2023.03.25 순차통역 연습하기

안녕하세요, 국제진료센터 지킴이입니다. 

저는 일주일에 한 번씩 대학원 동기와 순차통역 연습하고 있습니다. 

각자 원하는 주제를 말하고 자료를 준비해서 서로 공부하고 있습니다.

오늘 주제는 사랑니 발치였습니다.

오늘은 단어 자체가 너무 어려웠는데요. 오늘 제 스터디파트너가 준비한 자료를 보고 자동번역기를 통한 번역도 한번 보도록 하겠습니다. 

 

우선 단어가 정말 무시무시했는데요 단어를 함께 공부해보도록 하겠습니다.

영문은 자동번역기를 사용해서 붙여넣기 하였기에 참고만 하면 되겠습니다!

 

 

1. 이가 시리다: tooth ache (or sensitivity)
2. 상아질 지각과민증: dentin hypersensitivity
3. 상아질 민감증: dentin sensitivity
4. 치관: crown
5. 치근: root
6. 법랑질: enamel
7. 백악질: cementum
8. 상아질: dentin
9. 치수: pulp
10. 치수강: pulp cavity
11. 상아세관: dentinal tubule
12. 치경부 우식증: cervical caries
13. 불소이온: floride ion
14. 인산삼칼슘: tricalcium phosphate

 

 

‘이가 시리다’는 증상을 호소하는 환자가 많다. 이가 시려 치과에 가면, 의사로부터 어떤 진단을 받을까 정교수는 “시린이를 전문용어로 상아질 지각과민증(Dentin hypersensitivity) 혹은 상아질 민감증(Dentin sensitivity)이라 표현한다”고 말했다.

 

정승화 교수에게 이가 시린 이유와 시린이 증상을 덜 방법 등 다양한 시린이 궁금증에 대해 물었다.

 

Q. 시린이 증상의 원인은?

 

A. 시린이 증상의 원인은 다양합니다. 일반적으로는 잇몸질환 등으로 치아 뿌리가 노출됐을 때 이가 시린 증상이 나타납니다. 치아 구조를 단순히 나누자면, 치관(머리부분)과 치근(뿌리부분)으로 구분할 수 있습니다. 치관 바깥쪽은 뼈보다 단단한 법랑질(Enamel)로 이뤄졌고요. 치근 바깥쪽은 잇몸뼈와 치근 상아질을 이어주는 백악질(Cementum)로 구성돼 있습니다. 백악질은 뼈와 유사한 조성으로 유기질이 풍부하고 덜 단단한 특징을 보이지요. 치관의 법랑질과 치근의 백악질 안쪽에는 상아질(Dentin)이란 조직이 존재하고요. 상아질 안쪽에는 치수(Pulp, 신경과 혈관조직) 조직이 존재하는 치수강(Pulp cavity)이 있습니다. 상아질 조직에는 치수강과 법랑질, 그리고 백악질 쪽으로 이어지는 미세한 통로가 있습니다. 이를 상아세관(Dentinal tubule)이라고 하는데요. 이 세관으로 치수돌기들이 박힌 구조를 보입니다. 상아질은 법랑질과 백악질 그리고 잇몸에 의해 보호받습니다. 시린이 증상은 다양한 원인에 의해 상아질이 노출되면서 나타나는데요. 치약과 칫솔 같은 물리적인 자극에 의한 사례가 대표적입니다. 자극 때문에 백악질이 마모되면, 안쪽 상아질과 상아세관 입구가 열리게 됩니다. 상아세관은 치아 내부 신경과 소통구조를 이루고 있어서 외부의 자극에 민감하게 반응하지요. 보통 환자들은 시린이 증상이 어느 날 갑자기 나타났다고 생각합니다. 하지만, 아마도 오래전부터 상아질을 자극하는 원인이 있었을 겁니다. 치주질환에 의한 잇몸뼈 소실과 치근 노출, 마모도 높은 치약 사용으로 인한 치근 마모, 과도한 칫솔질에 의한 치근 마모 등으로 상아질 반응이 한계에 다다랐을 때 비로소 시린 증상이 발현되는 겁니다. 주로 중년 여성에서 증상을 호소하는 분이 많습니다. 

