• The Journal of Korea Assosiation for Disability and Oral Health
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• v.5 no.1
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• pp.12-17
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• 2009

Background : To do dental treatments successfully for dentally disabled patients who are unable to cooperate to procedures needs deep sedation (DS) or general anesthesia (GA). But there are some difficulties in selecting DS because of some disadvantages such as airway problem etc. But, if we select appropriate cases, DS would be better than GA. Methods : We reviewed total 238 cases of patients who had received dental treatments under GA or DS at the clinic for the disabled in Seoul National University Dental Hospital from November 2007 to February 2009. To compare anesthesia condition between DS and GA, we reviewed preanesthesia evaluation sheet, anesthesia or sedation records and PACU sheets retrospectively. Results : The number of DS cases was 25 (11%) and that of GA was 218 (89%). To maintain DS, intravenous propofol was infused with syringe pump (100%), and sevoflurane (134 cases) or propofol (13 cases) were used for sedation induction. Mean total treatment time for DS was 36 min and 2 hour 25 min for GA. The recovery time at PACU was 44 min for DS and 80 min for GA. There were no severe complications in DS, but 18 cases showed nausea and vomiting in GA. Conclusion : Deep sedation for disabled dental patients should be selected for effective behavioral control in conjunction with general anesthesia, considering duration and pain-evoking potentials of dental treatment and type and severity of patients' disabilities altogether.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.3
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• pp.581-589
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• 1997

42 dentally handicapped patients who require general dental treatments but behavioral managements had been an obstacle to proper treatments were chosen and the author conducted dental treatment under outpatient general anesthesia. Followings are the conclusions 1. The average time for the treatment procedure was 2 hours and 1 minute and the average of 9.52 teeth were treated for individual patient indicating its high efficiency. 2. The average time for the recovery was 3 hours and 14 minutes and none of the patients showed any specific serious complications. 3. Treatments under outpatient general anesthesia can be a proper patient management method for the dentally handicapped patients if the patient selection is proper.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.3
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• pp.177-181
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• 2012

Amyotrophic lateral sclerosis (ALS) is one of the major neurodegenerative diseases that involves degeneration at all levels of the motor system- from the cortex to the anterior horn of the spinal cord. Patients with ALS often have difficulty of ambulation for dental treatment though they have poor oral hygiene state. General anesthesia may cause respiratory problem due to its high sensitivity to muscle relaxant and weakened upper airway. In this case report, 38-year-old female patient with ALS required many dental treatments. Conscious sedation with intravenous target controlled infusion method was successfully employed and patient was discharged without any complications.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.2
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• pp.170-178
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• 2018

Behavior management of the child constitutes an important part of pediatric dentistry. The majority of children can be treated with adequate behavior management. However, some children who have extensive dental problems or mental, physical disabilities cannot cooperate. So, the need for general anesthesia as a special method of behavior management has increased recently. This study analyzes the records of patients who received dental treatment under general anesthesia. The 1378 cases of 1322 patients under 18 years of age, who received dental treatment under general anesthesia in department of pediatric dentistry at the Seoul National University dental hospital, from October, 2011 to December, 2015 were included. In this study, male (60.9%) was more than female (39.1%). The mean age of patients was 5.9 years and age from 5 to 9 years was the most frequent (56.0%). The primary dental treatment which patients received was dental caries treatment (51.1%), followed by surgical treatment (42.2%). The dental treatment under general anesthesia has many advantages including of performing a lot of treatments at once, producing good quality of treatment, and reducing the number of visits. General anesthesia may be a useful method of behavior management.

