• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.3
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• pp.219-226
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• 2021

Background: Patients with disabilities often require general anesthesia for dental treatment because of their cooperative or physical problems. Since most patients with disabilities take central nervous system drugs, the management of recovery status is important because of drug interactions with anesthetics. Methods: The anesthesia records of patients under general anesthesia for dental treatment were reviewed, and data were collected. Healthy patients under general anesthesia for dental phobia or severe gagging reflex were designated as the control group. Patients with disabilities were divided into two groups: those not taking any medication and those taking antiepileptic medications. The awakening time was evaluated in 354 patients who underwent dental treatment under general anesthesia (92 healthy patients, 183 patients with disabilities, and 79 patients with disabilities taking an antiepileptic drug). Based on the data recorded in anesthesia records, the awakening time was calculated, and statistical processes were used to determine the factors affecting awakening time. Results: Significant differences in awakening time were found among the three groups. The awakening time from anesthesia in patients with disabilities (13.09 ± 5.83 min) (P < 0.0001) and patients taking antiepileptic drugs (18.18 ± 7.81 min) (P < 0.0001) were significantly longer than in healthy patients (10.29 ± 4.87 min). Conclusion: The awakening time from general anesthesia is affected by the disability status and use of antiepileptic drugs.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.1
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• pp.1-5
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• 2017

According to the Ministry of Health and Welfare, the portion of physical disability was 51.4% which was the highest among the registered disabled in December 2015, followed by visual disability(10.1%), disability of the brain lesions(10.0%), hearing disability(10.0%). The aim of this study is to investigate the types of disability in patients with disabilities visiting the Pediatric Dentistry, Chonbuk National University Dental Hospital in 2016. Of the patients who visited the pediatric dentistry, 196 patients (7.5%) had disabilities, and 19 patients had two or more disabilities. Twelve patients (6.1%) had both disabilities of brain lesion and intellectual disorder. Of the 177 patients with only one disability, 54 patients (30.5%) had physical disorders and 123 patients (69.4%) had psychiatric disorders. In psychiatric disorders, intellectual disorder was the most with 98 patients (55.3%), followed by autistic disorder with 23 patients (12.9%). In physical disorders, disability of brain lesion was the most with 37 patients (20.9%), followed by speech disability with 8 patients (4.5%). In this study, as a result of analyzing the types of disability with the patients who visited the Pediatric Dentistry of Chonbuk National University Dental Hospital, most of them had either intellectual disorder, disability of brain lesion, or autistic disorder. Dentists need to understand their general and dental characteristics to treat children and adolescents with disabilities. Since the most chief complaint of the patients was dental caries, early interventions should be made by dentist to reduce the incidence of the disease.

• The Journal of Korean Physical Therapy
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• v.32 no.5
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• pp.312-318
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• 2020

Purpose: This study aimed to investigate the evidence that therapeutic horseback riding can improve balance, muscle, ADL, equivalenc, GMFM, gait, emotion with developmental disabilities and neural patients. Methods: To conduct meta-analysis, the search focused on studies that employed therapeutic horseback riding for developmental disabilities and neural patients for which eight databases (KIS, RISS, DBpia, National Assembly Library, Pubmed, Embase, Google scholar and Cochrane Library) were used to extract literature published from 2002 to September 2019. The data were analyzed the RevMan 3.5.3 program. Results: As a result of meta-analysis, therapeutic horseback riding total effect size is 0.552 for children with developmental disabilities and neural patients. And effect size result of according to assessment type variable first, balance effect size is 0.594. Second, muscle activities effect size is 0.425. Third, ADL effect size is 0.430. Fourth, equivalance effect size is 0.640. Fifth, GMFM effect size is 0.482. Sixth, gait effect size is 0.400 and seventh emotion effect size is 0.876. Conclusion: These findings is horseback riding is effective The effect size by outcome was observed to be the effective for children with developmental disabilities and neural patients. and also the horseback riding provided the positive effects of balance, muscle activities, ADL, equivalance, GMFM, gait, emotion for children with developmental disabilities and neural patients. It is hoped that this study will contribute to the development of effective treatments for children with developmental disabilities and neural patients therapeutic horseback riding and the development of study.

