In a nursing home, an elderly man grappling with high blood pressure and stroke has been bedridden for an extended period. Despite receiving professional care, simple tasks like brushing his teeth become arduous. Over time, the elderly resident not only experienced persistent mouth odour, but also suffered from swollen, inflamed gums that bleed at the slightest touch. The resulting toothache left him agitated and restless, greatly hindering his ability to eat and sleep peacefully.
As Dr Eugene Tang, a dentist in his late 70s, and his volunteer team entered the hospital room with their mobile dental equipment, the elderly resident appeared somewhat wary, and his gaze fixed blankly. Dr Tang approached him gently, kneeling to pat the elderly man's shoulder. Leaning in close, he spoke in a slightly louder tone, "Uncle, I'm here to clean your teeth. It might be a little uncomfortable, but there's nothing to fear."
(Photo by Goh Shoo Weng)
Dr Tang's gentleness is subtle yet pervasive; whether in a medical environment or beyond, he consistently wears a serene smile that conveys understanding and acceptance of all situations.
Even outside the clinical setting, the piercing sound emitted during the dental treatment, the sensation of water spraying in the mouth, and the occasional twinge of pain can induce high physical and mental tension. Amidst these harsh mechanical sounds, Dr Tang and his team wield a magical solution: the comforting presence of dentists, dental assistants, and volunteers, along with the soothing melodies that drift through the air intermittently.
The bedridden elderly resident could not sit in the dental chair, requiring Dr Tang and his assistant to bend their heads and lean down at an unusual angle. "Let's take it slow. We'll start with the left side, and we'll count to ten together," Dr Tang instructed gently, comforting the elderly resident as if the bothersome toothache would vanish once they reached ten.
"Simply tapping a resident on the shoulder or offering a gentle touch on the back of their hand while communicating directly to them can be incredibly effective," explained Jennifer Ee, the clinic manager, who has dedicated over three decades to serving at Dr Tang's dental clinic and has been actively involved in medical missions alongside him for many years.
Dr Tang's soft-spoken nature and genuine sincerity shine through in his interactions with everyone. Despite the rigour and seriousness displayed when he works, he manages to diffuse tension rather than exacerbate it. His gentleness is subtle yet pervasive; whether in a medical environment or beyond, he consistently wears a serene smile that conveys understanding and acceptance of all situations.
(Photo by Goh Shoo Weng)
Dr Tang and his team must pay constant attention to the patients’ emotions, comforting those in distress and addressing their concerns. Additionally, they must be mindful of the elderly residents' "stamina," as the deterioration of their oral muscles often prevents them from keeping their mouths open for a long period of time.
The team was divided into two groups, with Dr Tang occasionally overseeing shifts at the treatment zone downstairs, catering to residents with better mobility and independence. Nurses wheel the residents in wheelchairs by batches to wait beside the mobile treatment station. Specially imported wheelchair tilter support from Taiwan has been set up to facilitate the residents' access to dental care once they are reclined. However, despite the organised arrangement, challenges occasionally arise and disrupt the smooth flow of operations.
During the waiting or treatment process, some residents may grow impatient or become agitated, while others may seek excuses to avoid dental treatment out of fear. Dr Tang and his team must pay constant attention to the patients’ emotions, comforting those in distress and addressing their concerns. Additionally, they must be mindful of the elderly residents' "stamina," as the deterioration of their oral muscles often prevents them from keeping their mouths open for a long period of time.
“We must work in intervals, pausing intermittently to ensure the patient's comfort. Even if multiple teeth fillings are required, it's not feasible to complete them all in one session," explained Jennifer Ee, who briskly paced across the site, ready to lend a hand wherever needed.
Nursing home residents are restricted in their movements and mostly suffer from multiple chronic diseases, making them particularly susceptible to oral health issues such as bad breath, tooth decay, and periodontal disease. These conditions not only diminish their quality of life but also pose a significant risk of potentially fatal respiratory complications, such as pneumonia, as oral bacteria can enter the respiratory tract if ingested with food.
There are as many as 250 dental clinics on this tiny island of Singapore, making it convenient for the public to visit the dentist. However, for elderly people with mobility impairments or those who are bedridden, accessing dental services poses significant challenges. Even if family members were willing to assist them in leaving the house, the general dental clinics may not have the relevant equipment and healthcare professionals trained to accommodate patients with special needs.
(Photo by Goh Shoo Weng)
"Dr Tang consistently approaches dental therapies with a level of care as if the patient were his cherished loved one. He tirelessly does his best to alleviate any physical or mental suffering his patients may bear, whether it is a difficult life situation, a physical ailment, or a heartfelt sorrow."
Dr Tang now dedicates one weekend per month, alongside a team of 20 to 30 individuals, to provide dental treatment and care at a local nursing home, specifically for residents with mobility issues. Although maintaining the same posture for extended periods often leads to instant back pain once he leaves the treatment station, Dr Tang finds solace in knowing he can sleep well tonight.
As he spoke, Dr Tang, who has passed the retirement age, rose from his seat and demonstrated shoulder and neck exercises. "The occupational ailments dentists face are the same as the white-collar workers," he said smilingly. "Sore wrists, shoulders, and necks are common, we need to regularly move our body and get ample rest to sustain in our work."
