• Journal of Dental Anesthesia and Pain Medicine
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• 제21권3호
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• pp.227-236
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• 2021

Background: Emergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to improve the staff knowledge and familiarity with critical performance elements for emergencies encountered in the setting of a periodontics clinic. Methods: Emergency cognitive aids tailored to the clinic's resources were created for anaphylaxis, airway obstruction, and sublingual hemorrhage. The project pre-post-test repeated measures design evaluated the effectiveness of cognitive aids using a combination of hands-on simulation, written knowledge assessments, and self-efficacy surveys. Training sessions and simulations were provided to the clinic's existing care teams made up of a periodontist and two dental assistants with an anesthetist who was present for simulations involving sedation. Due to the small sample size (N = 14) and non-normal distribution, all metrics were evaluated using non-parametric statistics. Results: Significant improvements were found in knowledge assessment (-2.310, P = 0.021) and self-efficacy (-2.486, P = 0.013) scores when retention after a training session before and after the introduction of cognitive aid was compared. The mean simulation scores and times improved steadily or reached maximum scores during the project progression. Conclusion: Training sessions before and after cognitive aid introduction were effective in improving knowledge, self-efficacy, and simulation performance. Future projects should focus on validating the process for creating contextualized cognitive aids and evaluating the effectiveness of these cognitive aids in larger samples.

• 한국학교ㆍ지역보건교육학회지
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• 제15권3호
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• pp.81-93
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• 2014

Objectives: This study aims to find status of the oral health care, the oral health education program utilization and the oral health guidance according to the experience status of oral health education of special school teachers. Methods: The study subjects were 133 teachers at special schools in Seoul, Gyeonggi, Chungbuk and Jeonbuk regions. Results: 32.8% of the male and 67.2% of the female teachers have the oral health education experience. Barriers for the dental treatment to teachers with the education experience show in the order as 'disabled children's noncooperation' 49.2%, 'economic reasons' 37.7% and 'medical institution's rejection' 6.6% and, to teachers without the education experience, 'disabled children's noncooperation' 45.8%, 'economic reasons' 19.4% and 'not emergency situation' 13.9%(p<0.01). Regarding the necessity of arranged institution to manage the oral health, 91.8% of teachers with the oral health education answer as 'necessary'(p<0.05). Regarding the barriers on the performance of oral health program 27.9%, the majority of teachers with the education experience answer as 'insufficient administrative & financial support' and 36.1%, the majority of teachers without the education experience answer as 'insufficient understanding and expertise on the oral health education'. 86.9% of the teachers with the education experience and 62.5% of the teachers without the education experience are found to 'guide students on the oral health'(p<0.01). Conclusions: It was considered that various oral health education programs positively influential to the oral health care and education for disabled children should be developed according to the status of oral health education experience of special school teachers.

• 대한치과마취과학회지
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• 제3권1호
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• pp.34-37
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• 2003

Postoperative stroke is uncommon even in elderly patients, who have a higher incidence of all types of postoperative complications. The mechanism of postoperative stroke is not certain, but can be explained by intravascular clottings originated from thrombus or embolus or by intracranial hemorrhage. In a 66-year-old male patient with current hypertension medication, who underwent both neck dissection for malignancy metastasis under general anesthesia, the left hemiparesis and delayed emergency were found postoperatively. After transferred to intensive care unit, he got the thrombolytic therapy and then the therapies to decrease the swelling of the brain on the diagnosis of cerebral infarction in the vascular distribution of the middle cerebral artery. A brain MRI definitely showed the midline deviation to the left of the right brain hemisphere due to the progressing edematous changes. As he got worse, the emergency neurosurgical operation was proposed but rejected by his family. He died at postoperative 3 days. In this hypertensive patient. perioperative stroke could be originated from the surgical stimuli on major vessels, which were inevitable in neck dissection during the operation. We report this case of the postoperative stroke, which could be highly possible to be associated with extensive head and neck surgery.

