Wednesday, December 29, 2010

Child Dental Care in Seoul Korea

U.S. Dental ( also known as Tufts Dental )

Dr.Gina Sohn - Tufts Graduate
U.S.Dentist in Seoul / Licensed in MA, CT, NJ
http://www.drginasohn.com
Tel 02-553-7512 / Overseas 822-553-7512

Dental Care for Your Baby

1.When should my child first see a dentist?

"First visit by first birthday" sums it up. Your child should visit a dentist when the first tooth comes in, usually between 6 and 12 months of age. This visit will establish a dental home for your child. Early examination and preventive care will protect your child smile now and in the future.

2. Why so early? What dental problems could a baby have?

The most important reason is to begin a thorough prevention program. Dental problems can begin early. A big concern is Early Childhood Caries (formerly known as baby bottle tooth decay or nursing caries). Once a child diet includes anything besides breast-milk, erupted teeth are at risk for decay. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily and smile with confidence. Start your child now on a lifetime of good dental habits.

3. How can I prevent tooth decay from nursing or using a bottle?

At-will breast-feeding should be avoided after the first primary (baby) teeth begin to erupt and other sources of nutrition have been introduced. Children should not fall asleep with a bottle containing anything other than water. Drinking juice from a bottle should be avoided. Fruit juice should only be offered in a cup with meals or at snack time.

4. When should bottle-feeding be stopped?

Children should be weaned from the bottle at 12-14 months of age.

5. Should I worry about thumb and finger sucking?

Thumb sucking is perfectly normal for infants; many stop by age 2. Prolonged thumb sucking can create crooked teeth or bite problems. If the habit continues beyond age 3, a professional evaluation is recommended. Your dentist will be glad to suggest ways to address a prolonged thumb sucking habit.

6. When should I start cleaning my baby teeth?

The sooner the better! Starting at birth, clean your child gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a "smear" of toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, dispense a "pea-size" amount of toothpaste and perform or assist your child toothbrushing. Remember that young children do not have the ability to brush their teeth effectively.

7. Any advice on teething?

From six months to age 3, your child may have tender gums when teeth erupt. Many children like a clean teething ring, cool spoon or cold wet washcloth. Some parents swear by a chilled ring; others simply rub the baby gums with a clean finger.

7 Ways to Protect your child's Oral Health

1.Start Oral Care Early

Your child should see a dentist by the time he's a year old, according to the American Academy of Pediatrics and the American Academy of Pediatric Dentistry.

2.Teach the Brush & Floss Habit
Tooth brushing is also crucial from the start. Even before your baby has teeth, you can gently brush the gums, using water on a soft baby toothbrush, or clean them with a soft washcloth.Once there are additional teeth, parents have to buy infant toothbrushes that are very soft. Brushing should be done twice daily using a fluoridated toothpaste.
Flossing should begin when two teeth touch each other. Parents have to clean the teeth until children are able to tie their shoes or write in cursive.

3.Avoid "Baby Bottle Decay"
For years, pediatricians and dentists have been cautioning parents not to put an infant or older child down for a nap with a bottle of juice, formula, or milk.The sugary liquids in the bottle cling to baby's teeth, providing food for bacteria that live in the mouth. The bacteria produce acids that can trigger tooth decay. Left unchecked, dental disease can adversely affect a child's growth and learning, and can even affect speech.
If you must give your child a bottle to take to bed, make sure it contains only water, according to the American Academy of Pediatrics guidelines.

4.Control the Sippy Cup Habit
Bottles taken to bed aren't the only beverage problem. Juice given during the day as a substitute for water and milk is another. Often, that juice is in a sippy cup. It's meant as a transition cup when a child is being weaned from a bottle and learning to use a regular cup.
Parents mistakenly think juice is a healthy day-long choice for a beverage. But that's not the case. Prolonged use of a sippy cup can cause decay on the back of the front teeth, if the beverages are sugary. The American Academy of Pediatrics advises parents to limit the intake of 100% fruit juice to no more than four ounces a day. Sugary drinks and foods should be limited to mealtimes.

5.Ditch the Binky by 2 or 3
Sucking too strongly on a pacifier, for instance, can affect how the top and bottom teeth line up (the "bite") or can affect the shape of the mouth. Pacifiers should be dropped by age 2.

6.Beware of Mouth-Unfriendly Medicines
Many medications that children take are flavored and sugary. If that sticks on the teeth, the risk for tooth decay goes up.
Children on medications for chronic conditions such as asthma and heart problems often have a higher decay rate.
Antibiotics and some asthma medications can cause an overgrowth of candida (yeast), which can lead to a fungal infection called oral thrush. Suspect thrush if you see creamy, curd-like patches on the tongue or inside the mouth.

