Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.44
no.4
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pp.143-150
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2018
The number of geriatric patients seeking dental service is ever-rising because of increased life expectancy, also with problem of increased chronic medical conditions. One of them are patients on anti-thrombotic medication. Bleeding complication after minor oral surgery by anti-thrombotic agents is of concerns to dentists on dental management of these patients. Risk and benefit of the anti-thrombotic agents must be weighed before initiating dental procedures, which should be established as a treatment guideline. Purpose of the paper is to optimize the management of the dental patients on antithrombotic medication via standardization of treatment protocol of such a patient.
The aim of this research was to analyze the differences for the oral health status of the elderly people living in the long-term care facilities and the non-resident elderly. The study was conducted on 469 elderly people of the same age, gender and basic living conditions. Elderly residing in long-term care facilities had higher dental caries prevalence(p=0.019), DT(p=0.001), and MT(p=0.047) than non-resident elderly, and had lower FT(p<0.001) than non-resident elderly. The elderly living in facilities were 1.93 times more likely to be caries than non-residents, and 0.73 times more likely to have a filled tooth. The probability of denture use was 0.15 times for the maxillary and 0.13 times for the mandibular. The probability of denture needs was 5.61 times for the maxillary and 5.65 times for the mandibular. All of these results showed significant differences. As a result of this, it can be used as basic data for establishing oral health policy for oral health promotion of the elderly living in Long-term care facilities.
This study was executed to find out the outcome of Incremental Dental Care from September to November, 2004. 40 visitors to oral health center were examined on the oral conditions every week, seven times during above-mentioned period. Various tests were practiced in order to check their oral conditions before and after IDC such as tooth-brushing method/frequency/duration, calculus index, PHP index, halitosis and dental caries activity. Question and answer sheets were presented to student dental hygienists and 40 visitors respectively after IDC program. Results obtained are as follows. 1. Rotation method of toothbrushing increased from 27.8% to 88.9%. for men and increased from 27.3% to 95% for women. 2. Toothbrushing frequency increased from 2.8 times to 3.0 times a day for men and increased from 2.6 times to 3.1 times for women. Toothbrushing duration increased from 2.3 minutes to 2.8 minutes for men and increased from 2.1 minutes to 2.9 minutes for women. 3. Calculus index reduced from 0.5 to 0.1 for men and reduced from 0.7 to 0 for women. PHP index reduced from 3.7 to 3.0 for men and reduced 3.2 to 1.7 for women. However, halitosis didn't mark any significant difference before and after IDC. 4. Saliva buffering capacity of medium plus showed no change for men(94.5%), however increased from 95.4% to 100% for women. Dental caries activity of medium plus in S.mutans reduced by 4.3 times(72.2% to 16.7%) for men and reduced by 2 times(36.4% to 18.1%) for women. LB test results reduced by 1.5 times(50% to 33.3%) for men and reduced by 2.5 times(50% to 18.1%) for women. Alban's test results reduced by 1.4 times(83.3% to 61.1%) for men and reduced by 1.2 times(81.8% to 68.2%) for women. 5. All participants including visitors and students realized the importance of IDC and expressed a great satisfaction with IDC program. In conclusion, it is considered very necessary that IDC program should be maintained and extended to whole country so as to enhance the peoples' oral health conditions.
The objective of this study was to examine whether there is an association of oral health conditions between mothers and their preschool children in Korea. A sample of 823 preschool children and their mothers were selected for this study from the database of the fourth Korean National Health and Nutrition examination Survey. Preschool children were defined as children aged 4, 5, and 6 years old. The subjects were clinically examined for the presence of caries lesions (dft index) and their mother was checked for the presence of dental caries (DMFT index) and periodontal status (CPI). The socio-demographic characteristics and mother's oral health behaviours were considered covariates in this study. Univariate and multivariate analysis was adapted to assess the association of oral health condition between mothers and their preschool children. In univariate analysis, there were significant differences between preschool children's dft index and their mother's age (p=0.005), dental treatment demand for the past one year (p=0.034), and DMFT index (p=0.016). In multivariate analysis, only mother's DMFT index was significantly associated with their children's dft index after adjusting for covariates. In conclusion, the mother's oral health was partly associated with their preschool children's oral health in Korea.
The purpose of this study is to verify factors affecting the use of dental hygiene care products in adults. The study used a nationally representative sample of Koreans (2013 Korea National Health and Nutrition Examination Survey) aged 19 years over (n=4,839). Dependent variable was frequency of tooth brushing per day, use of dental floss, use of interdental brush and use of mouth rinse. Independent variable was sociodemographic factors, health behaviors, perceived health and oral health conditions. The chi-square test and logistic regression analysis were performed to identify the factors affecting the use of dental hygiene care products. All analyses were performed using PASW Statistics version 18.0. Resulting of chi-square test, the use of oral hygiene care products was statistically significant with gender, age, education level, household income, marital status, dental utilization, dental examination. Resulting of logistic regression, in female, the higher the education level was identified as common factors for variables in use of dental hygiene care products. Dental hygienist among dental professionals should play an important role as contributor to the national oral health promotion that recognizes the impact of each factor by refining dental hygiene care products and reflect personal characteristics and preferences through the oral health educational media and program development.
