Journal of The Korean Dental Society of Anesthesiology
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v.10
no.1
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pp.27-33
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2010
The gag reflex is a physiologic reaction which safeguards the airway from foreign bodies. But, an exaggerated gag reflex can be a severe limitation to a patient's ability to accept dental care and for a clinician's ability to provide it. The overactive gag reflex can be due to psychological factors or physiological factors, or both. Psychological factors can include fear of loss of control and past traumatic experiences. A 58-year-old man, scheduled for extraction of left upper second molar, left lower second and third molar and implantation of left upper second molar, and left lower second molar had no specific underlying medical problems. He had exaggerated gag reflex. Dental treatment was successfully performed using intravenous sedation. Intravenous sedation with midazolam and propofol was a useful management technique for reflex control during dental treatment extended to the posterior regions in the oral cavity.
Objective: Microscrew implants (MSls) offer many advantages, but some complications are known to occur during their insertion. One of the most commonly reported complications is root injury. Our aim was to identify factors associated with root injury and to evaluate their qualitative and quantitative values. Methods: Thirty-five orthodontists placed MSls (AbsoAnchor$AbsoAnchor^{(R)}$, Dentos Co. Ltd, Daegu, Korea) in the upper jaw of typodonts, labially between the second premolar and the first molar, in low and high vertical positions. Root contacts were counted, and distances between MSI apices and roots were measured. Fear level of the orthodontists was surveyed before and after the experiment. Wilcoxon's test, chi-square test, and Mann-Whitney test were used for statistical analysis. Results: Overall root contact rate of MSI insertion was 23.57%. The root contact rate was significantly higher in MSls inserted at $90^{\circ}$ (45.71%) than at $30^{\circ}$ (1.43%). The distance between the dental root and MSI also increased significantly in MSls inserted at $30^{\circ}$. Mean fear level before MSI insertion (4.6) significantly decreased after insertion (3.2); the causative factors were risk of injury to dental root and maxillary sinus or mandibular canal. Conclusions: Root injury is relatively rare, and oblique angulation reduces the risk of root and MSI contact.
Objectives: This study aims to recognize the importance of dental hygiene process diagnosis of dental hygiene process which can comprehensively grasp the patient's problem and to use it as a basis for establishing the patient's preventive treatment plan. Methods: This study did survey to 443 patients who received treatment based on the oral health care program from a dental clinic in Busan from January 2015 to January 2017. Data analysis was performed using IBM SPSS Statistics (Version 21.0), and statistical significance level was set at ${\alpha}=0.05$. Binary logistic regression analysis was performed to the dental hygiene problems affecting the dental hygiene plan. Results: There were significant differences in dental hygiene problems between male and female respondents on various dental problems such as dental plaque deposition, attrition, stain, dental fear, possibility of jaw joint disorder, food pressing, possibility of malocclusion. There were also significant differences in dental hygiene plans between male and female respondents in air-Jet, non-smoking education, and sealant. The most common dental hygiene plan was scaling, The problem of stain showed that the scaling plan was 0.20 times less. The explanatory power of the model was 43.5%, and the Hosmer and Lemeshow tests were 0.345. Conclusions: Therefore, if we continue to study the factors affecting the dental hygiene problems and the plan, we can reduce the burden of the dental hygienists applying the dental hygiene process in the dental clinic. And, it is expected that the oral health care program using the dental hygiene process will spread to the dental clinic as an excellent oral preventive program.
The purpose of this study was to investigate the level of cultural competence and its influencing factors among 530 dental hygiene students. The analysis was performed using PASW Statistics ver. 18.0, and the following conclusions were drawn. Cultural knowledge levels showed a significant difference according to general characteristics in four components of cultural competence levels. Cultural competence and its four components were higher in subjects who have a religion (p<0.05). The differences in cultural competence levels according to culture-related characteristics are as follows. In individuals with experience of taking foreign culture-related classes, intention to work overseas, or fluency in a foreign language, cultural competence levels and its four components such as cultural comfort, knowledge, awareness, and behavior intent were higher (p<0.05). Intention of overseas employment was the factor most strongly influencing the level of cultural competence of the subjects. The more intention the subjects have to work overseas, the more they have experienced foreign culture-related lessons, the more fluently they speak a foreign language, and the higher level of cultural competency they reached (p<0.05). As the research results show, it is necessary to establish a continuing plan to understand and communicate with individuals of other cultures through foreign language and foreign culture classes in schools in order to improve the level of cultural competence. This education would reduce the fear and stress that subjects might make a mistake in meeting with people from other cultures, and it could be a preparatory process to actively carry out dental hygiene practice with foreigners.
