• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.4
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• pp.229-233
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• 2012

Hemophilia, the most common of the inherited bleeding disorder, is the result of a deficiency of clotting factor. Since bleeding after dental treatment may cause severe or even fatal complications, people with hemophilia must be given special dental care. We report on the diagnosis and treatment of a 9-year-old boy having severe hemophilia visited our department with the chief complaints of pus discharge on the left lower molar region. In the clinical and radiographic examination, periapical abscess and dental caries were diagnosed. Considering complexity of the treatment and complication in the coagulation, it was decided to carry on the treatment under general anesthesia. Clotting factor IX concentrates were intended to provide 50-70% plasma level. Pulpectomy, resin restoration and Stainless steel crown were given under general anesthesia. Several teeth were extracted and the sockets were packed with Surgicel$^{(R)}$ (Oxidized Regenerated Cellulose, Johnson and Johnson Co. Neuchatel, Switzerland) under general anesthesia. Transpalatal arch and lingual arch were given for maintaining the extracted space before discharged. For people with severe hemophilia, factor replacement is necessary before scaling, surgery or regional block injections. Therefore, if several extractions are needed, dental care under general anesthesia would be effective and efficient management.

• The Journal of the Korean dental association
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• v.53 no.11
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• pp.855-869
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• 2015

The purpose of this study was to evaluate the oral health promotion of the disabled persons by voluntary dental services in Ulsan Metropolitan City. Two dentists taken a calibration training for national oral health survey examined the oral health status of 473 disabled persons from two special schools for the disabled children and adolescents, a residential facility and a gymnasium for the disabled persons in 2009-2010. The surveyed disabled persons in the age range was from 7 to 74 years old. Voluntary dentists, oral hygienists and other civilian volunteers had supplied with the oral health care services to the disabled persons at dental clinics of special schools for the disabled children and adolescents, and a dental clinic supported from Nam-Gu Public Health Center in Ulsan Metropolitan City since 1997. The obtained data from these surveys were analyzed with the SPSS statistical package. Among subjects aged 12-14 years, subjects with decayed, missing and filled teeth (DMFT) in permanent dentition was 46.9%; subjects with untreated decayed teeth, 17.2%. The number of decayed, missing and filled teeth in permanent dentition was 1.36. The proportion of decayed components of DMFT score was 28.00%; proportion of missing components of DMFT score, 1.43%; proportion of filled components of DMFT score, 70.57%. The proportion of filled components of DMFT score among disabled persons of all age group in Ulsan were evaluated to be a similar level to non-disabled citizens in Ulsan from 2010 Korean National Survey. The oral health care programs for disabled persons by voluntary services of dental professionals and other civilians are evaluated to be effective for the oral health promotion of disabled persons in Ulsan.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.2
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• pp.83-89
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• 2023

Background: With advances in safety measures for anesthesia, conscious sedation has gained popularity in the field of dentistry and has become essential in dental practice worldwide. However, in Tanzania, intravenous (IV) sedation is rarely practiced in the dental field. Therefore, we report the establishment of sustainable IV conscious sedation in dental practices and subsequently train local OMS residents in Tanzania. Methods: In 2019, intravenous conscious sedation was initiated at the University Dental Clinic of the Muhimbili University of Health and Allied Science (MUHAS), Tanzania. During the preparatory phase of the program, local oral and maxillofacial surgeons (OMSs) were given a series of lecture notes that concentrated on different aspects of IV conscious sedation in dentistry. During the on-site training phase, an oral surgeon from the United States joined the OMSs for case selection, IV-conscious sedation procedures, and patient follow-up. Patients were recruited from existing patient records at the MUHAS Dental Clinic. Results: The first conscious IV sedation program in dentistry was successfully launched at the University Dental Clinic in Tanzania. The local team of OMSs was trained on the safe administration of sedative agents (midazolam or ketamine) to perform various minor surgical procedures in a dental office. Nine patients with different ages, body masses, and medical conditions benefited from the training. No complications were associated with IV conscious sedation in the dental office. Conclusion: This was the first successful "hands-on" training on IV conscious sedation provided to OMSs in Tanzania. It laid the foundation for the sustainable care of patients with special needs requiring oral health-related care in the country.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.84-88
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• 2019

Malocclusion occurs more frequently in Special Health Care Needed (SHCN) patients than those in general. As caregiver's needs for orthodontic treatment tend to increase, the dentist should know how to decide the extent of treatment. This case report is about orthodontic treatment for two SHCN patients; one patient with cerebral palsy, and another patient with autism. A 10-year-old patient with cerebral palsy showed protrusion and rotation of maxillary anterior teeth. To resolve his chief complaints and make better oral hygiene, he underwent orthodontic treatment using micro tube appliances for 6 months. Another 11-year-old patient with autism had anterior crossbite and showed space deficiency of #13 and chronic gingivitis because of poor oral hygiene. She underwent orthodontic treatment with maxillary skeletal expander, facemask and AP expansion appliance. After 18 months we found positive overjet and ended the treatment. When giving SHCNs orthodontic treatment, the extent of treatment can be chosen according to the patient's cooperative ability and the traits of disabilities. Before initiating orthodontic treatment, the caregivers should be aware of their limitations of the treatment. Since oral hygiene is crucial factor in every dental treatment, education of oral hygiene process for the caregivers and SHCN patient must be done before the orthodontic treatment.

