The purpose of this study were to investigate the chief complain and dental treatment needs in handicapped patient. This study examines treatment records of 1025 patients in free dental clinic for handicapped patients during 10 years from 1999 to 2008. The results were as follows : 5.8 average visit per patient; mean patient age was 25; 544 patients was younger than 20. Handicapped patients classified according to types of disability. Crippled disorder were 19.1%, brain disorder were 4.5%, visual disorder were 3.1%, auditory disorder were 4.1%, speech disorder were 0.9%, mental retardation were 67.1%, and developmental disorder were 25.1%. Performed treatments were 322 scaling, 13 fluoride varnish, 727 preventive resin restoration, 1296 resin restoration, 600 amalgam restoration, 46 GI restoration, 612 extraction, 289 pulp treatment of primary teeth, 75 pulp treatment of permanent teeth and 138 stainless steel crown restoration. Many handicapped patients have some difficulty to dental treatment. They have limited access to dental care, which is compounded by a shortage of skilled dental professionals who are willing to treat these population and financial problems.

1. 이 증례는 Pierre Robin Sequence로 진단받은 14개월 남아로 PRS의 3요소 중 하악왜소증, 설하수증의 소견을 보이고 있었으며 기도확보는 측와위를 통하여, 섭식은 PEG 도관삽입술을 시행하여 유지하고 있었다. 2. PRS는 해부학적 폐쇄 질환이기도 하지만 성장 장애이기도 하므로 여러 분야의 다원적 접근 및 치료계획이 필요하며, 다른 증후군들과 연관되어 심장질환, 신경질환, 안과질환, 청력문제 등이 동반될 수 있으므로 치과 진료실 에서 PRS 환아의 진료시 이 점을 유의해야할 것이다.

Macroglossia is a tongue pathology of multiple etiology as systemic disease like cerebral palsy and Down syndrome etc. It can cause abnormal oral conditions including anterior open bite or dyspnea by changing occlusion and oral habits. So many handicapped children who have macroglossia need to get surgery of large tongue to improve esthetics, function, and treatment stability. The purpose of this report is to evaluate 2 patients, one has cerebral palsy and the other lymphangioma, who have experience of glossectomy with review of literature.

Dental treatment of mentally challenged patients under general anesthesia is a series of challenging procedures not only for dental operators but also for dental anesthesiologists. Patients presenting with uncooperative behavior often resist the perioperative management for adesthestic administration. This case report suggests oral premedication as a conjuctive method for anestheitic induction. A 26-year-old male dental patient with autism was referred to dental treatment under general anesthesia. The patient refused to enter dental clinic office and was not able to receive preoperative assessment. In the day of operation, 15 mg of midazolam was given to the patient for oral premedication prior to anesthetic induction. Ater 20 minutes, the patient presented with drowziness and was transferred to the office. Anesthestic staff were able to achieve appropriate intravenous access and mask inhalation. The patient recieved 8 hrs long dental treatment and recovered in a noncomplicated way. Oral midazolam is commonly used to reduce anxiety for combative and irritated pateints. In this case, oral midazolam sedation was used as a preanesthetic management of a highly uncoopearive patient.