충남장애인구강진료센터에서 시행된 외래전신마취와 치과치료에 대한 조사연구

류연숙,김종수,김승오,You, Yon-Sook,Kim, Jong-Su,Kim, Seung-Oh 대한치과마취과학회 2011 Journal of Dental Anesthesia and Pain Medicine Vol.11 No.2

Background: Dental treatment under outpatient general anesthesia is an option for disabled person, children and dentally disabled person who have the difficulty of cooperating voluntary with dental care. The aim of this study was to access the patients who had dental management under general anesthesia at Chungnam dental clinic for the disabled. Methods: This survey is consisted of 114 severely disabled and dentally disabled person who undergone dental treatment under general anesthesia from January to June 2011. Data were collected by individual dental and anesthesia records. Results: Of the 114 patients studies, the 45 patients was the dentally disabled and the 69 patients was the severely disabled. Rate of dental treatment among male patients was higher than among female patients. The dentally disabled was an similar age distribution. In the severly disabled, above 13-year-old was higher than below 12-year-old. The most popular induction method of general anesthesia was sevoflurane inhalation after induced sedative effect of nitrous oxide inhalation. The severly disabled who had definitely negative behavior was applied inhalation of high concentration sevoflurane. Conclusions: Chungnam Dental clinic for the disabled provide dental management for the disabled and the dentally disabled.

치과의사의 장애인 치과진료실태에 관한 조사 연구

최충호 대한구강보건학회 2003 大韓口腔保健學會誌 Vol.27 No.1

The purpose of this study were to prepare baseline data for developing and implementing oral health policies in disabled people. So it was stueied that dental services status of the disabled performed by dentists. Dentists's recognition about the dental treatment of the disabled was investigated, and professional, institutional, and social problems were analyzed. Survey was performed in 10,493 dentists with questionnaire by mailing method. The rerurned rate of answer was 5.0% The questionnaire contained dental treatment experience for the disabled, what are the desirable dental treatment for the disabled, the difficulty and the method to solve the problem when dentists treat the disabled, the demand of oral health education in realtion to dental treatment of the disabled. The obtained results were as follows; 1. The characteristic of the respondents and dental treatment experience for the disabled; Respondents had a more rate in male(77.2%), under 40 years old(60.6%), 5-9 years of dental practitioner(40.2%), a lage city(60.3%) and dental clinic by oneself(87.1%). Many respondents had concern about dental treatment for the disabled(77.2%) and the had a experience of dental treatment for the disabled(94.0%). The dentists who treat the disabled days was 47.7%. The dentists who want to participate with network for treating disabled was 63.6%. 2. Desirable dental treatment type for the disabled; Many dentists treated disabled patients in their clinic(past:62.2%, present:46.5%). So they want to treat the disabled in specialized institute(42.5%). It needs more acceptable conditions-like support system for the cost and time consuming problem for the disabled. 3. The problems and the solutions of the disabled's dental health; The difficulty of cooperation and insufficiency of specialty or confidence was main problems. So they needed treating equipment for the disabled and improvment of specialty. Decreased ability of disabled's dental health management(52.4%) was main problem to promote the disabled's dental health. The suggested solutions were the obligation of facilities for disabled's dental treatment in new dental service institute(34.1%)and the improvement of social recognition for the disabled(22.1%). 4. The need and experience of education for disabled's dental treatment; The dentists who had the experience of education were 41%. They received the information in dental college(19.7%), books(8.3%), graduate or training course(6.8%) , small group study(2.9%) and education for dental practitioners(1.5%). The needs of education were understanding of the disabled(32.7%), behavior control therapy(30.4%), changing of treatment method according to the degree of disabled(25.8%) and the education for emergency situation(5.9%).

