• Journal of Dental Anesthesia and Pain Medicine
• /
• v.21 no.2
• /
• pp.87-98
• /
• 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
• /
• v.15 no.1
• /
• pp.74-78
• /
• 2019

Atypical teratoid rhabdoidal tumor(AT/RT) is a rare and fast-growing tumor usually diagnosed in childhood. Routine magnetic resonance imaging(MRI) assessment of AT/RT patients is done to detect metastatic tumors and recurrent lesions. The purpose of this case report is to present a case about caries treatment of a 3-year-8-month old female patient with AT/RT under general anesthesia. A 3-year-8-month old patient with AT/RT visited Seoul National University Dental Hospital for caries treatment. At the first dental visit, she was receiving chemotherapy. Multiple caries were observed from clinical and radiographic examination. The dental procedure was successfully performed under general anesthesia. Patients with brain tumor may take routine MRI to detect metastatic tumors and recurrent lesions. Dentists should take into consideration of possible dislodgement of restoration by ferromagnetic properties and artifact formation on MRI image. Ready-made zirconia crowns can be a good restoration option for such patients.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.12 no.1
• /
• pp.6-10
• /
• 2016

Esophageal atresia is the abnormal development of the esophagus that connects the mouth to the stomach. This birth defect results in the incomplete connection of the esophagus to the stomach causing an inability to swallow properly and breathing difficulties. Surgery is the only treatment for esophageal atresia. Patients undergone an esophageal reconstruction usually suffer from gastroesophageal reflex. A 5-year old boy with congenital esophageal atresia and Sciwitar syndrome visited Seoul National University Dental Hospital because generalized excessive loss of tooth structure. The patient had history of multiple operations for reconstruct esophagus. He had little food intake experience thought oral and had difficulty to swallowing. The patient was generalized severe erosive and decayed state. For patient, the dental procedure under general anesthesia was scheduled due to the multiple caries with erosion and poor cooperation. Under general anesthesia, pulpectomy and restoration as well as extraction was performed. Gastroesophageal reflex is potentially serious condition, with various extraesophageal adverse effects such as dental erosion. To prevent progression of dental caries, dietary counselling and oral hygiene instruction should be reinforced. Also, restorations to erosive teeth will maintain esthetics and function and preserve pulp vitality.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.43 no.4
• /
• pp.354-364
• /
• 2016

To evaluate the oral health status and to assess the resultant dental treatment needs in adolescents, 2,062 adolescents aged 14-17 years attending middle and high schools in Yangsan were surveyed by clinical examination and questionnaires. The obtained results were as follows. In the dental caries examination based on WHO criteria, the treatment needs of 66.7% of the subjects were determined. Assessment of dental erosion by the VEDE system indicated the treatment needs in 27.8% of the subjects, while MIH examination based on EAPD criteria indicated the treatment needs in 14.7%. Assessment of malocclusion using the occlusal index showed good occlusion in 67.8%, no need for treatment in 19.7%, slight need for treatment in 6.8%, definite need for treatment in 4.5%, and worst occlusion in 1.1% of the subjects, showing 12.5% of average treatment need. The prevalence and treatment need for periodontal disease was found to be 71.2% by CPITN assessments. The assessment of temporomandibular disorders by Helkimo's anamnestic index showed no symptoms in 67.1%, mild symptoms in 13.4%, and severe symptoms in 19.5% of the examinees. The overall treatment need of TMD was 20.6%. Periodontal diseases were ranked the highest in treatment need, followed by dental caries, dental erosion, MIH, TMD, and malocclusion in order. The results of this study indicated the overall status of adolescents'oral health and dental treatment needs. These might hopefully provide fundamental data and contribute to establishing promotional projects for adolescent oral health in Korea.

