Objectives: Unmet needs for dental treatment are one of the potential contributing factors to poor oral health because oral health problems worsen if left untreated. This study aimed to demonstrate the prevalence of and the causes for unmet dental needs, and to evaluate the association between unmet needs for dental treatment and oral health status. Methods: Data on 3,883 subjects aged ${\geq}18years$ from the Korean National Oral Health Survey 2006 were analyzed. Information regarding unmet needs for dental treatment was obtained using standardized questionnaires. Eight trained dentists examined decayed, missing, or filled teeth (DMFT). Multiple regression models were built to assess the association between unmet needs for dental treatment and the DMFT scores. Results: The prevalence of perceived unmet needs for dental treatment was 34.7% among the adult Korean population. Economic constraints were the main cause (38.6%) for unmet dental needs. The average DMFT scores were higher in the subjects with unmet needs for dental treatment than in those without. In individuals with unmet needs for dental treatment within the past 1 year, the number of decayed teeth after adjusting for confounders was likely to be greater by 0.58 and that of missing teeth by 0.27 compared to that in their counterparts with no unmet dental needs in the past 1 year. Conclusions: Perceived unmet needs for dental treatment were significantly associated with poor oral health status among the adult Korean population. Further studies are needed to clarify the direct and indirect effects of unmet needs for dental treatment on an individual's oral health status by investigating critical variables of the causal pathways among perceived dental needs, dental care utilization, and oral health status.
This article discusses how to conduct treatment planning and decision making in special needs dentistry. Special needs patients often lack cooperative ability during dental treatment and have a deteriorated oral health status. To overcome the limitation in communication with special needs patients and solve their complicated dental problems, dentists need to have extensive preoperative information about the patients and their caregivers. Treatment procedures should be organized in a patient-centered and cost-effective manner. Additionally, clinical outcomes need to be predicted taking into consideration of the patients' condition. The clinical experience of committed dentists is another factor that enhances the benefits of extensive treatment in special needs patients with many limitations. The insightful treatment decision-making of dentists will contribute to improving the oral health of special needs patients despite the various obstacles.
Objectives: This study was conducted to analyze the factors related to unmet dental care needs in Korean adults who needed dental treatment. Methods: This study analyzed data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). Among the adults who participated in the National Health and Nutrition Examination Survey, 2,723 dental treatment who performed oral examinations were the final subjects. General characteristics and oral health characteristics were analyzed with complex sample chi-square test using the IBM SPSS program. Factors related to unmet dental care were analyzed by multiple logistic regression analysis. Results: As for unmet dental care needs related factors, bad oral health was 3.383 times higher, and usually was 1.736 times higher. In the use of dental clinic unmet dental care needs was 0.121 times lower. Unmet dental care needs was high, 1.366 times for those with the experience of tooth pain and 2.736 times for those with chewing difficulty. Conclusions: Based on the above results, it can be seen that oral health status or oral discomfort is related to unmet dental care needs. It is necessary to set goals to improve unmet dental care, recognize that one's oral health condition is very important, and continuously educate about oral health for each life cycle.
Objectives: The purpose of this study was to compare the dental treatment needs of workers depending on their shifts and working patterns. Methods: Only workers aged 15 or older according to the $6^{th}$ Korea National Health and Nutrition Examination Survey (2013-2015) were considered eligible. A total of 9,092 people who responded to health surveys and completed oral examinations and interviews were selected for the study. Statistical analysis was carried out by the complex samples general linear model. Results: As the daytime workers' age increased, the requirement for restorative treatment decreased. In contrast, the requirement for tooth extraction caused by dental caries and periodontal disease increased. As the evening shift workers' age increased, the requirement for restorative treatment decreased. In the case of shift workers, the requirement for restorative treatment was lowest in those aged 50-64 years and highest in those aged 30-49 years. In the case of smokers; the daytime workers required a higher amount of restorative treatment, pulpal treatment, and tooth extraction due to dental caries and periodontal disease; the night shift workers required a higher amount of restorative treatment; and the shift workers required a higher amount of tooth extraction caused by periodontal disease. The results of comparing the dental treatment needs depending on working patterns were: the need for restorative treatment was higher in night shift workers (0.377) than in shift workers (0.245); the requirement for pulpal and restorative treatment was higher in daytime workers (0.055) than in night shift workers (0.010); requirement for tooth extraction due to periodontal disease was higher in night shift workers (0.060) than in evening shift workers (0.012). Conclusions: There are differences in dental treatment needs depending on the workers' working patterns. Collective oral health care is needed at workplaces to promote the workers' oral health.
