In the welfare law for the disabled in Korea, the disabled is defined as "the persons sho have significant limitations of daily or social life due to physical or mental disabilities over a long period." The number of registered domestic disabled person in 2008 survey was approximately 2.1 million. 90% of the disabled was caused by the aposteriori illness or accidents. So, in this aging society, the number of people with disabilities will increase even more. In general, people with physical and mental disabilities tend to have more oral diseases, but, are difficult to get treated. Therefore, a thorough oral care through individualized prevention is more important than ever. In this article, we review the oral care methods in dental office and home and in the hospital for the elderly and finally focus on a denture care method. According to this article, the dental professionals can be able to select and apply the oral care method in agreement with the characteristics of the disabilities. Particularly, it is important to prevent the aspiration pneumonia in the elderly in hospital.
Background: This study aimed to analyze trends in oral health research among people with disabilities. Methods: Data were obtained from 70 oral studies on individuals with disabilities from 2000 to 2024. Keywords were analyzed. Frequency, betweenness centrality, and cluster analyses were performed using NetMiner. Results: The main keywords for oral health research on disabled people were oral health, dental caries, DMFT (decayed-missing-filled-teeth), dental treatment, oral health centers, and disabled children. As a result of the centrality analysis, DMFT had the highest connectivity, followed by disabled children, special care dentistry, oral health behavior, periodontitis, and health insurance. Cluster analysis results of research on disabled people: Group 1, oral diseases and functions of disabled people; Group 2, oral care for disabled children; Group 3, dental treatment for disabled people; Group 4, oral health policy; Group 5, oral care by dental hygienists; and Group 6, conservative dentistry. Conclusion: Considering the increase in the number of disabled people in a super-aging society, research on ways to promote oral health for disabled people, oral health policies, and training of oral health experts for disabled people is required.
This study developed key elements of dental service guidelines for the disabled patients. In order to provide consumer-oriented service guidelines for the dental patients with disability, service design method was applied. Using service design method guided by the double diamond design process, this study implemented consumer survey, observation, and contextual interviews for consumers' needs assessment. And customer journey map, mind maps, and blueprints were utilized to visualize consumer needs and guidelines for dental care services for the disabled. According to the study, disabled consumers have needs for expertise of the medical staff, dental care institutions specialized on the disabled, financial support, establishment of the facilities for the disabled, comfortable atmosphere in the institutions, and communication with medical staffs. Based on the needs of the disabled, 5 key elements of the dental care services were developed: convenience, expertise, empathy, financial support, and education and management. And service design guidelines were proposed to implement key elements of dental care services for the patients with disability. This study is significant in that it is the first attempt to apply the service design technique from the consumer perspectives in the field of dental care for the disabled. Furthermore the process of this study has become a reference that can be utilized and applied to other medical institution.
The purpose of this study was to examine the general attitude of dental hygiene students toward the disabled and their oral care in an effort to improve their awareness of the disabled and their accessibility to them and suggest some of the right directions for dental hygiene education related to dental treatment for the disabled. The subjects in this study were dental hygiene students at three different colleges located in South Jeolla Province. The general attitude of the selected students toward the disabled and their oral care were investigated from November 1 to December 20, 2007. The findings of the study were as follows: When their general attitude toward disabled people was checked, they agreed the most that there was nothing that the disabled lagged behind nondisabled people. Those who felt the need for that took a more positive attitude in eight items, and the differences between them and the others were significant. Whether they were cognizant of the necessity of dental treatment education for the disabled made the most significant differences to each variable of their attitude toward the oral care of disabled people, and those who were aware of the necessity showed a more positive attitude in five items. The differences between them and the others were significant. The findings of the study illustrated that the dental hygiene students took a relatively favorable attitude toward disabled people's oral health care, and that they hardly felt a sense of distance to them. So it can be predicted that they will get to take the right attitude to them in the future. Yet the dental hygiene curriculum should give more weight to dental treatment education for the disabled and offer more relevant information, since they didn't get high scores on positive attitude.
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.
This study conducted a 'specialist tooth brushing' method against the severely disabled once every other week. The purpose of this study is to analyze and validate the effectiveness of maintaining healthy periodontal management when consistent oral hygiene lasts with minimum stimuli for 24 - months. The conclusions were as follows. Table 2 compares the difference between group 1 and 2 from the 1st to 11th management and verifies the actual difference in measurement of each index. Group 1 used a professional tooth brush while Group 2 used a general brush. There were found many significant differences in dental index. As for PHP, Oral Malodor index and gingival bleeding, it was found that one or two times of dental care can make substantial differences in dental health condition. These results show that as the number of toothbrush method has been increased, gingival bleeding and periodontal index are significantly improved, not to mention the improvement of gingivitis and periodontal disease. This is because periodontal tissue is affected by brushing method, brushing time and consistency of dental care. During the 6-month period, 20 minutes of active periodontal care was intensively conducted, and for 18-months the effect of consistent care was verified by 10-minute periodontal care once every other week. As a result of the test, it was found that there was no complete regression in the basic periodontal treatment and the periodontal health condition had been maintained for 24 months. Also this test shows that, despite of inconsistent dental hygienic care, regular plague control can prevent dental diseases and maintain the dental health. This study proved that periodontal condition can be maintained by periodontal care once every other week as the tooth brushing properly stimulates the gums with positive effect. Therefore, professional dental healthcareworkers should be designated for each facility for the disabled, and dental health of the disabled should be professionally cared on a regular basis, and consistent and repetitive management by the dental care specialist are required.
