The Journal of Korea Assosiation for Disability and Oral Health
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v.3
no.2
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pp.75-79
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2007
Background: Down's syndrome, or trisomy 21, is the commonest congenital chromosome anomaly. With improvement in medical care, these patients increasingly reach adulthood in spite of their physical maldevelopment and mental retardation. And, the number of those who required general anesthesia for dental treatment is increasing. Methods: We reviewed the 26 cases of 22 patients with Down's syndrome who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 22 years. They all had severe mental retardation and some had congenital heart anomaly, epilepsy, hypothyroidism, acute leukemia, autism, cleft palate, and chronic renal failure. For anesthesia induction, 4 cases was needed physical restriction, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (17 cases) and sevoflurane (9 cases). All patients received nasotracheal intubation and 3 cases needed difficult airway management. Mean total anesthetic time was $166{\pm}60$ min and staying time at PACU was $92{\pm}48$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.
Kim, Sun Young;Bang, Jae-Beum;Kim, Kwang Chul;Lee, Eun Young;Choi, Sung Chul
The Journal of Korea Assosiation for Disability and Oral Health
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v.10
no.2
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pp.68-77
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2014
An opportunity for dental students to come into contact with individuals with disabilities is insufficient. Therefore, prejudice and negative attitudes towards persons with disabilities persist. Working under the assumption that educating dental students regarding people with disabilities will bring about positive awareness, we conducted this study. We investigated the changes in the recognition of the issues and needs of people with disabilities before and after special care dentistry class of students of dental college that will include an experience in a dental clinic with a disabled person. Seventy-two Kyung Hee University School of Dentistry third-year dental students attended the special care dentistry class in one semester and they took the same survey was before and after the class. In the questionnaire, we used the disability factor scale (DFS) that Siller has proposed. The authoritarian virtuousness factor getting lower to a significant level after receiving an education. This means that after the education, the respondents realize that how hard to adapt the disabilities. After receiving an education, the rejection of intimacy factor score significantly get higher than before they took the class. This means that after the training, positive attitudes towards those with disabilities were better than those towards the opposite sex. We were able to confirm a positive change in the recognition for persons with disabilities through the special care dentistry class. Our study shows that educating dental students on the how to take care of individuals with disabilities can bring about a positive change in the attitudes students may have regarding them.
Journal of The Korean Dental Society of Anesthesiology
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v.14
no.1
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pp.57-62
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2014
Background: The aim of this study was to analyze outpatient anesthesia for dental treatment in handicapped patients with behavior disorder in order to use data for carrying out better and safe anesthetic management. Methods: The data were drawn from the 100 patients with behavior disorder who visited CNUDH dental clinic for disabled based on anesthesia record to investigate patient's systemic condition, cooperative level, anesthesia method according to patients cooperation, and side effects after recovery time. Results: Mental retardation (58%) is the most reason to choose general anesthesia. The methods of induction according to cooperative level are intravenous propofol injection in 22 cases and inhalation of sevoflurane in 78 cases. Induction time of anesthesia were within 10 seconds in cases of propofol induction and average $48.8{\pm}18.5$ seconds in cases of inhalation induction. The time spent on dental treatment was average $3.2{\pm}1.1$ hours. After the end of treatment, average time to move from unit chair to recovery bed, to recliner, and to discharge from hospital are $10.4{\pm}5.1$, $36.9{\pm}17.1$ and $72.4{\pm}16.0$ minutes, respectively. During recovery, there are nausea with 9%, vomiting with 4%, dizziness with 2%, finger injury with 1%. Conclusions: This study showed our successful anesthetic outcomes without any severe side effects or complications. Through this study, it will be used for safe anesthetic management as useful reference data.
Objectives : The purpose of this study was to examine the state of oral health care among special school personnels in an attempt to provide some information on the improvement of the oral health care of students with disabilities who would be under the first hand influence of school personnels. Methods : The subjects in this study were personnels who were selected by random selection in five different special schools located in the city of Jeonju, North Jeolla Province. A self-administered survey was conducted in person from July 5 to 14 after the purpose of this study was explained. Results : 1. Concerning their general characteristics, the level of oral health knowledge was high in the personnel whose career is 5 years more, and the younger personnels had a better oral health knowledge, and the men were more knowledgeable than the women. 2. As to oral health education experience, the rate of the respondents who ever received oral health education stood at 35.3 percent. In relation to the frequency of oral health education, the biggest group that accounted for 58.2 percent received that education once. As for the route of education, the largest group that represented 52.7 percent received that education at dental hospitals or clinics. In relation to satisfaction with oral health education, the greatest group that accounted for 38.5 percent were dissatisfied with that education. 3. As for an intention of receiving oral health education in the future, the biggest group that accounted for 60.9 percent intended to receive that education if they would have free time, and the largest group that represented 47.7 percent believed that oral health education should be conducted by dental hygienists. 4. Concerning their general characteristics, the level of oral health promotion behavior according to age in both bushing and supplies of oral health care was high in forties-1.89 point and 3.33 point, and that in regular visit to a dental clinic was the highest in twenties for 2.58 point, and that in dietary control was the highest in twenties for 2.59 point. 5. Their oral health knowledge had a significant positive correlation to their toothbrushing, regular dental clinic visit and dietary control that were the subfactors of oral health promotion behavior. 6. As for the impact of oral health promotion behavior on oral health knowledge, toothbrushing exerted the greatest influence on that(${\beta}$=0.306, p<0.001). Conclusions : Appropriate institutional measures should be taken to let dental hygienists who are expert in oral health care provide incremental oral health care for students and adults with disabilities in educational institutions and facilities for the disabled, and the development of oral health education programs is urgently required to offer systematic oral health education for not only students with disabilities but their teachers and guardians.