Objectives: This study aimed to assess the relationship between dental care needs and dental service use in Korean elderly. Methods: Using the sixth Korea National Health and Nutrition Examination Survey, from 22,948 individuals, 1,572 (male 701, female 871) elderly individuals aged above 65 years were included in the study. All analyses were stratified by sex. Results: In males, the group with subjective needs was 3.74 (95% confidence interval [CI]: 2.58-5.41) times more likely to use dental services than the group without subjective needs. For females, the group with subjective needs was 2.17 (95% CI: 1.57-2.98 ) times more likely to use dental services than the group without subjective needs. Conclusions: To conclude, the elderly with symptoms, used the dental services for pain relief and functional recovery. Fundamental efforts to improve oral health are needed, such as providing treatment, prevention and educational services, besides efforts to provide treatment-oriented dental services. Further research is needed for the middle and elderly individuals who are in the blind spot of the existing policy.
Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.
Lim, Mathew Albert Wei Ting;Borromeo, Gelsomina Lucia
Journal of Dental Anesthesia and Pain Medicine
/
제17권2호
/
pp.91-103
/
2017
General anesthesia is commonly used to facilitate dental treatment in patients with anxiety or challenging behavior, many of whom are children or patients with special needs. When performing procedures under general anesthesia, dental surgeons must perform a thorough pre-operative assessment, as well as ensure that the patients are aware of the potential risks and that informed consent has been obtained. Such precautions ensure optimal patient management and reduce the frequency of morbidities associated with this form of sedation. Most guidelines address the management of pediatric patients under general anesthesia. However, little has been published regarding this method in patients with special needs. This article constitutes a review of the current literature regarding management of patients with special needs under general anesthesia.
Oshagh, Morteza;Salehi, Parisa;Pakshir, Hamidreza;Bazyar, Leyla;Rakhshan, Vahid
대한치과교정학회지
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제41권6호
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pp.440-446
/
2011
Objective: Our aim was to determine the correlation between dental treatment need as assessed by the components of the index of orthodontic treatment need (IOTN) and a self-evaluation questionnaire in a population selected from the dental clinics of Shiraz, Iran. Methods: The dental treatment needs of 240 participants (120 men and 120 women) were measured on the basis of the IOTN dental health component (IOTN-DHC), IOTN aesthetic component (IOTN-AC), IOTN AC determined by the examiner (IOTN-ACE), and a self-evaluation questionnaire (SEQ). The correlations between the treatment needs assessed by all the methods as well as the correlations of the treatment needs with age and gender were assessed using a Spearman's correlation coefficient (${\alpha}$ = 0.01). Results: All methods were significantly correlated ($p{\leq}0.001$). The associations of IOTN-ACE with IOTN-DHC and SEQ were moderately significant (rho = 0.49 and 0.41, respectively). The associations of IOTN-AC with IOTN-DHC and SEQ were weakly significant (rho = 0.24 and 0.35, respectively). The IOTN-DHC was moderately associated with SEQ (rho = 0.53). Gender and age were not associated with treatment needs estimated by any of the methods used ($p$ > 0.06). Conclusions: The correlations between the self-evaluation and the IOTN components in young adults were close to those reported in children, and IOTN-ACE was more reliable than IOTN-AC.
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.
Objectives: The objective of this study is to provide basic data needed in developing an educational program designed to upgrade capacity and awareness of preventive dental treatment among oral health workers, by analyzing levels of awareness of preventive dental treatment and educational needs among dentists and dental hygienists. Methods: The collected data was analyzed with SPSS program ver. 19.0. The data was under t-test. Results: The frequency level of giving preventive dental treatment to patients among dentists and dental hygienists is below mid-point, 3 on the 5-point Likert scale. In terms of frequency level per item, scaling & polishing was ranked the highest, followed by periodontal maintenance, tooth-brushing instruction, and prescription and instruction of oral care product in descending order. On the questions asking how important preventive dental care they perceive to be, both dentists and dental hygienists perceived it to be highly important. When they were asked to rank those items by the importance of education, they considered periodontal maintenance as the most important one, followed by individual education of oral health, incremental oral health care, scaling& polishing, toothbrushing instruction, and prescription and instruction of oral care product. Respondents pointed out problems in running a preventive dental treatment program as follows: overwork, lack of dedicated workforce, un-fixed costs, and lack of necessary equipment. When they were asked to point out items needed to run such a program, the largest number of respondents indicated dedicated workforce placement, followed by improving awareness of the customer, and improving awareness of the dental workers. Conclusions: In order to effectively run a preventive dental treatment program, it is necessary for oral health workers to clearly understand the concept of it. It is also necessary to develop and operate an education program on preventive dental treatment targeting oral health professionals.
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