 

 

Many patients complain of tooth sensitivity, saying "my teeth are sensitive". When they visit a dentist for tooth sensitivity, the diagnosis they may receive from the doctor is dentin hypersensitivity or dentin sensitivity, which are specialized terms for tooth sensitivity. Professor Jeong was asked various questions about tooth sensitivity, such as the causes of tooth sensitivity and ways to reduce sensitivity.

Q. What are the causes of tooth sensitivity?

 

The causes of tooth sensitivity are diverse. Generally, when the roots of the teeth are exposed due to gum disease, tooth sensitivity may occur. When we divide the structure of a tooth into simple parts, we can distinguish it into the crown (head) and the root. The outside of the crown is made up of enamel, which is harder than bone. The outside of the root is composed of cementum, which connects the gum bone and root dentin. Cementum has a composition similar to bone, with abundant organic matter and less hardness.

Inside the enamel of the crown and the cementum of the root is dentin, a tissue. Inside the dentin is a pulp cavity containing nerve and blood vessel tissues. In the dentin tissue, fine channels extend toward the pulp cavity, cementum, and enamel. These channels are called dentinal tubules. The tooth pulp, consisting of nerve fibers, blood vessels, and other tissue, extends through these tubules.

Dentin is protected by enamel, cementum, and gums. Tooth sensitivity occurs when dentin is exposed due to various causes. Physical stimulation from toothpaste and toothbrushes is a typical case. If the cementum is worn away by the stimulation, the entrance to the dentinal tubules in the inside dentin is opened. The dentinal tubules communicate with the tooth's nerve structure, making it sensitive to external stimuli.

Patients usually think that tooth sensitivity suddenly appears one day. However, there may have been causes of dentin stimulation for a long time. Tooth sensitivity occurs when dentin sensitivity reaches its limit due to gum disease, tooth root exposure, dentin wear caused by the use of highly abrasive toothpaste, and dentin wear caused by excessive brushing. Middle-aged women tend to complain of tooth sensitivity.

 

Q. 시린이 증상의 또 다른 원인은?

충치(치아우식)나 치수염 때문일 수도 있습니다. 법랑질 또는 치경부 우식증이 진행되면 상아질 가까이 법랑질이 파괴되거나 상아세관 반응에 의해 이가 시린 증상이 나타날 수 있습니다. 또, 저작력이 과도한 경우도 문제가 됩니다. 즉 음식을 입에 넣고 씹는 힘이 지나치게 작용하면, 치관 부분 법랑질에 가는 균열(Crack, 크랙)이 생기고, 실금 같은 미세한 틈 사이로 미생물과 타액이 침투해 안쪽 상아질에 영향을 줄 수 있습니다. 상아질까지 균열이 나타난다면, 환자는 더욱 민감한 반응을 보일 수 있지요.

 

위와 같은 원인들이 존재하는 상황에서 차가운 물, 뜨거운 음식, 칫솔질, 저작 운동, 찬바람, 구토나 위산 역류 같은 자극이 가해지면 시린이 증상이 나타납니다. 이와 같은 증세가 있다면 치과에 방문해서 정확한 원인을 찾고, 그에 맞는 처치를 받아 증상을 완화해야 합니다.

Q. What are other causes of tooth sensitivity?

 

Tooth decay or pulpitis can also be a cause.  If enamel erosion or root caries progress, tooth sensitivity may occur due to the destruction of enamel near the pulp or the reaction of dentinal tubules. 

 

Also, excessive force can be problematic. When the force of chewing food is applied excessively, cracks can occur in the enamel near the tooth surface, and microbes and saliva can penetrate into the inner enamel through tiny cracks like leaks. If cracks occur all the way to the enamel, patients may show even more sensitive reactions.

 

In situations where these causes exist, tooth sensitivity can occur when stimulated by cold water, hot food, brushing teeth, chewing, cold wind, vomiting, or acid reflux. If you have these symptoms, you should visit a dentist to find the exact cause and receive appropriate treatment to relieve the symptoms. does it sound natural?

