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ISSN : 0376-4672
노인치과환자들을 대할 때 일반 성인치과환자들의 연장선에서 보는 시각의 패러다임에서 탈피해야 한다. 왜냐하면 노인치과환자들은 일반 성인치과환자들과 확실하게 다른 특성을 가지고 있고 다른 접근법이 있기 때문이다. 그 동안 노인치과환자들이 소수이었기 때문에 이러한 특성들이 무시되어도 아무런 탈이 없었지만 앞으로 노인인구가 전체인구의 1/3을 차지하는 시대에서는 더 이상 무탈할 것 같지 않다.
The age structure has been experiencing substantial change due to the decreased birth rate as well as the increased life expectancy. Gorge Magnus, an English economist, casts warnings of population ageing which has the potential of huge socioeconomic impact human society has never experienced before. The prediction that proportion of elderly people in need of oral health care will increase substantially is a new challenge to dentists in the future. The old paradigm that the aged person is just the person who was born earlier and needs the same conventional oral health care should be shifted to the new one. Elderly people tend to express their political interest related with health care system by actively participating in the national elections. The need to sustain economic status for the extended life span makes them seek eagerly esthetic health care to maintain sound social function. Most of them are under multiple chronic diseases and take related medicines. In addition, many studies report about mental change as well as physical change among the aged people. Since the prevalence of dental diseases among the aged is higher than other chronic devastating diseases, the aged seeking oral health care will increase. The aged who has different physical and psychological status as well as chronic disease and related medicine will show unexpected response to the conventional oral health care. In addition,the impact of tooth loss is substantial physically, mentally and emotionally. Dentist should prepare different approaches for the elderly dental patient.
치과의사와 환자의 커뮤니케이션은 치과진료에서 중요한 부분이다. 커뮤니케이션이 잘 되면 여러 가지 긍정적인 효과가 있는데, 그 중에는 환자 불안의 감소, 환자 만족의 증가, 환자의 동기부여 증가, 환자의 건강행동교육 내용에 대한 이행률 증가, 그리고 보다 나은 건강결과가 속한다. 치과의 기술적 숙련도는 치과진료에서 중요한 요인인데, 바로 이 기술적 숙련도에 대한 환자의 인식은 다시 의사의 커뮤니케이션 방식에 달려있다는 점도 유념할 필요가 있다.
Dentist-patient communication has long been recognized as an important part of dental care. It has many positive outcomes,including reducing patient dental anxiety and increasing patient satisfaction and patient compliance. Above all, the need to communicate through conversation with dentist must be perceived as a basic dental patient’s need for good clinical outcomes. In the future, increasing geriatric dental patients will pose challenges to dental profession. Factors influencing dentist-geriatric patient communication should be researched and relevant techniques should be shared among dentists.
노인 인구의 급격한 증가는 향후 치과 치료를 받는 환자의 상당수가 필연적으로 노인이 될 것임을 예견하고 있다. 이는 우리가 매일 시행하는 진료 술식에서 병력조사와 진단과정에 더 많은 시간과 노력을 들여야하고 약물 투여량과 치료기간을 변경하여야 하며, 어떤 약물은 피하거나 줄여야 하고 예방적 항생제 투여를 고려해야 하며, 감염과 출혈의 가능성에 더욱 주의하여야 함을 말해 주는 것이다.
The geriatric population is the most rapidly growing part of the general population, which leads to an increase of chronic conditions and illnesses that will influence both oral and systemic health. The most common chronic diseases in elderly population are arthritis, hypertension, heart diseases, diabetes, and cognitive impairment. Chronic impairments such as visual, hearing,orthopedic, and speech disorders are also prevalent among older adults. All these chronic conditions have potential oral complications and the treatments of systemic diseases also has implications for the maintenance of oral health. Therefore, oral health care professionals should catch up with increasing knowledge in this field and can modify the treatment strategy for older adults. In addition, oral health care professionals should understand the changing need of oral health problems in this age and prepare the future demand.
흡연은 인체에 다양한 전신 질환을 유발하는 위험인자(risk factor)로서, 폐암의 90%, 만성 폐질환의 70%, 심근경색 질환의 80%, 허혈성 심질환의 30% 가 흡연에 의해 유발된다고 추정되고 있다. 이 외에도 많은 전신 질환이 흡연과 깊은 관계를 보여, 골다공증 환자의 경우에는 장기간 흡연 시 골다공증 증상이 악화될 수 있으며, 폐경기에 접어든 여성의 경우에는 흡연 시 고관절 골절 빈도가 높게 나타나고 금연 시에는 그 위험율이 현저히 감소하는 것으로 밝혀졌다.
Cigarette smoking is a significant risk factor for periodontaldiseases and implant treatments. Smoking control is regarded as a key to the success of dental treatments as well as the well-being of the patients. The aim of this study was to reviewthe effects of smoking on periodontal health, and the results of periodontal therapy and implant treatments. Also, in vitro, microbiological, immunological and epidemiological relationships were studied. In vitro studies show that smoking interferes with normal healing process and increased tissue destruction. There is still controversy on the population of microbes of smokers. Smokers showed significantly less gingival inflammation and bleeding on probing compared with non-smokers. After periodontal treatments, a compromised clinical outcome was noted for smokers in terms of pocket depth reduction and gain in attachment levels. In conclusion, data from in vitro, epidemiological, cross-sectional and case?control studiesstrongly suggest that quitting smoking is beneficial to patients before periodontal and implant treatments.