefully, the price will come down.

 

Howard Farran:

And you see the price coming down with Clear Sure and iROK?

 

Dr. Loh Kai Woh:

I think so.

 

Howard Farran:

What else has got you excited in orthodontics?

 

Dr. Loh Kai Woh:

Other than technology, the usual stuff like patients' appreciation. What I really am excited is that we are doing more and more cases non extraction. Now the diagnosis is no more based on how crowded your teeth are but where your lips are. Many orthodontists now are lecturing on diagnosis based on the face, not on the teeth. As long as your teeth are retruded, we can widen your arch, expand your arch a bit to support the lips, even though it is crowded. I have done cases that's ten millimeters crowding non extraction with self-ligating brackets, and it's not a problem. As I say, I just post one case in YouTube, and I hope that in future, I will post more.

 

Howard Farran:

I wish you would post it on Orthotown ...

 

Dr. Loh Kai Woh:

I would love to. I would love to.

 

Howard Farran:

Or Dentaltown. Orthotown is only for orthodontists. You have to be an orthodontist, but then Dentaltown has an orthodontist section, and orthodontists post cases there. I wish you would post those cases ...

 

Dr. Loh Kai Woh:

Sure. [inaudible 00:09:53] I would love to. j

 

Howard Farran:

And what's really neat is so many of these dentists are posting their cases on the apps. We have a Dentaltown app, an Orthotown app, and then a Hygienetown app for hygienists. I would love to see those cases sharing those. That would be fantastic.

 

Dr. Loh Kai Woh:

I think it's important that we share, and I appreciate your doing all this work in Dentaltown, Orthotown, and Hygienetown, you called it, and share it for free for people all over the world. There are a lot of people in other part of the world that are not very wealthy. They can't go to States to learn something. They have no money to further their education. I think what you guys are doing are really admirable.

 

Howard Farran:

There's nothing more romantic to me than to be in a dental school in Tanzania or Ethiopia or Nepal and watching some eighteen-year-old little kid learning dentistry on their iPhone on Dentaltown. It just makes me feel like such a proud papa to be able to transfer so much knowledge from the older forty, fifty, sixty-year-old dentists from around the world to any nineteen-year-old kid in any dental school on earth.

 

Dr. Loh Kai Woh:

That is exciting. When we were in dental school, if the teacher doesn't teach us, we don't know. They have the privilege of the whole knowledge, and we are in the dark. Now, no more. We can Google and learn. That's really exciting.

 

Howard Farran:

Think about when we were kids. It took five years to write a textbook, and then when the school bought the textbooks, they would use them for ten years. You could be ... At the best case scenario, it was five-year-old information. At the worst case scenario, it could be ten, fifteen, twenty. I've been in dental schools in Nepal where all the textbooks were at least twenty years old. Then they switch from a twenty-year-old textbook to Dentaltown and watch some course that was posted yesterday. The internet is a complete game changer.

 

Dr. Loh Kai Woh:

That's correct. It's amazing.

 

Howard Farran:

Complete game changer. So what else has got you excited in ortho? You said computer. You said self-ligating. You said technology like Propel. Microabrasion causing injury to the bone to make the teeth move faster through the bone. What about diagnosing? 3-D X-ray machines, computer aided modeling? Is that a game changer? Are you still mostly using a two-dimensional panograph and two-dimensional [inaudible 00:12:44].

 

Dr. Loh Kai Woh:

I have a cone beam CT in my office. Generally speaking for diagnostic orthodontics, I think the two-dimensional approach is good enough, unless you have, like, for example, you want to see how much bone the patient has whether you can widen the arch enough. Are you going to push the teeth out of the bone, every other bone, then the 3-D X-ray would be useful. I would say the 3-D X-ray is useful for selective cases. Maybe a periodontal case, or a case that's very crowded, and you see that the mucosa is very [inaudible 00:13:20]. We dare not widen it because you are going to push it out the available bone.

 

 

With the cone beam CT, you can see the amount of available bone there. You are more confident. This are not common cases. Routinely, I think that what are using now is still good enough.

 

Howard Farran:

Would ...

