Purpose: This mixed-methods study aimed to investigate the oral health status of elderly residents in long-term care facilities and to explore caregivers' experiences and educational needs regarding oral care.Materials and Methods: Quantitative data were collected from 132 elderly residents in four facilities in Seoul through oral examinations and surveys. Differences in oral health indicators across long-term care grades were analyzed using Kruskal-Wallis and chi-square tests. Qualitative data were gathered through semi-structured indepth interviews as an exploratory qualitative inquiry.Results: The mean number of remaining teeth was 12.58±9.74. Approximately 54.7% of residents required partial or full assistance with toothbrushing. High prevalence rates were observed for masticatory discomfort (36.5%), food debris retention (50.4%), and dementia (73.9%). Qualitatively, caregivers identified oral care as their most burdensome task due to safety risks. Caregivers reported limited proficiency and insufficient access to oral hygiene aids appliance. They expressed a strong desire for practical, skill-based training, particularly regarding uncooperative residents, and showed positive perceptions toward VR-based simulation as a potential training modality.Conclusion: The oral health of institutionalized elderly is significantly poor, yet caregivers face challenges in providing adequate care. Although subjective oral health needs and the demand for assistance increased with care dependency, objective hygiene outcomes did not differ by grade, suggesting that oral care provision may not be sufficiently tailored to functional status. Systematic, skill-based education programs for caregivers and establishment of professional dental referral systems within long-term care settings are needed.
The division of the Korean Peninsula has produced long-standing disparities in health-care systems, yet no nationwide oral health survey of the North Korean population is publicly available. This narrative review synthesized national-level estimates from international organizations, limited studies among children inside North Korea, literature on the North Korean oral health-care system and its marketization, and studies of clinical indices and post-resettlement dental-care access among North Korean refugees, to examine the structural vulnerability of North Korean oral health care and the oral health inequalities that persist after resettlement. Although North Korea officially espouses free medical care and preventive medicine, shortages of medical resources, limited access to restorative and prosthetic treatment, and the expansion of informal fee-based care have been reported. Among refugees, older age groups had a greater proportion of missing teeth within the DMFT index, whereas the filled-teeth component remained low; extensive alveolar bone loss and reduced oral health-related quality of life were also reported. Children from refugee families showed more untreated caries and unmet dental-care needs than South Korean children. After resettlement, cost burden, limited understanding of the health-care system, and low oral health literacy were reported as barriers to dental care. Policy for North Korean refugees should therefore move beyond one-time treatment support toward standardized initial screening, early treatment of untreated caries and periodontal disease, tailored education to improve oral health literacy, sustained linkage for high-cost treatment, and life-course management, providing a basis for oral health policy in preparation for possible inter-Korean health-care exchange and cooperation.
Purpose: This retrospective study investigated the clinical characteristics and surgical outcomes of lower lip mucocele at a single institution, focusing on the effectiveness of concomitant minor salivary gland removal in preventing recurrence.Materials and Methods: Medical records of 19 patients who underwent surgery for lower lip mucocele at Inje University Busan Paik Hospital between 2011 and 2025 were retrospectively reviewed. Patients were classified into two groups: 1) Group A (n = 16) achieved complete resolution with a single procedure including concomitant excision of the mucocele and the underlying minor salivary gland(s) and 2) Group B (n = 3) experienced recurrence after primary excision at our institution and subsequently underwent re-operation with additional minor salivary gland removal. Among the 19 patients, 4 (Cases 1, 6, 8, and 9) had previously been treated at outside facilities before referral.Results: The cohort comprised 12 males and 7 females, with a mean age of 22.1 years (range: 8–59 years). All 16 patients in Group A achieved resolution with a single operation. In Group B, recurrence developed within 2–5 weeks after primary excision; however, re-operation with additional minor salivary gland removal achieved resolution in all 3 patients. One patient developed transient commissure hypoesthesia, which partially recovered at final follow-up.Conclusion: Concomitant excision of the mucocele and the underlying minor salivary gland(s) is effective in preventing recurrence. When recurrence occurs, additional gland removal achieves resolution. Minor salivary gland removal should be incorporated as a standard component of the surgical protocol for lower lip mucocele.