This study was to develop an instrument for multidimensional measurement of Korean scaling fear (KSF)-1.0 and analyze related factors. A sample of 720 subjects(scaling patients and community people) was studied in Daegu city from November in 2008 to March in 2009. Authors first conceptualized the KSF, item generation, item reduction, and questionnaire formatting were performed in the stage of the development. Item descriptive, missing%, item internal consistency, and item discriminant validity were analyzed in the item-level, also descriptive, floor and ceiling effect were analyzed in the scale-level. Cronbach's alpha, test-retest, inter-dimension correlations, and factor analysis were performed to evaluate the validity and reliability in the new instrument. Confirmative factor analysis was did to evaluate the fit of model. The results for item-level and scale-level were acceptable except item discriminant validity. The reliability for 0.92~0.96 of corelation coefficient range(Cronbach's alpha 0.96~0.98) was high in the test-retest, and there was no significant difference in paired t-test. Item internal consistency(range of pearson corelation coefficient 0.39~0.95) was also high. The result of explanatory factor analysis was the same as the intended dimension structure, also confirmatory factor analysis results revealed that the dimensional structure model were fined well in the evaluation of model fit($x^2$= 1245.66, df=146, p=0.0000; GFI=0.85; AGFI=0.80; RMSEA=0.10). Factors related to KSF by multiple regression were gender($\beta$=0.28, p=0.0004) and teeth brush method($\beta$=-0.15, p=0.0053) in scaling patients, also gender($\beta$=0.25, p=0.0002), educational level($\beta$=0.14, p=0.0155), teeth brush method($\beta$=-0.09, p=0.0229) and time of daily work out($\beta$=-0.10, p=0.0055) were significantly associated with KSF in no scaling group. In conclusion, The results of this study reveal that the new developed measurement scale was reliable and val id instrument for measuring the KSF in dental hygiene patients and community people. We recommend that further research should develop more the instrument for the Korean scaling fear.
Technological advances in contemporary medicine has discovered the causes of countless diseases and recorded a noticeable medical performance. As technology develops, the role of hospitals is expanding to include disease prevention of inpatients, on top of their fundamental role of treating diseases. Recently, hospitals are becoming more influential as they create environments to provide comfort and stability to patients. In this regard, contemporary hospitals are increasingly shifting their focus to create a patient-centric environment as well as develop into humanistic establishments. The same goes to dentists, as well. Since inpatients often have fear and frustration over treatment, hospitals should figure out the environmental factors that are more effective and relaxing for patients and design medical services to provide them. The patients' movement and spaces during their treatment were categorized by stages and collected for gazing information using eye tracking. It analyzed users' gaze information according to Heatmap analysis of distribution and frequency and was determined the presence or absence of stimuli on the components of space. This research is an advanced research to study and enhance treatment environment based on the analysis of patients' gazes. It attempted to create an opportunity to get closer to patient-centric environment by understanding the stimulants and obstacles and controlling the background settings.
Objectives : The purpose of this study was to examine factors related to the satisfaction level of patients with dental services. Methods : The subjects in this study were 200 patients at three different dental clinics in South Gyeongsang Province, on whom a survey was conducted from June 1 to July 31, 2009. The collected data were analyzed, and the findings of the study were as follows. Results : In regard to the general characteristics of the patients investigated, the women(61.5%) out-numbered the men. By age, those who were at the age of 30 and down made up the largest age group(47.0%). By academic background, the greatest group received junior-college education(54.0%). By occupation, the company employees constituted the largest group (50.5%). By income, the greatest group earned an income of 2 to 2.99 million won(75.0%). Second, as to connections between the characteristics of dental treatment and the reason of choosing the dental clinics, the largest group(70.4%) chose the dental clinics by word of mouth or the recommendation of others. Concerning the reason of dissatisfaction, the biggest group(72.7%) was unsatisfied with medical costs. As for the degree of explicit complaint, the greatest group(49.7%) sort of complained about what made them dissatisfied. Regarding the type of treatment, the biggest group(49.0%) received prosthodontic treatment. In relation to fear for dental treatment, the largest group(34.0%) feared receiving the treatment, and the biggest group(42.6%) did that due to the sound of machines. Third, satisfaction with services(0.762) had the closest correlation to overall satisfaction level, followed by satisfaction with employees(0.735), satisfaction with dentists(0.644) and satisfaction with convenient facilities (0.579). Fourth, the factors that affected overall satisfaction level were gender, the reason of choosing the dental clinic, satisfaction with dentists, satisfaction with employees, satisfaction with services and satisfaction with convenient facilities. The patients who were better satisfied with services(p<0.001), who were more contented with dentists(p<0.001), who chose the dental clinics by the recommendation of others(p<0.01), who were male(p<0.05), who were more gratified with employees(p<0.05) and who were more contented with convenient facilities expressed better overall satisfaction. Conclusions : The above-mentioned findings suggested that dental institutions should keep track of the expectations of patients to prepare differentiated strategies for marketing and human-resources development in consideration of their own circumstances to boost the satisfaction level of patients. Specifically, it's required to heighten the satisfaction level of patients with dentists.
