Oral Cancer

Oral Cancer- So, I saw a young patient the other day as a referral from a General Dentist, with swelling around a tooth on the lower jaw. What was unusual about this swelling was that this tooth had swelling around the front and the area near the tongue. It also did not go down after debridement of the soft tissue that the general dentist performed a few days before. The swelling persisted and got slightly bigger. I took a sample of the tissue and realized that the tissue did not bleed on the inside of the epithelial layer. The area was a whitish tissue with areas that seemed abnormal. The answer came back from pathology: Squamous Cell Carcinoma- a malignant oral cancer that was invasive.

This patient was a young 21 year old female. She had no significant medical history.

This news was devastating to me.

I had to break this news to her and her family.

I quickly called the physician referral line at Memorial Sloan Kettering to get her an appointment with the Head and Neck Surgery Department. They asked for her primary medical insurance: "She doesn't have Primary Medical Insurance."

This was even more devastating.... I didn't know what she was going to do. I knew this treatment will cost an amount that could bankrupt her and her family. Pre-existing condition= she will never have insurance that will cover this.

She will see the docs tomorrow so I will get an update- My prayers and hopes are with my patient.

Gum Grafting

Receeding gums is a problem that occurs in patient young and older. There are a couple of contributing factors that causes gum recession:

1. Toothbrush abrasion- the use of a Medium or coarse bristles with rigorous brushing motion can cause gum recession and tooth abrasion as well
2. Post orthodontic treatment- some patients can get this after braces 
3. Abnormal bite- abnormal forces can cause tooth abfraction and gum recession
4. Smoking- patients that smoke have a higher risk of gum recession

The treatment includes:

1. Connective tissue grafting- taking the underlayer of tissue from the roof of the mouth, leaving the top epithelial layer on- this option has the best esthetic result
2. Free Gingival graft- taking both the epithelial layer and connective tissue layer- this is indicated when there is NO keratinized tissue remaining
3. Soft tissue allograft- Donated tissue from a cadaver- this prevents a secondary surgical site but can be more costly financially
4. Use of Emdogain- porcine enamel- helps healing and root coverage- an additional cost, but has superior results

 This is a mirror image of the sites that required soft tissue grafting

This is the healing after a connective tissue graft done on the 3 teeth at the same time

Welcome!

Hi! I'd like to introduce myself- I'm Nancy S. Kim DDS.  I'm a dentist, well, more like a specialized dentist. I'm a periodontist which is a dentist that specializes in the health of the gums and the underlying bone in your mouth! I mostly do specialized surgeries like gum grafting, bone grafting and dental implants.

I grew up in Baltimore, Maryland where I was lucky enough to have attended an all girls school, Bryn Mawr School for middle and high school.  I'm an alum of Johns Hopkins University where I played Division I Women's Lacrosse- So you may see me occasionally post some things about JHU Lacrosse- Go HOP!

I then went to University of Maryland, Baltimore College of Dental Surgery- the FIRST Dental school in the world!! Yup, currently the home of The National History of Dentistry where George Washington's denture rest :)  After I got my DDS, I moved to the big city of New York and did a GPR at New York Presbyterian Hospital, Weill Cornell Medical Center. I LOVED this program. I learned so much and began to encounter the real deal in on call emergency dental work... I also spent 4 months as Memorial Sloan Kettering Cancer Center where I learned Dental Oncology and treatment with treatment manifestations.... I'll probably blog more about that too...

Then I spent 3 years at New York University where I did my post graduate surgical residency in Periodontics and Dental Implantology. I became Board Certified in Periodontics in 2008 which was a great accomplishment for me personally and professionally.

My hope with this Blog is to give you the trends and interesting topics that I encounter in the dental world. Not only cases, but issues in the news that constantly come out.

I will love to hear what you have to say about some of my posts.

I have private practice in Manhattan on 61st street and Park Avenue
Please feel free to contact me anytime:

115 East 61st Street, 14th Floor
New York, New York 10065
(212) 838-7219
www.nycperioimplants.com