This study proposed a registered dentist model for the disabled based on consumer in-depth interview and supplier survey. This study proposed that dental clinics in the community take role as registered dentists for the disabled. Qualification screening and facility prerequisites are required to be selected as the registered dentists for the disabled and patients of the registered dentists were restricted to the disabled who can cooperate to dental treatment services with or without the aid of physical bondage. In order to encourage the participation in the program, subsidies for the registered dentists were necessary. Also, this study proposed financial supports for the medical expenses for patients at the same level as the current dental care center for the disabled. The registered dentist program for the disabled meets the needs of disabled consumers, such as accessibility of medical institutions, expertise of medical staff, and ongoing treatments with familiar medical staff. The registered dentist program for the disabled is expected to provide prevention and ongoing management for oral health promotion of disabled people and it also contribute to lower economic burden of oral health care of the disabled.

The purpose of this study was to examine the state of the articles in the Journal of Korean Association for Disability and Oral Health. All the papers in the Journal of Korean Association for Disability and Oral Health of 2005 to 2018 were analyzed. A total of 181 papers were classified according to its type, field of the study, school, the number of authors, references, and written language. According to the type of the paper, 38 (21.0%) were original articles, 12 (6.6%) were review articles, 124 (68.5%) were case reports and 7 (3.9%) were others. In relation to the field, the most were pediatric dentistry. According to author's school, some schools showed preponderances. As to the number of researchers, the most common number of researchers was four (39 articles, 21.5%), and the number of the articles written by six (37, 20.4%) was similar to that of the articles written by three and five (28, 15.5%). As for the number of references, this number ranged from minimum 0 to maximum 40, and the average was 14.8. Regarding the language of the articles, English was used in 5 articles (2.8%), and Korean was used in 176 articles (97.2%). Thirty-nine (21.5%) papers were done in collaboration with workers of the other field. The efforts of this study was to provide useful information of the journal and the development of research in Special care dentistry.

This study was designed to evaluate basic data about dental treatment under general anesthesia in pediatric dentistry of Wonju Severance Christian Hospital. Sex, Age, location, preoperative physical status, intubation methods, inhalation agents, duration of anesthesia and treatment, performed treatment and postoperative follow-up period and frequency were collected based on electronic medical records of 239 patients who visited pediatric dentistry at Wonju Severance Christian Hospital from March 2011 to February 2017. There were the most patients between the ages of 5 - 9, and there was no significant difference between male and female. The largest number of patients visited the hospital from Wonju, where the hospital was located. Most of preoperative status was ASA Class I. Orotracheal intubation was used in 169 of patients (70.7%). As an anesthesia maintenance agent, drug containing sevoflurane was used in 153 of patients (64.0%). In performed treatment, dental restoration, sealant and stainless steel crowns were performed 3.8, 1.8 and 1.1 times per person. 129 patients (54.0%) attended follow-up appointments under 6 months and those of the number of appointments were 1 - 4 times in average. General anesthesia as a behavior guidance in pediatric dentistry is increasing. Clinical guidelines for pediatric patients under general anesthesia are required through follow-up studies.

Patients with mental disability who are classified as dental severely disabled, have poor oral health status and many difficulties in taking health services. The purpose of this study was to investigate factors of influencing in visiting oral health care services. After receiving approval from institutional review board in Seoul National University, 39 participants were recruited and the oral health examination and questionnaire were taken. Data were analyzed using one-way ANOVA, independent t-test, hierarchical linear regression for predicting influence of each participants' characteristics on oral examination time and care time. In regression model, the higher the disability grade and the lower the degree of cooperation, the more oral examination time increased. However possibility of communication was not significantly influenced. Also, the higher the disability grade and the lower the degree of cooperation, the more oral care time increased. However possibility of communication was not significantly influenced. These results are expected to provide objective data for introduction and establishment of visiting dental care.

본 증례는 유전적 피부질환의 하나로 피부의 착색과 망막의 이상 그리고 다수의 유치 및 영구치 결손과 치아의 형태 이상을 나타내는 색소실조증 환자에 대한 보고이다. 현재 환자는 큰 불편감 없이 유치를 유지하고 있으며 향후 영구치열기까지 정기적인 관찰과 관리가 필요하며, 영구치열 완성 후 영구적인 보철적 수복이 필요할 것으로 사료된다.

