• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.14-22
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• 2019

The aim of this study was to determine the factors contributing to the barrier of dental treatment for special needs patients perceived by the main caregivers of the patients. A questionnaire was developed with three parts: patient-related factors, caregiver-related factors, and factors for treatment barriers. Patient- and caregiver-related factors were analyzed for correlations with the barrier factors. Fisher's exact test and Chi-square test were used at the level of 0.05. A total of 52 caregivers (mean age [SD]=50.2 [11.5] years) for the patients with intellectual and cognitive disabilities (mean age [SD]=38.9 [21.3]) responded to the questionnaires. Oral hygiene status, need for assistance in tooth brushing, and cooperation for tooth brushing were correlated with the level of treatment cooperation of the patients (p<0.05). The above three factors were also correlated with the treatment barrier despite patients presenting oral symptoms (p<0.05). Two thirds of the caregivers felt the treatment cost as severe or a considerable financial burden. For patients, insurance types and need for assistance in tooth brushing, and for caregivers, education levels and financial status were significant factors contributing to financial burden (p<0.05). There were background factors of the patients and their caregivers associated with access to dental treatment for special needs patients. Deficient cooperative skills and financial burdens were the main obstacles to treatment access. Tooth brushing skills and oral hygiene status can be proxy measures to cooperative ability for dental treatment.

• Asian Oncology Nursing
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• v.5 no.2
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• pp.107-115
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• 2005

Purpose: The present study was designed to identify cancer patients' needs when chemotherapy ends. Method: In-depth interview with focus questions was applied for the study. The participants were recruited from the patients receiving cancer chemotherapy in a university hospital. They were seven cancer patients with stomach cancer and two with liver cancer at the ending period of their chemotherapy protocol. Participants were interviewed on discharge date of last treatment and when they returned for the first outpatient follow-up. The focus question was 'what are your needs at this point?' The interviews were audio-taped and transcribed before analysis. The data were analyzed for common categories, special analytic categories, and conceptual categories. Results: Thirty two common categories, ten special analytic categories, and six conceptual categories were identified as patient's needs. The six conceptual categories were comfort needs, social needs, information needs, humanism needs, environmental needs, and self-efficacy needs. Conclusion: There were characteristic specific patients' needs when chemotherapy ends. There are needs to develop and to apply nursing intervention for cancer patients.

• 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.1
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• pp.71-80
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• 2021

Background: The options for stabilization appliance therapy for masticatory muscle pain include soft occlusal and hard stabilization appliances. A previous study suggested that hard stabilization appliance therapy was effective for patients with local myalgia who developed long facets on their occlusal appliances. The objective of this study was to identify patients in whom a soft occlusal appliance should be used to treat masticatory muscle pain by analyzing the type of muscle pain present and patient factors that influenced the effectiveness of this treatment. Methods: The study included 42 patients diagnosed with local myalgia or myofascial pain according to the Diagnostic Criteria for Temporomandibular Disorders Diagnostic Decision Tree. The analysis of patient factors included variables believed to be associated with temporomandibular disorders. First, a temporary screening appliance was used for 2 weeks to assess each patient for bruxism during sleep. Soft appliance therapy was then started. For each patient, the effectiveness of the appliance was evaluated according to the intensity of tenderness during muscle palpation and the treatment satisfaction score at one month after starting treatment. Results: Data from 37 of the 42 patients were available for analysis. Twenty-five patients reported satisfaction with the appliance. In logistic regression analysis, the odds ratio for reduction of facet length was 1.998. Nineteen patients showed at least a 30% improvement in the visual analog scale score. The odds ratio for local myalgia was 18.148. Conclusion: Soft appliance therapy may be used in patients with local myalgia. Moreover, patients who develop short facets on the appliance surface are likely to be satisfied with soft appliance therapy. Soft appliance therapy may be appropriate for patients with local myalgia who develop short facets on their occlusal appliance.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.50-54
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• 2016