 

Q. 치과 치료 후 이가 시리다는 환자도 많은데.
스케일링을 받은 후 시린이 증상을 호소하는 분도 많습니다. 대개 치석을 오래 방치한 뒤 잇몸병까지 진행된 케이스에서 이러한 일이 잦은데요. 치근상아질 부위까지 형성된 치석을 스케일링으로 제거하면, 상아질이 노출되면서 시린이 증상이 발생하는 것입니다. 물론 시간이 지나면 이러한 시린이 증상은 완화되지요. 따라서 스케일링이 시린이의 원인이라는 말은 잘못된 말입니다.

또, 치과에서 잇몸치료 후 시린이 증상을 호소하는 분도 상당수인데요. 잇몸치료 특성상 발생하는 일로 볼 수 있습니다. 치근부위 치면세균막과 치주낭 안쪽 염증을 제거하기 위해, 날카로운 수기구나 초음파 스케일러로 치근 표면을 활택하는 데요. 바로 이 과정에서 상아세관이 노출되면서 이가 시릴 수 있습니다. 치주질환 치료는 더 이상의 잇몸뼈 소실을 막기 위해 하는 것인 만큼, 치료 후 시린이 증상이 어느 정도 있다는 것을 인지해야 합니다. 다행히 이 경우도 시간이 지나면서 시린이 증상이 많이 완화됩니다.

 

Q. Tooth sensitivity after dental treatment is a common complaint among patients.

 

Many people experience sensitivity after scaling. This is often the case with patients who have allowed tartar to build up for a long time, which can lead to gum disease. When tartar that has formed on the dentin-enamel junction is removed by scaling, the dentin is exposed and sensitivity can occur. However, this sensitivity usually subsides over time. Therefore, it is incorrect to say that scaling is the cause of tooth sensitivity.

 

In addition, many patients complain of sensitivity after gum treatment at the dental clinic. This can be considered a characteristic of gum treatment. To remove the bacterial film on the root surface and the inflammation inside the periodontal pocket, a sharp hand instrument or an ultrasonic scaler is used to actively remove the root surface. During this process, the dentinal tubules may be exposed, causing tooth sensitivity. As periodontal disease treatment is aimed at preventing further loss of the gum bone, it is important to be aware of the potential for tooth sensitivity after treatment. Fortunately, in most cases, tooth sensitivity will subside over time.

 

Q. 시린이를 방치했을 때 생기는 문제는?

 

시린이를 방치하면, 외부 자극 요인에 따라 시린이 증상이 나타났다가 사라지는 양상이 반복됩니다. 다행일 수 있는 점은 이러한 상아질 민감 반응이 지속되면서 치아 신경(치수)의 민감도가 둔해질 수 있다는 것이지요. 또한, 상아질 안쪽 치수강 쪽에서 새로운 상아질을 만들어 상아세관을 좁게 하거나 폐쇄해서 치수의 반응성을 낮추기도 합니다. 인간의 감각이 시린이 증상에 자연스럽게 적응하는 것으로 볼 수 있고요. 이와 더불어 3차 상아질 형성으로 증상이 서서히 줄어드는 것도 맞습니다.문제는, 이러한 과정을 겪는 동안 상아질 노출과 외부 자극은 계속된다는 것입니다. 칫솔질에 의해 상아질은 더욱 마모될 것이며, 시린이의 또 다른 원인일 수 있는 치주질환과 충치, 균열, 파절이 지속될 수 있습니다. 따라서 시린이 증상이 발생했고 주기적으로 증상을 느낀다면, 치과에 방문해 정확한 원인을 확인하고 적절한 처치를 받아야 합니다.

 

Q. What are the problems that arise when tooth sensitivity is left untreated?

 

If tooth sensitivity is left untreated, the symptoms of tooth sensitivity appear and disappear repeatedly in response to external stimuli. Fortunately, this tooth sensitivity can persist and cause the sensitivity of the dental nerve (pulp) to decrease. In addition, new dentin can be formed inside the dentinal tubules near the dentin-pulp border, narrowing or closing the dentinal tubules and reducing the reactivity of the pulp. It can be seen as a natural adaptation of human sensation to tooth sensitivity.