Drug-induced gingival overgrowth is an abnormal increase of gingival tissues caused as a side effect of systemic medication. This report presents a severe case of valproate-induced gingival overgrowth combined with ulcerative and hemorrhagic lesions in a patient with Lennox-Gastaut syndrome. Considering the patient's limited cooperative ability, gingivectomy and excisional biopsy under general anesthesia were performed. The lesions were successfully treated without recurrence. When gingival enlargement does not subside with nonsurgical treatments, surgical procedure and excisional biopsy are to be performed. Postoperative management of oral hygiene is critical to prevent recurrence.

저자는 입술 및 혀에 대해 자해증상을 보이는 2명의 Lesch-Nyhan 증후군 환아에서 구강조직에 대한 자해행동을 예방하기 위해 soft mouth guard를 이용한 보존적 치료법과 전악발거의 침습적 방법을 이용하여 치료한 증례를 보고하는 바이다. Lesch-Nyhan 증후군 환자의 자해행동을 예방하기 위한 치료법은 아직 정립된 기준이 존재하지 않아 각 환자의 자해양상 및 정도에 따라 치료방법은 달라질 수 있다. 가능하다면 치아를 보존할 수 있는 장치 또는 BTX-A 제재 등을 이용한 보존적 방법을 먼저 시도해 보는 것이 좋다. 이 때 치료의 성공률을 높이기 위해서는 치과적 접근 이외에도 소아정신과와의 협진을 통한 정신심리학적 접근, 필요시 약물치료를 고려하는 것 등 여러 방향으로 접근하는 것이 더욱 바람직한 결과를 가져올 것으로 사료된다. 보존적 접근이 실패할 경우 더 이상의 조직상실과 전신적 감염 예방을 위해 극단적 방법이지만 전악발거를 고려해야 할 것이다.

중등도의 혈우병 A 환아와 중증의 혈우병 B 환아가 응고인자 투여 후 전신마취 하에 각각 매복 과잉치 발거술 및 다수 유치의 우식치료를 받았다. 이와 같이 혈우병 환자의 치과치료 시에는 부족한 응고인자를 보충해주는 등의 응고인자 수준의 관리와 복잡한 의과적 처치 및 술 후 관리가 요구된다. 또한 치과치료 시 출혈을 유발되지 않도록 주의해야 하며 응급 상황 등에 대비하여 국소적 지혈 방법 등을 숙지하고 있는 것이 필요하다.

이번 증례에서는 다수의 치아우식증과 치주질환이 있는 다운증후군 환자의 구강완전회복을 위해 수복치료 시 고려해야 할 부분에 대해 살펴보았다. 다운증후군 환자의 경우 포괄적인 보철치료를 받았다 할지라도 보호자 동반의 지속적 구강건강관리가 필요하며, 또한 치료 시 환자뿐만 아니라 보호자에게 치료와 관리방법에 대한 설명을 수행하는 것, 치료 전 구강건강상태와 구강관리습관, 전신 병력과 교육 여부도 보철치료의 성공적 예후에 매우 중요한 요소가 된다. 결과적으로 다운증후군환자의 단순발치에서부터 치주치료, 보철치료 등 치과적 치료 적용 시 다양한 요인들을 파악하고, 보호자 환자와의 라포 형성, 경제적 상황에 맞는 치과치료 선택 등 올어라운드(all-around) 형태의 치료계획 수립이 성공적인 치과 치료를 가능하게하며, 나아가 환자의 삶의 질을 개선시키고 건강한 삶을 영위할 수 있도록 할 수 있다.

The need for oral health rights for people with disabilities is very high, and current oral health care system does not fully reflect these demands. Efforts to promote oral health of people with disabilities are urgently needed. In order for the disabled to have oral health rights, access to oral health services for people with disabilities should be improved and barriers to access should be resolved. In this study, we propose oral health service delivery system to guarantee oral health rights for the disabled. In addition, before applying the proposed oral medical delivery system, the external effects of the system application were predicted and the expert verification was conducted to find out the solution. There are some controversies about the development of the service delivery system proposed in this study. As a result of the expert verification, there were disagreements about the suitability of the service provider, the suitability of the service recipient, the appropriateness of the service content and scope, and the appropriateness of the cost and the revenue source. Subsequent Delphi surveys require the development of structured questionnaires for discussions that require consensus. It is expected that a reasonable consensus of expert opinions will be derived.