• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.1
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• pp.9-16
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• 2020

The aim of this study is to investigate visual exploration of children and adolescents during dental treatment by examining time ratio of eye opening in various age groups. This study reviewed 5 - 15 year-old patients who visited the department of pediatric dentistry of Yonsei University Dental Hospital from March to October 2018. Restorative treatment or sealant application was done by one pediatric dentist. A trained observer used 2 stopwatches to measure total treatment time and time of open eye. Average ratios of eye opening were calculated and compared. 60 patients were investigated, with 15 patients in each age group. Average ratio of eye opening increased as age decreased (p < .001). The average of 13 - 15 year-olds was significantly shorter than that of children younger than 12 years (p < .005). This study indicated that children have higher rates of eye opening during dental treatment than adolescents.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.1
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• pp.85-92
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• 2000

Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment : do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications(syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after $1{\sim}2$ weeks. The final prognosis was comfortable without common complications.

• Journal of dental hygiene science
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• v.14 no.3
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• pp.417-423
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• 2014

The aim of this study was to evaluate the relationship between prosthetic status and health related quality of elderly by using EuroQol-5 dimension (EQ-5D) which is a standardized instrument used as a measure of health outcome. Data from 1,179 elderly subjects (over 65 years old) from the fifth Korea National Health and Nutrition Examination Survey were used in our analysis. Oral examination were conducted to obtain wearing prosthetic and needed prosthetic. EQ-5D is a widely used health condition measuring instrument. It consists of the five dimensions: Mobility, Self-care, Usual activities, Pain/discomfort and Anxiety/depression. EQ-5D index is a score calculated out of a weighting system. In this study, the mean score of the EQ-5D index among the elderly was 0.86. For EQ-5D index gender, female showed statistically significantly lower quality of life than male. The related factors EQ-5D index, when the lower demand for fixed prosthodontics and full denture. Wearers in partial and complete denture than non-wearers showed higher EQ-5D index. In order to improve EQ-5D index among the elderly who demand prosthetic status, which has lost its function through providing proper dental prostheses.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.2
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• pp.109-117
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• 2024

Background: Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference. Methods: A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). Results: The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Conclusion: Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

• Journal of Oral Medicine and Pain
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• v.40 no.2
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• pp.47-54
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• 2015

Purpose: Besides depression and anxiety, recently pain catastrophizing has been emphasized for an important psychological factor explaining pain response in various pain conditions including temporomandibular disorders (TMDs). The aims of this study were to evaluate pain catastrophizing of TMD patients and to investigate how the level of pain catastrophizing related with clinical variables and psychometric morbidity. Methods: Inclusion criterion was all new TMD patients ${\geq}18$ years old attending the Department of Orofacial Pain and Oral Medicine of Dankook University Dental Hospital (Cheonan, Korea) over three-month period in 2014, who completed questionnaires. The questionnaires included the Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), and Symptom Check List- 90-Revised (SCL-90-R). All of them were examined clinically and diagnosed. Results: One hundred fifty five patients diagnosed as TMDs were participated in this study (mean age of $38.7{\pm}15.2$ years, male:female=1:2.5). Mean PCS score of the patients was 17.3 with standard deviation of 12.6. By the median of the PCS score (i.e., 15), the subjects were categorized into the high (${\geq}15$) and low catastrophizers (<15). Increased pain severity and interference and increased score of psychological features of SCL-90-R were found in the TMD patients with higher level of catastrophizing (p<0.001) and there was weak to moderate correlation between those factors (p<0.05). Difference in catastrophizing level was not found for other variables such as age, gender, duration of pain, education level and types of TMDs. Conclusions: Conclusively, pain catastrophizing of TMD patients relates positively to pain severity and pain interference. In addition to depression and anxiety, pain catastrophizing is positively correlated with variable other psychological morbidity such as somatization, obsessive- compulsive, interpersonal sensitivity, paranoid ideation and psychoticism. Types of TMD diagnosis do not seem to affect catastrophizing level. The results of this study suggest that pain catastrophizing should be emphasized and assessed in the TMD patients.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.4
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• pp.494-505
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• 1999

In spite of the progress in techniques and materials of the prosthodontic rehabilitation of patients with complete edentulous arches, prosthodontists still face patients' complaints about dissatisfaction and discomfort from their dentures. In the past several decades, prosthodontists tried to find the factors that influence the patient's satisfaction with dentures. However the results are contraversial especially with the psychological factor. In this study using 'patient denture satisfaction questionnaire' and Hopkins Symptom Checklist, we tried to find the correlation between the patient's denture satisfaction and the patient's psychological aspects. 23 complete edentulous patients who have visited the Department of Prosthodontics, Yonsei University Dental Hospital from September 1998 to June 1999 for complete denture treatment were asked to complete the questionnaires 4 to 6 weeks after the upper and lower complete delivery. After the measurement of validity of the questionnaires, correlations between the patient's general satisfaction with their new upper and lower complete dentures and the other satisfaction questions including the satisfactions with esthetics, retention, mastication, speech, comfort and other people's opinion and between the patient's general satisfaction with their new upper and lower complete dentures and the 5 symptoms of Hopkins Symptoms Checklist including somatic, obsessive-compulsive, interpersonal sensitivity, depression and anxiety were analyzed. Among the several satisfaction questionnaire items, comfort with the lower denture showed highest relation to the patient's general satisfaction with dentures. However, only the anxiety scale of Hopkins Symptoms Checklist among the other symptom scales was related to the patient's general satisfaction with dentures. The two questionaires used in this study turned out to be valid means of analyzing patient's denture satisfaction and psychological status before and after the complete denture treatment.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.12
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• pp.161-169
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• 2018

