일부 성인의 치과진료비 부담에 따른 치과 건강보험 확대 및 민영치과보험 가입 의사

김윤경 ( Youn Gyung Kim ),김은지 ( Eun Ji Kim ),노수현 ( Su Hyun Nho ),백은진 ( Eun Jin Baek ),신민서 ( Min Seo Shin ),황수정 ( Soo Jeong Hwang ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.6

The high dental treatment cost has been considered as one of the major reasons for inappropriate dental treatment in Korea. The aim of this study was to investigate the opinions of expansion of National Health Insurance (NHI) in dental treatment fields not covered with NHI and buying private dental insurance. This survey was carried out targeting 266 adults from their 30s to 50s with convenience sampling. The higher orders in stress of dental treatment cost were orthodontic treatment, dental implant, prosthodontic treatment, and caries treatment not covered with NHI. The higher orders in needs of expansion of NHI were caries treatment not covered with NHI, prosthodontic treatment, and orthodontic treatment. The agreement percentages with age restriction in NHI were scaling 57.1%, denture 23.3%, implant 14.3%, respectively. The subjective oral health had impact on the stress of dental treamtent cost and expansion on NHI. Although only 8.3% subjects had private dental insurance, 68.4% of the subjects had positive opinions buying private dental insurance. The correlation coefficients between stress of dental treatment cost and buying private dental insurance were implant 0.408, caries treatment not covered with NHI 0.404, denture 0.394, crown and bridge 0.375, and orthodontic treatment 0.313. Expansion of NHI in dental treatment and development of private dental insurance was suggested to treat dental disease in appropriate time.