• Journal of Korean Academy of Dental Administration
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• v.10 no.1
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• pp.22-32
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• 2022

This study investigated factors affecting care for elderly patients, management of systemic disease, infection management, improvement of medical care quality, and educational requirements, and provide basic data for quality care for elderly patients with systemic diseases. An online survey was conducted among dental hygienists working at dental institutions and data of 172 individuals were analyzed using the SPSS 21.0 program. Descriptive statistics was performed for general characteristics. For factor analysis by general characteristics, t-test and ANOVA were performed. For differences between groups Scheffe verification was performed. A correlation analysis between factors was performed using Pearson's correlation analysis, and a factor analysis affecting the improvement of healthcare quality was performed using multiple linear regression analysis. Care for elderly patients was 52.33/75, management of systemic disease was 12.65/17, and infection management was 96.92/130. Improvement of medical quality (institutional effort) was 22.87/35, and improvement of medical quality (personal effort) was 22.72/35. The most common educational needs were "necessary". Analysis revealed a positive correlation between factors.. Factors affecting improvement of medical quality (personal effort) were age, final academic background, place of work, and the presence or absence of annual medical examinations. The findings of this study indicate that there is a significant correlation between factors. For the qualitative care of elderly patients, education programs related to elderly characteristics, systemic diseases, and infection management should be actively conducted by dental hygienists, and interest and research on geriatric dental hygiene is needed, centering on associations and educational institutions.

• Journal of the Korean Society of School Health
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• v.12 no.1
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• pp.131-141
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• 1999

The purpose of this study was to serve as a basis for the planning of oral health education and the development of an oral health-promotion program for patients who visited dental clinics by examining how much dental hygienists offered oral health education to adult patients at dental clinics. A parent group was selected, being made up of 1,600 dental hygienists who registered with the Dental Hygienist Association and worked in Seoul. The questionnaire survey was carried out and an ${\chi}^2-test$ was made using the data collected from 218 subjects to determine how their practice of oral health education was different according to certain general characteristics(the sort of organization for which they worked, age, the term of their service, and the mean number of patients per day). As a result, the following findings were obtained: 1. Thees general characteristics made the following differences to the content of oral health, education: The sort of organization for which the subjects worked made a significant difference in the following tooth brushing instruction (p<0.05), the effect of oral prophylaxis or education about aftereffects (p<0.05), the regular examination of prosthesis (p<0.05), smoking-prohibition education (p<0.05), and the prevention poor-quality fillings (p<0.01). The mean number of patients per day made significant differences to the regular examination of prosthesis (p<0.05) and the prevention poor-quality fillings (p<0.01). But no significant disparity was generated by age or the term of service. 2. The general characteristics made the following differences to education about nutrition and diet counseling: The sort of organization for which the subjects worked had a significant effect just on the importance of a balanced menu (p<0.05). Age made significant differences in advice for vitamin, mineral, protein or other nutrients (p<0.01), and the importance of balanced menu (p<0.001). The term of service made significant differences in the importance of balanced menu (p<0.01), and advice for nutrients including vitamin, mineral or protein (p<0.01). 3. The general characteristics made the following differences to the recommendation and use of oral hygiene aids: The sort of oragnization for which they worked made significant differences only to a gingival massager and water pick (p<0.05). No significant difference was produced by age, the term of service or the mean number of patients per day. 4. The use of educational media for oral health was different according to the general characteristics: The use of pamphlets or booklets significantly varied depending on the organization for which they worked and with the mean number of patients per day (p<0.05). The use of slides or slide projectors was significantly affected by age (p<0.05). But no significant disparity was yielded by the term of service. 5. The general characteristics made the following difference as to whether a continued oral management system was carried out or not: The sort of organization for which they worked had very a significant effect on this result (p<0.001), and no significant disparity was made by age, the term of service or the mean number of patients per day. 6. The place where oral health education was giver differed according to the following general characteristics: The sort of organization for which they worked made very a significant difference as to the use of an examination room's dental unit chair or waiting room (p<0.01), and to the use of an oral health education room or reception counter (p<0.001). The term of service had a significant effect on the use of a counseling room (p<0.01). And the mean number of patients per day made significant differences in the use of a dental unit chair or reception counter (p<0.05), and to the use of an oral health education room or waiting room (p<0.01).

