Journal of The Korea Institute of Healthcare Architecture
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v.23
no.3
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pp.19-27
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2017
Purpose: The characteristics of site plan and space configuration of public dentistry through examining the public dental healthcare centers for the disabled in Korea and comparison between them are necessary for the development of planning of the dental healthcare system. This study has been started to provide basic informations such as nationwide distribution, site relationship, and space configuration for the planning of public dental hospital architecture. Methods: Literature review of publicness and public dental healthcare and investigation on current status of public dental healthcare center for the disabled in Korea have been conducted. The site plan and space configuration of eight public healthcare centers for the disabled have been analyzed. Results: The result of this study can be summarized in three points. The first one is that public dentistry in Korea are distributed public dental hospital for the disabled in Seoul and public dental healthcare centers for the disabled in eight provinces. The second one is that the types of the dental healthcare center for the disabled are divided with remodeling type which is diverted from existed dental or medical out patient clinic space or independent building type which is planned with a new and exclusive usage for the disabled. The third one is that the space configuration of dental healthcare center for the disabled is needed more required programs, larger treatment unit space, and more private clinic space than typical dental treatment plan. Implications: This study is the starting point for the research of public dentistry and it is necessary to analyze the dental prevention and dental public policy to develop the public dental healthcare system.
Dental treatment for the disabled should be a customized that considers the characteristics and degree of cooperation of each disabled patient. There are additional considerations during implant treatment and tooth extraction in disabled patients. Since some brain lesion disorder or cardiac disease patients may be taking antiplatelet or anticoagulant medications, it is necessary to evaluate whether these medications should be discontinued before an invasive procedure. Precautions should be taken for patients with heart valve disease considering the risk of infective endocarditis, especially during invasive dental procedures. Moreover, disabled patients may have difficulty in following instructions and cautions. There are specific considerations for each stage of implant treatment in disabled patients. In the case of patients who are in the pre- or post-transplant state, it is necessary to assess their general condition and oral disease due to the risk of infection. Since disabled patients with various systemic diseases may visit the dental clinic, it is important to understand their characteristics and treatment process in order to flexibly adjust the dental treatment plan accordingly.
Oral health projects that cater to the disabled should be more prevailing in order to ensure the maintenance and successful promotion of the oral health of disabled people. 70 public dental clinics that conducted oral health projects geared toward the disabled were examined to get a precise grip on their oral health projects. The findings of the study were as follows: 1. 31 out of 70 public dental clinics investigated(44.3%) were equipped with two or more dental hygienists who were professional human resources in charge of the oral health projects for the disabled. As for the age and disability type of the beneficiaries of the oral health projects, adolescents(74.3%) and people with mental retardation(87.1%) benefited most from the oral health projects. Concerning the most common implementation frequency of the projects, the projects were carried out once to three times a week(62.9%). 2. The most dominant oral disease treatment provided to disabled people was amalgam treatment and resin treatment(68.6%), which were the early dental caries treatment. The most common preventive treatment that was offered to improve their oral health was oral prophylaxis(82.9%). As for reform measures for the oral health projects, education of personnels in charge of the projects and their specialization(58.6%) were most emphasized. 3. Regarding factors related to the preventive oral health projects for the disabled, the implementation of oral prophylaxis and toothbrushing education was linked to the age of the beneficiaries. More oral prophylaxis was offered to teens, and more toothbrushing education was provided to preschoolers and adolescents. The age of the beneficiaries and the number of dental hygienists responsible for the projects had something to do with the application of fluorides. 4. Concerning the relationship of the preventive oral health projects for the disabled to the number of dental hygienists, one of the personnels in charge of the projects, the application of fluorides( 54.4%) and pit & fissure sealing(56.8%) were more prevalent when there were two or more dental hygienists. There was a statistically significant disparity in that regard(p<0.05). The above-mentioned findings illustrated that in order to boost the oral health of the disabled, dental hygienists who are responsible for the oral health projects for the disabled should put ceaseless efforts into fostering their professional knowledge and ability and offering quality service to disabled patients. Every public dental clinic should be equipped with plenty of professional personnels to enlarge the scope of treatment and ensure the efficiency of treatment and the preventive projects.