• Journal of dental hygiene science
• /
• v.2 no.1
• /
• pp.21-24
• /
• 2002

It is important to practice preventive method to control oral disease. Dental caries tendency has been decreased in developed countries, but early childhood caries(ECC, BBTD) became serious dental problems in many countries. To slove these problems, more positive and definite prenatal programs on infants and child are needed. Mostly the control of oral health was affected by a mother's knowledge and behavior in this stage. According to many studies, prenatal education is the most effective method to promote oral health in children. But in Korea, there is little oral health education programs for pregnant women, nursing mothers, infants and children. The purpose of this study was to access the knowledge and opinions of caries prevention among gravid women. 330 pregnant women(primiparae=181, multiparae=149), aged 23 to 39 years were randomly selected at prenatal health education courses in Seoul, Korea, 2000. Face-to-Face interviews were conducted by a trained interviewer using questionnaires included demographics, attitude toward children's dental cares, knowledge of early childhood caries, knowledge concerning pregnancy and oral health. The obtained results were as follows; (1) Most respondents were very concerned about their children's oral health. (2) 58% of the respondents were unaware of early childhood caries and the proportion was significantly higher among primipara (p<0.05). (3) Only 43% of the respondents believed that improper breast feeding could develop ECC, the proportion was significantly higher among primipara(p<0.05). (4) 82% of the respondents reportedly believed that the fetus takes away calcium from the mother's teeth during pregnancy. (5) 71% of the respondents believed that dental treatment during pregnancy was unsafe. There is a relatively low level of accurate knowledge regarding infant nutritions, maternal need for oral health and dental caries prevention among pregnant women. Oral health education and promotion programs that are science-based are needed for gravid women.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.2
• /
• pp.212-222
• /
• 2004

The application of acidulated phosphate fluoride gel(APF) and fluoride varnishes are the most common topical fluoride therapy. The purpose of this in vitro study was to compare the remineralization effects of two topical fluoride agents, APF gel and fluoride varnish with microtomograph and 3D image analyzer without sample preparation and chemical fixation. For the purpose of the study, the artificial caries lesion was caused on the caries-free permanent pre molar and 48 specimens were divided into three groups each containing 16 specimens No application was performed on group 1, which acted as control group. Group 2 was treated with APF gel and was removed after a minute. Group 3 was treated with the topical application of fluoride varnish and removed after 45 minutes. Each specimen was placed into a closed container with 50ml of a artificial saliva during three months and the 3D images of the remineralization area were taken using the SkyScan each month. Using the density-measuring program in V $works^{TM}$, the density value of the remineralization area was measured. The following results were obtained: 1. All groups demonstrated an increase in the density of artificial caries lesion with time. 2. The density was significantly higher in APF gel and fluoride varnish group than control group at 1 month, 2 months, 3 months after the treatment(P<0.05). 3. The difference of the density between that "prior to treatment" and that "1 month after treatment" in Group 2 and Group 3 was significantly higher than that of Group 1 and, the difference of the density between that "1 month after treatmen" and that "2 month after treatment" in Group 3 was significantly higher than that of Group 1 and 2(P<0.05). 4. The fluoride varnish was more effective after 2 and 3 months and continuous than the APF gel.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.13 no.2
• /
• pp.99-103
• /
• 2017

The primary responsibility for the oral hygiene of the disabled is usually the parents. Dental care of the disabled is early detection and recovery of lesions and continuous management. For this to be successful it is necessary to use diagnostic tool that can detect the early stages of dental caries which is difficult to detect with the naked eye. It is also important to educate and motivate the caregivers on oral hygiene management. Quantitative Light-induced Fluorescence-Digital (Billuminator, Inspektor Researh Systems BV, Amsterdam, The Netherlands), which provides overall caries inspection and visual information, can be useful for caregiver education. A 3-year-old girl who was hospitalized with Pallister-Killian syndrome, Hypothyroidism visited our clinic with chief complaint of rugged upper incisors. This girl had multiple dental caries and oral hygiene was very poor. Periodic QLF-D images were taken to provide caregiver education and oral hygiene management was improved. A 13-year-old girl with cerebral palsy visited our clinic for regular check up. Using QLF-D, we explained to the parents that there is a need for treatment of dental caries, and education of oral hygiene management was conducted. Improvement of oral hygiene in the disabled can be achieved through caregiver education. QLF-D is a diagnostic device that can detects early caries by irradiating light in the visible ray area to the teeth. It can also detects microleakage of restoration, plaque and calculus without disclosing agent. Clinicians can use the QLF-D to perform a general oral examination for the disabled. Also, QLF-D can be used to store visual information and educate caregivers. The accumulation of information using QLF-D makes it possible to provide feedback on oral care of parents, which is more advantageous for caregivers education.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.38 no.2
• /
• pp.137-145
• /
• 2011