• Health Policy and Management
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• v.22 no.2
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• pp.207-224
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• 2012

This study estimates the total health expenditure of ambulatory dental care and explores the factors related to disbursements. The study used two waves of a 2008 Korea Health Panel (KHP) survey, of which each wave is composed of 7866 households and 24,659 persons. The KHP includes missing expanses of reimbursement data of the National Health Insurance (NHI), such as out-of-pocket, drugs, and private health insurance. The study estimates total monthly ambulatory dental expenditure and the sub-special categories of dental care. For influential factors analyses, the study exploits log-linear model with age, gender, education, job, equivalence income, the status of chronic diseases, means-tested benefit recipients, private insurance, and the composite deprivation index as independent variables. The total monthly outpatient health spending is estimated to be 102,468 won per household, and for dental, each household spends 31,115 won per month. Older age, means-test recipients, non-regular workers are more likely to spend less money on dental care, whereas private insurers, high income, and those who live in less deprived areas are more likely to spend more money for dental services. From the study we found that the KHP data are more suitable to estimate the total amount of health care markets, especially when the NHI coverage is low, such as for dental care in Korea.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.208-213
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• 2013

The spectrum of physically challenged patients who visit to a dental clinic for treatments are diverse: from ones of mild disabilities, who lead their lives in a similar way of ordinary people, to others who suffer from diseases that are difficult to be diagnosed, and need medical expertise due to systemic care or special techniques and instruments because of behavior management and difficulty of treatments. The patient in this case was 25-year-old autistic male patient who visited the clinic on account of overall treatment for multiple carious lesions. He could perform normal daily life to some degree under the care of a guardian. This case report describes predicaments of making a treatment plan resulted from lack of information about disabled patients, and difficulties of proceeding treatment procedures under general anesthesia. It is considered that sufficient consultation and history taking are needed before treatment for disabled patients.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.4
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• pp.237-241
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• 2014

Acquired Immune Deficiency Syndrome is the state which develops after complications with the infection from HIV. Irrespective of their state, all HIV infections have infectivity. According to a 2013 U.N. AIDS global report, the number of reported newly infected with HIV is constantly falling, while that of Korea has been increasing over recent years and it surpassed 10,000 in 2013. This phenomenon might be attributed to the unusualness of the blood test for early detection of HIV infection. From this fact, we can assume that we have strong possibilities for encounters with infections in the office. But many misconceptions about the disease makes patients try to hide their medical history, which can lead to a nationwide spread of the infection without proper management. Even though it may be difficult to take care of HIV patients in smaller dental offices, large scale hospitals have the means to arrange protocols to treat them. We present a case about dental treatment of a patient with AIDS that has a history of cerebral infarction and hepatitis type B under general anesthesia. The purpose of this case report was to discuss the special considerations of dental care for patients with HIV.

• Korean Journal of Health Education and Promotion
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• v.7 no.1
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• pp.27-32
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• 1990

Since the medical insurance covered the total population in Korea in July, 1989, the number of patient's visitation to the tertiary care hospital had changed because of referral regulation. In the referred patients through the secondary care hospitals such as out-patients of departments of internal medicine, general surgery, obstetrics and gynecology, pediatrics had decreased as well in-patients in these departments. However, departments of urology, dermatology, dentistry, ophthalmology and ear-nose-throat had more or less similar number of patients after medical insurance implemented for the total population. Contrarily, the number of patients visited emergency clinics and department of family medicine had increased very many. Thus, expansion of emergency clinic department, new special clinic set-ups, establishment of family medicine department in each hospital etc are strongly recommend.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.4
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• pp.215-220
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• 2013

The co-occurrence of congenital central hypoventilation syndrome (CCHS) and Hirschsprung's disease (HD) is termed Haddad syndrome, which is an extremely rare discorder. It was reported first by Haddad in 1978 and there are approximately 60 cases reported in the worldwide literature. Recent studies described that congenital central hypoventilation syndrome had deep relation to the mutation of the PHOX2B gene in its diagnosis and phenotype. This article presents a case report: Dental treatment of a 3-year-old male patient with Haddad syndrome under outpatient general anesthesia. The special considerations of dental care, especially caries theatment of the patient with Haddad syndrome are discussed.

• Restorative Dentistry and Endodontics
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• v.24 no.4
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• pp.639-646
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• 1999

The dental care delivery system and the dental specialty system have a very close relationship each other. Compared to Korea. Western European countries with predominant public sector in dental service have recognized merely 2 or 3 dental specialties, while North American countries with predominant private sector, 8 or 9 ones. It is desirable to adopt the dental specialty system as soon as possible in Korea to encourage scientific development in various dental specialties and qualitative advance in dental service. We, however, have to establish equitable dental care delivery system which can use limited dental resources efficiently as follows. 1. clarifying the different roles in assignments between general dentists and specialists by the amendment of the related laws such as the Medical Act and establishing the organic patient-referral system. 2. adopting the dental specialty system and expanding personnel and equipments so that the dental college hospitals, especially dental divisions of general hospitals, night function as secondary care facilities with specialties. 3. determining the size of dental specialists according to the national needs for dental specialized service's, whose number is to be not more than 10% of the total dentists. 4. transferring the function of accredating dental specialists to the efficient, self-controlled professional organization such as the Korean Dental Association rather than putting it under the governmental control. 5. conducting a comprehensive review of specialty education and practice for re-recognition, and maintaining competence of specialists by re-accredating them periodically. I expect this article to contribute to further discussion about the dental specialty system in Korea in productive and practical way. I am sure that we can Establish this system in the near future when people in every walks of life-the academic circle, the press, the authority concerned, consumer groups and the Korean Dental Association-take part in the discussion with special concern.