Transforming Dental Care Access in Gangwon Province

Dentistry is an essential part of healthcare, and with the recent aging population, the importance of implants for older people has been particularly emphasized. However, many patients in underserved areas such as Gangwon Province still cannot receive proper dental care. Based on his 10 years of experience running a dental hospital in Seoul, Dr. Lee Sangmin, the director of Yonhee Plant Dental Clinic, opened a clinic in Gangneung, Gangwon Province. He is also the only dentist in Gangwon Province who teaches about Osstem implants. I met with Dr. Lee Sangmin.

- Gangwon Province is a medically underserved area.

While running a hospital in Seoul, I saw many patients come from all over the country, and I realized that the level of essential medical care in Gangwon Province was relatively low. What stayed with me was that people said it was difficult to receive proper service or treatment in Gangwon, which led me to come to Gangneung.

- What is the special feature of Yeonhui Plant Dental Clinic?

The unique feature of Yeonhui Plant Dental Clinic is that it can perform high-level implant surgeries. We recently performed an implant procedure for a 95-year-old patient, the oldest in Gangneung. We specialize in complex treatments, such as performing surgeries to remove and re-implant when there is inflammation after the implant, bone grafting and implant placement when the bone is too thin in the inner maxillary sinus near the zygomatic bone, and placing 10 implants first to create full implants when there are no teeth left. Only a few places in Gangneung can handle such high-difficulty procedures, and our clinic is one of them.

- What is the difference from the previous hospital?

Our goal at the Seoul hospital was to operate as a highly efficient general hospital. We aimed for a one-stop service, with five specialists from various departments—conservative dentistry, prosthodontics, periodontics, oral surgery, oral medicine, and integrated dental medicine—working together for faster treatment than in a general hospital. However, we faced the issue of maintaining a high-quality treatment.
In Gangneung, we now focus on my primary specialty, implants. Our clinic currently has two medical staff members: one specialist and one general dentist who handles routine treatments.

- In Gangwon-do, there are many elderly individuals. What dental conditions do they primarily suffer from?

When I first started seeing patients in Gangneung, I was surprised. Overall, the patients were older, and their oral health was much worse than that of others in the same age group.

The accessibility to dental care was low, and patients could not properly maintain their dental health due to the high costs. In nearby areas like Samcheok in Gangwon-do, there are fewer than 10 dental clinics, and most of them have been open for a long time, so they are far removed from new treatments and technologies. As a result, patients have difficulty maintaining their dental health and receiving proper care. Since opening my clinic in Gangneung, I have treated many of these patients.

- There must be many patients who come after encountering incorrect information.

Treatment methods vary for each patient, and since there are so many different cases, it is often necessary to modify the approach based on the patient while still adhering to established principles. Patients usually come after hearing about these cases.

Sometimes, patients come after receiving incorrect information and request to have surgery done within a day. In such cases, I explain that although they may feel uncomfortable due to the lack of teeth, we can proceed with the safest and most proven method if they wait a bit longer. Most of them agree. Doctors explaining and treating based on principles is ultimately the best path.

- One-day implant surgery is becoming popular.

Implants involve a healing process where osteoblasts, the bone-forming cells, attach to the surface of the implant and create bone, allowing it to solidify. Just like bone formation takes time, implants also require time for the bone to fuse with them. If the implant is used before it has enough time to properly bond with the bone, the risk of failure increases.

It is often said that the success rate is around 80%, but in reality, this is not a high figure. If you place 10 implants, it means that 2 of them might fail. Rather than accepting this failure rate, I believe it is better to wait two or three months and perform a safer procedure. Therefore, except in special cases, I do not perform one-day implant surgeries.

However, in exceptional cases, if a tooth is broken due to external impact and the alveolar bone is strong, a one-day implant may be performed. But these cases are very rare.

- There are now various implant products available. Which product do you use?

I use reputable implant products. I primarily use two types: Osstem implants and Topplan implants. While domestic implants are excellent, I tend to prefer European-made implants because the implants themselves are manufactured in Europe. Currently, I have a lineup of four types: SIC implants and Straumann implants in addition to the two mentioned above. I am actively collaborating with European professors and participating directly in the product development of SIC implants.

- You are very interested in underserved populations. What kind of volunteer work are you involved in?

Since 2007, I have been involved in medical volunteering in Seoul, particularly participating in the Hidden Patient Support Project for 3 to 5 years, where I treated a variety of patients as a healthcare provider. Since last year, I have also connected with welfare centers in Seoul to assist in identifying patients in need of dental care in the underserved regions of Gangwon Province. Currently, I am also participating in Season 2 of the Hidden Patient Support Project and am considering further collaboration with welfare centers in Gangwon Province.