치과 진료 경험 유무에 따른 구강건강관리에 대한 조사 연구: 수도권 지역을 중심으로

박명숙 ( Myung Suk Park ),남영신 ( Young Shin Nam ) 아시아.유럽미래학회 2010 유라시아연구 Vol.7 No.3

본 연구는 치과 진료 경험 유무에 따른 구강건강관리에 대한 조사로 치과진료 경험이 있는 대상자와 없는 대상자의 각각의 특성을 분석. 비교하여 대상자별로 구강건강관리에 관련 있는 요인을 파악하기 위하여 치과진료 경험이 없는 대상자 300명, 치과진료 경험이 있는 대상자 300명으로 전체 600명을 대상으로 자기기입식 설문조사를 하였으며 SPSS 15.0을 이용하여 분석한 결과 다음과 같은 결론을 얻었다. 1) 대졸자는 치과진료 유경험자에서 많았으며 거주지에서는 시지역에 거주하는 자가 가장 많았으며 그 중에 치과진료 유경험자가 180명(60%), 치과진료 무경험자가 156명(52%)이었다. 직업에서는 치과진료 무경험자에는 학생, 유경험자에는 전문직이 가장 많았다. 2) 구강관련 교육 경험 유무에서는 ``예``로 응답한 자가 유경험자에서 159명(53%), 무경험자에서 117명 (39%)로 유경험자에서 교육을 받은 경험이 더 많았다. 3) 칫솔질 횟수는 치과진료 유경험자와 무경험자 모두에서 일일 3회가 가장 많았으며 1회에서는 유경험 자에 비해 무경험자가 많았고 3회와 4회 이상에서는 반대로 무경험자에 비해 유경험자가 많은 것으로 나타났으며 통계적으로 유의하였다. 4) 치과진료 유경험자중 구강관련 교육경험이 있다고 응답한 자에서 일일 4회 이상 칫솔질하는 자는 27명(17%)이었고 교육경험이 없다고 응답한 자에서는 6명(4.3%)이었다. 치과진료 무경험자에서 구강 관련 교육경험이 있다고 응답한 자에서 일일 4회 이상 칫솔질 하는 자는 20명(17.1%), 구강관련 교육경험이 없다고 응답한 자에서는 10명(5.4%)이었다. 치과진료 유경험자와 무경험자 모두에서 구강 관련 교육경험이 있다고 응답한자에서 일일 4회 칫솔질 하는 자가 많았다. 5) 치과진료 경험 유무에 따른 인식도는 유경험자에서 4.14, 무경험자에서 3.96점으로 치과진료 유경험 자에서 인식도가 높았고 지식도에서도 유경험자에서 1.86, 무경험자에서 1.75점으로 치과진료 유경험 자에서 인식도가 높았으며 통계적으로 유의한 차이를 보였다. 다음과 같이 제언하고자 한다. 첫째, 대상자의 일반적 특성(교육수준, 수입, 거주지)에 상관없이 구강건강관리에 기본이 되는 칫솔질에 대한 실천 제고를 위해 노력해야 할 것이다. 둘째, 치과진료 무경험자가 접근할 수 있는 구강건강관리 프로그램 개발이 필요하다. 셋째, 현재 대부분의 치과위생사의 근무지가 치과의원으로 집중 되어있는데 보다 많은 연구를 통해 치과 위생사의 역할 확대를 통하여 다양한 분야에서의 치과위생사의 자리 매김이 필요하며, 치과위생사의 역할 확대는 더 나아가 국민의 구강건강 증진에 대한 기여도가 클 것으로 사료된다. As a survey on oral health care according to the appearance of experiencing dental treatment, the purpose of this study was to grasp factors relevant to oral health care by subject through analyzing and comparing characteristics in each between the subjects with experience of dental treatment and the subjects without experience. It carried out self-reported questionnaire survey targeting totally 600 people such as 300 subjects without experience of dental treatment and 300 subjects with experience of dental treatment. As a result of analyzing by using SPSS 15.0, the following conclusions were obtained. 1) University graduates were large in people with experience of dental treatment. As for residence, there were large people who dwell in city region. Among them, subjects with experience of dental treatment were 180 people(60%). Subjects without experience of dental treatment were 156 people( 52%). As for job, it was the largest in students as for people without experience of dental treatment, and in professional job as for people with experience. 2) In the appearance of experiencing the oral-related education, the subjects, who responded as saying of ``Yes,`` were 159 people(53%) as for subjects with experience, and 117 people(39%) as for subjects without experience. Thus, the experience of having ever been educated was larger in people with experience. 3) As for toothbrushing frequency, three times a day was the largest both in people with experience of dental treatment and people without experience. One time was larger in people without experience than people with experience. In 3 times and over 4 times, people with experience were indicated to be larger than people without experience, on the contrary. It was statistically significant. 4) In the response as saying of having experience of the oral-related education regarding people with experience of dental treatment, the subjects, who toothbrush over 4 times a day, were 27 people(17%), and were 6 people(4.3%) in respondents as saying of having no experience of education. In the respondents as saying of having experience of the oral-related education regarding people without experience of dental treatment, the subjects, who toothbrush over 4 times a day, were 20 people( 17.1%) and 10 people(5.4%) for the respondents as saying of having no experience of the oral-related education. As for all of subjects with experience of dental treatment and of subjects without experience, people of toothbrushing 4 times a day were large in the respondents as saying of having experience of the oral-related education. 5) The awareness level according to the appearance of experiencing dental treatment was 4.14 points in people with experience and 3.96 points in people without experience. Thus, the awareness level was high in subjects with experience of dental treatment. The knowledge level was 1.86 point in people with experience and 1.75 in people without experience. Thus, the awareness level was high in people with experience of dental treatment. Statistically significant difference was shown. It aims to suggest as follows. First, regardless of subjects`` general characteristics(educational level, income, residence), there will be necessity for striving to reinforce practice on toothbrushing, which becomes the basis in oral health care. Second, oral health care program needs to be developed that can be approached by people without experience of dental treatment. Third, the working places of most of dental hygienists are now concentrated on dental clinic. Still, there is necessity for dental hygienists`` positioning in diverse fields, through expanding dental hygienists`` role through more researches. Furthermore, it is considered to be likely to greatly contribute to promotion in people``s oral health.

치과치료와 턱관절장애의 연관성에 관한 연구

김영균(Young-Kyun Kim),이용인(Yong-In Lee) 대한치과의사협회 2008 대한치과의사협회지 Vol.46 No.5

The risk of temporomandibular joint disorder (TMD) can be increased during dental treatment due to excessive mouth opening and change of occlusion. The aim of this study is to find the relationship between dental treatment and TMD in the patients who developed TMD after dental treatment. The subjects of this study were 21 patients, who developed TMD after dental treatment and were treated with active TMD therapy in Seoul National University Bundang Hospital from June 2003 to February 2007. The subjects were examined with preceding dental treatment, synptom, diagnosis, treatment method of TMD and prognosis of TMD. The obtained results were as follows. 1. Preceding dental treatments were: Implant treatment, 14 cases: Tooth extraction, 3 cases and others. 2. TMD Symptoms were: Pain on TMJ. 12 cases: sound on TMJ, 3 cases: Mouth opening limitation, Headache and others. 3. Diagnoses of TMD were: Synovitis and/or capsulitis, 10 cases: 8 cases of Internal derangement and others. 4. Most TMD were treated by stabilization splint. 5. Prognoses of TMD were: Improvement, 6 cases: sustained 11 cases. In conclusion, the risk of TMD is increased during implant treatment. Prognoses of TMD after dental treatment were bad. It might be that these patients were non-cooperative and have distrust of dental treatment. Because the overloading on TMJ is possible in dental treatment of patients with underlying TMD. prior explanation and knowledge of TMJ treatment are very important in these cases.

