• Journal of Korean society of Dental Hygiene
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• v.12 no.4
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• pp.665-674
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• 2012

Objectives : This study purposed to identify factors related to dental service quality perceived by dental clinic patients, and for this purpose. Methods : The data conducted a questionnaire survey of 362 patients who had visited a dental clinic in Daejeon twice or more in August 2010 and aged over 20 during the period from the 1st to 31st of August 2010 and obtained results as follows. Results : The patients' general characteristics, perceived dental service quality was higher in older ones, married ones, high school or lower school graduates, civil servants, self-employed ones, and housewives, and the differences were statistically significant. according to the patients' dental clinic use characteristics, perceived dental service quality was higher when the stay in dental clinic was short, and the difference was statistically significant. Conclusions : Perceived dental service quality was related to the patients' general characteristics and dental clinic use characteristics. therefore, dentists and dental hygienists should make efforts to be more patient-oriented and to create pleasant dental care environment.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.21-27
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• 2019

Background: Emergencies in dentistry can be classified as medical and dental. Medical emergencies occur mainly during dental treatment in patients with a systemic disease. Dental emergency departments are largely divided into dental emergency rooms located in dental college hospitals and medical emergency rooms located in medical institutions. This study aimed to analyze the characteristics of and provide help to dental emergency patients in a dental hospital. Methods: Overall, 1806 patients admitted to a dental emergency room at Yonsei University Dental Hospital for 1 year were included. The data collection period was from October 1, 2014 to September 30, 2015. An investigator reviewed medical records from the electronic medical record (EMR) system and radiographs. Results: The patients were 1,070 men and 736 women. The sex ratio was 1.45:1. The commonest age group was of 0-9 years, including 451 (25.0%) patients, followed by 20-29 years, including 353 (19.5%) patients, and 30-39 years, including 277 (15.3%) patients. Of the 108 patients transferred to the Severance emergency department, 81 had trauma, 19 were in pain, 4 were bleeding, and 4 had other complaints. Among chief complaints, 1,079 patients (60.3%) had trauma, 564 (31.5%) had pain, and 75 (4.2%) had bleeding. Twenty-three cases (1.3%) were caused by temporomandibular disorder (TMD). Conclusion: Dentists should be able to adequately assess patients in a dental emergency room and treat trauma, pain, and bleeding.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.99-111
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• 2021

Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. It has a worldwide pooled prevalence of 5.29%. The characteristics of ADHD can increase the probability of dental treatment, while special behavior management can be required to allow proper treatment. In South Korea, the use of sedation in dental treatment has rapidly increased in recent decades. The present study aimed to investigate the trend and effects of sedation in patients with ADHD undergoing dental treatment in South Korea. Methods: The study used customized health information data provided by the Korean National Health Insurance Service. Among patients with the record of sedative use during the period from January 2007 to September 2019, those with International Classification of Diseases-10 codes for ADHD (F90, F91) were selected; the data of their overall insurance claims for dental treatment were then analyzed. The patients' age, gender, sedative use, and dental treatment were analyzed per year. The annual number of general anesthesia or sedation cases was also analyzed, and changes in the method of behavior management with increasing age were examined. Results: The study involved 7,654 patients with ADHD (6,270 males; 1,384 females). The total number of dental treatments was 137,778, while the number of sedation cases was 16,109, among which 13,052 involved male patients and 3,057 female patients. The number of general anesthesia cases was 631, among which 538 involved male patients and 93 female patients. The most frequently used sedation method in the dental treatment of patients with ADHD was N2O inhalation. The percentage of sedation cases was highest in patients aged 4 years, and it decreased with increasing age. Conclusion: In South Korea, both sedation and dental treatments were slightly more common in patients with ADHD than in the general population. With increasing age, the frequency of dental treatments and the percentage of sedation cases decreased.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.2
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• pp.125-132
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• 2011

Background: Adult patients with intellectual disabilities often strongly resist the anesthetic administration for dental procedures. This study aimed to evaluate the effect of midazolam premedication in improving the cooperation level of patients who are likely to be combative and irritated during general anesthesia (GA) induction. Methods: The patients who had received dental treatment under ambulatory GA for more than two times were included. And we selected 13 patients total that needed physical restraint or ketamine IM prior to induction at the first GA, and were prescribed midazolam tablet (7.5-15 mg) at the following GA. We reviewed pre-anesthetic records and anesthesia records, and evaluated cooperative levels of patients (4 levels scale) during anesthesia induction and recovery time retrospectively. Results: All 13 patients (Male 11, Female 2) had severe mental disabilities. The average age of the patients was 24 ${\pm}$ 7 (13-37) years and their average weight was 58 ${\pm}$ 16 (34-91) kg. At the first GA, 10 patients needed physical restraint prior to induction (level 3). And 3 patients were so poorly cooperative that the induction procedure was performed after intramuscular injection of ketamine (level 4). But after the midazolam intake, 7 patients were willing to receive the anesthetic induction (level 1, 2), and 6 patient needed physical restraint (P < 0.05). There were no statistical differences in the duration of general anesthesia and postoperative recovery. Conclusions: Oral intake of midazolam was effective in improvement of cooperation without any complications.