For over two decades, Dr Tang has dedicated himself to serving local communities and participating in numerous overseas free medical missions in countries like Sri Lanka, Cambodia, and the Philippines. When asked about the various encounters at the sites of the free clinics, which he had never shared with anyone, Dr Tang remained humble, he refused to take credit for his contributions but expressed profound gratitude for the collective efforts of his team, which have enabled the successful accomplishment of their medical missions.
He repeatedly emphasised that not only physicians but everyone in the medical mission team is indispensable: Oral health therapists and dental assistants who sacrifice their weekends, and volunteers who focus on calming patients before treatment and paying careful attention to their behaviour and taking on logistical and administrative tasks.
With heartfelt sincerity, Dr Tang remarked, "The importance lies not solely in the work of doctors, but also in the tireless efforts of individuals like Sis Jennifer, who meticulously organises all essential materials for our free dental missions. She ensures that every supply is replenished, and all laptops are uploaded with patient lists and profiles. Every volunteer's dedication is exemplary—they consistently arrive at the clinic before us and leave later than us, contributing even more than we do."
(Photo by Goh Shoo Weng)
The four-word Chinese phrase "视病如亲" (which means treating patients as one's own family) encapsulates a deeply held ethos in the medical community. Dr Tang upholds this principle daily in his clinic situated in the Central Business District. For him, it means extending familial care to patients facing financial hardships and shouldering their medical expenses without hesitation. Even on his days off, he remains dedicated, reaching out to patients to monitor their dental issues' progress during the medical observation period, offering both clinical support and comforting words. His compassion even transcends the clinic walls; when a patient he has known for years passes away, he would extend his condolences to the grieving family.
Having worked together for more than 30 years, Jennifer Ee spoke warmly of Dr Tang, noting his unwavering commitment to the wellbeing of his patients. She said, "Dr Tang consistently approaches dental therapies with a level of care as if the patient were his cherished loved one. He tirelessly does his best to alleviate any physical or mental suffering his patients may bear, whether it is a difficult life situation, a physical ailment, or a heartfelt sorrow."
(Photo by Goh Shoo Weng)
At that moment, Dr Tang suddenly realised that life has ups and downs. With this realisation dawned the understanding that seemingly irrational requests from patients might stem from their suffering.
Dr Tang was introduced to Tzu Chi in 2004 when he attended the memorial service of his fellow peer, Dr Ling Sing Yew. Since then, his involvement with Tzu Chi has been marked by his dedicated service to local communities and remote villages overseas, treating both adults and children. Irrespective of the age of his patients, Dr Tang establishes good patient interaction through music, dance, balloons, and his approachable personality. As the dental convenor of the Tzu Chi International Medical Association of Singapore for many years, Dr Tang is recently busy preparing for the launching of the new clinic's dental department and has also been training and mentoring a younger volunteer medical team.
Approaching his seventies in the coming year, he recently completed a two-year Graduate Diploma course in Geriatric Dentistry at the National University of Singapore. "Now I feel greater confidence that I am providing treatment based on scientific evidence. That gives me peace of mind," Dr Tang said.
Walking for miles in worn slippers to access medical care, children from distant villages gifted Dr Tang two small pomegranates as a token of gratitude after undergoing dental extractions. Even after many years, tears still filled Dr Tang's eyes as he reminisced about the poignant moments and heart-warming gestures he experienced during his overseas clinic missions.
There are countless stories of encounters between doctors and patients; one memory remains vivid for Dr Tang. One day at the local free clinic, an elderly woman arrived late for her appointment, but she was agitated and pushed to be seen first. Initially, Dr Tang couldn't help but perceive her behaviour as unreasonable. However, upon visiting the elderly woman's home together with the volunteers, he discovered that her family was burdened with numerous hardships: Her son was afflicted by illness and was unable to walk upright, constrained to crawling on hands and knees.
At that moment, Dr Tang suddenly realised that life has ups and downs. With this realisation dawned the understanding that seemingly irrational requests from patients might stem from their suffering. Hence, it is crucial to be able to uncover the meaning behind a patient's behaviour. Doing so not only enables the healthcare provider to be present for the patients but also helps the healthcare provider themselves in navigating the emotional complexities that arise in such encounters.
(Photo by Goh Shoo Weng)
Despite being a Christian, Dr Tang finds within the world of Tzu Chi a profound sense of brotherhood and compassion that resonates with Christian principles. He holds dear the values embraced by both Buddhism and Christianity. For him, the essence of great love transcends the barriers of race, religion, and nationality. The volunteer team that serves at the monthly free clinic comprises individuals from diverse backgrounds, including Singaporeans and foreigners, as well as Buddhists, Muslims and Sikhs.
"Actually, there isn't much to seek in life; being able to eat is the most important thing. And for me as a dentist, being able to relieve patients of their toothache or inability to eat is simply the best."
After a pause, Dr Tang added, "Professionalism is not defined by professional titles, but the willingness to connect with patients with your smile, your touch, and your willingness to listen to them to understand their needs and deliver the needed treatment with care."
Despite repeatedly emphasising that his role isn't significant, Dr. Tang demonstrates an innate sense of responsibility to listen to the voices of those in pain through his actions and words. To him, being a dentist is merely a professional label; his true calling lies in alleviating patients' suffering and offering them solace.
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