• Journal of The Korean Dental Society of Anesthesiology
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• v.6 no.2 s.11
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• pp.82-88
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• 2006

Background: The number of patients with disabilities who require general anesthesia for dental treatment is increasing. Methods: We reviewed the cases of 538 patients with disabilities who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul national university dental hospital according to the types of disabilities and comprehensive treatments. Results: The patients mean age was 17.4 years and fifty-eight percent of the patients had epilepsy, autism, mental retardation and cerebral palsy. About twenty-five percent of the patients were medically compromised such as brain disease, heart disease and genetic problem. In 142 cases, more than two dentists from the clinical departments systemically co-worked to provide the patients with comprehensive treatment as accurately and quickly as possible under general anesthesia. Conclusions: The number of medically compromised patients was high and the system of comprehensive dental treatment was well run.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.3
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• pp.183-191
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• 2012

In most persons with disabilities had poor oral hygiene because of less attention and ability to perform a dental care. So the increased prevalence and severity of dental disease were common oral state. Although most persons with disabilities need a adequate dental treatment, it is often very difficult to treat because of noncooperativity and involuntary muscle movements. Dental treatments under sedation and general anesthesia were make to provide a high-quality dental service because of decreased anxiety and fear associated dental treatment in persons with disabilities. The dental professionals must be able to select and apply the proper sedation methods in agreement with the characteristics of the disabilities, general conditions, sedation experience and capacity of dentist, type and time of dental treatment, equipments of dental clinic, consent of patient's protector. The proshodontic treatment procedures, such as abutment preparation, dental impression taking process, try-in process of prosthesis and adjustment of occlusion, are difficult even for patients without disabilities. Those procedures are more difficult to patients with disability because it's too hard to control breathing and muscle. In this report, we performed prosthetic dentistry procedures to three patients with disabilities under dental sedation and general anesthesia.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.2
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• pp.61-67
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• 2014

The aim of this study was to analyze the clinical characteristics of patients with cognitive and behavioral impairments receiving dental treatment under general anesthesia (GA-dental treatment). From August 2007 to April 2014, information was collected from 475 patients who received GA-dental treatment at the Clinic for Persons with Disabilities, Seoul National University Dental Hospital. The demographic factors (gender, age, disability, medication, GA history, residency type, caregiver, meal type, oral hygiene maintenance, and cooperation level) and dental status (operating duration, DMFT, malocclusion, periodontal disease, tooth defect, and treatment protocol) of the patients were evaluated. DMFT and malocclusion levels were compared among the patients with ANOVA and Sheffe's post-hoc test, and chi-square test, respectively. The correlation between the demographic characteristics and dental status of the patients were analyzed with the Pearson's correction test. The mean age of the patients was 27.1 (7 - 83) years and they had intellectual disabilities (55.4%), developmental disorders (17.9%), brain disorders (16.6%), neurocognitive disorders (4.6%), or others (5.5%). The mean DMFT (DT) was 8.6 (5.2) with a significant difference among the disability types (p<0.05). The incidence of malocclusion was higher in patients with intellectual disabilities and brain disorders than in the other types (p<0.05). The operation time ($191.4{\pm}91.2min$) was correlated with decayed or endodontically-treated teeth (p<0.05). Special needs patients requiring GA-dental treatment showed unfavorable oral conditions. Dental practitioners experience time restrictions and additional costs under a GA setting. Treatment planning and decision-making can be efficiently facilitated by evaluating the clinical characteristics of the patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.87-98
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• 2021

Patients with disabilities have difficulties tolerating in-office dental treatment due to limitations relating to cooperation and/or physical problems. Therefore, they often require general anesthesia or sedation to facilitate safe treatment. When deciding on dental treatment under general anesthesia, the plan should be carefully determined because compared to general patients, patients with disabilities are more likely to experience anesthetic complications because of their underlying medical conditions and potential drug interactions. Clinicians prefer simpler and more aggressive dental treatment procedures, such as extraction, since patients with impairment have difficulty maintaining oral hygiene, resulting in a high incidence of recurrent caries or restorative failures. This study aimed to review the available literature and discuss what dentists and anesthesiologists should consider when providing dental treatment to patients with severe disability under general anesthesia.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.1-6
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• 2019

