• Journal of The Korean Dental Society of Anesthesiology
• /
• v.12 no.1
• /
• pp.11-16
• /
• 2012

Background: The purpose of this study was to evaluate the safety and effectiveness of intravenous ketamine-midazolam sedation in uncooperative children and disabled people undergoing dental procedures. Methods: From September 2009 to January 2012, total 114 intravenous deep sedation were carried out using midazolam and ketamine at pediatric dentistry in Wonkwang University Daejeon Dental Hospital. Patients' dental charts and sedation records were retrospectively reviewed. Results: 103 cases were enrolled, divided into four groups. There were 22 children under five in group 1, 14 children over six years with severe anxiety in group 2, 34 disabled person in group 3 and 33 children over six years with surgical procedure in group 4. Carries treatment (56 cases) was the most common dental treatment. The highest ketamine usage was 4.15 mg/kg, the longest duration of dental treatment was 41.6 minutes in children under five group. Nausea and vomiting (16 cases) was the most common side effect. Conclusions: Intravenous ketamine-midazolam sedation appears safe and effective for uncooperative children and disabled person undergoing dental procedures. But, emesis is a common side effect of ketamine occurring with increasing age.

• Journal of Korean society of Dental Hygiene
• /
• v.11 no.1
• /
• pp.103-111
• /
• 2011

Objectives : This study of oral health problems was conducted to 311 students in Special Schools in order to inquire into the state of their oral health behaviors, to find out the main obstacles against dental services, to secure dental reasonable basis for oral health promotion. Methods : A questionnaire survey was conducted in the Special School of the 311 students in the area of the metropolitan Seoul. By means of Chi-squared test and Fisher's exact test, oral hygiene habits for each type of the subjects, the contents of dental care services, the prerequisites to improve oral health, were inquired. To evaluate the effects to the current oral health status of types of disability, 2-way ANOVA was practiced. Results : The handicapped with Visual impairment, mental retardation, multiplicity with disabilities, answered negatively in their own oral health status. 47.4% of the deaf can do brush for theirselves without the inconvenience, but in other types of disability they showed that they were helped by others. Subjects did not use the secondary oral hygiene necessaries because, except brain damage, almost of types of disability impeded the convenient use. 60 to 88.2 percent of the total respondents were the recent visitors to dental clinique within 1 year, and the most common motives of the visiting dentist, is a routine medical examination, their movements to the dentist in all types of disabilities, needed helps of others. Most of them received medical treatment at a private dentist, the handicapped preferred the private care and place(49.8%). Only in the case of the brain disorders, extremely much of the disabled answered that they were needed the preventive treatment, and the another cases of disability were largely needed the treatment of the decayed teeth. To improve the oral health of the people with disabilities, at the opening of the clinics and hospitals over a certain size, the mandatory medical facilities for the care of the disabled should be preceded and followed by the improvement of dental insurance system so as to reduce the burdens of the cost of dental care. Conclusions : The improvement of oral health policy for the disabled are needed inevitably: Development of secondary oral hygienic easy to use for the disabled, the building systems of medical dental hospital with the disabled facilities, by the improvement of the insurance system, the reduction of the burden of payments.

• 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 the Korean dental association
• /
• v.47 no.1
• /
• pp.31-42
• /
• 2009

This study was conducted to investigate the effects of the public dentist's professional education for 81 dentists employed at the public health centers and dental clinics in the National hospitals. The purpose of this education was to improve public dentist's abilities to perform their duties. The 3days education was from 28 May until 30 May in 2008. The total 81 participants consisted of 8 medical position dentists, 20 employment position dentists, and 53 public health dentists. The survey provided appraisal of the education and suggestion of the development after this education. The obtained results were as followings : l. The public dental health project for the disabled people(91.4%) was a top priority. The second rank was the public dental health education project (87.6%) and the public dental health project for the aged people(86.4%) was followed. 2. The participants agreed that public dentist's professional educational programs were necessary(87.6%). 3. The participants did not have difficulties in attending this education(56.8%). 4. The participants who participated in 2008 public dentists' professional education were satisfied with this educational programs(81.4%). 5. Not only did the public dentists need the preventive dentistry programs and the treatment of the disabled people but also needed the health administrative programs and the health statistical programs in the future.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.41 no.1
• /
• pp.18-26
• /
• 2014