윌리엄스 신드롬 환자의 치과치료를 위한 고려사항

신지선 ( Jisun Shin ),이준행 ( Joonhaeng Lee ) 대한예방치과·구강보건학회 2018 大韓口腔保健學會誌 Vol.42 No.4

Williams syndrome is a rare congenital disorder with various physical abnormalities and characterized by facial, oral, and dental features. Individuals with Williams syndrome typically have eating disorders in the early childhood, which lead to prolonged night feeding. Prolonged night feeding is a risk factor for rampant dental caries. Williams syndrome is caused by the microdeletion of chromosome 7, resulting in elastin deficiency. Elastin is integral to cardiovascular health. Many patients with Williams syndrome have complex cardiovascular abnormalities that must be considered a part of dental management. Complications related to cardiovascular diseases may induce adverse effects such as dangerously elevated blood pressure. This may occur in patients during stressful dental treatment. In addition, characteristics of auditory hyperalgesia and anxiety disorders among patients with William syndrome, complicate receiving routine dental management. Therefore, dental treatment under sedation or general anesthesia may be preferable for patients with Williams syndrome; in particular, patients who are very uncooperative and/or needs extensive dental treatment. A thorough evaluation of each patient’s physical condition is required before making decisions regarding dental treatment. Careful monitoring and preparation for emergencies are very important during and shortly after dental treatment under general anesthesia or sedation. Monitoring is critical until vital signs have stabilized and return to normal. A 28-month-old man diagnosed as having Williams syndrome, visited the Dental Hospital of OO University for the management of rampant dental caries. We reported on the management of this patient who had peripheral pulmonic stenosis, and received dental treatment under general anesthesia. We also reviewed the characteristics of Williams syndrome and discussed considerations for dental treatment under general anesthesia.

치과치료 공포감 관련요인분석

이효영 ( Hyo Young Lee ),나미향 ( Mi Hyang Na ),이용환 ( Yong Hwan Lee ) 한국치위생학회 2012 한국치위생학회지 Vol.12 No.1

Objectives : The purpose of this study is to seek analysis of related factors for dental fear and to know the fear component affecting the treatment of the dental treatment. Methods : Total of 320 females and males aging from 10 to 40 years old with dental treatments done from May to July 2010 have participated with self-entry survey method utilizing the Dental Fear Survey questionnaire. The data received was analyzed using the descriptive statistic, t-test, ANOVA and multiple correlation analysis with level of significance as p<0.05. Results : The dental fear factor were significantly high in woman by 2.79±0.92 and in 40`s age group by 2.82± 0.84 (p<0.05). Participants with frequent tooth ache, experiencing pain while treating the tooth ache and breaking the dental treatment appointment showed higher fear factor. Thoughts of having poor dental health condition caused bad influence on fear factor. Overall, the factors affecting the fear of the dental treatments were gender, an ache while treating, number of missed appointment, and distrust of the dentist, stimulation factor were the factors affecting the treatment. Conclusions : The fear factors in the dental treatment were higher with gender, related characteristics of the oral health and distrust of the dentist. Therefore accurately recognizing the sensitive patient with dental treatment, proper management of the toothache, effort to increase the creditability of the doctors and separately treating patient customized for each individual patient will reduce the fear of the dental treatment.(J Korean Soc Dent Hygiene 2012;12(1)57-65)

FACTORS AFFECTING PATIENTS' DECISION-MAKING FOR DENTAL PROSTHETIC TREATMENT

Jung, Hyo-Kyung,Kim, Han-Gon The Korean Academy of Prosthodonitics 2008 대한치과보철학회지 Vol.46 No.6