This report describes periodontal ligament (PDL)–preserving autotransplantation combined with graft-free crestal sinus membrane elevation in a posterior maxillary site with limited residual bone height. A 28-year-old woman with a non-restorable maxillary first molar and approximately 3 mm of residual crestal bone height underwent autotransplantation of a mature third molar with simultaneous graft-free sinus membrane elevation. Approximately nine years of follow-up demonstrated stable function with preservation of the PDL space, no ankylosis or pathologic root resorption, and progressive bone formation within the sinus-associated void. PDL-preserving autotransplantation with graft-free sinus membrane elevation may represent a viable biologically based alternative in selected posterior maxillary cases.
Mastication is a complex functional process involving the teeth, tongue, lips, and masticatory muscles, and it has been shown to be closely associated with cognitive function. Mild cognitive impairment (MCI) represents an intermediate stage between normal cognition and dementia, characterized by measurable cognitive decline without significant impairment in activities of daily living. Early intervention at this stage is critical to delay progression to dementia. Masticatory dysfunction has been identified as a potential risk factor for cognitive decline in older adults. This study aimed to identify the key variables among subjective and objective measures of masticatory function that are associated with MCI. The results demonstrated significant differences in posterior occlusal support, tongue pressure (TP), oral diadochokinesis (ODK), and masseter muscle thickness (MMT) between groups, whereas no significant differences were observed in masticatory performance (MP) or bite force (BF). Logistic regression analysis further revealed that posterior occlusal support and oral muscle–related functional parameters were significantly associated with MCI. These findings suggest that interventions such as orofacial muscle training and posterior occlusal rehabilitation may play a role in mitigating cognitive decline in older adults with MCI.
Future dental care will evolve based on evidence-based diagnosis and treatment, which requires advancements in the field of laboratory and diagnostic dentistry. However, the current diagnostic tests specialized in dentistry are very limited, and the field's development is still in its infancy. The most important factor hindering progress is the long-term unchanging lack of awareness within the dental community regarding the use of diagnostic tests. This in turn affects education on laboratory and diagnostic dentistry, lack of interest and research in related fields, insufficient development of diagnostic test items, and the inactivity of the dental industry related to laboratory and diagnostic dentistry. To overcome these barriers, a shift in the mindset of dental professionals is necessary to shake off this lack of awareness. Furthermore, in the short-term, it is necessary to explore ways to revitalize the application of existing dental diagnostic tests and to expand the application of existing diagnostic tests by modifying them to be useful in dentistry. In the long-term, revitalizing research and development in the field of laboratory and diagnostic dentistry is essential.
IgG4-related disease (IgG4-RD) is a rare immune-mediated inflammatory disorder that can involve salivary glands and mimic benign tumors radiologically. This report presents a case of IgG4-RD of the parotid gland initially suspected as pleomorphic adenoma. A 66-year-old female patient presented with swelling and pain in the left temporomandibular joint region. Magnetic resonance image and ultrasonography-guided fine needle aspiration suggested a benign cystic tumor, and both parotid lesions were initially suspected to be bilateral pleomorphic adenomas. Excisional biopsy was performed on the larger lesion in the left parotid gland. Histopathological examination revealed a lymphoepithelial cyst with storiform fibrosis and dense infiltration of IgG4-positive plasma cells (72/HPF). Serum IgG4 level was elevated (141 mg/dL), satisfying the diagnostic criteria for IgG4-RD. The patient was referred to rheumatology for systemic evaluation and steroid therapy was considered. This report highlights the diagnostic challenge of differentiating IgG4-RD from benign parotid tumors.
Purpose: This study aimed to examine Gyeonggi-do dentists’ opinions on the model of registered dentists for the elderly. Materials and Methods: An online survey was conducted from June to August 2025, among members of the Gyeonggi-do Dental Association. Of the 4,690 members, 392 dentists participated (response rate = 8.4%), and 387 samples were analyzed after excluding 5 responses with inappropriate answers. The questionnaire was constructed with general characteristics, service items, and willingness to participate. Frequency and cross-tabulation were analyzed using IBM SPSS Statistics ver. 26.0 (IBM Corp, Armonk, NY, USA), with significance at α = 0.05. Results: Half of the respondents were in their 50s and most worked in dental clinics. The perceived needs for every service item were high; oral examination, professional oral hygiene care, and scaling showed the highest necessity within each category. Patient history review and professional oral hygiene care were the greatest necessity in dentists with longer practice experience, whereas preventive service was rated higher by women and those with the least experience (p < 0.05). Most respondents suggested that individuals aged 65 years or older be the best target group, and 87.6% expressed willingness to participate. No significant differences were found in general characteristics for these questions (p > 0.05). Conclusion: Gyeonggi-do dentists recognized the importance of a preventive-oriented approach and the shift toward long-term care in the model of registered dentists for the elderly. It is necessary to include perspectives from various stakeholders, such as local government officials, to develop feasible strategies for implementation in future studies.