 

Dr. Loh Kai Woh:

By the way, before I forget. Impacted teeth. This is where cone beam CT is very important. Impacted teeth you want to see in three dimension. For example, impacted canine. How am I going to check the canine out? Is the canine crown very near the roots of the incisors? 3-D X-ray would be very useful for impacted teeth. That is the exception.

 

Howard Farran:

Would ... When you travel around the world like in southeast Asia, you have a different mix of orthodontic cases than say if you were in Europe. Japanese, Korean, Singapore, Malaysian, Vietnamese. Different mixes of ortho than say German. What are the more typical Asian profile, typical ortho cases that would be different than say if you practiced in London?

 

Dr. Loh Kai Woh:

Okay. That's a very good question. In Singapore, we have a [inaudible 00:14:44] population. I still treat a lot of white patients, Caucasian patients. What is the difference between the Caucasian patient and the Asian patient? There's racial differences. For example, the lips of the Asians are more protruded than the Caucasian. The incisor angle is different from the Caucasian. The incisors are more protruded. The question we ask ourself, should we treat an Asian face like a Caucasian face. If you want to do that, then you would extract teeth to bring the lips in. If you don't, then we can maintain our lip or even move it a little bit out. To the perception of the Caucasian orthodontist, hey, this is too bimaxillary protrusion, protruded. But it's not true. There's a racial characteristic. The biggest change I would think there are difference between the Caucasian and the Asian would be the lip profile. We can accept more lip protrusion. Those are norms.

 

Howard Farran:

So you're seeing Caucasians accept less lip protrusion ...

 

Dr. Loh Kai Woh:

That's correct.

 

Howard Farran:

Than Asians.

 

Dr. Loh Kai Woh:

Then, of course, you [inaudible 00:15:51]the degree which is the blacks. The blacks even more protruded. You see in America. You look at a Caucasian lips and the lips of the African American. Their lips are completely different. [inaudible 00:16:05]within the Caucasian and the blacks.

 

Howard Farran:

I think it's so funny how Caucasians are trying to use Botox and dermal fillers to push their lips out, and then a lot of Asians are trying to pull their lip back. It's kind of funny because all these women are beautiful whether they do anything or not. I just think it's funny how they think they have to do this.

 

Dr. Loh Kai Woh:

That's why I say my personal opinion is that we try not to extract teeth because as you grow older, the lips will shrink. You will extract four teeth. It looks nice at the age of fifteen. By the time you reach fifty-five, the lips will be collapsed and then you start using fillers. If I don't extract teeth, I position the teeth slightly forward at the age of fifteen. Then by the time they're fifty, they just look nice, beautiful.

 

Howard Farran:

So when you got out of ortho school in Pittsburgh Steeler country in 1982, did you come right back to Singapore?

 

Dr. Loh Kai Woh:

Yes. I had to come back because I was a scholarship holder.  I came back to teach at the University of Singapore.

 

Howard Farran:

And when you came back in '82, was orthodontics mostly children, and now in 2016, it's more half children, half adults? How has the patient mix changed from '82 to 2016?

 

Dr. Loh Kai Woh:

This is a very interesting question. Most of our orthodontists at that time were trained in England. I was the first orthodontist trained in the States for three years program. The first one. I admitted to school in 1979. When I came back, fixed appliances still not very common. We were still using the removable appliance with the wire spring to move teeth. Of course, now, because of the knowledge that spread across the world so rapidly, fixed appliances is ... Everybody is using fixed appliances. We throw away the removable appliances with finger spring. In term of patients whether they're children or adult, obviously, there are more adults having braces now because they're more aware of it. And because the more education they receive. They go to the internet. They see that, hey, I'm forty-five. I still can make my teeth straight. So there's no question to me that the perception of adults wearing braces is no more a taboo. They accept it very well.

 

Howard Farran:

What about tooth whitening from '82? I remember back in the 80s, a lot of people around the world thought American teeth were too white. Are you seeing more tooth whitening, more bleaching in Asia?