• 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.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.91-103
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• 2017

General anesthesia is commonly used to facilitate dental treatment in patients with anxiety or challenging behavior, many of whom are children or patients with special needs. When performing procedures under general anesthesia, dental surgeons must perform a thorough pre-operative assessment, as well as ensure that the patients are aware of the potential risks and that informed consent has been obtained. Such precautions ensure optimal patient management and reduce the frequency of morbidities associated with this form of sedation. Most guidelines address the management of pediatric patients under general anesthesia. However, little has been published regarding this method in patients with special needs. This article constitutes a review of the current literature regarding management of patients with special needs under general anesthesia.

• Journal of Oral Medicine and Pain
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• v.5 no.1
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• pp.11-16
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• 1980

It is generally accepted that dental procedures can be the causes of dental anxiety, and dental anxiety is described as a significant influence on physical reactions, which may complacate the dental treatment, and there has been much emphasis in the control of it. So it is very useful for dentists to know the degree of anxiety of their patients for the treatment planning and prevention of unexpected emergent state which may be caused by severe anxiety. For the study of the degree of the dental anxiety, 1,041 patients of the Dept. of Oral Diagnosis of S.N.U. hospital and some private clinics were evaluated for dental anxiety by means of dental anxiety scale questionaire. The results were as follows : 1. The mean value of 517 male patients and 524 female patients were are $9.31\pm2.76 and 12.01\pm2.78$ in respective. 2. There was no significant alteration by age and educational backgrounds. 3. Four male patients and nineteen female patients achieved scores ranging from 17 to 20 which have been known to dental phobics.

• 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 Dental Anesthesia and Pain Medicine
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• v.18 no.4
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• pp.245-254
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• 2018

Background: When performing dental treatment under general anesthesia in adult patients who have difficulty cooperating due to intellectual disabilities, anesthesia induction may be difficult as well. In particular, patients who refuse to come into the dental office or sit in the dental chair may have to be forced to do so. However, for adult patients with a large physique, physical restraint may be difficult, while oral sedatives as premedication may be helpful. Here, a retrospective analysis was performed to investigate the effect of oral sedatives. Methods: A hospital-based medical information database was searched for patients who were prescribed oral midazolam or triazolam between January 2009 and December 2017. Pre-anesthesia evaluation, anesthesia, and anesthesia recovery records of all patients were analyzed, and information on disability type, reason for prescribing oral sedatives, prescribed medication and dose, cooperation level during anesthesia induction, anesthesia duration, length of recovery room stay, and complications was retrieved. Results: A total of 97 patients were identified, of whom 50 and 47 received midazolam and triazolam, respectively. The major types of disability were intellectual disabilities, autism, Down syndrome, blindness, cerebral palsy, and epilepsy. Analyses of changes in cooperation levels after drug administration showed that anesthesia induction without physical restraint was possible in 56.0% of patients in the midazolam group and in 46.8% of patients in the triazolam group (P = 0.312). Conclusions: With administration of oral midazolam or triazolam, general anesthesia induction without any physical restraint was possible in approximately 50% of patients, with no difference between the drugs.

• The Journal of the Korean dental association
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• v.57 no.7
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• pp.372-378
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• 2019

The dental implants in modern dentistry brought out a new era in everyday dental practice. Increasing of dental implants usage, various failures and complications has occurred. Failures and complications of dental implant treatments that can happen in implant surgery, in mechanical or prosthetic problem and in biological aspect. The aim of this study was to assess implant failures for 6 years as well as find out how to overcome implant failure. In Jeju National University hospital, 26 dental implants in 17 patients were removed by implant failure through 2013.1.1.-2018.12.31. Each implant failure case was analyzed in report form with various informations about failure retrospectively. The present study showed 26 failed dental implants of 17 patients were removed. 13 implants(50%) of 8 patients(47.06%) were failed before functional loading and 13 implants(50%) of 9 patients(52.94%) were failed after functional loading. 11 implants(42.31%) of 7 patients(41.18%) with medical disease were extracted. 6 implants(23.08%) of 5 patients(29.41%) with additive bone graft were failed. We discuss with 26 failed dental implants of 17 patients about their causes, solutions and prevention retrospectively for 6 past years. Precise diagnosis and treatment planning are needed. Medically compromised patients and patients with implants and additive bone grafts should be cautiously treated with high failing possibilities.