7.Stand Firm on Oral Hygiene
• Plan to help your children longer than you may think necessary. "Children don't have the fine motor skills to brush their own teeth until about age 6," says Hayes. Flossing skills don't get good until later, probably age 10.
• Schedule the brushing and flossing and rinsing, if advised, at times when your child is not overly tired. You may get more cooperation from a child who isn't fatigued.
• Get your child involved in a way that's age-appropriate. For instance, you might let a child who is age 5 or older pick his own toothpaste at the store, from options you approve. You could buy two or three different kinds of toothpaste and let the child choose which one to use each time. You may offer him a choice of toothbrushes, including kid-friendly ones that are brightly colored or decorated.
• Figure out what motivates your child. A younger child may gladly brush for a sticker, for instance, or gold stars on a chart.

Sunday, December 26, 2010

Wisdom Teeth Extraction in Seoul Korea

U.S Dental ( also known as Tufts Dental )
 
Dr.Gina Sohn - Tufts Graduate
U.S. Dentist in Seoul / Licensed in MA, CT, NJ
http://www.tuftsdental.net
Tel 02-553-7512 / Overseas 822-553-7512

Wisdom teeth: what is the optimal age for removal, and should all wisdom teeth be removed?

1.What is the optimal age for surgery?

The NIH study found that the lowest morbidity was associated with third molar removal in patients aged 15 to 25 or when the roots are two-thirds formed. Reasons for this included: more favorable root form, greater distance to the inferior alveolar nerve, softer/more pliable bone, and more rapid healing.

2.Should all third molars be removed?

The easy answer is "no."
 There are, however, many indications for third molar extraction, possibly too many to list in this short piece.

• Symptomatic teeth, including third molars with acute or chronic issues, including dental caries, pericoronitis, odontogenic abscess, etc.
• Any impacted tooth with associated pathology is indicated for extraction, and would include cyst and tumors. If pathology is suspected, a biopsy of the associated tissue should be planned.
• Periodontal compromise of adjacent teeth.
• If orthognathic surgery is planned-specifically a bilateral sagittal-split osteotomy-removal of the third molars should be planned for a more predictable surgical outcome.
• Second molars that have failed to erupt often have the developing third molars just distal to them. Once this is recognized, the second molars are effectively "pinned" into place. Extraction of the third molars often allows these teeth to erupt.
• Arch length deficiency.
• There are many special cases when third molar extractions are indicated, including fractures, complex medical issues, or behavioral issues.

Wednesday, December 22, 2010

Veneers & Lumineers in Seoul Korea

U.S  Dental (also known as Tufts Dental )

Dr.Gina Sohn - Tufts Graduate
U.S.Dentist in Seoul / Licensed in MA, CT, NJ

FACEBOOK
 http://www.drginasohn.com
 Tel   02-553-7512 / Overseas 822-553-7512
Yongsan / Itaewon area


Veneers




Veneers




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Veneers






Lumineers








Veneers




Lumineers








Lumineers





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No-Prep Veneers

No-prep porcelain veneers ( such as Lumineer ) have been around for more than two decades, and the incredible success of bonding porcelain to 100% enamel is well-documented.

Now, there are refined techniques, new and improved materials, and better training in emulating nature so that the end result of prepless veneers can rival or exceed the results of traditionally prepared veneers. Contrary to common thinking, this style of dentistry is not easy; in fact, if done well, this approach can require more skill and expertise than traditional porcelain veneers.

Case selection for “prepless” veneers is critical, and, clearly, additive-only restorations are not for every situation. The case types that may be well-suited for no-preparation veneers are:

• microdontia such as peg laterals, tooth-to-arch discrepancies, and, in general, undersized teeth.
• short, worn teeth that have lost volume due to occlusal wear, abrasion, erosion, or some combination of these factors.
• bicuspid extraction orthodontic cases where anterior teeth are overly lingualized and the arch form is narrow.
• large lips that create a big frame and allow enlargement of the teeth for proper proportion.

In recent years, a new trend has emerged that will not likely be reversed: the movement toward more conservative preparations and even no preparation for many cosmetic smile design cases. It is strongly likely that this trend is here to stay as the consumer, when given a choice, will always seek out more conservative alternatives.

Wednesday, December 1, 2010

Root Canal Treatment in Seoul Korea

U.S.Dental ( also known as Tufts Dental ) 

Dr.Gina Sohn - Tufts Graduate
U.S.Dentist in Seoul / Licensed in MA, CT, NJ
http://www.drginasohn.com
Tel 02-553-7512 / Overseas 822-553-7512

Root Canal Treatment

Good root canal treatments begin with proper diagnosis.

