노인요양시설에 있는 노인환자의 구강실태 및 치료수요도
Oral health status and treatment need of institutionalized elderly patients
양순봉, 이호용, 한동후, 정문규, 문홍석,
소속 상세정보
양순봉 ( Yang Soon-Bong ) - 연세대학교 대학원 의학과
이호용 ( Lee Ho-Yong ) - 연세대학교 치과대학 치과보철학교실
한동후 ( Han Dong-Hoo ) - 연세대학교 치과대학 치과보철학교실
정문규 ( Jeong Mun-Gyu ) - 연세대학교 치과대학 치과보철학교실
문홍석 ( Moon Hong-Seok ) - 연세대학교 치과대학 치과보철학교실
KMID : 0362420080460050455
Abstract
문제제기: 노인요양시설은 치과진료영역 가운데 가장 취약한 상태에 놓여 있고 신체적, 정신적 장애로 인해 주관적 치료요구도를 파악할 수 없는 상태지만 이에 대한 기초적인 실태조사가 전무한 상태이다.
목적: 본 연구는 노인요양시설에서 노인환자들의 치아우식증에 의한 구강실태를 조사하고, 기능치아와 보철물로 이루어진 교합단위를 분석하여 그에 따른 치과치료수요도를 분석하는데 목적이 있으며 향후 적절한 진료방향을 수립하는데 기여하고자 한다.
연구재료 및 방법: 노인요양시설에서 758명의 노인환자와 D치과의원에 내원한 212명의 65세 이상인 노인을 대상으로 2000년 국민구강건강실태조사에서 작성된 치아우식검진지침에 입각하여 구강실태조사를 시행하였다.
결과: 노인요양시설의 노인에게서 고령으로 갈수록 대조군에 비해 악화되고 있는 구강상태를 알 수 있었고 매우 높은 치료수요를 파악할 수 있었다.
고찰: 노인환자의 구강건강관리를 위해서는 무엇보다도 이들을 보살피는 간병인과 간호 인력들이 가지고 있는 구강건강의 중요성에 대한 인식을 바꾸기 위한 노력이 절실히 필요한 상황이다. 이제는 무치악 환자에게 시행되고 있는 일회성 의치사업 일변도의 복지정책방향을 보건복지부와 일선 지방자치단체에서 사후관리를 원칙으로 한 전문가에 의한 무치악 환자의 의치사업으로 강화해야 하며 유치악의 노인환자들에 대한 정기적인 치과검진을 시행하고 이동진료 및 왕진시스템이 보완된 구강건강관리 및 보존, 수복진료 형태로의 전환을 고려할 시점이라 생각된다.
Statement of problems: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective needof dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions.
Purpose: The aims of thecurrent study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze theirdental treatment needs.
Material and methods: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was morethan 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. Results and conclusion:The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residualteeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (P < .05). The number of fixed partialdenture in institutionalized elderly was lower than that of the same ages in control group (P < .05). The percentage wearing removable partial denture was notsignificant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institu-tionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institution-alized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was high-er than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete den-ture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of in-stitutionalized elderly were lower than that of the control group (P < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partialdentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in themaxilla (P < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teethwas less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of oc-cluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase theawareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth areincreasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control ofdentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project ofedentulous patients should be done by specialists who’ll also be responsible for postmanagement. Through this research of institutionalized elderly, the oralhealth status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in or-der to solve the rising treatment needs of the elderly patients.
키워드
노인요양시설;구강실태;치료수요도;교합단위;간병인;구강건강관리
Oral health status;Treatment need;Institutionalized elderly;Occluding pairs;Caregiver
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