Purpose: Demands for long-term elderly care facilities and related welfare services are steadily increasing as the aging tendency of Korean society accelerates. However, oral health assessment and management of elderly in long-term care facilities are insufficient. This study aimed to investigate correlation between natural teeth and oral health status of the elderly in long-term care facilities. Materials and Methods: This study was conducted on the elderly patients in long-term care facilities. Two dentists performed dental examination to elderly patients in long-term care facilities, and surveyed their natural teeth condition based on Korea national health and nutrition examination survey. Oral health conditions of patients were also recorded, and statistical analysis was performed between natural teeth condition and oral health status. Results: Xerostomia, temporomandibular joint pain, and limited mouth opening were related with all of the factors about natural teeth. The elderly in long-term care facilities with less natural teeth, less than 20 natural teeth, and edentulous state were proven to have severe xerostomia, temporomandibular joint pain, and limited mouth opening. In addition, poor periodontal condition, oral stomatitis and tongue coating were related with natural teeth condition of the elderly in long-term care facilities. Conclusion: Natural teeth of the elderly long-term care facilities are proven to be significantly related with several diseases of orofacial area in this study. Thus, comprehensive evaluation of natural teeth and oral health management to maintain natural teeth should be actively pursued for the elderly in long-term care facilities.
Preoperative laboratory testing is an essential yet frequently overlooked component of safe dental surgical practice. As the aging population increases the prevalence of systemic diseases among dental patients, structured preoperative evaluation prior to routine procedures such as tooth extraction and implant surgery has become increasingly important. Clinical cases demonstrate that blood tests play a decisive role in preoperative decisionmaking, enabling detection of previously undiagnosed conditions including uncontrolled diabetes, renal tubular dysfunction, and hematologic malignancies. Although no universally accepted protocol currently exists, the necessity of routine preoperative blood testing should be carefully considered in an aging society - not only to optimize surgical outcomes, but also to ensure the safety of both patients and clinicians. Routine preoperative laboratory evaluation should be regarded as a fundamental safeguard in ambulatory oral and maxillofacial surgical care.
Patients with intellectual disability, autism spectrum disorder, cerebral palsy, or severe dental fear often have difficulty undergoing routine outpatient dental treatment, leading to repeated delays or treatment failure. In such cases, sedation may serve as an important option bridging general anesthesia and routine outpatient care. Remimazolam is a recently introduced sedative and general anesthetic agent approved in major regions. This article reviews the clinical significance of remimazolam in dental treatment for patients with disabilities and summarizes the rationale for considering it as an agent for dental sedation.
This review comprehensively examines the current status, clinical applicability, and future directions of artificial intelligence (AI) in diagnostic and laboratory dentistry. Dental AI primarily utilizes deep learning models based on radiographic and histopathological images to assist in diagnosis of conditions including dental caries, periodontal disease, periapical lesions, implant-related assessments, temporomandibular disorders, and oral squamous cell carcinoma (OSCC), enhancing diagnostic sensitivity and specificity. Recently, AI applications have expanded to salivary and blood biomarker analyses, integrating inflammatory cytokines (IL-1β, TNF-α, MMP-8), OSCC-related proteins (CYFRA 21-1, SCC-Ag, p53), salivary microbiome profiles, and blood-based indicators such as C-reactive protein, HbA1c, and bone metabolism markers, enabling predictive and personalized diagnostic modeling. The potential use of large language models (LLMs) has garnered attention, offering capabilities for analyzing electronic health records and clinical text data to support diagnosis, recommend treatment strategies, and assist in patient counseling and education. In the United States, several dental AI platforms, including Pearl Inc.’s Second Opinion®, have received FDA 510(k) clearance and are entering clinical practice, while in Korea, commercialization is progressing through Ministry of Food and Drug Safety approvals. Nevertheless, challenges remain, including insufficient data standardization, limited multi-institutional datasets, legal and ethical considerations, and integration with clinical workflows. To address these issues, multi-institutional prospective validation, development of generalizable models, multimodal AI research, and implementation of explainable AI are necessary. Overall, dental AI is evolving beyond image interpretation toward a multimodal clinical decision support system that integrates imaging, biomarkers, clinical information, and LLMs to support personalized diagnostics and treatment planning after validation.