The purpose of this study was to obtain the data for dental caries experience and occlusal pattern to utilize these data for motivating oral health promotion and activating oral health care programme in preschool children of multicultural family. Caries prevalence on primary teeth was surveyed for 3-5 years old 190 children of multicultural families in Chonbuk province. The results were as follows : 1. Dental caries prevalence rate of primary teeth (dmf rate) was 61.7% at 3 years of age, 88.7% at 4 years of age, and 92.6% at 5 years of age (p>0.05). 2. Average score of dmft index was 2.22 at 3 years of age, 4.97 at 4 years of age, and 6.62 at 5 years of age (p>0.05). 3. Most of the caries-prevailed tooth was maxillary primary central incisor and showed 28.8% at 3 years of age, 56.7% at 5 years of age. 4. dmft index and dmfs index of children of Vietnamese, Cambodian, and Filipinos women were higher than those of Chinese and Japanese. 5. In sagittal primary molar relationship, flush terminal plane type was 82.6%, distal step type was 5.2% and mesial step type was 8.4%. This study is the first report for children of multicultural families in Korea. More attention for children of multicultural families will be needed in aspect of oral disease prevention and treatment.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.37 no.4
• /
• pp.412-421
• /
• 2010

As a most conservative, minimally invasive trial against early caries lesions, resin infiltration concept has been introduced and studied mainly about effective materials and pre-treatment methods of surface layers to arrest the lesion effectively, which is still going on. This study was performed with an aim of evaluating the efficacy of arresting the caries process in the natural incipient lesions in spite of removing the surface layers and we obtained the results as follows: 1. It was revealed that infiltration groups(1, 3, 5) showed lower radio-density decline between pre- and posttreatment than control groups(2, 4, 6)(p<0.05). 2. Group 5, in which the surface layer was removed with hydrochloric acid, showed the most significant anticariogenic effect(p<0.05). 3. Under SEM evaluation after infiltration, group 1 and 3 showed more irregular destruction and intensive loss of surface layers than group 5. In conclusion, it was thought resin infiltration can be an effective tool against the early caries lesions although surface layers are removed.

• Journal of dental hygiene science
• /
• v.8 no.1
• /
• pp.1-6
• /
• 2008

The purpose of this study was to analyze the reasons and mean age for tooth extraction among patients living in Busan city. The researcher observed 1,119 patients' teeth extracted due to dental caries, periodontal disease and other reasons. This study examined the reasons for tooth extraction by age, sex, and tooth-kind. The reasons for tooth extraction were dental caries, periodontal disease, eruption problems and others. The obtained results were as follows; 1. Among the reasons for tooth extraction, dental caries accounted for 25.9%, periodontal disease 56.5%. 2. Periodontal disease was the main reason for tooth extraction and continued throughout life irrespective of sex. However dental caries was remarkably increasing in those aged 30 years old and under. 3. In the extraction of permanent teeth, males outnumbered females while upper teeth did lower teeth. 4. Although the third molars were most extracted in all kinds of teeth, the main reasons for the extraction were eruption problem. 5. The mean age of the tooth extracted was 47.9 years in both sexes for the mandibular first molars and the mandibular first molars had the shortest life except third molars of total teeth. The mandibular canines had the longest life of total teeth. Because dental caries and periodontal disease are the main causes of tooth extraction in Korea, the dental health policy should be focused on the prevention and treatment of these two diseases in the government level.