Regular dental visit of disabled patients is an important strategy for maintenance of oral health because of the lack of awareness of oral care. But there is limited information about follow up period in disabled patients after dental treatment. The aim of this study was to investigate the pattern of dental visit and dental management of special care needs patients according to the types of disabilities. A total of 140 patients who received dental treatment at Seoul National University Dental Hospital from 2010 to 2012 were reviewed. Patients were divided 3 groups according to the types of disabilities (disorder of external physical function, disorder of internal organ, psychic disability). Patient's characteristic, dental treatment performed, follow up period and frequency were investigated. The mean follow up period was 28.2 months and average frequency of visit was 3.69 times per year. There was no difference in period and annual visit between 3 groups, but significantly difference in cooperation with medical hospital in affiliation. Regular check-up was the most common dental treatment in all groups. In psychic disorder group, the proportion of sedative treatment was significantly higher than other groups. The results of this study provide information necessary for treatment planning and dental management of disabled patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.6
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• pp.527-545
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• 2021

The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

• The Journal of the Korean dental association
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• v.49 no.12
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• pp.732-738
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• 2011

Special needs patient are one of the underserved dental patient groups in Korea. However, Lack of attitudes to oral care and the knowledge of health professionals are identified as barriers to oral health for people with disabilities. Health authorities have a key role in ensuring that the need for a comprehensive dental services is met. This review may help oral health professionals understand the dental considerations according types of disabilities and provide appropriate and necessary dental care for special needs patients.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.9 no.1
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• pp.1-10
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• 2013

This article discusses the provision of sedation for uncooperative special need dental patients. Most of dental treatments have been performed in these patients with the techniques of behavioral control. However, if this behavioral control fails during treatment, it is nearly impossible to treat them without either sedation or general anesthesia. Sedation is also beneficial for patients because it circumvent the aggravation of negative behaviors related to their stress during the treatment. Also, the morbidity and mortality related to dental sedation is relatively low. In this regard, the provision of sedation for people with special needs can be considered as a safe and necessary techniques for their treatment.

• Journal of Korean Public Health Nursing
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• v.13 no.1
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• pp.114-127
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• 1999

In order to care the persons who are dying a nurse should first solve her / his own conflicts about death. and be aware of their own concepts of death and dying. In order to find out patient's spiritual needs and to give better spiritual nursing care. a nurse should know her / his own spiritual needs and be aware of their own concepts of spiritual nursing problems. To improve nurse's understanding towards death and dying and nurse's knowledge towards spiritual needs and spiritual nursing care. 14 weeks(two hours a week) spiritual nursing care education was given to 3th grade baccalaureate nursing college student. Before and after spiritual nursing care education. 30 items of prepared questionare focused on the attitudes toward death and dying was asked. Pre and post results are as follow ; 1. The dying patient's emotional and physical needs. There was no significant difference between pre and post educated groups. Both of the situations. they agreed upon$(69.64\%)$ that the dying patients have high emotional and physical needs to solve. 2. Telling the truth of dying process. There was no significant difference between pre educated group$(53.33\%)$ and post educated group$(55.95\%)$. 3. Attitudes of medical personnels. There was no significant difference between pre$(51.49\%)$ and post educated groups $(53.87\%)$. These responses indicate that nursing college student didn't have enough experiences on dying patients care. 4. General attitudes on death and dying. Number of nursing students who were thinking positively toward death and dying were Increased (pre $39.68\%$. post $45.44\%$) and who were thinking negatively toward death and dying were also decreased (pre $37.30\%$. post $33.93\%$). 5. Attitudes toward mechanical assistance for life-expanding of helpless patient. There was a significant difference between pre and post educated groups. About $34.13\%$ of them approved upon mechanical assistance for life and about $33.14\%$ of them disapproved. 6. Attitudes of family members of dying patient. There was no significant difference between pre and post educated groups. About $45.24\%$ of both groups, agreed upon that the family members feel annoyed with dying patients and about $22.42\%$ of both groups disagreed. Whether they received the spiritual nursing education or not, they were aware of that the family members feel annoyed with dying patients. 7. Special facility and educational preparation for dying patient. There was a significant difference between pre$(82.14\%)$ and post$(90.87\%)$ educated groups. These responses indicated that after they received the education, they felt more about the necessity of special facility and educational preparation for the death and dying patients. 8. Special facility and welfare system for the old. There was a significant difference between pre$(58.33\%)$ and post$70.64\%$ educated groups. There responses indicated that after they received the education, they felt more about the necessity of special facility and welfare systems for the old.

• Journal of Korean Dental Science
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• v.16 no.1
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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.