한국 장애인의 치과의료 이용실태와 개선방향

심수현(Su-Hyun Shim),이원(Won Lee),최봄(Bohm Choi) 대한치과의사협회 2010 대한치과의사협회지 Vol.48 No.4

1. 치과의사 분포가 적은 군 단위 이하 비도시 지역의 장애인 치과 접근도를 개선해야 할 필요가 있다. 2. 장애 환자의 진료시 일반인 진료 시와 다르게 보조 인력의 추가 투입의 필요성 및 만일의 사고시의 보상 제도가 마련되어야 할 것으로 생각된다. 3. 응답한 치과의사의 39.7%만이 장애인에게 일반인과 같은 수가를 적용하고 있었고, 38.2%의 치과의사는 장애인에게 전혀 비용을 받지 않고 있었다. 4. 여러 어려움에도 불구하고 대다수의 장애인을 진료하는 치과의사들은 일반인과 마찬가지로 장애 환자에게 필요한 치료를 모두 제공하려고 노력하고 있는 것으로 생각된다. 그러나 임플란트, 보철, 교정, 심미 치료의 접근성은 어려운 것으로 나타났다. 5. 현행의 공공 지원금 배분이 접근도가 높은 공공 병원에 집중되고 있어 실제 수행하는 진료 비중에 따른 분배 체계의 합리적인 개선이 요구되는 상황으로 보인다. Objective: In spite of increasing dental treatment for the disabled, there was a few collected data on dental treatment status and dentists’ perception in Korea. The purpose of this study is to research the current dental treatment status for the disabled in Korea and to suggest public health policies for the disabled. Material and methods: Total of 68 dentists who have treated the disabled regularly were asked to fill questionnaires regarding dental treatments for the disabled. Results: 1. It is necessary to set up public dental center for the disabled in rural area. 2. In case of dental treatments relating to cerebral palsy, ADHD, autism, the compensation for treatment time and extra investment is needed. 3. Only 39.7% of dentists charged treatment fees to the disabled as same as normal patients. Moreover 38.2% of dentists answered that they dido’t charge treatment fees at all when their patient are disabled. 4. 23.5% of dentists provided all of dental treatments including dental implant and orthodontic appliances in Korea. However, 54.3% of dentists reported the improvement of access to dental implant, orthodontic and esthetic treatment is needed. 5. It is imperative for the government to improve the support system for the disabled. Conclusions: Through this research only 26.5% of dentists answered that they had received the fund from the government and 11.1% of them were satisfied with the support for the disabled in Korea. This indicated the improvement of government financial support system for the disabled is needed.

서울시 장애인의 치과의료서비스이용에 관한 연구

장수현 ( Suhyun Jang ),권혜영 ( Hye Young Kwon ),이호용 ( Ho Yong Lee ) 한국보건경제정책학회 2016 보건경제와 정책연구 Vol.22 No.4

This study was to investigate dental service utilizations and determinants of external service use among disabled patients living in Seoul. Data were extracted from 2014 National Health Insurance Claims Data, provided by the NHIS(National Health Insurance Service). Among the disabled living in Seoul, 42.4% of them used dental services in 2014. The average length of stay per patient was 1.8 days, Annual medical costs incurred per patient was KRW 179,671. A binary logistic regression model was used to identify determinant factors of external dental service uses. Independent variables including age, sex, income level, severity of disability, type of disability, type of hospitals and residential districts were considered. Male, younger disabled and physical disabled were more likely to seek dental services in other districts. Specifically, those who were affluent were much more likely to use external dental services since economic barriers were lessened compared to the poor. Compared to those living in South-East 2 area, the disabled living in Central and South-East 1 area was more likely to use external dental services (OR=1.54[1.49:1.58] and OR=1.69[1.64:1.73], respectively). In the subgroup analysis by segmenting hospitals and clinics settings, South-West area had a poor distribution of dental care resources for the disabled, followed by Central and North-West districts. North-East 2 district was to be lack of hospital-level dental services whereas South-East 1 district was to be lack of dental clinics for the disabled. In conclusion, this study is meaningful to investigate dental service uses among the disabled living in Seoul. Policy that enhancing access to dental services for the disabled should be developed and implemented.

장애인의 미충족 치과의료 현황 및 관련 요인 분석

박신후,황성완,안병기 경희대학교 경영연구원 2019 의료경영학연구 Vol.13 No.3

In this study, the current status and related factors of unmet dental care were analyzed using the 2016 Korea Medical Panel data. 913 persons with disabilities were selected and analyzed. Types of disabilities were classified as dental and non-disabled. The results of this study need to provide quality services to meet the unmet dental care needs of people with disabilities and complement policies to address the problem of dental access for people with disabilities. Among the study subjects, 643 (70.4%) were unsatisfied, and in general characteristics, Gangwon-do area, disabled people who were not economically active, severely disabled persons in the disability class, and dental disabled persons in the disability type did not have access to dental care. Came out. This was statistically significant. As a result of hierarchical logistic regression analysis to determine factors related to unsatisfactory dental care, the type of disability in Model 1 was 1.77 times higher than that of non-dentally disabled persons and 1.83 times higher in Model 2. In addition, it was confirmed that 1.45 times of disabled people who were not economically active and 2.04 times of unsatisfied dental medical treatment occurred in Jeolla Province. This was statistically significant. The results of this study need to provide quality services to meet the unmet dental care needs of people with disabilities and complement policies to address the problem of dental access for people with disabilities.