Deep sedation is considered for the dental treatment of pediatric or disabled patients who have severe anxiety or involuntary movement. Deep sedation using sevoflurane inhalation in emergency dental practice, therefore, is also preferred for fast induction and recovery. This survey consists of 121 people with pediatric or disabled patients who underwent dental treatment under deep sedation using sevoflurane inhalation from January 2013 to October 2013. Patients who were scheduled for deep sedation were classified into a non-emergency sevoflurane sedation group, whereas patients who underwent emergency sedation due to trauma and patients with disabled characteristics itself were classified into an emergency sevoflurane sedation group. Of 121 patients studied, 95 patients received dental care under non-emergency sedation, 26 patients received dental care under emergency sevoflurane sedation. The two groups were analyzed according to: gender; age; primary reason for sedation; duration of sedation; treatment time; induction methods; treatment information; and departments. Non-emergency sevoflurane sedation in pediatric or disabled patients was safe and effective for controlling the behavior. Emergency sevoflurane sedation was a useful method for younger pediatric patients with traumatic injury who need simple, short time emergency treatment. Deep sedation using sevoflurane inhalation not only will reduce the use of general anesthesia gradually but also will be a useful method to emergency treatment for pediatric or disabled patients.

• Journal of dental hygiene science
• /
• v.20 no.1
• /
• pp.16-24
• /
• 2020

Background: Dental treatment has shifted to the center of the community, and the public policy of the country has expanded to support the vulnerable classes such as the disabled. The dental profession needs education regarding oral health services for persons with disabilities, and it is necessary to derive the competencies for this. Therefore, we conducted this study to derive the normative ability to understand the role of a dental hygienist in the oral health service for persons with disabilities and improvement plans for education. Methods: We conducted a qualitative analysis for deriving competencies by analyzing the data collected through in-depth interviews with experts in order to obtain abilities through practical experience. Based on the competency criterion, relevant competency in the interview response was derived using the priori method, and it was confirmed whether the derived ability matched the ability determined by the respondent. Results: The professional conduct competencies of dental hygienists, devised by the Korean Association of Dental Hygiene, consists of professional behavior, ethical decision-making, self-assessment skills, lifelong learning, and accumulated evidence. Also, core competencies of the American Dental Education Association competencies for dental hygienist classification such as ethics, responsibility for professional actions, and critical thinking skills were used as the criterion. The dental hygienist's abilities needed for oral health care for people with disabilities, especially in the detailed abilities to fulfill these social needs, were clarified. Conclusion: To activate oral health care for people with disabilities, it is necessary for dental hygienists to fulfill their appropriate roles, and for this purpose, competency-based curriculum restructuring is indispensable. A social safety net for improving the oral health of people with disabilities can be secured by improving the required skills-based education system of dental hygienists and strengthening the related infrastructure.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.6 no.2
• /
• pp.77-83
• /
• 2010

This article discusses the issues of benefit and risk associated with outpatient general anesthesia and deep sedation for the special need dental patients. The purpose of administering anesthesia for patients with special needs is to provide effect dental treatment. But there are many complications such as sore throat, nausea and vomiting, airway trauma, airway obstruction and hypoxic brain damages, etc. In order to decrease incidence of complication, before general anesthesia meticulous patient evaluation is much important. But, there are a number of factors that make it difficult to accurately assess the anesthetic risk for many people with special needs. These include limited medical workups, uncooperative behavior, and difficulties in postoperative cares, etc. But Judging from several years experience of many contries, it appears that the incidence of mortalities for people with special needs in dental setting is minimal and the incidence of morbidity is limited. In the long run, the delivery of general anesthesia and deep sedation for people with special needs can be considered a very safe and successful procedure.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.9 no.1
• /
• pp.1-10
• /
• 2013