Background: Sevoflurane sedation in pediatric and disabled patients has the advantage of faster induction and recovery compared to general anesthesia, as well as minimum influence on the respiratory and cardiovascular functions, and airway protective reflexes. This study aimed to evaluate the clinical efficacy of sevoflurane sedation used in dental treatment at one provincial dental clinic center for the disabled. Methods: We investigated patients' gender, age, reasons for undergoing sedation, medication history prior to treatment, duration of anesthesia, treatment length, type of treatment, and yearly patterns, for 387 cases of dental treatment performed using sevoflurane sedation from January 2013 to October 2016. Results: We analyzed 387 cases (215 male patients, 172 female patients). Male patients aged 20 year or older accounted for 39.0% of all patients, marking the highest proportion. Patient's lack of cooperation was the most common reason for performing dental sedation. Prosthetic treatment was the most frequently practiced, accounting for 174 treatment cases. The mean lengths of the entire treatment and of the dental procedure were 55.2 min and 39.8 min, respectively. Conclusions: Sevoflurane sedation has the advantage of fast anesthesia induction and recovery compared to general anesthesia; therefore, it can be used efficiently to induce anesthesia in pediatric and disabled patients during short dental procedures, enabling stable treatment of these patients.
Kim, SoYun;Paik, Hye-Ran;Jin, Bo-Hyoung;Lee, Jae-Young;Kim, Jihyun;Kim, Young-Jae
The Journal of Korea Assosiation for Disability and Oral Health
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v.14
no.2
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pp.59-64
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2018
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.
Purpose : The purpose of this study was to survey the present status of the regional oral health centers for the disabled. Material and methods : Face to face interviews with oral healthcare professionals in eight regional oral health centers and literature reviews were conducted among eight regional oral health centers for the disabled during 2, July to 30, August 2017. Results : It is necessary to establish more regional oral health centers for the disabled in area where the number of disabled person as percentage of whole region population is high. Also, all the centers appeared a lack of professional manpower including dentist, dental hygienist and anesthesiologist, equipment and facilities for the demands of patients and their guardians. It is essential for the government to improve the support system to regional oral health centers for the disabled. Conclusions : This study can be used as a reference for the countermeasure to make a new policy and activate the accessibility of dental care services in the public for the disabled.
Objective: In spite of increasing dental treatment for the disabled, there was a few collected data on dental treatment status and dentists' perception in Korea. The purpose of this' study is to research the current dental treatment status for the disabled in Korea and to suggest public health policies for the disabled. Material and methods: Total of 68 dentists who have treated the disabled regularly were asked to fill questionnaires regarding dental treatments for the disabled. Results: 1. It is necessary to set up public dental center for the disabled in rural area. 2. In case of dental treatments relating to cerebral palsy, ADHD, autism, the compensation for treatment time and extra investment is needed. 3. Only 39.7% of dentists charged treatment fees to the disabled as same as normal patients. Moreover 38.2% of dentists answered that they didn't charge treatment fees at all when their patient are disabled. 4.23.5% of dentists provided all of dental treatments including dental implant and orthodontic appliances in Korea. However, 54.3% of dentists reported the improvement of access to dental implant, orthodontic and esthetic treatment is needed. 5. It is imperative for the government to improve the support system for the disabled. Conclusions: Through this research only 26.5% of dentists answered that they had received the fund from the government and 11.1% of them were satisfied with the support for the disabled in Korea. This indicated the improvement of government financial support system for the disabled is needed.