치위생과 학생들의 장애인에 대한 태도

곽정숙(Jung-Suk Kwag),우승희(Seung-Hee Woo) Asia association of Disability and Oral health 2011 International Journal of Disability and Oral Healt Vol.7 No.1

The purpose of this study was to examine the general attitude of dental hygiene students toward the disabled and their oral care in an effort to improve their awareness of the disabled and their accessibility to them and suggest some of the right directions for dental hygiene education related to dental treatment for the disabled. The subjects in this study were dental hygiene students at three different colleges located in South Jeolla Province. The general attitude of the selected students toward the disabled and their oral care were investigated from November 1 to December 20, 2007. The findings of the study were as follows: When their general attitude toward disabled people was checked, they agreed the most that there was nothing that the disabled lagged behind nondisabled people. Those who felt the need for that took a more positive attitude in eight items, and the differences between them and the others were significant. Whether they were cognizant of the necessity of dental treatment education for the disabled made the most significant differences to each variable of their attitude toward the oral care of disabled people, and those who were aware of the necessity showed a more positive attitude in five items. The differences between them and the others were significant. The findings of the study illustrated that the dental hygiene students took a relatively favorable attitude toward disabled people’s oral health care, and that they hardly felt a sense of distance to them. So it can be predicted that they will get to take the right attitude to them in the future. Yet the dental hygiene curriculum should give more weight to dental treatment education for the disabled and offer more relevant information, since they didn’t get high scores on positive attitude.

치위생과 학생들의 장애인에 대한 인식도에 관한 조사연구

곽정숙(Jung-Suk Kwag),김윤정(Yoon-Jung Kim),우승희(Seung-Hee Woo) 한국콘텐츠학회 2009 한국콘텐츠학회논문지 Vol.9 No.7

본 연구는 장애인 구강관리를 담당할 치위생과 학생들의 교육 방향성을 제시하고, 장애인에 대한 건전한 인식도를 높이고자, 전남지역에 소재한 3개 대학 치위생과 학생 538명을 대상으로 설문조사를 실시하였다. 장애인에 대한 태도 및 장애인 구강관리에 대한 태도를 조사한 결과, 친구나 가족 중에 장애인이 있는 경우나, 장애시설에서 봉사활동 또는 구강보건활동 경험이 있는 경우는 장애인에 대해 긍정적인 태도를 보이는 것으로 조사되었고, 특히 장애인 구강보건활동 경험이 있는 경우에는 장애인 구강보건에 더욱 긍정적인 태도를 내타내었다. 이에 장애인 접촉의 기회를 늘려 장애인과의 거리감을 좁히고, 장애인 구강관리에 더욱 긍정적이고 적극적인 태도를 형성하는 것이 필요하다고 하겠으며, 뿐만 아니라 장애인 환자 진료 시 가장 문제점이 되는 의사소통의 어려움, 장애인 치료에 대한 경험부족, 장애인 치료에 대한 지식 부족 등을 해결하기 위해서는 87.5%가 교육이 필요하다 하였고, 교육의 형태는 이론과 실습의 병행교육이 필요하다고 했다. 또한 국가에서도 장애인 구강보건에 대한 체계적인 정책을 수립하여 장애인 구강건강프로그램을 개발하고 장애인 진료에 소요되는 많은 시간과 노력에 보상할 수 있는 의료보험제도개발 등이 필요하다고 사료된다. The purpose of this study was to investigate consciousness about the disabled on dental hygiene students and search for course of dental hygiene education as oral health care with the disabled. The subjects in this study were 538 dental hygiene students from three college in Jeonnam province. For statistical analyses of collected data, the descriptive analyses and chi-square were adopted. The obtained results were as follows. Seniors showed positive attitude about the disabled and dental service of the disabled(p<0.05). The common types of contact the disabled were physical. Cerebral palsy and inner disabled were rarely. The problems are difficulty in communication, short of clinical experience in dental service of the disabled, noncooperation of the disabled, short of knowledge in dental service of the disabled. To dental service of the disabled, demand as necessity of education was 87.5%, theory and practice at the same time was 68.0% in pattern of education. Finally, 49.5% of respondents observed special dental clinic to utilization pattern of dental service of the disabled.

