Hyperparathyroidism (HPT) is a significant condition marked by the overproduction of parathyroid hormones, affecting both systemic health and orofacial regions. Predominantly, secondary HPT associated with chronic kidney disease (CKD) is critical because of its link to widespread conditions such as diabetes and hypertension. This short article highlights the vital role of dental professionals in identifying HPT through panoramic radiography, which can reveal critical orofacial signs such as brown tumors, altered dental development, and specific bone changes. With the CKD prevalence expected to increase alongside an aging population, the importance of early detection of HPT and its manifestations in dental settings cannot be overstated. Dental practitioners play a crucial role in the early detection of HPT, emphasizing the importance of being knowledgeable about its orofacial manifestations.
문제제기: 노인요양시설은 치과진료영역 가운데 가장 취약한 상태에 놓여 있고 신체적, 정신적 장애로 인해 주관적 치료요구도를 파악할 수 없는 상태지만 이에 대한 기초적인 실태조사가 전무한 상태이다. 목적: 본 연구는 노인요양시설에서 노인환자들의 치아우식증에 의한 구강실태를 조사하고, 기능치아와 보철물로 이루어진 교합단위를 분석하여 그에 따른 치과치료수요도를 분석하는데 목적이 있으며 향후 적절한 진료방향을 수립하는데 기여하고자 한다. 연구재료 및 방법: 노인요양시설에서 758명의 노인환자와 D치과의원에 내원한 212명의 65세 이상인 노인을 대상으로 2000년 국민구강건강실태조사에서 작성된 치아우식검진지침에 입각하여 구강실태조사를 시행하였다. 결과: 노인요양시설의 노인에게서 고령으로 갈수록 대조군에 비해 악화되고 있는 구강상태를 알 수 있었고 매우 높은 치료수요를 파악할 수 있었다. 고찰: 노인환자의 구강건강관리를 위해서는 무엇보다도 이들을 보살피는 간병인과 간호 인력들이 가지고 있는 구강건강의 중요성에 대한 인식을 바꾸기 위한 노력이 절실히 필요한 상황이다. 이제는 무치악 환자에게 시행되고 있는 일회성 의치사업 일변도의 복지정책방향을 보건복지부와 일선 지방자치단체에서 사후관리를 원칙으로 한 전문가에 의한 무치악 환자의 의치사업으로 강화해야 하며 유치악의 노인환자들에 대한 정기적인 치과검진을 시행하고 이동진료 및 왕진시스템이 보완된 구강건강관리 및 보존, 수복진료 형태로의 전환을 고려할 시점이라 생각된다.
Background: To analyze the effect of self-regulation on the fear of dental treatment in order to use it as basic data for efficient oral health care among male adolescents. Methods: A survey was administered to 241 first graders of specialized high schools in Daegu using a self-entry method. Twenty questions about fear of dental treatment and fifteen questions about self-regulation were included. The higher the score, the higher the fear of dental treatment and the self-regulation ability, showing a high reliability of 0.972 and 0.750, respectively. Results: The mean score of the participants' self-regulation ability was 3.25±0.51 and that of the degree of fear for dental treatment was relatively low at 1.72±0.85. It was confirmed that the higher the academic performance (F=7.635, p<0.01), the better was the self-regulation based on self-diagnosis (F=3.142, p<0.05), and was associated with higher health awareness (F=5.894, p<0.01). The degree of fear for dental treatment was significantly higher in the self-diagnosis-induced poor health group (F=4.933, p<0.01) and associated with a lower awareness of health (F=3.093, p<0.05). The participants' self-regulation ability was significantly negatively correlated with the degree of fear regarding dental treatment (r=-0.269, p<0.01). Regression analysis was performed using the degree of fear as a dependent variable and including sub-area variables of self-diagnosis-based health status, perception of health, and self-regulation ability as independent variables (β=-0.163, p<0.05). Among the self-regulation abilities, controlled composition (β=-0.232, p<0.01) had a significant effect; the higher the composition, the lower the degree of fear. The total explanatory power of this variable was 8.5%. Conclusion: An appropriate customized education program that can encourage individuals to practice self-care and maintain oral hygiene along with a clear understanding of underlying individual oral health conditions during adolescence is essential for promoting oral health.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제47권1호
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pp.25-33
/
2021