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.114-118
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• 2017

Sedation or general anesthesia is often required to offer dental treatment to patients with special needs. However, patients with ASA classification of III or higher are not indicated for moderate sedation and might be exposed to danger when treated at outpatient dental clinic. For this reason, it is recommended to treat those patients under general anesthesia. The dental team can supervise and monitor the whole procedures during treatment with an appropriately equipped facility. This case report describes the dental treatment of a 7-year-old girl with multiple disabilities. Preoperative evaluation including medical consultation was carried out thoroughly and dental treatment was performed under general anesthesia safely.

• Journal of Korean society of Dental Hygiene
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• v.6 no.2
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• pp.93-102
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• 2006

This study investigated the satisfaction level of aged patients over sixty five years old or over who were treated in a dental hospital or clinic in the metropolitan area. The difference in satisfaction level by general characteristics of aged patients and characteristics related to the treatment as well as the correlation of satisfaction level by each factors with the overall satisfaction level of the treatment were analyzed, resulting as follows. 1. Satisfaction level of dentures by each factors resulted as following. Average general satisfaction level marked $3.47{\pm}0.74$, average functional satisfaction level marked $2.66{\pm}0.83$, and aesthetic satisfaction level marked $3.78{\pm}0.65$. 2. There were no significant difference in general and functional satisfaction level by each factors from the population statistic of the participants. Aesthetic satisfaction level differed by the educational background(p=0.01). 3. There were no significant difference in general and aesthetic satisfaction level by the oral health condition as well as the treatment quality. Functional satisfaction level differed by the oral health condition(p=0.01). 4. The correlation of satisfaction level by each factors with the overall satisfaction level of the treatment differed as follows. In case each factors were satisfactory, the overall result of the treatment marked satisfactory as well. However, in case each factors were dissatisfactory, the overall result of the treatment marked dissatisfactory showing difference with the above result(p=0.000). 5. Each factor showed statistically positive correlation. Functional satisfaction level and general satisfaction level showed the highest correlation(r=0.677).

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.99-104
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• 2012

Anticoagulation therapy with warfarin sodium is used to reduce the risk of thromboembolic events in patients with valvular heart disease, prosthetic heart valve, recurrent myocardiac infarction, etc. To keep anticoagulation state and minimize bleeding risk, patients with high risk of thromboembolism have been usually hospitalized for heparinization before oral surgery like extraction. However, this protocol requires time and high expense because of the long period of hospitalization and this is why low-molecular-weight heparin (LMWH) therapy is receiving attention in medical field as well as dentistry. LMWH has several advantages over unfractionated heparin (UFH) including predictable anticoagulant response which makes coagulation monitoring unnecessary in most patients and longer half-life than heparin which enables the patients to give themselves a subcutaneous injection once or twice daily. These advantages of LMWH make patients get oral surgery on an outpatient basis so that they can save time and cost. This case report introduces the use of LMWH in dental surgery and suggests proper use of LMWH. Though LMWH bridging therapy is widely used most of the previous studies are observational studies. Therefore randomized controlled trials are necessary to evaluate the safety and efficacy of LMWH bridging therapy.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.147-151
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• 2015

The difficult oral healthcare in intellectually disabled patients with poor behavioral control has led to debate over the cost-effectiveness and validity of implant treatment in these patients. The patient in the present report had schizophrenia that had led to poor oral care and severe dental caries in the full mouth. Tooth extraction and a removable prosthesis were planned, but the guardian wanted an implant procedure. Since the guardian showed strong will and cooperation with regard to the patient's oral healthcare, extraction followed by immediate implant placement was performed across two rounds of general anesthesia. Since the outcome appears successful, we present this case report. Immediate implant placement after tooth extraction requires fewer surgeries and rounds of general anesthesia, reduces horizontal bone resorption, and can achieve better esthetic results. Therefore, as long as a certain degree of oral care is possible, this can be a positive option for restoration of a partially edentulous mouth, even in intellectually disabled patients.