This study proposed a registered dentist model for the disabled based on consumer in-depth interview and supplier survey. This study proposed that dental clinics in the community take role as registered dentists for the disabled. Qualification screening and facility prerequisites are required to be selected as the registered dentists for the disabled and patients of the registered dentists were restricted to the disabled who can cooperate to dental treatment services with or without the aid of physical bondage. In order to encourage the participation in the program, subsidies for the registered dentists were necessary. Also, this study proposed financial supports for the medical expenses for patients at the same level as the current dental care center for the disabled. The registered dentist program for the disabled meets the needs of disabled consumers, such as accessibility of medical institutions, expertise of medical staff, and ongoing treatments with familiar medical staff. The registered dentist program for the disabled is expected to provide prevention and ongoing management for oral health promotion of disabled people and it also contribute to lower economic burden of oral health care of the disabled.
Background: To identify the factors that affect the current status and satisfaction of people with disabilities at community oral care centers. Methods: A structured self-administered survey, including five questions on facility environment, five on usage procedure, four on medical skill, four on care cost, three on friendliness, and three on satisfaction, was administered to 218 residents of the G-disabled community care center. It comprised a Likert 5-point scale (strongly agree, 5 points; agree, 4 points; moderate, 3 points; disagree, 2 points; not at all, 1 point). The reliability of the measurement tool was 0.932 for Cronbach's α. Results: The evaluation of community oral care centers for the disabled showed that the environment was hygienic (4.42±0.73), reservation system was well maintained (4.18±0.95), and the dentist-in-charge was satisfied with the treatment (4.37±0.62). The participants agreed that the details were sufficiently explained (4.29±0.71). However, in terms of medical expenses, the score of "have fully heard the explanation of medical expenses and reductions" was 3.88±0.92. The factors affecting satisfaction were sex, final educational background in the facility environment, usage procedure, and medical skill. Conclusion: To increase the satisfaction of people with disabilities at community oral care centers, it is necessary to establish a facility environment and service according to the patients' need and increase the reduction or exemption benefits between different treatment cost categories. Oral health management policies for the disabled should be developed based on these factors, so that the oral care of vulnerable groups in blind spots can be maintained.
This study surveyed and analyzed attitudes toward people with disabilities, awareness of considerations in dental treatment for individuals with disabilities, the need for education on dental treatment for people with disabilities, and the educational requirements for dental hygienists working in dental medical institutions. The study was conducted to highlight the importance of dental treatment education for people with disabilities and to provide foundational data for future dental treatment education programs targeting dental hygienists. A total of 221 dental hygienists working in dental care institutions nationwide participated in a self-administered online questionnaire from November 2 to 15, 2022. This study concludes that there is a significant correlation between the attitudes of dental hygienists toward the disabled, their recognition of considerations in dental treatment for the disabled, the need for education on dental treatment for the disabled, and their educational experience in providing dental treatment for the disabled. In order to improve these factors, it is important to implement and expand systematic dental care education for people with disabilities in the school curriculum, as well as in supplementary education and seminars.
Background: Dental treatment under outpatient general anesthesia is an option for disabled person, children and dentally disabled person who have the difficulty of cooperating voluntary with dental care. The aim of this study was to access the patients who had dental management under general anesthesia at Chungnam dental clinic for the disabled. Methods: This survey is consisted of 114 severely disabled and dentally disabled person who undergone dental treatment under general anesthesia from January to June 2011. Data were collected by individual dental and anesthesia records. Results: Of the 114 patients studies, the 45 patients was the dentally disabled and the 69 patients was the severely disabled. Rate of dental treatment among male patients was higher than among female patients. The dentally disabled was an similar age distribution. In the severly disabled, above 13-year-old was higher than below 12-year-old. The most popular induction method of general anesthesia was sevoflurane inhalation after induced sedative effect of nitrous oxide inhalation. The severly disabled who had definitely negative behavior was applied inhalation of high concentration sevoflurane. Conclusions: Chungnam Dental clinic for the disabled provide dental management for the disabled and the dentally disabled.
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