• 치위생과학회지
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• 제16권5호
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• pp.355-360
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• 2016

본 연구는 우리나라 성인의 미충족 치과의료와 그에 관련요인을 파악하기 위해 진행되었다. 미충족 치과의료를 정의하는 데 있어 치과의료의 필요를 치통을 경험한 사람 중 적절한 치과 의료서비스에 접근하지 못한 사람으로 제한하여 의료 필요에 따른 충족을 보다 명확하기 측정하기 위해 노력하였다. 미충족 치과의료의 원인으로는 경제적 부담, 직업/학업적 이유, 다른 문제에 비해 덜 중요해서가 높은 비중을 차지하는 것으로 나타났다. 미충족 치과의료와 관련된 요인으로는 성별, 연령, 본인이 인지하는 구강건강 상태, 씹기 문제가 통계적으로 유의미한 것으로 나타났다. 이와 같은 결과를 바탕으로 건강보험 보장성 강화 정책과 관련하여 치과의료비의 본인부담금의 비중을 낮추는 방안을 제안할 수 있을 것이다. 또한 치과 의료서비스 접근에 있어 취약한 집단을 파악하고, 해당 집단에 대한 보건의료 정책 개발 및 서비스 제공이 이루어져야 할 것으로 생각된다.

• 한국치위생학회지
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• 제20권6호
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• pp.819-829
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• 2020

Objectives: This study aimed to assess the relationship between dental care needs and dental service use in Korean elderly. Methods: Using the sixth Korea National Health and Nutrition Examination Survey, from 22,948 individuals, 1,572 (male 701, female 871) elderly individuals aged above 65 years were included in the study. All analyses were stratified by sex. Results: In males, the group with subjective needs was 3.74 (95% confidence interval [CI]: 2.58-5.41) times more likely to use dental services than the group without subjective needs. For females, the group with subjective needs was 2.17 (95% CI: 1.57-2.98 ) times more likely to use dental services than the group without subjective needs. Conclusions: To conclude, the elderly with symptoms, used the dental services for pain relief and functional recovery. Fundamental efforts to improve oral health are needed, such as providing treatment, prevention and educational services, besides efforts to provide treatment-oriented dental services. Further research is needed for the middle and elderly individuals who are in the blind spot of the existing policy.

• Journal of Periodontal and Implant Science
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• 제46권6호
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• pp.405-414
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• 2016

Purpose: This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. Methods: A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010-2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. Results: Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. Conclusions: The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.

• 대한치과의사협회지
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• 제53권11호
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• pp.779-788
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• 2015

Individuals with special needs include those with behavioral issues, developmental disorders, cognitive disorders, congenital or genetic disorders, or systemic disease. These conditions may place them at increased risk for oral diseases. Dental management of patients with special needs require in-depth understanding of the background of disability and available behavioral guidance theories. Therefore dental team members need more training in the theory and practice of behavior management principles, which might lead to a clinical experience that is more respectful of the dignity and independence of patients with special needs. The dental professional should be flexible to modify the behavior management approach according to the individual patients needs. Also a family/care-giver centered approach based on their preferences and concerns, the patient's challenging behaviors, and related medical problem can serve to improve the treatment planning and oral health management of dental patients with special needs. This article focuses on uncooperative behavior and behavior management, which help practicing dentists to understand their role in the care of patients with special needs.

• 한국치위생학회지
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• 제15권3호
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• pp.411-416
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• 2015

Objectives: The purpose of this study is to identify oral health status and oral health care needs of elderly patients in long-term care hospital. Methods: Oral health examination was carried out by a dentist and questionnaire was completed by direct individual interview by a dental hygienist for 245 elderly patients in seven long-term care hospitals in Daegu from March 12 to April 16, 2011. Results: Those who need dental care were 188(76.7%) and was done by oral health examination by a dentist. 93 patients(38.0%) wanted dental care and 63 patients(25.3%) need dental care. The most important dental service in the elderly patients was denture and prosthetic service. As demand for denture and prosthetic service exceeds the supply, but only 35.9 percent of the elderly received the dental care service by the estimation of the caregivers. Conclusions: It will be necessary to establish the customized dental care service for the elderly patients in long term care hospitals. The oral health education for the caregivers is very important and the continuing education program must be implemented in the future.

