• 대한장애인치과학회지
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• 제9권1호
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• pp.18-24
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• 2013

Objectives: The goal of this study is to establish data baseline to ameliorate oral health policies for patient. The research was conducted in dental clinic at Seoul Metropolitan Children's Hospital - the major municipal hospital for the disabled. The outpatients' visiting patterns to the dental clinic were analyzed, compared to other medical departments. For further research related to TMD, the questionnaires were given to the subjects. Material and methods: Data for visiting patterns/frequencies was collected from patient records of 1419 outpatients who visited the dental clinic at Seoul Municipal Children's Hospital in 2011. Then TMD-related questionnaires were given to 127 outpatients who were over 13 years old. Results: 1. 219 out of 1419 patients (15.4%) who visited the dental clinic at Seoul Municipal Children's Hospital in 2011 were the disabled. 2. Compared to normal patients, disabled patients visited the dental clinic and rehabilitation medicine department more frequently.(p<0.05) However, there was no apparent difference in visiting frequencies between the disabled and the normal patients in the psychiatric department.(p=0.3237) 3. 44% of the TMD-related questionnaire subjects responded that they often consumed relatively hard or tough food, 53% answered they had unilateral chewing habit, 3% had bruxism, and 12% had clenching habit. Conclusion: In the dental clinic at Seoul Municipal Children's Hospital, 19% of outpatients over 13 years old had TMD such as clicking and pain. Also, the disabled patients' visits to the dental clinic were considerably more frequent, compared to the normal patients and to other medical departments. Accordingly, the result may suggest that the proper systematic supports from the government are essential to the dental clinic at municipal hospital for the disabled.

• 대한치과마취과학회지
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• 제11권2호
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• pp.133-140
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• 2011

Background: Dental treatment under outpatient general anesthesia is an option for disabled person, children and dentally disabled person who have the difficulty of cooperating voluntary with dental care. The aim of this study was to access the patients who had dental management under general anesthesia at Chungnam dental clinic for the disabled. Methods: This survey is consisted of 114 severely disabled and dentally disabled person who undergone dental treatment under general anesthesia from January to June 2011. Data were collected by individual dental and anesthesia records. Results: Of the 114 patients studies, the 45 patients was the dentally disabled and the 69 patients was the severely disabled. Rate of dental treatment among male patients was higher than among female patients. The dentally disabled was an similar age distribution. In the severly disabled, above 13-year-old was higher than below 12-year-old. The most popular induction method of general anesthesia was sevoflurane inhalation after induced sedative effect of nitrous oxide inhalation. The severly disabled who had definitely negative behavior was applied inhalation of high concentration sevoflurane. Conclusions: Chungnam Dental clinic for the disabled provide dental management for the disabled and the dentally disabled.

• 대한장애인치과학회지
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• 제12권2호
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• pp.55-65
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• 2016

The objective of this study was to estimate the proper amount of subsidy required to operating dental hospital or clinic for the disabled. Models for estimating operating profit of general dental hospital/clinic and opportunity cost of operating dental hospital/clinic for the disabled was formulated. Data were collected from various sources such as the annual reports of Purme Hospital, one of the running dental hospitals for the disabled, statistics from Healthcare Bigdata Hub, operated by Health Insurance Review & Assessment Service of Korean Government, and the deliberation data of non-reimbursable treatments in Seoul Dental Hospital for the Disabled. A dental hospital/clinic for the disabled was less profitable than a general dental hospital/clinic, of which the reason is that the chair time for the average patient is longer. However, It was false that a dental hospital/clinic for the disabled scored less average insurance fee for a treatment. Disabled patients had more frequent prosthodontic treatments, which had a high average insurance fee. There were some groups of treatments that could yield higher profitability in a dental hospital/clinic for the disabled; recall checks, and periodontal treatments.

• 대한장애인치과학회지
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• 제6권2호
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• pp.84-93
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• 2010

The developmental disorder(intellectual disorder(ID) and autism spectrum disorder(ASD)) can severely impair a patient's ability to communicate and socialize. So they require physical management techniques, pharmacologic agents, and general anesthesia more than the normal at the dental clinic. The behavior therapy is a kind of the psychotherapy and is applied to the patient with behavioral problems. Seoul Dental Hospital for Disabled(SDHD) set up the Dental Behavior Clinic for the patients with developmental disorder and treated 32 patients with ID or ASD, blind. 18 patients were treated according to the ordinary plans, 14 patients stopped the treatment by different reasons. The various results of the treatment were produced by the kind or severity of the diseases, age and cooperation of the patients and the caregivers. Especially, the behavior therapist helped to figure out the characteristics of the patients and to make individualized treatment plans. In the future, it will be necessary to treat more patients and to make the dental behavior therapy objectify. And through the dental behavior therapy, it will be expected that the patients will become more cooperative to the dental clinic and can receive regular check-up peacefully, reducing the frequency of the general anesthesia.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권3호
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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.