The purpose of this study was to investigate the effect of alcohol drinking motivation on the drinking behaviors of female college students. It is necessary to examine the drinking behavior of female college students not only for their academic performance and health status but also for future reproduction concerns. The subjects of this study included 296 college students in their 20s. Research data was analyzed using SPSS 24.0 and AMOS 22 statistical programs. Results of this study found academic and human relationships had the greatest effect on the stress level of female college students. In addition, the perception of drinking was more influential on the drinking problem, and female college students who perceived anxiety through the drinking problem tried to change the behavior of drinking. Also, the perception of drinking by the influence of alcohol was more significant than that of drinking by college students who perceived anxiety through drinking problem. Second, if drinking is beneficial in the internal or external motivation of the individual, it maintains drinking behaviors and changes the behavior of drinking when experiencing the problem of drinking. Through these results, we aim to contribute to the reduction of the negative risk of alcohol by understanding the drinking preference of female college students and examining the drinking culture according to drinking motives.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.1
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• pp.38-44
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• 2015

Children commonly experience orofacial injuries and often need emergency treatment. Due to fear and anxiety, children tend to be uncooperative in emergency rooms. Ketamine hydrochloride is a well-known sedative agent at medical-based emergency rooms which has been used for procedural sedation. In this paper, we will discuss the sedation of uncooperative young patients, who needed dental treatments in the emergency room at Wonju Severance Christian Hospital, using ketamine. We collected the records of patients under 18-years-old who visited the emergency room for dental treatment from January 2010 to May 2014. The data was categorized by age, sex, required dental treatments and application of ketamine sedation. Among 659 pediatric patients who visited for emergency dental treatments, 118 patients were treated under sedation using ketamine. Majority of patients were under the age of 6 (110 patients), and the most frequent cause of sedation was suture of oral laceration (105 patients). Though ketamine should not be used by dentists alone, dentists in emergency rooms can easily meet the patients under deep sedation using ketamine. Hence, dentists in emergency rooms need to be aware of the clinical effects, considerations, and potential adverse effects of ketamine.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.19-28
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• 2023

Background: Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings. Methods: A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps. The charts were completed at two oral surgeons and one general dentist's office over 6 months. Hypoxia, hypotension, bradycardia, and over-sedation were considered adverse events and were collected using Tracking and Reporting Outcomes of Procedural Sedation (TROOPS). Furthermore, patient recovery time, sedation length, drug dose, and patient satisfaction questionnaires were used to measure sedation effectiveness. Results: Of the 101 reviewed sedation charts, 54 were of men, and 47 were of women. The mean age of the patients was 40.5 ±18.7 years, and their mean BMI was 25.6 ± 4.4. The patients did not experience hypoxia, bradycardia, and hypotension during the 4694 min of sedation. The average minimum Mean Arterial Pressure (MAP) and heartbeats were 75.1 mmHg and 60.4 bpm, respectively. 98% of patients agreed that the sedation technique met their needs in reducing their anxiety, and 99% agreed that they were satisfied with the sedation 24 hours later. The average sedation time was 46.9 ± 55.6 min, and the average recovery time was 12.4 ± 4.4 min. Remifentanil and propofol had mean initial effect-site concentration doses of 0.96 µ/.ml and 1.0 ng/ml respectively. The overall total amount of drug administered was significantly higher in longer sedation procedures compared to shorter ones, while the infusion rate decreased as the procedural stimulus decreased. Conclusion: According to the results of this study, no patients experienced adverse events during sedation, and all patients were kept at a moderate sedation level for a wide range of sedation times and differing procedures. The results showed that TCI pumps are safe and effective for administering propofol and remifentanil for moderate sedation in dentistry.

• Journal of Oral Medicine and Pain
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• v.38 no.1
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• pp.19-28
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• 2013

With Korea's rapid entry to aged society, elderly population has become a major age group both in the whole society and medical field and its importance will be constantly stressed out. Elderly population is also important in the field of oral medicine which deals with chronic and recurrent diseases in the orofacial region of non-dental origin but there exist few studies indicating epidemiology of elderly patients in this regards. This study aimed to investigate change of age distribution of new patients in a university-based dental hospital and oral medicine clinic for last decade and to investigate clinical epidemiology of elderly patients (${\geq}$ 65 years) of oral medicine clinic. This study was performed retrospectively using medical records of the new patients in Dankook University Dental Hospital in 2001 and 2011. According to the study, percentage of elderly new patients increased in both dental hospital and oral medicine clinic and degree of the increase was greater in oral medicine clinic than in the whole hospital (p=0.000). 13.5% of adult patients ${\geq}$ 18 years of oral medicine clinic were elderly patients ${\geq}$ 65 years. 83% of elderly patients were suffering from one or more systemic diseases. Although TMD was the most common reason for elderly patients who visited oral medicine clinic, oral soft tissue diseases, dry mouth, burning mouth syndrome and oromandibular dystonia was more frequently diagnosed in elderly patients compared to adult patients aged 18 to 64 years. Pain severity and interference of Brief Pain Inventory and depression and anxiety scores of Hospital Anxiety Depression Scales were higher in elderly patients than in the adult patients (p<0.05). Increase of elderly patients with chronic oral diseases and pain needs more attention of dentists and specialists of oral medicine to improvement of assessment and development of tailored management because large portion of the elderly patients have systemic diseases, polypharmacy and impaired communication, possibly restricting treatment options.