• 한국병원경영학회지
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• 제22권3호
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• pp.118-132
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• 2017

This study developed key elements of dental service guidelines for the disabled patients. In order to provide consumer-oriented service guidelines for the dental patients with disability, service design method was applied. Using service design method guided by the double diamond design process, this study implemented consumer survey, observation, and contextual interviews for consumers' needs assessment. And customer journey map, mind maps, and blueprints were utilized to visualize consumer needs and guidelines for dental care services for the disabled. According to the study, disabled consumers have needs for expertise of the medical staff, dental care institutions specialized on the disabled, financial support, establishment of the facilities for the disabled, comfortable atmosphere in the institutions, and communication with medical staffs. Based on the needs of the disabled, 5 key elements of the dental care services were developed: convenience, expertise, empathy, financial support, and education and management. And service design guidelines were proposed to implement key elements of dental care services for the patients with disability. This study is significant in that it is the first attempt to apply the service design technique from the consumer perspectives in the field of dental care for the disabled. Furthermore the process of this study has become a reference that can be utilized and applied to other medical institution.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권4호
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• pp.191-199
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• 2019

Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.

• 한국치위생학회지
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• 제20권5호
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• pp.571-580
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• 2020

Objectives: This study aimed to investigate the factors associated with unmet dental needs among adults with activity limitations. Methods: Data were obtained from the seventh Korean National Health and Nutrition Examination Survey (KNHANES). The final sample consisted of 945 adults aged 20 years or older with limited activity. Logistic regression analysis was used to examine the influence of predisposing, enabling, and need factors on unmet dental needs. Results: The proportion of adults with unmet dental needs during the last year was 52.2% in the middle-aged group and 45.5% in the older adult group. Higher household income was associated with fewer unmet dental needs in both groups. In the older adult group, married people were less likely to have unmet dental needs. In the middle-aged group, adults who perceived their oral health as poor were more likely to have unmet dental needs. Conclusions: All three factors (predisposing, enabling, and need) were found to be associated with unmet dental needs among adults with activity limitations. Special efforts should be made to improve access to dental care services for middle-aged adults with activity limitations.

• 대한치과의사협회지
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• 제49권12호
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• pp.732-738
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• 2011

Special needs patient are one of the underserved dental patient groups in Korea. However, Lack of attitudes to oral care and the knowledge of health professionals are identified as barriers to oral health for people with disabilities. Health authorities have a key role in ensuring that the need for a comprehensive dental services is met. This review may help oral health professionals understand the dental considerations according types of disabilities and provide appropriate and necessary dental care for special needs patients.

• 치위생과학회지
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• 제19권1호
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• pp.48-59
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• 2019

Background: The purpose of this study is to provide the data for discussions related to oral health promotion policies for single-person households by analyzing the status of unmet dental needs and related factors in single-person households in Korea, based on the Anderson model. Methods: The data, obtained from 544 single-person households of those over 20 years old who were targeted for the 6th Korea National Health and Nutrition Examination Survey, were analyzed through a complex sample frequency analysis, complex sample cross analysis (Rao-Scott chi-square test), and complex sample binary logistic regression analysis on a complex sampling design. Results: The most frequently given reason for an unmet dental need among single-person households was economic (52.4%). Factors related to the unmet dental needs of single-person households are smoking, which is a predisposing factor; personal income levels, which are an enabling factor; chewing discomfort; and limited daily activities, which are need factors. Smokers, the high-income group, the chewing-discomfort group, and the limited activity group showed high unmet dental care experience. Smokers had a 2.75 times higher rate of unmet dental care than non-smokers, and the high-income group had a 5.29 times higher rate of unmet dental needs than the median group. The rate of unmet dental needs for the chewing discomfort group was 3.27 times higher than the non-chewing discomfort group, and the limited activity group had a 7.87 times higher rate of unmet dental needs than the non-limited activity group. Conclusion: It is necessary to map out policies designed to help maintain and promote met dental needs considered to be internally heterogeneous to single-person householders, based on the Anderson model.