STATEMENT OF PROBLEM: Factors affecting patients' decision-making for dental prosthetic treatment should be examined in terms of understanding improving patients' oral health. PURPOSE: The main purpose of this dissertation was to investigate patients' dental prosthetic treatment and factors affecting patients' decision-making for dental prosthesis treatment in Deagu and Gyungbook areas. MATERIAL AND METHODS: This study was based on the preliminary survey of dental patients conducted from July 1 to August 31 in 2006. A total of 700 questionnaires had been distributed and 640 were collected. 629 questionnaires were used for the statistical analysis. Descriptive and inferential statistics, such as frequencies, cross tabulation analysis, correlation analysis, logistic regression analysis, and multiple regression analysis were introduced. In the multiple regression analysis and logistic regression analysis, twenty-two independent variables were employed to explore the factors which have impacts on decision-making and satisfaction. RESULTS: The results of this dissertation are as follows: Logistic regression analysis turned out that monthly income, age, degree of expectation, marital status, and employer-insured policy of national insurance statistically increased the odds of decision-making of dental prosthesis treatment. But educational attainment decreased the odds ratio of the decision-making of dental prosthesis treatment. However, the rest independent variables do not have statistically significant impacts on the decision-making of dental prosthesis treatment CONCLUSION: Among independent variables, marital status had the most significant influence on the decision making of dental prosthesis treatment. Finally, suggestions for the future study and policy implications to improve satisfaction of the patients' dental prosthetic treatment were discussed.

성인의 구강의료접근성의 관련요인 -구강질환의 의사진단 및 처치율을 중심으로-

노희진 ( Hie Jin Noh ),최충호 ( Choong Ho Choi ),손우성 ( Woo Sung Sohn ) 한국보건행정학회 2008 보건행정학회지 Vol.18 No.4

Objectives: The aim of this analysis was to investigate factors associated with dental visits in terms of getting diagnosis and receiving care for diagnosed dental diseases among Korean adults. Methods: Data used in this analysis were from the 2005 Korean National Health and Nutrition Examination Survey which involved a representative sample of 25,487 adults nineteen years of age and older who resided in Korea. This analysis used data of adults who had completed health interview survey (n = 25,215). Uni- and bi-variate analysis, Chi-square test, and logistic regression analyses were conducted using SAS. Results: The percentages of people diagnosed (treated) dental caries, periodontal disease, and temporomandibular joint disorder were 70.4(77.1), 16.1(55.7), and 0.6(37.4), respectively. The reception of treatment for diagnosed dental caries and periodontal disease was significantly associated with older age, high monthly household income, and high education attainment. Logistic regression model indicated that age, monthly household income, education attainment, type of health insurance, and chewing problem were significantly associated with getting diagnosis and treatments of dental diseases. Most frequently answered reason for non- or delayed treatments of diagnosed dental diseases during the last one year was cost of treatments. Conclusions: The findings indicated that socio-economic-status still significantly affected reception of needed dental treatments among Korean adults despite the national health insurance system. Oral health policy and programs should be augmented to provide further support to adults of low socio-economic-status who are more prone to dental diseases yet lack resources for needed dental treatments.

Analysis of behavioral management for dental treatment in patients with dementia using the Korean National Health Insurance data

Kim, Taeksu,Chi, Seong In,Kim, Hyuk,Seo, Kwang-Suk The Korean Dental Society of Anesthsiology 2021 Journal of Dental Anesthesia and Pain Medicine Vol.21 No.5

Background: The global population is aging rapidly, and accordingly, the number of patients with dementia is increasing every year. Although the need for dental treatment increases for various reasons in patients with dementia, they cannot cooperate during dental treatment. Therefore, behavioral management, including sedation (SED) or general anesthesia (GA), is required for patients with dementia. Thus, this study aimed to investigate the trends and effects of SED or GA in patients with dementia undergoing dental treatment in South Korea based on the Korean National Health Insurance claims data. Methods: This study utilized customized health information data provided by the Health Insurance Review and Assessment Service. Among patients with records of using sedative drugs during dental treatment from January 2007 to September 2019, patients with the International Classification of Diseases-10 code for dementia (F00, F01, F02, F03, and G30) were selected. We then analyzed the full insurance claims data for dental care. Age, sex, sedative use, and dental treatment of patients were analyzed yearly. In addition, the number of cases of GA or SED per year was analyzed, and changes in behavioral management methods with increasing age were investigated. Results: Between January 2007 and September 2019, a total of 4,383 (male, 1,454; female, 2,929) patients with dementia received dental treatment under SED or GA. The total number of SED and GA cases were 1,515 (male, 528 ; female, 987 ) and 3,396 (male, 1,119 ; female, 2,277) cases, respectively. The total number of cases of dental treatment for 4,383 patients with dementia was 153,051 cases, of which 2.22% were under GA and 0.98% were under SED. Midazolam was the most commonly used drug for SED. Conclusion: Although gingivitis and pulpitis were the most common reasons for patients with dementia to visit the dentist, GA or SED for patients with dementia was frequently used in oral and maxillofacial or periodontal surgery.