This involves listening to the patient’s description of the problem, followed by clinical tests to reproduce the patient’s subjective pain or symptoms.

The clinical tests that need to be incorporated into the diagnostic evaluation are 1) cold, electric pulp tester (EPT) and/or heat tests for pulp vitality; 2) percussion testing to determine the status of the periodontal ligament; 3) palpation testing to evaluate the gingival tissue and bone for infection or inflammation; 4) probing and mobility testing; and lastly, 5) radiographic examinations.

Also, it is important to review a patient’s medical and dental history as part of the diagnostic process.

One of the more influential factors regarding the long-term restorative prognosis is the periodontal (surrounding gum and bone) status of the tooth being treated. Primary pathosis from a root canal certainly can cause secondary periodontal lesions. When the root canal etiology is removed in these situations, the periodontal problem is also likely to resolve. However, when the bone loss is primarily from gum disease, it can create a less predictable prognosis for the tooth even with the appropriate root canal treatment.

Root canal disease is mediated by bacteria.

Treatment goals should be directed to reducing the critical concentration of microbial irritants to the lowest level possible. Thorough canal instrumentation, with either stainless steel hand files or Ni-Ti rotary files, removes the bulk of tissue and microbial contamination, but adjunctive chemical agents are needed to optimize debridement. Current concepts support the following approaches:

• lubricating and chelating agents during cleaning and shaping,
• copious irrigation during all phases of instrumentation with 2.5% sodium hypochlorite, constantly refreshed
• deep penetration of a side port, narrow gauge irrigating needle, constantly moving in and out of the canal space during each irrigation
• removal of residual smear layer at completion of instrumentation prior to obturation.

In addition to the quality of the root canal treatments performed ,root canal success is equally dependent upon the quality of the coronal seal established by a filling and a crown,during and after the procedure. Consideration also must be given to whether the tooth will need a post.
Timely placement of these restorations are critical. If bacteria are allowed to enter the coronal portion of the root canal, they will eventually penetrate the interface between root canal and the obturation material, resulting in recontamination of the canal space and subsequent inflammation.

Root canal performed teeth tend to get drier, more brittle over time,and more prone to frature. Tooth fractures occur while chewing foods most of the time. Crowning prevents these possible tooth fractures by embracing the tooth as one entity. It is hard to predict when the root canal tooth will break. The best timing for crowning  might be the night before the tooth will break. :-)
Before treatment planning a crown for a root canal treated tooth, the tooth should show;
1. Radiographic evidence of a good apical seal.
2. No sensitivity to pressure (percussion).
3. No sensitivity to palpation of the periapical area.
4. The tooth is asymptomatic.
5. Acceptable root canal filling.

Thursday, November 11, 2010

Teeth Whitening in Seoul Korea

U.S. Dental ( also known as Tufts Dental ) 

Dr.Gina Sohn - Tufts Graduate
 Licensed in MA, CT, NJ

FACEBOOK
http://www.drginasohn.com
Tel 02-553-7512 / Overseas 822-553-7512
Yongsan / Itaewon area




























































Whitening Programs in our clinic

Zoom 2 (In-Office)
Zoom teeth whitening is safe, effective, not painful, and very fast.
 One day Zoom
    2 Sessions program - Reasonable start ! 
    3 Sessions program - Zoom company recommends this program the most.

Home Teeth Whitening

Customized upper and lower trays with gels are provided and worn for 6 hours per day or over night while sleeping for 1 - 2 weeks.
This is more affordable and can conveniently done at home at your own time.
Home whitening is slow but easy and gets you consistent results.

Please, do it once a day, every day, until your teeth get as bright as you want.
Afterwards, to keep up the brightness of your teeth, regular home-whitening once a week or two is recommended.

The Best Regime for the Best Result.
After years of experiences, we find that  combining Zoom in-Office with Home whitening is the most cost-effective and gets you the best results.
With Zoom whitening only, your teeth get instantly bright. However, the brightness starts to fade away sooner than you note it. Doing home whitening on a regular basis will offset or slow down this fading-away process.

Before you get committed.
Most people get good results but some don’t.
The whitening results depend on the reaction between your teeth and whitening gels.
Even after your teeth get brighter, it won’t last forever.
Retouching every 3 months or 6 is recommended if you’d like to keep up the whiteness.

This rule applies to every kind of teeth whitening methods.





How Teeth Whitening works ?

Teeth whitening has been used for more than 150 years to improve the appearance of teeth.

Decades of whitening teeth have proven the process to be effective and safe if done according to accepted protocols.

Teeth whitening action is accomplished by release of hydrogen peroxide or carbamide peroxide that becomes hydrogen peroxide. The whitening agents are available in various concentrations ranging from 10% carbamide peroxide (equal to 3.4% hydrogen peroxide) to 38% hydrogen peroxide.