To provide physical therapy service of good quality keeping people healthy and obstain structural reformation coping with the demands of in medical service market to foreign intercourse on 21C, we should make legal system fer the physical therapy practice. Thus we suggest the Ministry of Health and Health and the authorities should, 1. Exclude the provision of physical therapist from the classfication of medical technician on the Medical Technician Law Article 2. and establish the independent Physical Therapist Law 2. Eliminate the provision of physician or dentist's guide the Medical Technician Law Article 1. or reform it to physician or dentist's request so that physical therapists may have a independent practice, or 3. Add the provision of the physical therapy center to the Medical Technician Law, the enforcement ordinances and enforcement regulations, such as the provision of optometrist or dental technician.
Journal of the korean academy of Pediatric Dentistry
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v.37
no.1
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pp.65-72
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2010
General anesthesia has been researched and developed in dentistry as on type of management technique to sedate patients who may be uncontrollable or require medical consideration. There has been continuous research into this area, but analysis of large set of patients over a sustained period of time is lacking. Thus, this study analyzes the records of patients who received general anesthesia at the Yonsei University Dental Hospital Department of Pediatric and Clinic for the Disabled. 1. Patient's age ranged from 1 to 66, with under 5 being the largest group with 410 members(38.5%). The study included more men than women, with 695 male members(65.3%). 2. Type of dental procedure performed were as follows(per person) : 5.6 Dental restoration; 2.3 Endodontic treatment of deciduous and primary teeth; 2.5 preformed crowning; and 1.6 extractions. Procedures took an average of 100 minutes. 3. 1022 patients(95.9%) received dental care under general anesthesia once and 43 patients(4.1%) received dental care under general anesthesia two or more times. Dentistry under general anesthesia has the many benefit. However, without appropriate post-treatment care, it is difficult to maintain good oral health. Therefore, it is important to improve the efficiency and safety of general anesthesia through future research.
Journal of the korean academy of Pediatric Dentistry
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v.36
no.2
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pp.264-269
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2009
Seoul National University Dental Hospital opened The Clinic for The Disabled to provide dental treatment under outpatient general anesthesia. 432 patients underwent general anesthesia for dental treatment. The informations such as the pattern of dental treatment, the reasons of general anesthesia, the characteristics of the patients were analyzed. Followings are concluded. 1. The patients below 15 years old made up 50.60%. 2. The reasons for general anesthesia included mental and physical disabilities, systemic disease, dental phobia, and so on. 3. Restorative treatment was the most common procedure with the average of 9.7 teeth treated per one patient. 4. 62(14%) patients underwent general anesthesia for dental treatment more than once. 5. The efforts for better multidisciplinary system to provide more comprehensive and effective dental treatment including periodic recall check, preventive treatment for handicapped patients are necessary.
Journal of the korean academy of Pediatric Dentistry
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v.27
no.2
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pp.202-207
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2000
The purpose of study was to compare the caries experience between the mentally retarded(MR) and the normal(N) children and adolescents and to survey the dental visit frequency. preventive dental care, and tooth-brushing behavior of the mentally retarded. Two hundred and fifty MR and two hundred and ten N subjects were selected for the study. 1. The number of teeth which had experienced caries was 3.28 in MR and 4.66 in N. The number of decayed teeth was 2.24 in MR and 1.50 in N. The number of filled teeth was 0.71 in MR and 3.06 in N Filled teeth rate was 19.78% in MR and 58.89% in N The differences between MR and N were all significant(P<0.01). 2. Dental visit frequency of MR was 1.15 per year, and the 51.2% of MR did not visit the dental clinic for the last one year. 38.0% of MR had received the preventive dental care. 3. Toothbrushing frequency per day was 2.16 and the toothbrushing time for 78.3% of MR was less than two minutes. 51.2% of MR brushed their teeth by themselves, 13.3% did with the help of the carers, and 35.5% totally depended on the carers. In conclusion, MR experienced less dental caries than N, had more untreated caries than N, and had need for regular preventive dental care.
The Journal of Korea Assosiation for Disability and Oral Health
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v.14
no.1
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pp.26-30
/
2018
Aspiration of tooth can occur not only during dental treatment, but also due to factors like trauma or physiologic exfoliation of primary tooth. If this occurs, complications such as fever, cough, dyspnea, pain, and bronchitis can be appeared. 9 years-old girl with Lennox-Gastau syndrome visited the dental clinic for regular checkups. Calcified tooth-like material was observed in the chest PA x-ray, and maxillary left primary first molar was not observed in the patient's oral cavity. She had a history of hospitalization for pneumonia two months ago. Because it was considered that the tooth was likely to be aspirated and caused pneumonia, the extraction of remaining primary teeth with mobility was performed. It is necessary to reduce the risk of aspiration in patient with disabilities by performing active treatment such as removal of primary tooth with mobility or ill-fitting restorations.
People with class I intellectual disability need lifelong assistance and protection from their surroundings due to impaired adaptive functioning. They have poor oral health and show higher prevalence of dental caries, periapical inflammation and tooth loss that require proper prosthetic restoration. Because removable prostheses for intellectually disabled patients often lack stability, retention, and maintenance, fixed prostheses are essential and the only available option is dental implants. In this case, a 45 year-old male patient with class I intellectual disability had poor oral hygiene with most of his teeth missing and visited the clinic to recover his masticatory function. Due to such systemic conditions, the definitive restoration of choice was the implant-supported fixed dental prosthesis made of biocompatible and highly strong monolithic zirconia. In consequence of the treatment process, the patient was able to improve his oral environment aesthetically and functionally.
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