Objectives: Many conditions of the oral and maxillofacial region require hospitalization and in-patient care. The average length of stay (LOS) of these patients varies and is usually affected by multiple confounding variables. However, even with an increasing number of hospital admissions, published evidence on the factors that affect the LOS of oral and maxillofacial patients is lacking. Therefore, this study assessed the LOS of in-patients at the oral and maxillofacial surgery department of a government-funded, multi-specialty hospital in Malaysia, based on their reasons for admission and other factors. Materials and Methods: Our samples were collected retrospectively over a 5-year period and included patients with maxillofacial infections, post-trauma stabilization, facial bone fracture surgery, benign and malignant lesion surgery, dentoalveolar surgery, and other maxillofacial surgeries as reasons for admission. Factors potentially affecting LOS were also recorded, and their significance was determined using multiple logistic regression analyses. A P-value of less than 0.05 was considered to be statistically significant. Results: A total of 1,380 patients were included in this study. Most (84.5%) of our in-patients were of Malay ethnicity, and males outnumbered females in our sample by 502 subjects. The median LOS of our in-patients was 3 days. Sex, ethnicity, age, reason for admission, and American Society of Anesthesiology (ASA) classification were factors that significantly affected LOS. Conclusion: The median LOS reported in this study was 3 days. LOS was significantly affected by sex, ethnicity, age, reason of admission and ASA classification.
A 26-year-old female patient with Down syndrome visited to recieve dental treatment under gnenral anesthesia 6 years ago. The patient had difficulties in oral examination, radiograph taking and laboratory test. The patient had congenital heart disease and medical consultation based on the echocardiography was provided by a cardiologist indicating that the patient could tolearte general anesthesia during dental treatment. And two times of general anesthesia were administered during a dental treament with the interval of 3 years and no postoperpative complicaton was reported. At the third dental operation, the patient had a relatively good condition and her prescreening test revealed no abnormalities. Without further consultation with a cardiologist, general anesthesia was administered to the patient. Anaesthesia was based on thiopental and ventilation of desflurane and $N_2O$ in oxygen via an endotracheal tube with an appropriate monitoring. During the maintenance of anesthesia, the blood pressure of the patient started to drop and the oxygen saturation also began to decrease. Consequently, the proceding operation was discontinued and also inhalation anesthesia was ceased. As the patient was recovered from anesthesia, her systemic conditions were alleviated. After the complete recovery of the patient, she visited the cardiologist, and the cardiologic test revealed her severe right ventricular dilatation. In the anesthesia of patients with congenital heart disease, information on their systemic conditions needs to be undated from the medical consultation, which assures the safety of treatment.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제30권6호
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pp.545-550
/
2004
Salivary glands, major and minor, are susceptible to a wide variety of pathologic conditions. Excision of the submandibular gland is a surgical procedure often undertaken. The procedure is the treatment of choice for patients with neoplasm of the submandibular gland and those with non-neoplastic submandibular disorders which are not controlled with conservative medical measures. Extirpation of the submandibular gland may also be undertaken for diagnostic purposes. We evaluated 84 patients who had been admitted to the dept. of oral and maxillofacial surgery of Pusan National University Hospital from January, 1989 to December, 2002 and had been performed submandibular gland excision. The results are as follows : 1. The patients undertaken the excision of the submandibular gland showed an age range of 16 to 71 years. The average was 49.1. 2. They consisted of 60 males(71.4%) and 24 females(28.6%), having 2.5 : 1 of genda ratio. 3. The most common symptom was swelling in 41 cases(48.8%), followed by the pain in 23 cases(27.4%). Other symptoms included mass, dysphagia, facial abnormaly and neck dyscinesia. 4. 42 cases(50.0%) showed sialadenitis and sialodochitis associated with salivary calculus. 5. According to the histopathologic study, all cases consisted of 17 neoplasmatic conditions(20.3%) and 67 non-neoplasmatic(79.7%). The neoplasmatic cases included 13 benign tumors and 4 primary malignant tumors. Sialadenitis and sialodochitis associated with or without salivary calculus were most marked, found in 50 cases(59.3%), in the non-neoplasmatic conditions. Pleoomorphic adenoma showed the highest frequency of the benign tumor.