• 대한치과의료관리학회지
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• 제8권1호
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• pp.15-23
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• 2020

The aim of this study is to identify future-oriented tasks for Korean dental hygienists based on a literature review. A literature search is performed using 14 keywords related to tasks carried out by dental hygienists, and included articles published from 2000 to 2019 in the databases KISS, RISS, DBpia, NDSL, Papersearch, Pubmed, and Google Scholar. Six reviewers assessed the titles and abstracts of articles, and an article was selected if the study was considered to cover future-oriented tasks for Korean dental hygienists. Based on the results six local studies and two foreign studies were used for literature review and data extraction. In total, 38 tasks were classified as future-oriented tasks of dental hygienists according to the following criteria: 1) tasks that were specifically referred to as future-oriented tasks, and 2) tasks that could be classified as future-oriented tasks although no specific reference was made. Of these, the most frequently mentioned tasks were measuring periodontal pocket depth, dental hygiene assessment, providing dietary advice, infiltration anesthesia, and root planing. These were extracted from five of the eight studies, including both local and foreign studies. Dental hygiene planning, emergency, emergency management, and smoking cessation were the next most common tasks based on four studies. Even though some of these future-oriented tasks for Korean dental hygienists are included in the dentistry curriculum, and are currently performed as clinical practice for dental hygienists. Nonetheless, the reference to the legal scope is unclear. It is necessary to reconsider the scope of tasks of dental hygienists to reflect changes in domestic and foreign dental care delivery, thereby contributing to the oral health promotion of the public, where safety is guaranteed under legal protection.

• 한국치위생학회지
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• 제10권2호
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• pp.283-295
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• 2010

Objectives : It surveyed the recognition level of oral health in class teachers who have influence of students' oral health knowledges and behaviors in our country, developed a program available for supplementing reinforcement in school oral health education, and planned the knowledge contents necessary for school oral health education hereafter. Methods : To arrange the basic data necessary for school oral health program, it carried out questionnaire survey by personal self-administration targeting 460 teachers for 19 elementary schools where are located in Jinhae city from May 7, 2007 to June 13. The following conclusions were obtained. Results : 1. The path of acquiring oral health knowledge was shown the high frequency with 23.9% and 23.3%, respectively, through publicity brochure and dental clinic. As for the opinion about the aim of maintaining dental hygiene, the prevention of dental caries was the highest with 53.7%. 2. The opinion about which the regular visit to the dentist is very effective for preventing dental caries accounted for 56.7%. The opinions about which the limit to sugar intake and the use of dental floss are effective for preventing dental caries accounted for 52.2% and 46.3%, respectively. 3. The opinion about which the fluoridation beverage intake and the sealant are effective for preventing dental caries accounted for 33.9% and 33.0%, respectively. 4. The opinion about which the regular toothbrushing without toothpaste has a little effect and has no effect on preventing dental caries accounted for 42.6% and 38.5%, respectively. Conclusions : The elementary-school age period, which is the most core field out of the whole oral health, is the important period that is formed the basis of lifelong oral health care. It surveyed the recognition level of oral health in class teachers who are in charge of direct health care while making continuous life with students, and developed program available for supplementing reinforcement in school oral health education. Through this, there will be necessity for cultivating ability available for properly managing oral health for the whole life by allowing elementary-school students, who will be led to future adults' oral health, to be formed the attitudes toward the rationally oral health care.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.161-174
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• 2022

Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.

• 부모자녀건강학회지
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• 제4권2호
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• pp.56-72
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• 2002

Web sites on the internet are getting major resources to gain information related to child care. Though the numerous web sites deliver child care information, they have never been evaluated with criteria before. The purpose of this study is to identify existence and organization of child care portal sites and to analysis their contents, therefore to suggest guidelines for parents. The survey was conducted from Sep. 1. to Oct. 30., 2001. by means of Lycos Korea and Daum search engine and finally 45 portal sites related to child care were selected eliminating the commercial and personal homepages. The results were as follows: 1. Most of the sites(95.6%) were operated by corporations without registration(82.2%). Consultants were mostly professional (71.1%). 2. The contents were analyzed 4 categories including 19 themes. 3. Diet & Nutrition category include weaning food, breast feeding, bottle feeding and snack. The recipe and type of weaning food on months were topped(64.44%). 4. Infant Care category include bathing, sleeping, clothes, skin care and cord care. bathing method and heat of bathing water were topped(44.44%). 5. Growth & Development category was consisted of developmental characteristics, dental growth, play & exercise and learning & guidance. Developmental stage and motor development were topped (62.22%). 6. Health maintenance & promotion category was consisted of emergency care, prevention of accidents, vaccination, common pediatric disease and parental role. Care of diarrhea, constipation and fever, and precautions for vaccination were topped(48.89%).