 

Dr. Loh Kai Woh:

Definitely so. Definitely so. Somehow the whiter the tooth is, it is perceived as the person being more attractive and more young. Yes, there are much, much more requests for tooth whitening even from children. You'd be surprised. We have patients who finish a treatment at fifteen, they want tooth whitening. And as you know, now, tooth whitening is so common. There are so many type of material available for whitening teeth. It is very commonly requested for now. [inaudible 00:19:15] at cost of treatment.

 

Howard Farran:

Now do orthodontists in Singapore, do they provide cleanings with hygienists, or is that something they do not do, and the general dentist does that?

 

Dr. Loh Kai Woh:

It depends on the set up of the clinic. Clinics that set up purely restricted to orthodontics, then they would not provide cleaning. They do not provide hygienists. But there are many other clinics where you see multi-specialists practice or practice with general practitioners, then in-house they will provide cleaning and whitening.

 

Howard Farran:

So how many orthodontists are in Singapore?

 

Dr. Loh Kai Woh:

At last count, we had about one hundred twenty plus.

 

Howard Farran:

A hundred and twenty plus for five and a half million people. Is that enough, or do you think there should be more, or is it too many? What is the supply and demand like for an orthodontist in Singapore?

 

Dr. Loh Kai Woh:

Before I can give an answer about the supply of orthodontists to the population, we also must recognize that there are many general practitioners doing orthodontics, like many other countries. So just by looking at the number of orthodontists of the population and talk about the supply and demand, it may not be accurate. There may be another five hundred general practitioners doing orthodontics. Right at the moment, the unique thing about Singapore is that the government provides subsidized orthodontic treatment to all Singaporeans irrespective of their income.

 

Howard Farran:

Why is that? Why do they do that?

 

Dr. Loh Kai Woh:

Because the government felt that they have a role to do that. They provide free dental treatment for all children in school. They have dental cleaning in school. They all receive free dental treatment by the way.

 

Howard Farran:

In school?

 

Dr. Loh Kai Woh:

In their school, yeah. You have to opt out if you do not want this service. And from the school, if the dentist see a malocclusion, they send it to the National Dentist Centre. And they will provide them subsidized orthodontic treatment. So this very unique in Singapore. So if they enough cases to go around, I can also tell you that most of the children are done in the common clinic. We are treating more adults.

 

Howard Farran:

Oh, so when a child gets free dental or free ortho ...

 

Dr. Loh Kai Woh:

Subsidized, not free.

 

Howard Farran:

But it's at a government clinic.

 

Dr. Loh Kai Woh:

Yeah.

 

Howard Farran:

So you have government clinics and private clinics?

 

Dr. Loh Kai Woh:

Correct.

 

Howard Farran:

Yeah. And do you have many friends that work in the government clinics?

 

Dr. Loh Kai Woh:

Of course we have.

 

Howard Farran:

And do they like working there?

 

Dr. Loh Kai Woh:

Oh, some do. It's just like any other thing. Some of them like to work there. Some of them don't. Some of them are trained. They have to have [inaudible 00:22:01] to work there for a few years before they can go to private practice.

 

Howard Farran:

What are your hours at your dental office?

 

Dr. Loh Kai Woh:

I work from nine to six.

 

Howard Farran:

How many days a week?

 

Dr. Loh Kai Woh:

Five days a week.

 

Howard Farran:

Five days a week nine to six?

 

Dr. Loh Kai Woh:

Most of us work five and a half days a week.

 

Howard Farran:

Five and a half days a week? Is it fair to say that Asian dentists in general work more hours than European dentists?

 

Dr. Loh Kai Woh:

Oh, yeah. Some of them are open at night, too. I've seen dentists open nine to nine Monday through Friday, Saturdays nine to one, and Sundays nine to one. They work seven days a week.

 

Howard Farran:

I know. I have lectured around the world, United States, Canada, Australia, England, France, Italy. They work few hours. And then you go to Asia. They almost work twice as many hours.

 

Dr. Loh Kai Woh:

Maybe. I'm just thinking out loud. Maybe it's the tax structure.

 

Howard Farran:

The tax structure?

 

Dr. Loh Kai Woh:

Yeah.

 

Howard Farran:

I think it's just the cultural work ethic.

 

Dr. Loh Kai Woh:

Yeah. For example, I know people in Australia. The tax structure is so high. They say, why should I work so hard? When I cross a certain amount of income level, all the money goes to the government. So they don't work so hard. Maybe. I don't know. I'm just guessing.