Objectives: Oral diseases can be prevented, and early treatment through dental checkups is important. This study was investigated the relationship between dental checkups and unmet dental care needs in Korean adults. Methods: From the data of the 7th Korean national health and nutrition survey (2016-2017), the final 9,300 of the 16,277 participants selected as the method for extracting stratified colonies by complex sample design. A structured questionnaire interview was used, and chi-square test and multiple logistic regression analysis were performed. Results: The relationship between dental checkups and unmet dental care needs for the last one year was analyzed by controlling demographic characteristics, variables related to health conditions, and "use of dental clinics for the last year." The unmet dental care needs were 7.57 times higher (CI: 6.49-8.83) for non-users of dental clinics for 1 year, and 1.32 times (CI: 1.13-1.54) for dental checkups for 1 year compared to non-dental checkups patients. Conclusions: As described above, there was a close relationship between adult dental checkups and unmet dental care needs. Therefore, it is suggested that it is necessary to expand educational publicity and prepare policy strategies such as visiting dental checkups to improve the adult dental checkups.
Objectives: The study aimed to identify the oral health factors that affect the nutritional status of the elderly. Methods: The study was conducted over ten months from September 2013 to June 2014, and included senior citizens who were supported by the visiting health service. The rate of saliva release, the number of remaining teeth, and the ability of the elderly to identify nutritional conditions were evaluated. Statistical analyses were performed using the t-test, ANOVA, and multiple linear regression using SAS 9.4 (SAS Institute Inc., Cary, NC, USA.). Results: The study participants had an average irritation saliva secretion rate of $2.26{\pm}1.11mg$ per minute. The higher the rate of saliva secretion, the higher the mini nutritional assessment (MNA) score (p<0.001). The average number of remaining teeth was $8.21{\pm}9.76$. The MNA scores were highest in groups with 11 or more remaining teeth (p=0.001). The factors that affected the nutritional condition of the elderly were their ability to perform activities of daily living, saliva flow rate, and number of remaining teeth. The highest correlation among them was that of the standardized regression coefficient was - 0.386 by activity daily living, followed by a 0.170 saliva secretion rate and 0.118 remaining teeth in daily life performance. Conclusions: Activities of daily living and rate of saliva secretion showed the highest correlations to nutritional status of the elderly.
The job of dental hygienists is specialized, and they have to be capable of performing their primary duties including prevention of oral diseases, oral prophylaxis, and oral health education. To ensure their successful job performance, dentists should have an accurate understanding of their duties and need a change of mind-set about them. And there should be written legal and concrete regulations on the coverage of their work in order to let them boost their job performance with pride and a sense of responsibility. The purpose of this study was to examine the actual roles and job performance of dental hygienists in clinical field in an attempt to discuss the substantial job performance of dental hygienists and their job enlargement. It's basically meant to help enhance the efficiency and quality of medical services. The subjects in this study were 471 dental hygienists in dental clinics, dental hospitals, university hospitals and general hospitals across the nation, on whom a survey was conducted in person from March 2 to 25, 2005. The collected data were analyzed with SPSS Win 12.0 program, and the findings of the study were as follows: 1. The major jobs they currently performed included oral health education, hospital management, simple duties, extensive dental hygiene duties and joint treatment assistance. They hoped to continue to be responsible for oral health education, preventive treatment and extensive dental hygiene duties. 2. As for their current job by age, extensive dental hygiene duties, preventive treatment, joint treatment assistance, preserving treatment, prosthetic treatment and pediatric treatment were most conducted by the dental hygienists who were at the age of 26 to less than 31, and those who were at the age of 31 and up were most responsible for hospital management and simple duties. 3. As to job awareness by workplace, their workload was statistically significantly different according to their workplace. The hospital employees took care of more work than those in clinics. 4. Concerning job awareness by age, the younger dental hygienists suffered more role conflicts and were given a less free hand in work handling, the middle-aged group's job was uncertain. Legal regulations about the coverage of their work should be prepared in detail as a measure to stir up their responsible job performance and pride. In order to take advantage of experienced dental hygienists, their duties should be more differentiated and specialized, and their working conditions should be improved to boost their job satisfaction. That is, they should be given ample chances for promotion and serving as a middle manager and be given fair treatment according to their career. If their work is accurately darified and specialized based on career, it will boost the efficiency of dental treatment. Dental hygienists also should direct sustained efforts into self-development in order to become a skilled and professional oral health personnel.