The bleaching process allows the oxidizing agent to enter the enamel and dentin to produce a chemical action with discolored particles within the tooth structure. The result makes the molecules reflect less light so the tooth appears lighter.

Several factors or conditions can alter the speed at which whitening occurs.

  • The target surfaces must be carefully cleaned. 
  •  Higher concentrations produce a more rapid whitening effect. Higher concentrations are more likely to result in increased tooth sensitivity, though.
  • The higher the agent’s temperature, the faster the oxygen release, which speeds the reaction.
  • The longer the duration, the greater the degree of whitening is. However, extended periods may increase the likelihood of sensitivity.
Many patients worry bleaching will harm their teeth or soft tissues or produce a systemic problem. Tooth whitening, whether through an in-office procedure or at-home delivery system, is very safe when the proper protocols are implemented.

  •  A rubber dam or other protective barrier is mandatory to effectively seal off the gum.
  • Tooth sensitivity can occur in at least 50% of patients. Symptoms may begin on the second or third day of tray whitening, starting with an awareness of a “tingling” sensation and/or slight cold sensitivity. Often, this sensitivity diminishes without any significant discomfort. If the patient experiences increasing sensitivity, he or she should cease bleaching for 1 to 2 days. Persistent sensitivity, especially if severe, can be treated with 5% potassium nitrate with fluoride incorporated into a gel similar to bleaching gel. Bleaching-provoked tooth sensitivity is transitory, eventually disappearing even without treatment once the bleaching is completed.
Types of Techniques
Various methods of tooth whitening procedures achieve some degree of success. Although the specific procedures or techniques differ, all whitening techniques rely on placement of a concentration of hydrogen peroxide or a hydrogen peroxide-releasing solution on the tooth and holding it against the surface for a specified period.

In Office
Currently, in-office procedures use a relatively high concentration of hydrogen peroxide ranging from 25% to 38% in a gel solution. Concentrations as high as 38% hydrogen peroxide produce fast results; however, the ultimate effect is not greater than with at-home tray bleaching with 10% carbamide peroxide. The bleaching agent is applied to the target teeth, and then the teeth are exposed to the light ( Lazer) for 15 to 20 mins. This procedure is repeated two to three times during the appointment. Bleaching lights appear effective at speeding the whitening process for some patients. Generally, three applications per appointment can be accomplished without significant tooth sensitivity during or after the procedure. In-office procedures are effective; however, one appointment is unlikely to be sufficient. This may be the treatment of choice for patients unable or unwilling to undergo the slower at-home procedures.

At Home
The technique is relatively simple and easily accomplished. The only special equipment required is a well-fitting whitening tray designed specifically for the individual patient. The key to success lies in holding the agent in intimate contact with the tooth surfaces for the necessary time.
Carbamide peroxide gel provides some bleaching effect even up to 6 hours after tray insertion. It is at maximal effectiveness for the first 2 hours before its strength begins to diminish. The best recommendation is to advise the patient to wear the tray during sleep. The patient should brush his or her teeth and then insert the tray before bedtime. During sleep, the saliva flow is less and the time that the gel contacts the teeth is maximized. However, patients who do not tolerate wearing the tray during sleep can do the bleaching during the day. For the best benefits from the gel, the patient should wear the tray at least 2 hours. Some systems use a much stronger agent—25% to 38% carbamide peroxide or 10% or higher hydrogen peroxide. These more concentrated agents should be in place for only 30 min. Recommended time to wear the tray varies depending on the agent’s strength.

Over the Counter
OTC products vary widely in efficacy, primarily because of variations in methods of applying and retaining the bleaching agent to the teeth. While the actual bleaching agent may be similar to the dentist-supplied-and-supervised agent, it is the method of placing and holding the agent on the teeth that determines the product’s efficacy. The whitening effect of many OTC products, including toothpastes and mouthwashes, is questionable because of the limited period that they are in contact with the teeth.

Tetracycline medications are very effective antibiotics but can create a dental esthetic problem.
Although tetracycline stains are persistent, stains can be minimized, if not completely eliminated. However,they respond much more slowly than teeth stained by other agents. In fact, whitening tetracycline-discolored teeth may take 2 to 12 months of daily treatment to achieve a satisfactory result.The procedure for whitening these teeth may involve both in-office and at-home whitening procedures. The in-office procedure with 35% hydrogen peroxide serves as a “jump-start” to initiate the process. This is followed by at-home whitenings. If the result is not 100 % satisfactory,  further improvement in coloration can be achieved by use of translucent and esthetic porcelain veneers.