• 대한치과의사협회지
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• 제53권11호
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• pp.779-788
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• 2015

Individuals with special needs include those with behavioral issues, developmental disorders, cognitive disorders, congenital or genetic disorders, or systemic disease. These conditions may place them at increased risk for oral diseases. Dental management of patients with special needs require in-depth understanding of the background of disability and available behavioral guidance theories. Therefore dental team members need more training in the theory and practice of behavior management principles, which might lead to a clinical experience that is more respectful of the dignity and independence of patients with special needs. The dental professional should be flexible to modify the behavior management approach according to the individual patients needs. Also a family/care-giver centered approach based on their preferences and concerns, the patient's challenging behaviors, and related medical problem can serve to improve the treatment planning and oral health management of dental patients with special needs. This article focuses on uncooperative behavior and behavior management, which help practicing dentists to understand their role in the care of patients with special needs.

• 대한소아치과학회지
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• 제44권3호
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• pp.384-389
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• 2017

치과에 대한 거부감은 치과 치료의 역사만큼이나 오래되었다. 역사와 함께한 치과 치료 기술은 절개와 절삭을 포함하는 효과적인 치료와 함께 통증을 최소화하도록 지속적으로 발전하였으나 치과에 대한 부정적 인식은 기술의 발전만큼 감소하지는 못하였다. 특히 소아치과 환자들은 외부 자극에 대한 저항성, 정신적 발육, 인내심 등의 부족과 함께 부모의 영향을 포함하는 양육 방식의 변화로 인하여 DFA(dental fear and anxiety) 및 DBMP(dental behavior management problem)을 경험할 수 있다. 치과에 내원하는 환아가 경험하는 다양한 자극들 가운데 심리에 영향을 주는 요소들로는 치과의사, 치과 진료 기구들이 있으며 치과의사와 관계를 형성하는데 영향을 주는 사회적인 요인이 존재한다. 특히 최근에는 스마트폰과 관련한 중독이 사회문제로 대두되고 있으며 스마트폰의 사용이 구강에 미치는 영향과 치과에서 보이는 행동에 미치는 영향에 대해 알아본다.

• 대한장애인치과학회지
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• 제2권2호
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• pp.156-160
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• 2006

각각의 환자에게 알맞은 장치를 제작하여 장착한 결과 모두 양호한 치유양상을 보였다. 자해를 관리하기 위해서는 고정성, 가철성 장치를 모두 사용할 수 있다. 장치의 선택은 환자의 상태에 따라 결정되어야 한다. 파괴적인 행위가 중단되어 구강 내 상처부위가 회복되어도 아주 높은 빈도로 재발이 일어나므로 이를 방지하기 위해 정기 내원 관리가 필요하다.

• 치위생과학회지
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• 제22권2호
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• pp.90-98
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• 2022

Background: Integrated management of general, mental, and oral health is necessary to improve an individual's quality of life. This study aimed to identify the effects of mental and oral health behaviors on metabolic syndrome. Methods: A total of 4,227 Korean adults aged 20 years or older were selected as study subjects using raw data from the first year (2019) of the 8th period of the Korea National Health and Nutrition Examination Survey (KNHANES). A complex sample chi-square test and a complex sample logistic regression analysis were performed using the PASW Statistics ver. 18.0 program. Results: The effect on metabolic syndrome was significantly higher in male than in 1.833 times in male, 2.914 times in 30~49 years old, and 3.855 times in 50~64 years old, and 3.929 times in people over 65 years old compared to 20~29 years old, and compared to those with a college degree or higher, those with a middle school degree or lower are 2.116 times, those with lower income levels are 1.507 times higher, those with middle-lower are 1.359 times higher, those with middle-high are 1.401 times. Compared to non-smokers, smokers were 1.570 times higher than non-smokers and compared to those without speech problem and chewing difficulty, they were 1.717 times and 1.397 times higher, respectively and 1.973 times higher in those with 0~1 brushing times per day. Mental health did not affect prevalence of metabolic syndrome. Conclusion: It is necessary to improve maintain a healthy lifestyle to lower the risk of metabolic syndrome. It is necessary to establish effective dental hygiene customized education and an efficient health management system at the national level that can induce improvement of oral health behavior for the prevention and management of metabolic syndrome.

• 대한치과마취과학회지
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• 제2권2호
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• pp.101-106
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• 2002

Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.

• 대한소아치과학회지
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• 제32권2호
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• pp.244-250
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• 2005

자해 행위(self-injurious behavior)란 자살 의도 없이 자신의 신체 일부를 무의식적 혹은 고의로 손상시키는 것으로 정의한다. 이는 머리 및 몸 때리기, 피부 절단 혹은 손가락 깨물기 등의 형태로 나타나며, 눈, 성기 및 구강 내 자해 행위(self-inflicted oral mutilation)를 포함한다. 자해 행위는 일반적으로 정신지체, 혼수상태, 정신과적 문제, 약물의 독성 혹은 성격장애를 지닌 환자에게서 일어날 수 있다. 소아환자에서 자해 행위는 보통 입술, 협점막 및 혀 깨물기 등이 보고되고 있으며, 이러한 구강 내 자해 행위를 방지하기 위해 치과적 조절 방법들이 소개되고 있다. 본 증례에서는 구강 내 자해 소견을 보인 두 명의 소아환자들에 대해, 각각 변형된 activator 형태의 가철성 장치, 후방으로 연장된 tongue-rake 장치 및 mouthguard 등을 사용하여 양호한 치유과정을 보였기에 보고하는 바이다.