 

Howard Farran:

Tax policy can be some of it, but I just think ... It's my feeling that Asia just has a much harder work ethic.

 

Dr. Loh Kai Woh:

That's correct. That's correct. They work harder.

 

Howard Farran:

They just ... And a lot of them just, it's their identify. A lot of Asian people I know, no matter what field they're in, they just love to work. Their life is their work. They live above their shop.

 

Dr. Loh Kai Woh:

They live in a house. The clinic's in the garage. In Asia, it's like that.

 

Howard Farran:

Yeah. I see it. They live in their office, and if someone wants to see a dentist at nine o'clock on a Sunday night, they're right there. They're ready to see them.

 

Dr. Loh Kai Woh:

Some of them. Even at eleven at night.

 

Howard Farran:

Yeah. Yeah, I know. I've been in a city like at a restaurant, and I'll see a dental office. It's their office. It's their house. It's their family, and you could get a root canal, exactly, at eleven o'clock at night.

 

 

So what else has got you excited in orthodontics? What all have you seen changed since 1982? What else have you seen from '82 to 2016? That's a long time.

 

Dr. Loh Kai Woh:

I mentioned again ... I just recall what I've said. Self-ligating. Mini implant is exciting. [inaudible 00:24:44] very exciting. Thermal activated [inaudible 00:24:52] Then, of course, you have Invisalign. Now you have Propel. I think the next one will be perhaps more and more clinics will own a scanner, intraoral scanner, because that's the way to go. The new generation dentists are all very knowledgeable in technology. So what do they do? They cut a cavity or they want to do a study model, the scanner comes into play. Why is the scanner not taking up as quickly as it should be, the intraoral scanner? It's because of cost. As the cost comes down, then everybody will buy a scanner. So I'm waiting for the cost to come down, then I will buy a scanner, too.

 

Howard Farran:

What scanner do you like? What are you looking at?

 

Dr. Loh Kai Woh:

Well, I was looking at the studies on the internet. They have Itero. They have, I think there's one for Ormco. There's one from Planacar. There's one from Siemens. There's one from [inaudible 00:25:55] or something like that. There's so many. The 3shape. I'm very confused which one to buy.

 

Howard Farran:

What would you be doing with this scanner?

 

Dr. Loh Kai Woh:

We can study model. We do not take impression any more. We can use retainers on that. We can mix aligner. For a general dentist, of course, you can do crown and bridge. So there are a lot of use for intraoral scanner. I think the future is going to be an intraoral scanner future. In fact, every year there is one CAD/CAM conference in Singapore in November or December. It's been going for the past two or three years. It's very exciting to see the development.

 

Howard Farran:

It's no doubt the whole dental industry is going digital. It's going from analog to digital, from impressions to oral scanning. It's just going to come down to at what price does it make sense?

 

Dr. Loh Kai Woh:

And how fast. And how fast. How fast and how accurate. From what I get, the accuracy is quite okay. They've done all the studies of the accuracy. They are quite good, but now how fast? You don't want to spend half an hour scanning the upper and lower arch, you know. You can do it in five minutes or ten minutes or seven minutes, that's okay.

 

Howard Farran:

And it also depends on what your costs are like. If you're in a poor country, so the price is low and your labor is low, it doesn't make sense. But if you're in a country where labor is very expensive and your own labor is very expensive, then it starts to make sense.

 

Dr. Loh Kai Woh:

I had an interesting conversation with Dr. Wayne Hickory yesterday. Do you know that Singapore government actually subsidize the equipment that we buy?

 

Howard Farran:

They subsidize what?

 

Dr. Loh Kai Woh:

The equipment that we buy. For example, you buy equipment for a hundred thousand. They can subsidize up to sixty percent. The government gives you money to buy as long as it increases the productivity of your office. I think it's the only government in the world that gives money to the profession to upgrade.

 

Howard Farran:

Well, Singapore ... I studied business. I have a Master's in Business from Arizona State University, and Singapore is still considered the number one economic miracle of all time. No other society went from poor to rich that fast, ever. Everybody studies Singapore, and it was truly ... Everybody should study their tax model, their investment model. It was just amazing. You've lived through a lot of this. What year did Singapore get its independence, from 1964?