Background: To identify the factors that affect the current status and satisfaction of people with disabilities at community oral care centers. Methods: A structured self-administered survey, including five questions on facility environment, five on usage procedure, four on medical skill, four on care cost, three on friendliness, and three on satisfaction, was administered to 218 residents of the G-disabled community care center. It comprised a Likert 5-point scale (strongly agree, 5 points; agree, 4 points; moderate, 3 points; disagree, 2 points; not at all, 1 point). The reliability of the measurement tool was 0.932 for Cronbach's α. Results: The evaluation of community oral care centers for the disabled showed that the environment was hygienic (4.42±0.73), reservation system was well maintained (4.18±0.95), and the dentist-in-charge was satisfied with the treatment (4.37±0.62). The participants agreed that the details were sufficiently explained (4.29±0.71). However, in terms of medical expenses, the score of "have fully heard the explanation of medical expenses and reductions" was 3.88±0.92. The factors affecting satisfaction were sex, final educational background in the facility environment, usage procedure, and medical skill. Conclusion: To increase the satisfaction of people with disabilities at community oral care centers, it is necessary to establish a facility environment and service according to the patients' need and increase the reduction or exemption benefits between different treatment cost categories. Oral health management policies for the disabled should be developed based on these factors, so that the oral care of vulnerable groups in blind spots can be maintained.
Kim, Jin-Bom;Kim, Byung-Jae;Han, Dong-Hun;Jun, Eun-Joo;Kim, Han-Na;Kim, Min-Ji
The Journal of the Korean dental association
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v.53
no.11
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pp.855-869
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2015
The purpose of this study was to evaluate the oral health promotion of the disabled persons by voluntary dental services in Ulsan Metropolitan City. Two dentists taken a calibration training for national oral health survey examined the oral health status of 473 disabled persons from two special schools for the disabled children and adolescents, a residential facility and a gymnasium for the disabled persons in 2009-2010. The surveyed disabled persons in the age range was from 7 to 74 years old. Voluntary dentists, oral hygienists and other civilian volunteers had supplied with the oral health care services to the disabled persons at dental clinics of special schools for the disabled children and adolescents, and a dental clinic supported from Nam-Gu Public Health Center in Ulsan Metropolitan City since 1997. The obtained data from these surveys were analyzed with the SPSS statistical package. Among subjects aged 12-14 years, subjects with decayed, missing and filled teeth (DMFT) in permanent dentition was 46.9%; subjects with untreated decayed teeth, 17.2%. The number of decayed, missing and filled teeth in permanent dentition was 1.36. The proportion of decayed components of DMFT score was 28.00%; proportion of missing components of DMFT score, 1.43%; proportion of filled components of DMFT score, 70.57%. The proportion of filled components of DMFT score among disabled persons of all age group in Ulsan were evaluated to be a similar level to non-disabled citizens in Ulsan from 2010 Korean National Survey. The oral health care programs for disabled persons by voluntary services of dental professionals and other civilians are evaluated to be effective for the oral health promotion of disabled persons in Ulsan.
Objectives: The purpose of this study was to identify the factors of satisfaction with regional oral health centers for people with disabilities in Korea. Methods: A survey was conducted with 784 patients who visited regional oral health care centers in Korea. A self-developed questionnaire (29 items) was adapted with a consent form and IRB (Institutional Review Board). All collected data were analyzed for statistics using SPSS version 25.0. Results: The study participants were 452 (57.7%) male patients, 207 (26.4%) aged 20-29 years old, and mostly had physical, developmental, and mental disabilities. The patients were introduced by their acquaintances, and the major reason for visit was specific dental care for the disabled. Most patients used their cars and took half to one hour to commute. The common factor affecting the comprehensive satisfaction was the facility satisfaction. Conclusions: A more comprehensive and standardized questionnaire should be developed for the annual evaluation of all centers. This study presents the basic data that can aid to activate the operation of the four oral health care centers for the disabled, which are scheduled to be implemented in the future, as well as 10 currently operated centers.
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