Objectives: This study was conducted at a request for cooperation through an analysis of the effect of toothbrushing facilities at a public health center in Seongdong-gu. Also, with the aim of furnishing basic data to the proposal of a program for improving the ability of school aged children in managing oral cavities and developing a correct toothbrushing habit, the study conducted an investigation of how toothbrushing facilities affect change in the oral environment management ability and behavior of oral health care. Methods: From among elementary schools located in Seongdong-gu, Seoul the study selected A Elementary School where toothbrushing facilities were established and have been operated since 2008, B Elementary School in an adjacent region within the jurisdiction of Seongdong-gu where the demographic environment was similar among schools where toothbrushing facilities were newly established in 2012, and C Elementary School without toothbrushing facilities. Then the study was aimed at first grade students of the schools and an investigation was carried out from April to December 2012. Through a dental checkup, the study evaluated the teeth and periodontal health conditions, and a test of the oral environment management ability was undertaken three times. Regarding change of oral health care behavior, the study carried out a self-recording survey. Results: 1. Concerning decayed and filled tooth(dft) and decayed and filled surface (dfs), A Elementary School where toothbrushing facilities have been established and operated from the past showed a relatively lower decayed, missing, and filled teeth index than B Elementary School where toothbrushing facilities were established in 2012 or C Elementary School without toothbrushing facilities; however, there was no significant difference (p>0.05). For CPI, there was no significant difference by school; however, in looking into the difference between boy students and girl students, Code (0) was discovered higher in boy students whereas Code (1) was shown higher in girl students. 2. In the PHP index test in accordance with the existence of toothbrushing facilities before the installation of toothbrushing facilities, for A Elementary School where toothbrushing facilities have been established and operated from the past, the school recorded 4.28 points whereas B Elementary School where the facilities were established in 2012 recorded 3.51 points. Meanwhile C Elementary School without the facilities posted 4.30 points. Therefore there was a statistically significant difference according to the existence of toothbrushing facilities (p<0.05). 3. In a comparison of teeth health care behavior according to the existence of toothbrushing facilities, the number of answers that the respondent did not brush their teeth after lunch over the past one week was higher in B Elementary School and C Elementary School where there were no toothbrushing facilities. Regarding the average number of brushing after lunch for one week, it was discovered higher in A Elementary School (p<0.01). 4. In change of teeth health care behavior before and after the establishment of toothbrushing facilities, the case of answering that the respondents did not brush their teeth after lunch for one week increased more after establishment than before establishment. Also the average number of teeth brushings after lunch for one week decreased further after the establishment of toothbrushing facilities; however, it did not show a significant difference (p>0.05). One of the reasons that they do not brush their teeth, "the lack of a place", decreased significantly after establishment than before establishment (p<0.05), whereas the answer, "because their friends do not brush their tooth" increased greatly after establishment than before establishment; however, there was no significant difference (p>0.05). 5. In the comparison of the degree of knowledge about dental health according to the existence of toothbrushing facilities, the degree of knowledge about dental health was shown significantly higher in A Elementary School with toothbrushing facilities than in B Elementary School and C Elementary School where there were no toothbrushing facilities (p<0.01). Conclusions: Given the above results, it is difficult to attract change in behavior only with an environmental improvement; therefore, it is deemed necessary to develop an educational program that will help children to make a habit of oral health care not only through a school but also through a related policy and financial support of government organizations as well as the construction of the basis of a systematic and consistent cooperative system with relevant organizations.
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