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.357-367
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• 2022

Background: Low-dose dexmedetomidine may be a suitable alternative to opioids for pediatric ambulatory procedures under general anesthesia (GA). However, the recovery profile remains unclear. Herein, we aimed to evaluate the effects of low-dose dexmedetomidine on the recovery profile of children. Methods: Seventy-two children undergoing ambulatory oral rehabilitation under GA were randomly and equally distributed into two groups (D and F). Group D received an infusion of dexmedetomidine 0.25 ㎍/kg for 4 min for induction, followed by maintenance of 0.4 ㎍/kg/h. Group F received an infusion of fentanyl 1 ㎍/kg over 4 min for induction, followed by maintenance at 1 ㎍/kg/h. The primary outcome was the extubation time. The secondary outcomes were awakening time, end-tidal sevoflurane (ET-Sevo) requirement, change in hemodynamic parameters, Richmond Agitation-Sedation Scale (RASS), Children's Hospital of Eastern Ontario pain scale (CHEOPS) score, length of PACU stay, and incidence of adverse events. Results: Statistically significant differences were observed in the recovery profile between the groups: the median time for extubation was 3.65 (3.44-6.2) vs. 6.25 (4.21-7) minutes in groups D vs. F (P=0.001), respectively, while the corresponding awakening times were 19 (18.75-21) and 22.5 (22-24) minutes, respectively (P < 0.001). The mean ET-Sevo was low in group D (1.1 vs. 1.2; P < 0.001). The heart rate was significantly low across all time points in group D, without resulting in bradycardia. The median RASS and CHEOPS scores were also significantly lower in group D. No significant differences were observed in the mean arterial pressure, incidence of adverse events, or length of PACU stay. Conclusion: Low-dose dexmedetomidine was more effective than fentanyl as an opioid substitute at providing a better recovery profile in pediatric ambulatory oral rehabilitation under GA. Dexmedetomidine also significantly reduced sevoflurane consumption without causing adverse events or prolonging hospital stay.

• 대한소아치과학회지
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• 제36권4호
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• pp.607-612
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• 2009

소아기의 악성 종양은 질병으로 인한 소아 사망의 가장 흔한 원인이다. 이에 대한 대표적인 치료 방법으로 항암 화학 요법과 방사선 요법의 단독 사용 혹은 이들의 병용을 들 수 있다. 그러나 이러한 치료 방법은 다양한 구강 내 합병증을 동반한다. 성인과 달리 소아 환자는 항암치료 시기에 일부 영구치가 활발한 발육단계에 있으므로 발육중인 치아에 치과적 합병증이 예상된다. 치과적 합병증의 정도는 화학약물의 종류, 용량 및 방사선 조사 빈도와 치료 당시 환자의 나이에 따라 달라진다. 본 증례들에서는 특정 영구치의 발육단계에 있는 만 1-4세경에 종양의 치료를 위해 항암 화학 요법과 방사선 치료를 받은 어린이 3명을 대상으로 치료 내용과 치아 발육 상황을 검토해 보았다. 이환된 치아의 수나 그 정도에 차이는 있으나, 각각의 환자에서 영구치 치배의 선천 결손, 왜소치, 치근 저형성 등 발육장애 관련 소견이 관찰되었다. 항암치료를 받은 병력이 있는 소아에 있어서 항암치료 이후에 나타날 수 있는 일반적인 구강 합병증 이외에 발육시기 동안 치아에 미치는 영향을 고려하여, 공간 문제를 포함하여 향후 발생 할 수 있는 다앙한 문제점 예방을 위한 장기적인 관찰과 관리가 필요할 것으로 생각된다.

• 지역사회간호학회지
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• 제22권2호
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• pp.212-222
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• 2011

Purpose: This study was conducted to survey children's health status and need of customized visiting health care services in one province. Methods: The participants in this study were 237 caregivers of infants and preschoolers. Data were collected at the participant's home or public health center. Results: Many of the children did not receive developmental screening tests or dental examinations. In the beneficiary group, the prenatal checkup rate and children's vaccination rate were lower, and caregivers had more health problems than the other groups. On the assessment of home safety, unsafe conditions were more frequently found in the beneficiary group. The caregivers in the beneficiary group showed lower child rearing confidence than the other groups, and wanted customized visiting health care services most in the areas of developmental screening, regular health check-up and counseling, nutritional supplementation, and oral health care. Conclusion: These results indicate that it is necessary for children and parents in poverty to be provided with professional home visiting interventions for the promotion of child health and prevention of developmental problems and diseases. These findings can be used for developing future customized visiting health care service programs for infants and children in this community area.