• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.12 no.2
• /
• pp.55-65
• /
• 2016

The objective of this study was to estimate the proper amount of subsidy required to operating dental hospital or clinic for the disabled. Models for estimating operating profit of general dental hospital/clinic and opportunity cost of operating dental hospital/clinic for the disabled was formulated. Data were collected from various sources such as the annual reports of Purme Hospital, one of the running dental hospitals for the disabled, statistics from Healthcare Bigdata Hub, operated by Health Insurance Review & Assessment Service of Korean Government, and the deliberation data of non-reimbursable treatments in Seoul Dental Hospital for the Disabled. A dental hospital/clinic for the disabled was less profitable than a general dental hospital/clinic, of which the reason is that the chair time for the average patient is longer. However, It was false that a dental hospital/clinic for the disabled scored less average insurance fee for a treatment. Disabled patients had more frequent prosthodontic treatments, which had a high average insurance fee. There were some groups of treatments that could yield higher profitability in a dental hospital/clinic for the disabled; recall checks, and periodontal treatments.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.15 no.1
• /
• pp.1-6
• /
• 2019

There are increasing number of patients having dental treatment under outpatient general anesthesia. There were researches that studied patients treated under outpatient general anesthesia in Chonbuk National University Dental hospital between 2005~2013. However, there has been an absence of research since 2013. Therefore, the aim of this research is to study cases regarding outpatient general anesthesia visiting Chonbuk National University hospital between 2014~2017 and analyze the trends of these patients. The medical records of 409 cases from January, 2014 to December, 2017 were reviewed. From the patients' charts, data on sex, residence, visiting dates, disability status, and types and number of treatments was collected and investigated. The number of cases has increased from 86 in 2014 to 140 in 2017. Among 409 cases, 275 cases(67.2%) had disabilities, with mental disabilities consisting most of the disabilities. 192 cases were aged under 20 years old mostly with no disabilities, 142 cases were 20~39 years old mostly with mental disabilities, and 75 cases were 40 years old or more mostly with physical disabilities. The conservative treatment was performed most frequently in both disabled and non-disabled patient groups. There was an increasing trend in the number of patients treated under outpatient general anesthesia, and more than half were disabled patients. In order to meet this demand, Chonbuk National University Dental Hospital increased the number of general anesthesia pracrice. To follow this trends, the implementation of safe outpatient general anesthesia system and cooperation among teams is needed to improve the quality of treatments.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.13 no.1
• /
• pp.1-5
• /
• 2017

According to the Ministry of Health and Welfare, the portion of physical disability was 51.4% which was the highest among the registered disabled in December 2015, followed by visual disability(10.1%), disability of the brain lesions(10.0%), hearing disability(10.0%). The aim of this study is to investigate the types of disability in patients with disabilities visiting the Pediatric Dentistry, Chonbuk National University Dental Hospital in 2016. Of the patients who visited the pediatric dentistry, 196 patients (7.5%) had disabilities, and 19 patients had two or more disabilities. Twelve patients (6.1%) had both disabilities of brain lesion and intellectual disorder. Of the 177 patients with only one disability, 54 patients (30.5%) had physical disorders and 123 patients (69.4%) had psychiatric disorders. In psychiatric disorders, intellectual disorder was the most with 98 patients (55.3%), followed by autistic disorder with 23 patients (12.9%). In physical disorders, disability of brain lesion was the most with 37 patients (20.9%), followed by speech disability with 8 patients (4.5%). In this study, as a result of analyzing the types of disability with the patients who visited the Pediatric Dentistry of Chonbuk National University Dental Hospital, most of them had either intellectual disorder, disability of brain lesion, or autistic disorder. Dentists need to understand their general and dental characteristics to treat children and adolescents with disabilities. Since the most chief complaint of the patients was dental caries, early interventions should be made by dentist to reduce the incidence of the disease.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.2 no.2
• /
• pp.156-160
• /
• 2006

Self-injurious behavior is defined as deliberated harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, body hitting, skin cutting, or finger biting and includes ocular, genital, and self-inflicted oral mutilation. Self-injurious behavior can occur with mental retardation, comatose status, psychotic problem, poisoning, or character disorders. In pediatric patients, self-injurious behavior usually is reported to lip, cheek and tongue biting, and many kinds of dental management methods have been introduced to prevent self-injurious behavior patients from self biting. This report presents some self-inflicted oral mutilation patients who were all treated successfully with several appliances.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.1
• /
• pp.19-25
• /
• 2004