There are increasing number of patients having dental treatment under outpatient general anesthesia. There were researches that studied patients treated under outpatient general anesthesia in Chonbuk National University Dental hospital between 2005~2013. However, there has been an absence of research since 2013. Therefore, the aim of this research is to study cases regarding outpatient general anesthesia visiting Chonbuk National University hospital between 2014~2017 and analyze the trends of these patients. The medical records of 409 cases from January, 2014 to December, 2017 were reviewed. From the patients' charts, data on sex, residence, visiting dates, disability status, and types and number of treatments was collected and investigated. The number of cases has increased from 86 in 2014 to 140 in 2017. Among 409 cases, 275 cases(67.2%) had disabilities, with mental disabilities consisting most of the disabilities. 192 cases were aged under 20 years old mostly with no disabilities, 142 cases were 20~39 years old mostly with mental disabilities, and 75 cases were 40 years old or more mostly with physical disabilities. The conservative treatment was performed most frequently in both disabled and non-disabled patient groups. There was an increasing trend in the number of patients treated under outpatient general anesthesia, and more than half were disabled patients. In order to meet this demand, Chonbuk National University Dental Hospital increased the number of general anesthesia pracrice. To follow this trends, the implementation of safe outpatient general anesthesia system and cooperation among teams is needed to improve the quality of treatments.

• Journal of The Korea Institute of Healthcare Architecture
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• v.25 no.3
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• pp.67-74
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• 2019

Purpose: In 2012, the Child Welfare Act was revised to provide better support to children with severe disabilities in Japan. Previously, inpatient facilities had been classified according to the type of disabilities of patients. After the revision of the Act, however, these facilities were assigned into the category of "medical-type facilities for children with disabilities", or "welfare-type facilities for children with disabilities." The focus of the study is to evaluate the reorganization of the Child Welfare Act and to analyze the new layout of Center K after its transition from a facility for children with motional disabilities to a medical-type facility for children with disabilities. Methods: A literature review was conducted to identify the trend in the treatment for persons with disabilities and the process of policy making in Japan. Field research was performed twice in 2015 and 2016, before and after the renovation of the Center K facilities depending upon the revision of the Child Welfare Act. Results: There is an increasing tendency of the population of persons with disabilities in Japan, and the severity level of disability of children with disabilities. In the case of Center K, two types of ward constructed to meet the two types of disability has been reconstructed into three types of unit following the various severity level of disability. Implications: As a result, it could be argued that it is also necessary in Korea to reorganize the facilities for persons with disabilities to deal with the fact that the population of persons with disabilities in Korea has been growing and their degree of disabilities also getting severe.

• Journal of Sasang Constitutional Medicine
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• v.17 no.1
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• pp.120-129
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• 2005

1. Objectives This study was conducted to establish a standard and classify suitability in the treatment of speech impediment and limb impediment among the children with development disabilities using Oriental Medicine treatment on the ground of Sasang Constitutional Medicine. 2. Methods 43 patients with pediatric development disabilities with speech impediment and 10 patients with pediatric development disabilities with limb impediment as the main symptoms had been chosen in this study. Oriental Medicine treatments on the ground of Sasang Constitutional Medicine were rendered and evaluated responses as well as pursuing most proper treatment methods. 3. Results & Conclusions 1) For pediatric development disabilities with speech impediment, Oriental Medicine treatment showed a significant effect on similarity of Autism and Cerebral Palsy, but insignificant effect on innate Autism. 2) For pediatric development disabilities with limb impediment, Bee venom was effective for severe limb impediment and limb asthenia, while as eight principles herbal acupuncture effective for mild limb impediment and spasticity. 3) Sasang Constitutional Medicine for treating speech impediment and limb impediment among the children with development disabilities showed general improvement as a fundamental healing through coordinating inner organ activities.