 

However, the problem is that dentin exposure and external stimuli continue during this process. Dentin will be further worn away by brushing, and conditions that may cause tooth sensitivity, such as periodontal disease, cavities, cracks, and fractures, may continue. Therefore, if tooth sensitivity occurs and you feel symptoms periodically, it is important to visit a dentist to identify the exact cause and receive appropriate treatment.

 

Q. 치과에 가면 어떤 치료를 받나?

잇몸병, 충치 등 특별한 질환 문제가 없음에도 이가 시린 경우가 있습니다. 이는 치아와 잇몸 사이로 노출된 치근상아질이 계속 자극받는 탓입니다. 이러한 사례에서는 불소바니시도포, 불소이온도포, 레이저 등의 처치를 통해 일시적으로 증상을 완화할 수 있습니다. 치과에서 해당 부위의 치질을 얇게 삭제하고 레진 충전을 하기도 하지만, 해당 부위의 구조적 특성과 저작압에 의해 쉽게 탈락됩니다. 증상이 심하고 개선되지 않을 때는 신경치료를 통해 아예 치아 치수조직을 제거하기도 합니다.

치과적 처치는 물론 중요합니다만, 이미 노출된 상아질은 근본적으로 회복되기 불가능합니다. 따라서 더 이상의 상아질 마모를 막고, 시린이 증상이 더 심해지지 않도록 관리해야 합니다. 증상 완화를 위해서는 치과 전문가의 처치를 받고, 일상생활에서도 치아와 잇몸 건강 유지에 노력을 기울여야 합니다.

 

A. What kind of treatment can you receive at a dental clinic?

 

Even if there are no particular health issues such as gum disease or cavities, there are cases where teeth can become sensitive. This is due to continued irritation of the exposed dentin between the tooth and the gum. In such cases, symptoms can be temporarily relieved through treatments such as fluoride varnish, fluoride ion application, or laser therapy. Dental clinics can also remove thin layers of affected enamel and fill the area with resin, but this may easily fall off due to the structural characteristics and low adhesive pressure of the affected area. When symptoms are severe and do not improve, nerve therapy may be necessary to remove the pulp tissue of the affected tooth.

While dental treatment is important, once dentin is exposed, it cannot be restored. Therefore, it is necessary to prevent further dentin erosion and manage the symptoms to prevent them from worsening. To alleviate symptoms, it is important to receive treatment from a dental professional and make efforts to maintain oral health in daily life.

 

Q. 일상에서 할 수 있는 시린이 관리법은?
치아 마모를 막으려면 잘못된 칫솔질부터 교정해야 합니다. 올바른 칫솔질은 칫솔을 치아와 잇몸 사이에 가볍게 위치한 후, 앞뒤로 짧은 진동을 주어 닦는 것입니다.

치과적 질환이 아닌, 단순 상아질 노출에 의한 시린이라면, 시린이 치약을 사용하는 것도 도움이 될 수 있습니다. 시린이 치약의 효과에 대한 많은 임상연구에서 1개월 이상 사용 후 증상이 완화된다는 보고가 있었습니다.

 

Q. What are some ways to manage tooth sensitivity in daily life?

 

To prevent tooth wear, it is important to correct improper brushing techniques. The proper way to brush is to position the toothbrush lightly between the teeth and gums, and then give short vibrations back and forth.

 

If the sensitivity is due to exposed dentin and not caused by dental disease, using a desensitizing toothpaste can also be helpful. Many clinical studies have reported that sensitivity can be reduced after using desensitizing toothpaste for more than one month.

Q. 시린이 치약의 효능, 원리는?
크게 2가지 원리입니다. 첫째, 상아세관 내 치수 신경반응을 진정 및 감소시키는 것입니다. 시린이 치약에는 주로 질산칼륨 약제가 첨가됩니다. 물론 과민성을 줄이는 탈감작에 의한 효과는 개인마다 다르게 나타날 수 있다는 점을 참고해야 합니다.