Tobacco smoking is a major risk factor of systemic health and also impairs oral health, which is related to development of oral cancers, periodontitis, delayed wound healing, tooth loss, failure of implant, etc. Aside from smoking, many other risk factors can be related to oral health and long-term effects of smoking on salivary flow and taste threshold are still in controversy. Authors considered dental students to be an appropriate group with good oral hygiene for a long-term study to reveal effects of smoking on oral health. This study was performed to compare smoking patterns and current oral health conditions between smokers and nonsmokers in dental students prior to long-term evaluation. 192 volunteers (85.7%) of 224 male dental students in Dankook University were evaluated through questionnaires and clinical examination in 2010. Questionnaires included smoking pattern, alcohol use, nicotine dependence, preventive care, psychological profile and clinical examinations comprised assessment of teeth or periodontal status, nicotine pigmentation, salivary flow, electrical taste thresholds and halitosis. From the study, (current) smokers were older, and drank more frequently with more alcohol intake compared to former smokers and nonsmokers(p<0.05). There was no significant difference among them in salivary flow rate, halitosis and electrical taste threshold. However, there was significant difference in DMFT rate, periodontal treatment need, nicotinic pigmentation between smokers and nonsmokers(p<0.05), irrespective of their levels of preventive care. The smokers in this study, who are young dental students with relatively shorter duration of smoking, less use of cigarettes and low level of nicotine dependence, did not reveal significant impairment of oral health. However, their oral health was found to be relatively impaired compared to nonsmokers', which suggests negative effect of smoking on the oral health and a need of smoking cessation.
Priority setting in national health insurances in major advanced countries and the nation was investigated to draw the criteria for priority setting and suggest the most rational criteria for dental insurance so as to help secure the efficiency of medicare financing and individual's health right and also elevate medical consumers' satisfaction with health insurance. 1. Priorities in national health insurance are different from country to country, depending on the medical security systems, priority introducing conditions, and social environment, but have many common factors. 2. The priority setting criteria for national health insurance in those countries include the following in common: the efficiency, equity, and cost effect of treatment, emergency of treatment, consumption of expense, efficacy of treatment, patient's receptiveness, patient's demand, severity of disease, and patient's responsibility for the disease. 3. In oral diseases, severe diseases including oral cavity cancer are low in rate, and in-hospital treatments are few. From the above findings, it is suggested that dental insurance should establish discriminative criteria for priority setting by reflecting the aspects of dental diseases and system difference between dental and other health insurances and taking account of efficiency of treatment through prevention, cost effect, prevalence and incidence of generalized diseases, and individual's financing burden.
Verruco-papillary lesions (VPLs) of the oral cavity described in the literature involve a spectrum of conditions including squamous papilloma, verruca vulgaris, focal epithelial hyperplasia, condyloma, proliferative verrucous leukoplakia and verrucous carcinoma. A majority of the VPLs are slow growing, benign in nature and have a viral aetiology. Virus associated benign mucosal outgrowths are not too difficult to diagnose either clinically or by microscopy. Apart from virus-associated lesions, VPLs harboring malignant potential or behaviour such as verrucous carcinoma, proliferative verrucous leukoplakia, oral verrucous hyperplasia (OVH), oral papillary squamous cell carcinoma (PSCC) and oral conventional squamous cell carcinoma with papillary features (CSCC) need to be further clarified for better understanding of their predictable biologic behavior and appropriate treatment. Current understanding of potentially malignant VPLs is perplexing and is primarily attributed to the use of confusing and unsatisfactory terminology. In particular, the condition referred to as oral verrucous hyperplasia (OVH) poses a major diagnostic challenge. OVH represents a histopathological entity whose clinical features are not well recognised and is usually clinically indistinguishable from a verrucous carcinoma and a PSCC or a CSCC. A consensus report published by an expert working group from South Asia as an outcome of the 'First Asian Regional Meeting on the Terminology and Criteria for Verruco-papillary Lesions of the Oral Cavity' held in Kuala Lumpur, Malaysia, recognised the clinical description of these OVH as a new entity named 'Exophytic Verrucous Hyperplasia'. Previously described clinical features of OVH such as the 'blunt' or 'sharp' variants; and the 'mass' or 'plaque' variants can now collectively fall under this newly described entity. This paper discusses in detail the application of the standardized criteria guidelines of 'Exophytic Verrucous Hyperplasia' as published by the expert group which will enable clinicians and pathologists to uniformly interpret their pool of OVH cases and facilitate a better understanding of OVH malignant potential.
Osteomyelitis of the jaw is an inflammatory process of the bone marrow that is caused by odontogenic local infection and trauma such as tooth extraction and fractures in the oral and maxillofacial region. The clinical signs include pain, swelling, pus formation, and limited mouth opening. Chronic osteomyelitis presents a diagnostic challenge because of the variability of symptoms across different disease stages and varying health conditions of the patients. This report presents a case of osteomyelitis that was misdiagnosed as a temporomandibular joint disorder (TMD) after tooth extraction. The patient was treated for inflammation after tooth extraction in the early stage; however, as the osteomyelitis progressed chronically, symptoms mimicked those of a TMD. The patient was finally diagnosed with osteomyelitis 6 months after tooth extraction. A review of this case and relevant literature revealed the necessity for a differential diagnosis of chronic osteomyelitis that mimics TMD symptoms.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.32
no.4
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pp.334-347
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2006
The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.
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