치과위생사의 장애인 환자에 대한 인식조사

이경준,김희수 사단법인 한국융합기술연구학회 2022 아시아태평양융합연구교류논문지 Vol.8 No.5

이 연구는 치과위생사의 장애인 환자에 대한 인식조사를 통해 궁극적인 장애인 구강건강 향상에 기여할 수 있는 기초자료를 제시하는 데 목적이 있다. 이를 위해 서울과 경기지역에 있는 치과 의원 및 병원에서 근무 경험이 있는 치과위생사를 대상으로 설문조사와 심층서면 인터뷰를 함께 실시하였다. 설문조사는 19개 문항으로 구성된 온라인 설문 참여 방식이었으며, 총 94명이 응답하였다. 심층서면 인터뷰는 설문조사의 결과를 바탕으로 5개의 심층 질의 분야를 설정하여 총 5명을 대상으로 실시하였다. 그의 주요 결과를 살펴보면, 우선 치과위생사 양성을 위한 교육과정에서 장애인 관련 교과목이 거의 개설되지 않거나, 인지도가 낮게 나타났지만, 장애인 치과학에 대한 중요성 및 관련 프로그램에 대한 배움 의향은 높게 나타났다. 또한 치과 치료 현장에서는 장애인 환자의 구강 관리 및 진료에 대한 교육이나 경험 도가 낮은 비율로 나타났고, 경험이 있는 응답자들은 교구 및 설비의 부족과 함께 치과위생사의 장애인 구강 관리에 대한 관심 부족 등을 어려움으로 인식하면서 장애인 환자에 대해 배려하는 태도가 필요함을 강조하였다. 마지막으로 제도적 차원에서 장애인치과 주치의제도에 대해서는 연구참여자 대다수가 잘 인식하지 못하고 있었으나, 장애인 건강권 차원에서 이 제도는 중요하게 인식하고 있었다. 이와 같은 연구 결과를 바탕으로 장애인 치과학 교육과정, 치과위생사를 위한 장애인 구강보건 교육과 프로그램 및 각종 근로 여건 개선, 장애인 치과 주치의제도 등을 논의, 제언하였다. The purpose of this study is to provide basic data that can contribute to the ultimate improvement of oral health of dental hygienists by investigating their perception of patients with disabilities. For this purpose, a survey and in-depth written interviews were conducted with dental hygienists who have worked in dental clinics and hospitals in Seoul and Gyeonggi-do. The survey was conducted with 19 questions, and 94 respondents answered. The interview was conducted with 5 subjects, setting up 5 areas of in-depth quality based on the results of the survey. In his main results, the curriculum for the training of dental hygienists showed that few subjects related to the disabled were open or the awareness was low, while the importance of dental science for the disabled and the intention to learn related programs were high. In addition, the dental treatment site showed a low rate of education or experience in oral care and medical treatment of patients with disabilities. In addition, the respondents who have experience emphasized the need for a consideration attitude toward patients with disabilities while recognizing the lack of parish and equipment as well as the lack of interest in dental hygienists' oral care for the disabled. Finally, the majority of the participants did not recognize the dental doctor system for the disabled at the institutional level, but this system was recognized as important in terms of the health rights of the disabled. Based on the results of this study, the researchers discussed and proposed the dental curriculum for the disabled, oral health education for the disabled of dental hygienists, programs and various working conditions, a dental doctor system for the disabled, and the introduction of dental hygienists for the disabled.

장애유형별 치과진료시 소요시간에 관한 비교연구

이우람(Wooram Lee),김영재(Young-Jae Kim) Asia association of Disability and Oral health 2014 International Journal of Disability and Oral Healt Vol.10 No.2

The objective of this study was to confirm the validity of classification of dental disability by measuring the dental treatment time required for disabled patients and identify the disability type that requires more of chair time. As a result of measuring a total of 123 patients who were admitted to the Seoul dental hospital for the disabled on Oct. 2014, I was able to make the following conclusions: 1. For dental counseling and check-up, the chair time did not show significant differences between the different types of disability. 2. For periodontal treatment, restorative treatment, root canal treatment, and surgical treatment, the difference of the chair time for dentally disabled patients was significantly longer than that of non-dentally disabled patients. 3. The difference in the total chair time for prosthetic treatment was statistically insignificant. However, each of the prosthetic treatment steps did show statistically significant differences.

치과진정법과 전신마취를 이용한 장애환자의 보철치료

김윤희,이진한,Kim, Yun-Hee,Lee, Jin-Han 대한치과마취과학회 2012 Journal of Dental Anesthesia and Pain Medicine Vol.12 No.3

In most persons with disabilities had poor oral hygiene because of less attention and ability to perform a dental care. So the increased prevalence and severity of dental disease were common oral state. Although most persons with disabilities need a adequate dental treatment, it is often very difficult to treat because of noncooperativity and involuntary muscle movements. Dental treatments under sedation and general anesthesia were make to provide a high-quality dental service because of decreased anxiety and fear associated dental treatment in persons with disabilities. The dental professionals must be able to select and apply the proper sedation methods in agreement with the characteristics of the disabilities, general conditions, sedation experience and capacity of dentist, type and time of dental treatment, equipments of dental clinic, consent of patient's protector. The proshodontic treatment procedures, such as abutment preparation, dental impression taking process, try-in process of prosthesis and adjustment of occlusion, are difficult even for patients without disabilities. Those procedures are more difficult to patients with disability because it's too hard to control breathing and muscle. In this report, we performed prosthetic dentistry procedures to three patients with disabilities under dental sedation and general anesthesia.