Backgrounds: Pain management is one of the most important factors affecting the success of pediatric dentistry. Therefore, new needle- and pain-free local anesthesia techniques have been developed in parallel with technological advancements. The purpose of this study is to compare the pain perception and dental anxiety levels associated with a needle-free injection system (Comfort-inTM) and the classic needle method during treatment-required infiltration anesthesia in children. Methods: This randomized controlled crossover split-mouth clinical study included 94 children who required dental treatment with local anesthesia using a dental needle or needle-free injection system for the bilateral primary molars. The Wong-Baker Scale (WBS) was used to measure pain perception at different times, and the Modified Child Dental Anxiety Scale (MCDAS) was used to measure the anxiety level of the child. A statistical software package was used to process the data. Statistical significance was set at P < 0.05. Results: There was no significant difference between the needle-free injection system and dental needle method during the induction stage for filling and pulpotomy (P > 0.05). "Pain on postoperative 1st day" was similar in both types of anesthesia (P = 0.750). Conclusions: The needle-free injection system was as effective as the dental needle method. The Comfort-inTM system was an acceptable alternative for patients during the postoperative period. Understanding how pain management may be provided during local anesthesia administration and a child's fear and anxiety regarding the dentist may lead to better dental compliance.
This study reached the following conclusions as a result of carrying out the questionnaire survey of self-descriptions for the satisfaction after the citizens of Daejon uses the dental clinics, in order to identify the factors of satisfaction to the medical services of such dental clinics to be utilized in the patient management by dental hygienists, provide the basic data to provide the medical services desired by patients. 1. 43.9% men responded to the facilities and 56.1% women to the atmosphere for the standards of selection of dental clinics by general characteristic, and the college graduates or more to the kindness (38.2%), high-school graduates (43.2%) and middle-school graduates (25.9%) or less to the close distance for the level of educational attainment (p=0.009), which was meant to have a statistical significance. 2. The execution of reservation system for the dental clinics showed 54.7%, the reserved time was observed upon the execution of such reservation system, the dental clinics where they practice such system were 40.6%, and the confirmation methods was done through the telephone with 62.5%. 3. The experience of fear upon the dental treatment showed 74.6%. The type of fear showed the machine sound (48.7%) for men and cry of others for women (70.8%) at the highest. 70% of those under 30 at the age responded to the sharp instruments at the highest. 83.3% of Yousung-gu showed the highest by responding to the cry of others for the residential areas. The statistically significant difference was shown in both the age and residential area (p=0.000). 4. Women showed higher in the distribution of gender for the sterilization of instruments for the external satisfaction of dental clinics(p=0.000) and those under 30 at the age showed the highest with 2.98${\pm}$0.95(p=0.001). Seo-gu (3.48${\pm}$0.77) was the highest for the residential area (p=0.000), and there was statistically significant differences in the gender, age and residential area. 5. Men showed higher satisfaction than women in the clean state and the statistically significant differences were shown (p=0.000) at the age as the high satisfaction was shown for those under 30 at the age (2.35${\pm}$0.79), those having the income not less than 10 million won and not more than 20 million won (2.43${\pm}$0.78), and Seo-gu (2.63 ${\pm}$0.69) for the residential area. 6. For the internal satisfaction of dental clinic by users for the medical services in the dental clinics, 61.1% women responded to no in the ability of solving the inconvenience in the service process, and showed low ability of solving the inconvenience from 30 at the age (26.2%) and by responding to Dong-gu (22.1%) for the residential area, showing statically significant differences(p=0.000). For the re-use of dental clinics, 46.6% men (p=0.043) for the gender, 24.3% under 30 at the age and 22.9% of Dong-gu for the residential area responded to the re-use, showing statistically significant differences for the gender and residential area (p=0.000). 7. The dissatisfaction showed a high rate of 69.5% for the satisfaction to the medical services of dental clinics. 46.2% men responded to the pain and women to the feeling of foreign substance for the reason of dissatisfaction while those under 30 at the age showed 55.6% for others, those between 50 and 59 41.7% for the feeling of foreign substance. 86.3% carried out the education for cautions after the treatments and most people turned out that they do not carry out the continuous health management of mouth as 20.5% responded to that they carry out such health management.
The purpose of this study was to examine the awareness of dental hygienists on ethical dilemma. The subjects in this study were 356 dental hygienists who worked in dental clinics. After a survey was conducted, the collected data were analyzed with a SPSSWIN 14.0 program. The findings of the study were as follows: 1. In relation to awareness of ethical principles, 64.9 percent knew the fact that there were ethical principles to abide by, though they weren't aware of the principles in detail. When they were in ethical dilemma, most of them consulted with their colleagues(84.0%). 2. As to the necessity of ethical education, 86.8 percent felt the need for that. Concerning intention of receiving ethical education, however, as many as 41.6 percent didn't yet have any particular intention about that, and 50.0 percent intended to receive that education. 3. As for influential factors for ethical decision making, hospital policies and decision-making process were most influential(3.50), and fear for a possible loss of job exerted the smallest influence on that(2.49). 4. Regarding the cause of ethical dilemma, they fell into an ethical dilemma the most due to their own professional duties(2.56), followed by patients(2.33) and cooperators(2.28). Their overall dilemma score was 2.39.
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