The aim of this study was to analyze the clinical characteristics of patients with cognitive and behavioral impairments receiving dental treatment under general anesthesia (GA-dental treatment). From August 2007 to April 2014, information was collected from 475 patients who received GA-dental treatment at the Clinic for Persons with Disabilities, Seoul National University Dental Hospital. The demographic factors (gender, age, disability, medication, GA history, residency type, caregiver, meal type, oral hygiene maintenance, and cooperation level) and dental status (operating duration, DMFT, malocclusion, periodontal disease, tooth defect, and treatment protocol) of the patients were evaluated. DMFT and malocclusion levels were compared among the patients with ANOVA and Sheffe's post-hoc test, and chi-square test, respectively. The correlation between the demographic characteristics and dental status of the patients were analyzed with the Pearson's correction test. The mean age of the patients was 27.1 (7 - 83) years and they had intellectual disabilities (55.4%), developmental disorders (17.9%), brain disorders (16.6%), neurocognitive disorders (4.6%), or others (5.5%). The mean DMFT (DT) was 8.6 (5.2) with a significant difference among the disability types (p<0.05). The incidence of malocclusion was higher in patients with intellectual disabilities and brain disorders than in the other types (p<0.05). The operation time ($191.4{\pm}91.2min$) was correlated with decayed or endodontically-treated teeth (p<0.05). Special needs patients requiring GA-dental treatment showed unfavorable oral conditions. Dental practitioners experience time restrictions and additional costs under a GA setting. Treatment planning and decision-making can be efficiently facilitated by evaluating the clinical characteristics of the patients.

An opportunity for dental students to come into contact with individuals with disabilities is insufficient. Therefore, prejudice and negative attitudes towards persons with disabilities persist. Working under the assumption that educating dental students regarding people with disabilities will bring about positive awareness, we conducted this study. We investigated the changes in the recognition of the issues and needs of people with disabilities before and after special care dentistry class of students of dental college that will include an experience in a dental clinic with a disabled person. Seventy-two Kyung Hee University School of Dentistry third-year dental students attended the special care dentistry class in one semester and they took the same survey was before and after the class. In the questionnaire, we used the disability factor scale (DFS) that Siller has proposed. The authoritarian virtuousness factor getting lower to a significant level after receiving an education. This means that after the education, the respondents realize that how hard to adapt the disabilities. After receiving an education, the rejection of intimacy factor score significantly get higher than before they took the class. This means that after the training, positive attitudes towards those with disabilities were better than those towards the opposite sex. We were able to confirm a positive change in the recognition for persons with disabilities through the special care dentistry class. Our study shows that educating dental students on the how to take care of individuals with disabilities can bring about a positive change in the attitudes students may have regarding them.

The objective of this study was to confirm the validity of classification of dental disability by measuring the dental treatment time required for disabled patients and identify the disability type that requires more of chair time. As a result of measuring a total of 123 patients who were admitted to the Seoul dental hospital for the disabled on Oct. 2014, I was able to make the following conclusions: 1. For dental counseling and check-up, the chair time did not show significant differences between the different types of disability. 2. For periodontal treatment, restorative treatment, root canal treatment, and surgical treatment, the difference of the chair time for dentally disabled patients was significantly longer than that of non-dentally disabled patients. 3. The difference in the total chair time for prosthetic treatment was statistically insignificant. However, each of the prosthetic treatment steps did show statistically significant differences.

1. 순측접근법은 치수치료를 순측으로 시행한 후 변색된 순측의 치질을 확대하여 삭제하고 레진으로 순면전체를 수복함으로써 치수치료와 동시에 심미성을 회복할 수 있다. 2. 순측으로 치수치료를 시행하므로 시야가 확보에 유리하고 기구조작이 용이해 행동조절이 잘 되지 않는 어린이에게 추천된다.

상악 전치부 완전탈구를 주소로 내원한 지적 장애를 동반한 뇌병변 장애를 가진 25세 환자에서 재식 후 구치부 bite block을 추가한 vacuum-formed splint을 이용한 교합 안정술을 통하여, 외상 치아의 동요도 감소 및 교합안정을 이루는데 도움이 될 것으로 사료 된다.

본 증례를 통하여 뇌병변 장애 1급 환아에 자해성 구강손상이 발생한 경우 치료에 대해 고려할 점은 다음과 같다. 뇌병변 장애 1급을 포함하는 의식 저하 환자에서는 혀, 입술 씹기 등의 자해성 구강손상 발생 빈도가 높다. 연성 구강보호장치의 용이성으로 우선적으로 고려될 수 있으나, 연성 구강 보호 장치로 병소가 개선되지 않을 경우, 교합 거상판을 포함한 아크릴릭 레진 가철성 장치를 고려할 수 있다. 교합 거상판을 포함하는 아크릴릭 레진 가철성 장치 장착이후 구강 위생 관리 및 치료 부위 유지를 위해 주기적인 치과 검진이 필요하다.

We experienced a case of dental treatment under general anesthesia in a 22-year-old female patient with dysphagia and dental phobia following partial glossectomy. She was diagnosed of squamous cell carcinoma of tongue and received surgical, radiation treatment two years ago. We report the experiences of anesthetic management for dental treatment in a patient with dysphagia and dental phobia following partial glossectomy.

Moebius syndrome is a rare, congenital neurological disease involving facial paralysis and limitation of eye movements. It results from maldevelopment of the sixth and seventh cranial nerves. Dental features of this syndrome include micrognathia, microstomia, tongue deformity, cleft palate, hypoplasia of the teeth, and congenital missing teeth. A 7-year-old female with Moebius syndrome was referred from a local dental clinic for caries treatment. She presented with facial paralysis and microstomia. Oral findings included multiple caries with enamel hypoplasia, congenital missing teeth, and tongue deformity. Dental treatments including restorative and preventive procedures were performed. Oral findings and management aspects of Moebius syndrome for this case are discussed. Early evaluation and multidisciplinary care are needed for children with Moebius syndrome.

저자 등은 개원 치과의원에서 하악 매복지치 발치중 유발된 불안장애와 과환기증 및 발치 창상 주위 출혈과 동통을 보였던 57세 여환을 신속한 정신안정법 적용하에 수액 약물요법과 외과적 처치(잔존 치근 남긴채 창상 지혈, 봉합, 배액술 등)로 관리하여 양호한 경과를 치험하면서, 평소 진료시 정신과적 장애문제에 큰 관심을 가져야 하며, 특히 수술시 스트레스 감소법에 더욱 유념하게 되었다.