 

Dr. Loh Kai Woh:

1965.

 

Howard Farran:

'65? And when were you born?

 

Dr. Loh Kai Woh:

'52.

 

Howard Farran:

So in '65, you were thirteen years old. You lived through it. You remember this.

 

Dr. Loh Kai Woh:

Yeah, yeah, of course. I remember when Singapore was quite poor.

 

Howard Farran:

You remember when it was poor?

 

Dr. Loh Kai Woh:

Yeah, of course. Of course.

 

Howard Farran:

When did it start going from poor to rich?

 

Dr. Loh Kai Woh:

Wow. Maybe in the 70s.

 

Howard Farran:

Why do you think Singapore went from poor to rich so fast whereas other countries around it, whether it be Malaysia or Thailand or Cambodia or Indonesia did not grow the economy that fast? What do you think was the Singapore miracle?

 

Dr. Loh Kai Woh:

I think it all boils down to our late previous prime minister Lee Kuan Yew because he has a vision, and he told everybody, look here, nobody owes you a living. Nobody owes Singapore a living. We have to work hard for ourself. We have to do things for ourself. Don't depend on other people. From there, he ... I think one of the most important thing he selected brains to run the country. He wanted the country to be run by very smart people, number one.

 

 

Number two, zero corruption. Zero tolerance to corruption. If you are corrupted, you'd be caught. You'd get what you deserved. There was literally no corruption. And education. A lot of money spent on education. You will look at the libraries of Singapore. Just go to the libraries. It's amazing the amount of resources that a child can receive. So now we have a generation of people whose education level goes up. And everyone receives free education, I think primary and secondary school.

 

 

From there, they select all these people. And, of course, they give scholarships to the better ones, and from there, they groomed them up to be leaders. So now Singapore has good leaders across the board whether it is in the government or in the statutory board or in the school, anywhere. The brains start to work. When the brains start to work, you also understand one thing. You cannot be corrupted. You cannot be corrupted. You work for the company. You work for the country, and that's how the whole country move up.

 

Howard Farran:

That's one thing that people don't talk enough about on economic policy, but when you talk to people who have a doctorate in economics, not dentistry, corruption is a huge factor. When you go to areas ... It reminds me of a joke. Can I tell a joke?

 

Dr. Loh Kai Woh:

Of course.

 

Howard Farran:

This might be a bit too racial, but a businessman shows a bridge to a reporter in America, and he says, "See that bridge? I got the government contract. I got ten percent of the deal." The next week they're in China, and the businessman tells the journalist, "See that bridge there? I got twenty percent of that deal." And then they go to Africa, and the guy says, "See that bridge there?" The guys says, "I don't see a bridge." He goes, "I know. I got a hundred percent of the deal." And when you study corruption ... The United States ranks high on the corruption level. When you look at corruption high in Mexico or Brazil or the United States, it really does hurt the economy. So compare the lack of corruption in Singapore to neighboring states, and how do you think that played into the economic expansion?

 

Dr. Loh Kai Woh:

Okay. One thing that's interesting to note is that our ministers are paid very highly. In fact, our prime minister is paid much, much higher than Obama.

 

Howard Farran:

Four times as much. A million dollars a year.

 

Dr. Loh Kai Woh:

Yeah.

 

Howard Farran:

And Obama is two hundred thousand.

 

Dr. Loh Kai Woh:

So if you want people to not be corrupted, they must be [inaudible 00:32:25] They mustn't be hungry. So if you are hungry as a leader, you will start to take in something that you're not supposed to take in. In fact, we have mentioned that if they're taking money they're not supposed to take, it costs you more than one million dollars. They might take ten million instead of one. So the first thing the government did was to pay the leaders well. This, of course, has a political price because people will say, hey, how can you make so much money? You're an administrator. You're supposed to serve me. But look at progress of Singapore. [inaudible 00:33:01] the corruption. Now the people above has a clear mind to work. They don't have to worry about, is somebody investigating me? Am I getting too much? So just focus on the work, and, of course, we have leadership to control. It's like a pyramid, isn't it? The top control downwards. So when it control all the leaders well, then the leaders also control the third layer, the fourth layer, fifth layer well.