Analysis of the Effects of Unmet Dental Care on Dental Treatment Needs: Based on the 8th Korea National Health and Nutrition Examination Survey (2019)

Jin-Sil Kim,박효정 대한예방치과학회 2022 International Journal of Clinical Preventive Denti Vol.18 No.4

Objective: The purpose of this study is to investigate the factors that unmet dental care in terms of oral health problems and dental care requirements affect the need for dental treatment. Methods: We used data from the 8th National Health and Nutrition Survey 1st Year (2019), which surveyed 10,859 participants. We included 5,581 adults aged ≥19 years. To analyze the general characteristics of the participants and determine whether and why their dental care was unmet, survey responses were reclassified and a frequency analysis was conducted. The Rao–Scott chi-square test and composite sample multiple logistic regression analysis was conducted to determine the relationship between general characteristics, oral health behavior, oral conditions, dental needs, and unmet dental care. Results: Multiple logistic regression analysis revealed association between dental needs and access to dental care. Unmet dental care-based analysis revealed that women were 0.77 times more likely to receive dental treatment than men. When prosthetics and implants were in the oral cavity, they were 1.30 and 1.36 times higher. Conclusion: Due to its retrospective cross-sectional design, the study only included participants of the 8th National Health and Nutrition Survey, limiting its ability to establish causal relationships. Future studies are warranted to provide an in-depth analysis by expanding not only the subjective oral health status but also objective oral health indicators according to dental preventive treatment standards and to use these data to determine the factors affecting the systemic health status of citizens.

치과내원환자의 주관적 구강건강인식과 치과공포의 관련성

윤현서(Hyun-Seo Yoon),박지현(Ji-Hyun Park) 한국콘텐츠학회 2012 한국콘텐츠학회논문지 Vol.12 No.6

본 연구는 부산·경남지역의 치과내원환자를 대상으로 주관적 구강건강인식과 상태 그리고, 치과진료 분야에 치과공포수준을 파악하여 추후 치과진료 시 치과공포를 줄일 수 있는 방안을 마련하여, 구강건강의 향상과 더불어 삶의 질 향상에 기초자료로 개발하고자 한다. DFS의 전체 문항에서 100점 만점에 남자(44.9점)보다 여자(53.1점)에서 공포감이 모두 높게 나타났다. 치료종류에 따른 공포수준은 임플란트 치료 치료회피요인(p=0.015), 교정치료 치료회피요인(p=0.002), 생리적 반응요인(p=0.009), 보철치료 치료회피요인(p=0.014), 신경치료 치료회피요인(p=0.005), 생리적 반응요인(p=0.017), 치주치료 치료회피요인(p=0.013), 생리적 반응요인(p=0.004), 정기검진을 받지 않는 경우 치료회피요인(p=0.027)이 높았다. 구강증상에 대하여 인지하고 있는 개수가 많을수록 치료회피요인(p=0.001), 자극반응요인(p=0.002), 생리적반응요인(p=0.005)로 높았다. 이상의 결과에서 치과공포를 줄이기 위해서는 정기검진과 예방적 처치를 위한 다양한 프로그램개발 및 구강보건교육을 실시해야 할 것이다. The purpose of this study is to develop basic data in improving quality of life along with the enhancement in oral health, by arranging a plan for being able to reduce dental fear given the dental treatment in the future by grasping the subjective oral health recognition & status, and the dental fear level of the dental treatment field targeting patients of visiting dental clinics in Busan and Gyeongnam area. In the whole items of DFS, a sense of fear was higher in women than men. A factor of avoiding dental treatment stood at 1.72 points in men and 2.10 points(p<0.001) in women. A factor of response to stimulation stood at 2.75 points in men and 3.20 points(p=0.001) in women. A fear level according to dental kind was high in a factor of avoiding implant treatment(p=0.015), a factor of avoiding orthodontic treatment(p=0.002), physiological reaction(p=0.009), a factor of avoiding prosthesis treatment(p=0.014), a factor of avoiding pulpectomy treatment(p=0.005), a factor of physiological reaction(p=0.017), a factor of avoiding periodontal therapy(p=0.013), a factor of physiological reaction(p=0.004), and a factor of avoiding treatment given not receiving regular checkup(p=0.027). In the above results, to reduce dental fear, there will be a need of developing diverse programs and oral health eduction for regular checkup and preventive treatment.