• Journal of Korean Dental Science
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• 제16권1호
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• pp.1-8
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• 2023

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.

• 대한소아치과학회지
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• 제40권1호
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• pp.28-39
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• 2013

전신마취 및 진정법은 소아 및 장애인에게 성공적 치과치료를 위해서 필수불가결하다. 이 연구의 목적은 충남장애인구강진료센터에 치과치료를 위해 시행된 전신마취와 진정법의 실태를 평가하기 위함이다. 2011년 1월부터 2012년 9월까지 전신마취, 세보플루란진정 및 정주진정을 받은 소아와 장애인 426명을 대상으로 조사분석하였으며 389명이 전신마취, 20명이 세보플루란진정 그리고 17명이 정주진정하에서 치과진료를 받았다. 전신마취의 비율이 두 진정법에 비해 높았다. 세보플루란진정은 소아환자의 외상처럼 짧고 간단한 치료에 유용하게 사용되었다. 정주진정은 공포와 불안을 가진 치과적장애환자에게 선택되었다. 세보플루란과 정주진정은 점차적으로 전신마취의 사용을 줄이고 치과적장애환자를 위한 유용한 방법이었다.

• 대한장애인치과학회지
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• 제11권2호
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• pp.58-61
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• 2015

The people with disabilities living in residential facilities have more difficulty in caring oral hygiene than those living at home. The purpose of this study is to evaluate the recent 2014 dental treatment records of free mobile dental clinic service for disabled people in Korea. 203 disabled living in residential facilities participated in mobile dental clinic. Patients classified according to types of disability. Mental retardation were 75.3%, mental disorder were 6.0%, crippled disorder were 7.4%, brain disorder were 6.5%, visual disorder were1.4%, auditory and speech disorder were 2.3% and autism disorder were 0.9%. Performed treatments were 99 scaling and curettage, 88 fluoride varnish and TBI, 4 extraction, 1 endodontic treatment, 16 caries control (resin filling, GI filling), 1 denture repair and 8 refuse the treatment. Free mobile dental clinic can not provide complex dental treatment. So, the organization should systemize advanced dental treatment and regular preventive programs. Furthermore, we need to have a more concerns about the people with disabilities living in residential facilities and constantly participate on a dental voluntary work.

• 대한소아치과학회지
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• 제31권1호
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• pp.19-25
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• 2004

치과적 장애인이란 치과진료 시 치과의사에게 자발적인 협조가 힘든 사람을 의미한다. 본 연구는 서울대학 치과병원 장애인진료실에서 치료받은 치과적 장애인 환자들의 임상진료 실태를 마취과적으로 분석하고 향후 장애인 치과치료에 대한 지침을 마련하고자 하였다. 1999년 1월부터 2002년 10월까지 서울대학교 치과병원 장애인진료실에 내원한 장애인 환자들을 대상으로 조사한 결과, 총 89명의 환자들에게 93건의 치과진료가 시행되었다. 환자의 대다수는 정신지체였고 전신마취 하 보존치료를 받았다. 주로 마취유도제는 thiopental, 근이완제는 vecuronium을 이용하였으며 산소, 아산화질소, enflurane을 함께 흡입시켜 마취를 유지하였다. 총 마취지속시간과 회복실 체류시간은 각각 $164.4{\pm}57.2$ 분과 $106.2{\pm}50.5$ 분이었고 회복 과정에서 심각한 합병증은 관찰되지 않았다. 본 연구는 외래환자마취에 기반한 서울대학교 치과병원 장애인진료실의 치료방침에 따라 특별한 문제없이 성공적인 마취가 가능하였음을 보여 주었다. 또한 증가하는 장애인 치과치료에 대한 수요를 충족시키기 위해서 적절한 시설과 인력을 갖춘 보다 맡은 외래환자마취 센터의 필요성도 제시한다고 할 수 있다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권4호
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• pp.283-288
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• 2016

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.