 

 

So the country progress. And don't forget, also, you must have smart people running the country. And people say why must you be smart? I can have a ... The smart people may not understand what the pauper feels, what the poor feels. For example, I was told that in some country, the government gives land to very rich people. I give you this land for seven years or sell it to you at a certain price, you build a shopping complex. So the poor people say, why are you so biased. Why not give it to us? Just because he's rich, you give it to him. But if the government give it to poor people, they have no resources to develop the place. So, in a way, the rich get richer, but the rich now employ the poor or the middle class. So how can you have so many rich people, but don't forget that as long as the rich people share their wealth, that's good enough.

 

Howard Farran:

Do you think having English as the official language was a big factor, too?

 

Dr. Loh Kai Woh:

Tremendously. Tremendously, because, you can see there are some countries that are very chauvinistic. They say, no, we do not learn English, because we want to have our own language, which is fine, which is fine. There's nothing wrong with that. In Singapore, because of our multi-racial component, we have to be very careful not to upset racial differences. It may cause racial discrimination and racial problems. So in order to choose a language that all the races will accept, Lee Kuan Yew chose English.

 

 

If he choose Chinese, then the Malay will say why not Malay? If he choose Malay, the Indian will say why not Indian? So he was very smart to choose English. That actually harmonizes the whole country. That's number one. You must have religious and racial harmony for the country to grow. You know that there's countries that have so much problem with race and religion. It can't grow. So what it has done, English became our main language, but we did not neglect the mother tongue. Everyone is [inaudible 00:35:42] the mother tongue. Whether you're Malay, Indian or Chinese. So now you preserve your own culture, so you get the best of both.

 

 

With English now, the Singaporean can go all over the world, but Lee Kuan Yew also had a vision. China is going to grow, before China grew. So he emphasized learning Chinese. So now a lot of our people are bilingual, good bilingual, English and Chinese. Even the Malays Indians are learning Chinese. So if you go to China to do business now, it's no problem. So that is foresight.

 

Howard Farran:

Yeah, it is amazing how you can go to so many countries around the world, and if you know English, you can get by fine. It really has become the international language, isn't it?

 

Dr. Loh Kai Woh:

Correct. That's correct.

 

Howard Farran:

And the countries that really adopt it seem to be doing so much better than when you go to a country and no one really speaks English.

 

Dr. Loh Kai Woh:

The Philippines, for example. They spot [inaudible 00:36:45] A Filipino can go anywhere because they learn English. You're going to spot an Indonesian overseas. They can't communicate.

 

Howard Farran:

Indonesians have a hard time with English.

 

Dr. Loh Kai Woh:

Indonesians only speak Indonesian.

 

Howard Farran:

In Japan, it's very hard to find any English.

 

Dr. Loh Kai Woh:

The young people are learning English. The young people are better now.

 

Howard Farran:

When I'm talking to dentists there, the majority of them can't speak English to me.

 

Dr. Loh Kai Woh:

They can read.

 

Howard Farran:

Yeah, they can read it, but they can't speak it.

 

Dr. Loh Kai Woh:

Because they don't practice.

 

Howard Farran:

You use it or lose it.

 

Dr. Loh Kai Woh:

They can read.

 

Howard Farran:

Well, is there anything else you want to talk about?

 

Dr. Loh Kai Woh:

Well, we're happy to have you here in Singapore and fortunate to have interview [inaudible 00:37:34]. I was given notice yesterday. I grabbed it, of course, knowing Howard is here. I wish you all the best, and please continue to help people in the world get a free education. I'm sure there are many people all over the world, especially less developed countries, who really, really appreciate the work you are doing for dentistry.

 

Howard Farran:

Well, thanks. It's a labor of love.

 

Dr. Loh Kai Woh:

That's great. That's great.

 

Howard Farran:

All right. Well, thank you so much for your time.

 

Dr. Loh Kai Woh:

Thank you very much. Take care.

 

Howard Farran:

Okay. Bye-bye.

 

 

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