• 대한치과마취과학회지
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• 제12권3호
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• pp.165-171
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• 2012

Background: The aim of this study was to investigate and compare the oral health conditions of Autism Spectrum Disease (ASD) and cerebral palsy(CP) patients visiting the Kyung Hee University Dental Hospital from January 2003 to december 2010. Methods: This study analyzed the data (patient's chart and radiograph) of fifty-eight ASD patients and fifty-seven CP patients. The oral health conditions of patients were surveyed by DMFT (dmft) and periodontal condition at the first visit. The performed dental procedure, behavior management methods and follow-up check were analyzed. Results: The average age of patients having ASD and CP was 12 year 2 month (ASD; 11 year 9 month and CP; 12 year 4 month). Within the limit of this study, the rate of dental caries was higher in CP patients than autism patients. Both of diseases showed the periodontal problem. Autistic patients showed more difficult management problems according to the rate of general anesthesia experiences. Conclusions: This article would contribute for dental practitioners to provide appropriate and specialized treatment to ASD patients and CP patients.

• 한국학교ㆍ지역보건교육학회지
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• 제11권2호
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• pp.13-28
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• 2010

Objectives: The purpose of this study was to examine health status and health behavior of adolescents by socioeconomic characteristics. Methods: Secondary analysis of the 2008 Korea National Health and Nutrition Examination Survey was conducted for 836 adolescence respondents. Results: First, the score of health status was 3.75 and high in 12-15 ages, living together with parents and private medical insured person. The score of oral health status was 2.85 and high in 12-15 ages, employed health insured, living together with parents. Second, dental treatment need was high in female, low income and dental checkup high in 12-15 ages and high income. Influenza vaccination was high in 12-15 ages. Diet contents was good in high income, living together parents and private medical insured and having breakfast was high in male, 12-15 ages, high income, living together with parents and private medical insured person. Third, smoking experience was high in male, low income, living together with single father or mother and drinking age was high in high income family. Forth, sinusitis was high in high income and small pox was high in low income. Conclusion: There might be many differences in the health status and health behavior of adolescents by sex, age, house income, type of family, private medical insurance. Our findings suggest that the need to develop appropriate health education program for high health problem behavior and intervention strategies for socioeconomic specified groups at greater risk.

• 대한소아치과학회지
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• 제27권1호
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• pp.146-150
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• 2000

장애인은 일반적으로 구강관리에 대한 인식과 수행능력의 부족으로 구강위생상태가 불량하며, 치과질환의 발생빈도가 높고 그 정도가심한 편이다. 장애인의 치과치료시 많은 어려움이 따르는 행동조절은 장애의 종류와 정도에 따라 심리적 물리적, 약물적 방법 및 전신마취 등을 선택할 수 있으나, 여러 가지 이유로 인하여 일반적인 방법으로 치료가 불가능할 경우 전신마취를 이용하게 된다. 장애인 환자에 있어서 보철치료는 정상인에서와 다를 바가 없으나 장애정도에 따라 치과의사의 세심한 주의가 필요하며, 수복후에도 철저한 구강위생관리를 위해 환자 스스로나 보호자의 각별한 노력이 요구된다. 본 증례는 경도의 장애를 가지고 있으나 치과치료에 대한 불안과 공포가 심하고, 다수치아의 수복을 위하여 장시간의 치과 치료가 요구된 경우로서 전신마취를 이용한 보존 외과적 처치 및 보철치료를 시행하여 비교적 양호한 결과를 얻었다.

• 대한장애인치과학회지
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• 제3권1호
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• pp.11-16
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• 2007

The use of general anesthesia as a special method of behavior management is necessary if certain handicapped or disabled child patient to receive dental treatment. This study was designed to report the results of 53 cases of complete oral rehabilitation under general anesthesia. The data were obtained from patients who were provided with dental treatment under general anesthesia for last 3years managed at the Dept. of pediatric dentistry in PNU Hospital. The distribution of age, gender, primary reason for general anesthesia, duration of dental procedure, number of treated tooth and periodic recall check-up were surveyed. In distribution of age, most(78%) were younger than 10 years and mean was 13.0 years. The reasons for providing general anesthesia were lack of cooperation due to various mental and physical handicapped situation(74%), congenital heart disease(13%), combined with medically compromised and behavior problem and others. The average duration of the treatments was 2 hours and 41 minutes and average duration of the anesthesia was 3 hours and 6minutes. The mean number of treated with restoration a children were 16.7 teeth. From the results, total dental rehabilitation under general anesthesia is a favorable modality to improve for disabled children's oral condition.