둘째, 노출된 상아세관을 밀봉하는 것입니다. 주로 인산삼칼슘, 염화스트론튬 같은 미세한 입자가 상아세관을 막는 역할을 합니다. 이중, 인산삼칼슘은 치아와 뼈를 구성하는 성분과 유사한 입자인데요. 국내 유통되는 시린이 치약에 많이 함유됐습니다. 치면세균막 제거를 위한 마모제 기능과 상아세관 밀봉 작용을 동시에 하는 성분이기 때문입니다. 여러 연구에서 인산삼칼슘 입자 크기가 작을수록 상아세관 밀봉 효과가 뛰어나다고 밝히고 있습니다. 특히, 나노 크기의 인산삼칼슘 입자는 상아세관 표면 부착력이 증가해 효과가 더 크다고 알려졌습니다. 이것을 'n-CAP'이라고 표현하기도 하지요.

 

A. The effectiveness and principles of desensitizing toothpaste for sensitive teeth:

 

There are two main principles. First, it aims to soothe and reduce the responsiveness of the dental nerves inside the dentin tubules. Desensitizing toothpaste often contains potassium nitrate, which can help achieve this effect. However, it's important to note that the effectiveness of the desensitizing action can vary depending on the individual.

 

Secondly, desensitizing toothpaste aims to seal the exposed dentin tubules. This is often achieved through the use of fine particles such as calcium phosphate or strontium chloride. Among these particles, calcium phosphate is similar to the components of teeth and bones. It's often added to desensitizing toothpaste for both its desensitizing and sealing effects. Many studies have shown that the smaller the particle size of calcium phosphate, the better the sealing effect on dentin tubules. In particular, nano-sized calcium phosphate particles (n-CAP) have been found to have even stronger adhesion to the surface of dentin tubules, thus providing a greater sealing effect.

Q. 두 가지 원리 치약 중 더 추천하는 것은?
신경 탈감작 원리에 의한 치약보다는 상아세관을 직접 밀봉해 주는 원리의 시린이 치약 사용을 권합니다. 사용 즉시 밀봉 효과를 볼 수 있기 때문입니다. 단, 밀봉 효과가 영구적이진 않습니다. 따라서 증상이 완화될 때까지 주기적으로 사용해야 합니다. 아울러 시린이 치약을 지속적으로 사용하면, 치약의 저마모도 특성으로 인해 치면 세균막이 덜 제거될 수 있습니다. 또, 불소가 함유되지 않은 시린이 치약을 사용하면 우식(충치) 발생 위험이 증가하는 만큼, 시린 증상이 어느 정도 완화되면 시린이 치약 사용 횟수를 줄이고 일반 수준의 마모도를 갖는 불소치약을 병용하시기 바랍니다.

치약 마모도 정보는 일반 소비자뿐 아니라 치과 전문가도 알기 어려운 현실인데요. 이러한 이유로, 복잡하고 어려운 치약 마모도 평가법을 개선하기 위한 연구도 수행 중에 있습니다. 간편한 마모도 평가법이 개발되어서, 치약의 상대 마모도 정보를 대중이 쉽게 알 수 있길 기대합니다.

 

Q. What is the recommended principle toothpaste between the two?

 

We recommend using a toothpaste that seals the dentinal tubules directly, rather than a toothpaste that works by desensitizing nerves. This is because the sealing effect can be seen immediately upon use. However, the sealing effect is not permanent, so regular use is necessary until symptoms are relieved. Also, if you continue to use the desensitizing toothpaste for an extended period, the low-abrasion properties of the toothpaste may result in less removal of plaque on the teeth. Furthermore, if you use a non-fluoride toothpaste for dentinal hypersensitivity, the risk of tooth decay increases, so once your symptoms have improved, we recommend reducing the frequency of using the desensitizing toothpaste and using a fluoride toothpaste with a normal level of abrasion.

 

Information on toothpaste abrasion is difficult for both consumers and dental professionals to understand. For this reason, research is also being conducted to improve the complex and difficult evaluation of toothpaste abrasion. We hope that a simple abrasion evaluation method will be developed so that the public can easily understand the relative abrasion information of toothpaste.