Purpose: This study aimed to explore the problems and needs of North Korean defectors in accessing dental care in South Korea by analyzing open-ended survey responses with Word2Vec, and to derive implications for oral health support strategies.Materials and Methods: A cross-sectional survey was conducted among 200 North Korean defectors in South Korea. Of these, 133 respondents who answered an open-ended question on improving dental care utilization were included in the text analysis. Data were analyzed using frequency analysis and Word2Vec in a Python-based Google Colab environment. To improve stability, the model was trained 10 times with random seeds, and only neighboring words reproduced in at least 70% of runs were interpreted. Subgroup analyses were performed according to settlement period in South Korea (≤10 vs. ≥11 years).Results: Although overall satisfaction with dental care in South Korea was high, “cost” emerged as the most frequent and central keyword, linked with “burden,” “high cost,” and “dental implants.” “Consultation/Education” was associated with “understanding,” “be unable to,” and “lack,” indicating gaps in comprehensible communication. Respondents with ≤10 years of settlement showed greater needs related to insurance, language, and service adaptation, whereas those with ≥11 years of settlement showed more concentrated concerns about financial burden, policy support, and persistent communication gaps.Conclusion: Despite high reported satisfaction, North Korean defectors’ dental care experiences in South Korea were shaped by persistent economic and communicative barriers. These findings suggest the need for financial support for high-cost treatments, health literacy-sensitive and culturally tailored explanations, and settlement-stage- specific support strategies.
Purpose: Despite limited evidence on the relationship between sleep and oral health, this study aimed to investigate the associations of sleep duration with masticatory discomfort and subjective oral health among Korean adults. Materials and Methods: This study included 155,106 participants aged ≥45 years utilizing data from the 2024 Community Health Survey conducted by the Korea Disease Control and Prevention Agency. Sleep duration was assessed based on daily sleep hours on workdays and weekends, averaged weekly, and categorized into five groups. Self-reported masticatory discomfort and oral health status were assessed using a questionnaire. Multivariable logistic regression models were used to evaluate the association between sleep duration and self-reported masticatory discomfort. Results: Inadequate sleep durations were significantly associated with increased odds of masticatory discomfort. Compared to individuals sleeping 7.0–7.9 hours, the adjusted odds ratio (AOR) of masticatory discomfort for those sleeping <5 hours was 1.377 (95% confidence interval: 1.273–1.491). These associations were significantly stronger among men (AOR = 1.503), adults aged 45–64 years (AOR = 1.467), individuals with moderate-to-severe depression (AOR = 1.611), white-collar or service/sales workers (AOR = 1.712 and 1.602, respectively), divorced individuals (AOR = 1.640), and urban residents (AOR = 1.405). Conclusions: Deviations from the recommended 7–8 hours of sleep are associated with increased masticatory discomfort. This association was stronger among men, middle-aged and older adults, white-collar and service workers, divorced individuals, and urban residents.
Purpose: This study aimed to implement a dental instrument reprocessing management system based on wireless ICT and RFID technology and evaluate its operational efficiency and applicability in the dental clinical setting. Materials and Methods: For the development of the instrument reprocessing system, hardware components including RFID tags, RFID readers, wireless internet devices, and a central server were integrated with software management programs. Once operational, the system collected information in real-time at each stage of the reprocessing workflow. System performance was evaluated in terms of stability, efficiency, and data accuracy. Results: During pilot operation, the system automatically recorded the reprocessing history of each instrument in chronological order. Functions such as verification of sterilization completion, real-time status monitoring, error detection in sterilization, and validity management were successfully implemented. Compared to traditional paper-based recording, instances of missing records and errors were significantly reduced, and rapid traceability was enabled in case of suspected infection events. Conclusion: The RFID-based dental instrument reprocessing management system can overcome limitations in repetitive and complex reprocessing workflows in dental practice, enhance operational efficiency, and provide tangible support for improving infection control standards.
Purpose: This study investigated the dental disease patterns and healthcare utilization of pediatric patients with rare diseases in Korea using national and clinical data.Materials and Methods: A comprehensive analysis was conducted on substantial data obtained from the Health Insurance Review and Assessment (HIRA) Service and clinical records from Jeonbuk National University Dental Hospital, focusing on patients between the ages of 0 and 19 who had been diagnosed with rare diseases during the period spanning from April 2019 to April 2024.Results: Analysis of HIRA data (387,838 patients) indicated that 61.9% of patients were aged 0–9 years. Disorders of tooth development and eruption accounted for 91.2% of care. The most common diagnoses were dental caries (33.7%) and disorders of tooth development and eruption (25.3%). Total medical expenses and out-of-pocket costs both increased annually. Data from Jeonbuk National University Dental Hospital revealed that patients with congenital malformations and nervous system disorders required frequent long-term management involving hygiene, restorations and extractions.Conclusions: Although the dental disease spectrum mirrors that of the general population, management is complicated by systemic conditions. Given the heavy reliance on primary care, specialized education for local practitioners is crucial. In order to improve quality of life, it is essential to establish primary treatments, expand insurance coverage for essential non-covered treatments and create a robust referral system between specialized centers and local clinics.
