• 대한장애인치과학회지
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• 제15권1호
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• pp.7-13
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• 2019

The aim of this study was to clarify the barriers of dental treatment for special needs patients felt by dentists and to determine the dentist-related factors contributing to the obstacles in treatment planning and decision making. Questionnaires were distributed and responded by dentists working at five public-based special care clinics in South Korea. Factors divided into three parts (dentist demographics, clinical factors, and educational and administrational factors) were assessed and analyzed for correlations between dentist-related factors and dentist-felt burdens for special care treatment. Fisher's exact test and Chi-square test were used at the level of 0.05. A total of 34 dentists responded to the questionnaires. Almost all dentists had obstacles in the treatment of special needs patients in terms of the patients' lack of cooperation (94.1%), proxy communication with caregivers (94.1%), payment reward system (63.6%), deficient workforce (67.7%), and others. The longer dentists had been practicing for special needs patients, the more they were dissatisfied with the reward system and a longer time was spent for communication with patients and their caregivers (p<0.05). For specialists, more obstacles were experienced in treatment planning due to a deficiency in the clinical information obtained from their patients compared to general practitioners (p<0.05). A total of 82.4% of the respondents approved of mandatory educational programs for special care dentists. There were practitioner-based factors related to the amount of obstacles felt by special care dentists. To overcome the treatment barrier of special needs patients, in-depth education and training are required in special care dentistry.

• 대한장애인치과학회지
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• 제14권1호
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• pp.7-10
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• 2018

Special care dentistry, also known as special needs dentistry, is concerned with the oral health of people who have intellectual disability, or who are affected by other medical, physical, or psychiatric issues. Dental schools must educate dental students for the competency in managing and treating individuals with special health care needs. The purpose of this study is to identify the current status of special care dentistry education in Korean dental schools. A questionnaire relating to the education of special care dentistry was sent to eleven dental schools in Korea via email. The result turned out that eight out of eleven schools had classroom teaching of special care dentistry, while only four had practical teaching programs. Nine schools had dental clinics for the disabled, in which two of them had special care clinics within the Pediatric dentistry clinic, and other seven in separate clinical sites. Despite the increased interest in special care dentistry, education including classroom teaching and practical teaching was still insufficient and needed more development. This study implicated a small but valuable understanding of special needs dentistry education in Korea.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권4호
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• pp.191-199
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• 2019

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.

• 대한치과의사협회지
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• 제53권11호
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• pp.770-778
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• 2015

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.

• 대한치과의사협회지
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• 제49권12호
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• pp.732-738
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• 2011

Special needs patient are one of the underserved dental patient groups in Korea. However, Lack of attitudes to oral care and the knowledge of health professionals are identified as barriers to oral health for people with disabilities. Health authorities have a key role in ensuring that the need for a comprehensive dental services is met. This review may help oral health professionals understand the dental considerations according types of disabilities and provide appropriate and necessary dental care for special needs patients.

• 대한치과의사협회지
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• 제53권11호
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• pp.779-788
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• 2015

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.

• 대한장애인치과학회지
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• 제9권2호
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• pp.91-97
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• 2013

The objective of this study was to explore perceptions of dental student of patients with special care. Their satisfaction with education, and their professional attitudes and behavioral intentions concerning treating these patients were the issues of this paper. Paper-and-pencil survey data were collected from 289 dental students at the school of dentistry, Seoul National University. Most respondents agreed that it is important to be educated about providing care for patients with special needs at the school. The higher grade students they are, they got the higher degree of understanding about treating these patients and the more satisfaction with the education. However, their intentions to treat these patients in their future professional lives were negatively correlated with degree of students. Based on these findings, it is recommended that school curriculum about treating patients with special care be reconsidered to develop students' comfort level in treating special needs populations.

• Child Health Nursing Research
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• 제13권2호
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• pp.128-135
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• 2007

Purpose: To investigate health problems in child day care centers, needs for Child Care Health Programs, and management of sick children by day-care staff. Methods: A cross-sectional descriptive study. Day-care staff (N=206) from 33 day care centers in Seoul, completed a structured questionnaire. Results: Almost half of the day-care staff (53.4%) experienced sick events in their child at least once a month. The most frequently reported difficulty in having a sick child was in not having a health professional to consult, and almost all day-care staff (99.5%) had asked parents not to bring a sick child to the day care center. The biggest reason of exclusion was due to infectious disease including measles, chicken pox, mumps, diarrhea·vomiting, and pink eye. The majority of day-care staff (97.6%) agreed that there is a need for Center-based Child Care Health Program (CCCHP), and expected general health & illness management, and special care for chronic disease from CCCHP. Conclusion: These results showed a high incidence of sickness in children in day care centers, and there were great demands for a Center-based Child Care Health Program for day-care staff. Also the results of this study can be utilized as a basis for the establishment of child care policy in Korea.

• 대한장애인치과학회지
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• 제11권2호
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• pp.53-57
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• 2015

Most special health care needs (SHCN) people suffer from oral health problems due to high incidence and severity of oral disease. The aim of the present study was to investigate the characteristics of dental treatment provided in this patient population. The study population comprised 485 SHCN patients who visited Kyung Hee University Dental Hospital from 2006 to 2014. Based on the medical record, the date were evaluated according to age, gender, type of disorder, reason for visit, type of behavior management, and type of dental treatment. The most common age group was 7-12 year olds (26%). The chief compliant was dental caries (39%), as followed by oral exam (12%) and trauma (12%). Approximately half of SHCN patients (45.9%) was treated under behavior management. Restorative treatment was the most common procedure with the average of 2.9 teeth treated per patient. The results of the present study may be valuable for establishing the data of SHCN patients for primary dental care.

• 부모자녀건강학회지
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• 제13권1호
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• pp.17-25
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• 2010

Purpose: This study was conducted to investigate the recognition on center-based child care health programs for parents with ill children. Methods: Cross-sectional descriptive study with convenient sampling method was used and 136 parents were recruited from two university hospital outpatient departments and hospitalized wards, and they completed a structured questionnaire. Results: Majority (57.4%) of parents experienced a leaving work early or being absent from their work due to children's illness. Most dissatisfying factors in child care centers were child health management. Most of parents agreed on the need for a center-based child care health program, and wanted a better management of health care by health professionals in child care centers. Conclusion: These results support that there is a great demand for center-based child care health programs. These special programs are needed for reducing a child rearing burden for working mothers and overcoming the low birthrate in Korea. Health-care programs in child-care settings can help parents meet the health needs of their children while reducing absenteeism from work, thereby contributing to job stability. These results suggest discussions of the related policy with child care centers responsible and national health and educational authorities.