This article discusses the provision of sedation for uncooperative special need dental patients. Most of dental treatments have been performed in these patients with the techniques of behavioral control. However, if this behavioral control fails during treatment, it is nearly impossible to treat them without either sedation or general anesthesia. Sedation is also beneficial for patients because it circumvent the aggravation of negative behaviors related to their stress during the treatment. Also, the morbidity and mortality related to dental sedation is relatively low. In this regard, the provision of sedation for people with special needs can be considered as a safe and necessary techniques for their treatment.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.27 no.2
• /
• pp.192-201
• /
• 2000

The purpose of study was to investigate the oral health care status in institutions and special schools for the disabled in Korea. Nurses in 123 institutions and nurse-teachers in 102 special schools were asked to fill questionnaires regarding periodic oral examination, preventive dental programs. and dental treatment. The results of this study were as follow. 1. 56.8% of institutions implemented regular oral examinations and all of special schools did it twice a year. 2. Preventive programs for dental caries were done in 69.1% of the institutions and 86.3% of the special schools. Programs included regular toothbrushing and dental health education. 3. Dental treatment was done in 84.2% of the institutions and 39.2% of the special schools. Institutions utilized private dental clinics(60.2%), public health centers(16.8%), volunteers(15.3%), and dental hospitals. 4. 17.7% of the institutions experienced the refusal to treat the disabled by private dental clinics.

• Journal of Korean society of Dental Hygiene
• /
• v.9 no.4
• /
• pp.606-619
• /
• 2009

Objectives : This study was to examine the state of customized visiting oral health programs in a bid to help facilitate the unified operation of the programs and the development of required guidelines. Methods : The subjects in this study were 49 dental hygienists who were professionals responsible for customized visiting health care programs across the nation. Results : 1. Regarding the form of employment of the dental hygienists were investigated many contract and daily workers. 2. As to the possession of equipment necessary for visiting oral health programs, denture cleaners(12.2%) were most widely possessed in some regions, followed by mobile scalers(10.2%) and mobile suctions(8.2%). In terms of expendable devices and materials, dental mirrors, pincettes and explorers were the most widely possessed dental checkup devices, and the most widely possessed oral hygiene supplies were toothbrushes, interdental brushes and denture cleaners. Those devices and materials were in more possession than the other types of devices and materials. The most widely possessed equipment for educational purpose was laptop computers, followed by beam projectors and screens. The most widely possessed teaching materials were dentiform, followed by CD-ROMs. 3. Those whom they visited the most for oral health care service were elderly people, followed by the disabled and patients with chronic diseases. The dental hygienists who went out to visit those people outnumbered the others who stayed at public health centers. Concerning the types of visiting oral health care service, the most prevalent service provided to the elderly included denture cleaning/management, oral massage and preventive treatment against dental caries. The most dominant service provided to the disabled involved education of the oral health care act, preventive treatment against dental caries and toothbrushing by professionals. The most common service offered to patients with chronic diseases was education of the oral health care act and oral health education. The dental hygienists paid a visit to a mean of 5.8 households a day. The average weekly number of households cared by the dental hygienists was 27.3. It took a mean of 37.1 minutes for them to take care of each household. 4. As for satisfaction level with the implementation of the visiting oral health programs, they expressed the greatest satisfaction at teamwork with professionals($3.56{\pm}0.94$), followed by the professionalism of their work($3.21{\pm}0.94$) and workload($3.08{\pm}0.94$). Their satisfaction level with the work conditions required for creative job performance($2.75{\pm}0.98$) and partnership with other institutions($2.64{\pm}1.03$) was below 3.0. In regard to the impact of their characteristics, marital status made a statistically significant difference to satisfaction level with workload. The unmarried dental hygienists were more pleased with their workload than the married ones(p<0.05). 5. As to needs for education for professionalism improvement, they asked for education about visiting oral health care skills the most, followed by education about oral health care for patients with chronic diseases, education of planning/evaluation and education of oral health care for the disabled. Conclusions : The top priority for the vitalization of the programs was the procurement of budget, followed by the procurement of equipment and educational media and the procurement of human resources.