Dentally disabled person means one who have difficulty in cooperating voluntarily with a dentist for routine dental care. Seoul National University Dental Hospital (SNUDH) Dental Clinic for Disabled has worked for them under outpatient anesthesia concept. The aim of this study was to determine the anesthetic characteristics of the patients attending for dental treatment at SNUDH Dental Clinic for Disabled in order to establish better future treatment plans. The data were drawn from the patients who visited SNUDH Dental Clinic for Disabled from January 1999 to October 2002. Total 93 dental treatments for 83 patients were enrolled in this study. Most patients had mental retardation and the conservative treatments were carried out under general anesthesia. Thiopental and vecuronium were mostly used for induction agent and neuromuscular blocker, respectively. Enflurane, with oxygen and nitrous oxide, was mostly used to maintain the anesthesia. Mean total anesthetic time was $164.4{\pm}57.2$ minutes and mean duration at the post-anesthetic care unit was $106.2{\pm}50.5$ min. Serious postoperative complications were not observed. These results showed our successful anesthetic outcomes without any severe side effect or complication and the needs of more outpatient centers for dental care for disabled.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.3
• /
• pp.187-193
• /
• 2024

Background: Patients with autism spectrum disorder (ASD) present challenges in dental treatment cooperation owing to deficits in communication skills and social interaction. Behavioral guidance, sedation, and general anesthesia may be employed to ensure the quality of dental care for individuals with ASD. This study aimed to examine the trends in dental treatment for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital, an oral health center for the disabled in the Gyeonggi region, over the past 10 years. Methods: This study utilized the order communication system to gather data on sex, age, cooperation level, number of quadrants treated, and administration of sedation or general anesthesia for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital between January 2013 and December 2022. Results: The total number of patients with ASD increased annually, possibly due to an increase in ASD prevalence and the hospital's designation as a center for disabled oral health. General anesthesia was predominant before 2017, with a shift towards N₂O-O₂ sedation. The most common age group for sedation or general anesthesia was 6-9 years, with a higher prevalence in males than in females. Notably, N₂O-O₂ and midazolam sedation resulted in better cooperation and fewer treated teeth than general anesthesia. Conclusion: This study highlights the evolving trends in dental treatment for individuals with ASD, indicating a shift towards outpatient methods, particularly N₂O-O₂ sedation. The sex distribution aligns with national statistics, emphasizing a higher prevalence of ASD in males than in females. These findings underscore the need for further research to establish evidence-based guidelines for optimal dental care strategies tailored to the unique needs of individuals with ASD.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.20 no.1
• /
• pp.1-8
• /
• 2020

Behaviour management and dental procedures performed in very young, pre-cooperative, highly anxious, or medically disabled children are challenging tasks. Various drugs and methods have, however, been introduced to facilitate treatment for this patient population. Midazolam is a benzodiazepine used as an adjunct to behavior management techniques in the dental treatment of pediatric patients. Midazolam can be used as a safe and effective drug for conscious sedation, general anesthetic premedication, and treatment of seizures during dental procedures. Nevertheless, further research involving pediatric patients would be beneficial.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.14 no.2
• /
• pp.59-64
• /
• 2018

This study proposed a registered dentist model for the disabled based on consumer in-depth interview and supplier survey. This study proposed that dental clinics in the community take role as registered dentists for the disabled. Qualification screening and facility prerequisites are required to be selected as the registered dentists for the disabled and patients of the registered dentists were restricted to the disabled who can cooperate to dental treatment services with or without the aid of physical bondage. In order to encourage the participation in the program, subsidies for the registered dentists were necessary. Also, this study proposed financial supports for the medical expenses for patients at the same level as the current dental care center for the disabled. The registered dentist program for the disabled meets the needs of disabled consumers, such as accessibility of medical institutions, expertise of medical staff, and ongoing treatments with familiar medical staff. The registered dentist program for the disabled is expected to provide prevention and ongoing management for oral health promotion of disabled people and it also contribute to lower economic burden of oral health care of the disabled.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.3 no.1
• /
• pp.11-16
• /
• 2007

The use of general anesthesia as a special method of behavior management is necessary if certain handicapped or disabled child patient to receive dental treatment. This study was designed to report the results of 53 cases of complete oral rehabilitation under general anesthesia. The data were obtained from patients who were provided with dental treatment under general anesthesia for last 3years managed at the Dept. of pediatric dentistry in PNU Hospital. The distribution of age, gender, primary reason for general anesthesia, duration of dental procedure, number of treated tooth and periodic recall check-up were surveyed. In distribution of age, most(78%) were younger than 10 years and mean was 13.0 years. The reasons for providing general anesthesia were lack of cooperation due to various mental and physical handicapped situation(74%), congenital heart disease(13%), combined with medically compromised and behavior problem and others. The average duration of the treatments was 2 hours and 41 minutes and average duration of the anesthesia was 3 hours and 6minutes. The mean number of treated with restoration a children were 16.7 teeth. From the results, total dental rehabilitation under general anesthesia is a favorable modality to improve for disabled children's oral condition.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.17 no.2
• /
• 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.