Focal osteoporotic bone marrow defect is an asymptomatic condition characterized by localized areas of decreased trabecular bone density within the jaw and is often detected incidentally on radiographic examination. Although it generally does not require treatment, it may increase the risk of complications during dental implant placement due to insufficient primary stability in areas of low bone density. This report describes three clinical cases of implant fixture displacement into focal osteoporotic bone marrow defects in the posterior mandible. Radiographic examinations revealed ill-defined radiolucent lesions without cortical expansion at the implant sites. One patient experienced inferior alveolar nerve injury following displacement, whereas no postoperative complications were observed in the remaining cases. These findings indicate that focal osteoporotic bone marrow defects may represent an underrecognized risk factor for implant displacement, and highlight the importance of careful preoperative radiographic assessment and cautious surgical planning in areas of suspected low bone density.
Purpose: This study aimed to explore how practice-owner dentists in Korea experience burnout, how it intensifies, and how they ultimately recover from it, using a phenomenological approach. Materials and Methods: In-depth interviews were conducted with twelve practice-owner dentists who had experienced both burnout and subsequent recovery. Interview data were analyzed using Colaizzi’s phenomenological analytic method to extract meaning units, formulate themes, and identify the essential structure of the lived experience. Results: Analysis revealed a three-stage experiential trajectory: 1) a discrepancy between idealized expectations and the realities of clinic operation, 2) a deepening and collapse of burnout characterized by emotional, physical, and relational deterioration, and 3) a recovery phase involving self-care, environmental adjustments, social support, and identity reconstruction. Triggering events – including challenging patients, legal threats, staff conflicts, and health issues – frequently intensified distress and precipitated an existential crisis. Conclusion: Burnout recovery among practice-owner dentists emerged as a transformative process in which individuals reinterpreted burnout as an opportunity for self-reflection and reconstructed a sustainable professional identity. These findings underscore the need for personal coping strategies, practical training, and structural support systems to mitigate burnout within this professional group.
The global demographic transition toward an aging society introduces complex clinical challenges in dental practice, specifically regarding the management of polypharmacy in elderly patients with multiple chronic comorbidities. This pharmacological complexity significantly increases the incidence of potential drug-drug interactions, which are associated with elevated risks of therapeutic failure and severe adverse drug reactions. Epidemiological data indicate a 40.7% prevalence of drug-drug interactions in dental patients, with a markedly higher interaction problem observed in individuals with cardiovascular disease. Despite the clinical significance, dentist’s recognition of these interactions is documented at 42.7%, indicating a critical gap in pharmacological surveillance. Age-related physiological alterations, including diminished glomerular filtration rates and altered distribution volumes, necessitate function-based dose titrations to prevent drug accumulation and toxicity. Specific dental pharmacotherapeutics, mainly non-steroidal anti-inflammatory drugs, antibiotics such as macrolides, and vasoconstrictors, demonstrate high-risk profiles when co-administered with systemic anticoagulants, beta-blockers, or antidepressants. Clinical safety in geriatric dentistry requires a systematic approach encompassing comprehensive medication history review, the utilization of web-based or application screening tools, dose individualization based on renal and hepatic function, and interprofessional collaboration to optimize individualized prescribing strategies. This systematic approach is essential for optimizing patient safety in an aging society.
Concrescence represents a rare tooth abnormality in which adjacent teeth are united in the cementum. Since the crown of a tooth has a standard anatomical structure, concrescence is not easily diagnosed clinically. In fact, it is easy to mistake concrescence as just overlapping in the radiograph of two adjacent teeth. The presence of concrescent teeth may influence the extraction of teeth, endodontic treatment, and even orthodontic treatment. Therefore, the possibility of these abnormalities in diagnosis and treatment plans should be considered for over-lapped teeth. This case report demonstrates the diagnosis of concrescence through preoperative cone-beam computed tomography and the subsequent histological analysis of the extracted tooth.
