한국 심신장애자들의 구강보건실태 및 구강보건의료 수요에 관한 조사연구

Abstract

[영문]

[한글]

우리 나라 심신장애자들의 합리적이고도 활용 가능한 구강보건관리 계획을 수립하는 데

에 필요한 기초 자료를 마련할 목적으로 1987년 현재 대한장애자 복지시설연합회와 한국

특수교육협회에 등록된 총 156개 재활원 및 특수학교에 수용되어 있거나 통학중인 심신장

애자 20,870명을 대상으로 하였으며, 이들 중 41개 재활원 및 특수학교의 남녀 심신장애

자 3,143명을 충화표본 추줄하여 조사 실시하여 다음과 같은 결론을 얻었다.

1. 사회문화관습자율은 지체 3.4%, 정박 1.1 %, 시각 0.5%, 청각 2.5%, 복합 3.0% 였으

며, 이러한 습관은 구강 경조직 및 연조직에 손상을 초래하는 것으로 나타났다.

2. 골병변 및 악안면 이상은 구강보건관리계획을 수립하는 데에 중요한 요인이라고 볼

수 없었다.

3. 구강 외 신체요인은 구강 관리능력과 구강병 진행에 큰 영향을 미치는 것으로 나타

났으며,본 연구에서는 정박군과 복합군 1,554명 전체에서 있었다.

4. 불요조치구강점막 질환자율은 지체 0.6%, 정박 0.8%, 시각 0.2 %, 청각2.1%, 복합 2

1.6%로 나타났으며, 요조치구강점막질환자율은 지체 1.3% ,정박 0.3%로 나타났다.

5. 불요치료치아결함자율은 지체 3.2% ,정박 5.7% ,시각 4.6% ,청각 4.4%, 복합3.0%로

나타났으며, 요치료치아길함자율은 지체 1,1%,정박 1.7% ,시각 1.8%, 청각 1.2%,복합 0.7

%로 나타났다.

6. 연성부착물부착도가 전체적으로 높아 구강위생상태가 불량하였고, 장애유형간에는

뚜렷한 차이가 관찰되지 않았다.

7. 치석부착도는 낮은 연령군 에서는 정박군에서 가장 높게 나타났으며, 연령 증가에

따라 각 장애유형간에는 큰 차이가 나타나지 않았다.

8. 치은염유병율과 치주병유병율은 정박군에서 높게 나타났으며, 20대에서 30대 사이에

현저한 증가를 나타냈다.

9. 치주처치수요는 치면세균막판리만을 필요로 하는 자는 낮은 연령의 지체군에서, 치

면세균막관리치면세마 수요자율은 청각군에서, 치주병치료 수요자율은 정박군에서 가장

높게 나타났다.

10. 의치 장착도 와 의치 수요는 장애 유형간에는 큰 차이가 없었으나 정박군애서는 낮

은 연령층에서 도 발견되었다.

11. 응급치과의료수요는 매우 높은 수요자율을 나타냈으며, 장애유형간에는 큰 차이가

없었으나 복합군에서 다소 높게 나타났다.

12. 유치우식경험도는 유치우식경험율이 장애유형간에 큰 차이를 나타내지 않았으며,

충전유치지수는 상당히 낮은 상태를 볼 수 있었다.

13. 영구치우식경험도는 영구피우식경험율이 장애유형간에는 큰 차이가 나타나지 않았

으며,상실영구치지수는 낮은 연령군에서는 정박군과 복합군 에서 높게 나타났다. 충전영

구치지수는 전체적으로 크게 낮은 수준을 보였다.

14. 치아처치수요는 전체적으로 조기치료단계를 넘은 진행된 처치수요가 많이 나타났다

.

15. 계속 가공의치수요는 낮은 연령군에서 높게 나타났으며 각 장애유형간에는 뚜렷한

차이가 관찰되지 않았다.

A SURVEY OF THE ORAL HEALTH ANO THE DENTAL NEEDS OF HANOICAPPED PATIENTS IN KOREA.

Ewi - Tae Chung, D.D.S., M.S.D.

Dept.of dental Science, Graduate school, yonsei Univ.

(Directed by Prof Chong-youl Kim,D,D.S., M,S,D, Ph.D.)

The purpose of this study was to review the available oral health care programs

of the handi-capped and to make any necessary recommendations for their

improvement. 3143 handicapped patients were sampled from 41 institutions and

special schools in Korea during 1987.

1. The rate of sociocultural habit was 3.4% in the physically handicapped, 1.1%

in the mentally retarded, 0.5% in the visually handicapped, 2.5% in the hearing

impaired and 3.0% in the multiply handicapped. These habits seemed to result in

damage t? both the hard and soft oral tissues.

2. Bone pathology and dentofacial anomaly did not seem to be important factors in

planning the oral health care programs.

3. It appeared that systemic factors influenced the ability to maintain proper

oral healthcare and to slow the advance of oral disease. In this study, 1554

patients were found to have systemic factors in total of the mentally retarded and

the multiply handicapped.

4. The rate of oral mucosal disease not requiring treatment was 0.6% in the

physically handicapped, 0.8% in the mentally retarded,0.2% in the visually

handicapped, 2.1% in the hearing impaired and 21.6% in the multiply handicapped.

The rate of oral mucosal disease requiring treatment was 1.3% in the physically

han야capped and 3.9% in the mentally retarded.

5. The percentage of defective teeth not requiring treatment was 3.2% in the

physically handicapped, 5.1% in the mentally retarded,4.6% in the visually

handicapped,4,4% in the hearing impaired and 3.0% in the multiply handicapped,

while the percentage requiring treatment was1.1% in the physically handicapped,

1.7% in the mentally retarded, 1.8% in the visually handi-capped, 1.2% in the

hearing impaired and 0.7% in the multiply handicapped.

6. Generally, patient oral hygiene was poor, with a high degree of soft deposits,

and no obvious difference was found among the various groups of the handicapped.

7. Among the younger patients, the degree of calculus deposit was highest in the

mentally retarded group, and in the older patients, there was no obvious difference

among the groups of the handicapped.

8. The Frequency of intense gingivitis and periodontitis was highest in the

mentally retarded group and obviously increased between the 3rd and 4th decades.

9. Those patients who required only simple oral hygiene instruction were

primarily the young physically handicapped, those who required oral hygiene

instruction with scaling were found mostly in the hearing impaired group while the

number of patients requiring periodontal treatment was high in the mentally

retarded group.

10. With regard to prosthetic and denture requirements, there was no obvious

difference among the handicapped groups, but some denture requirements were found

in the younger men-tally handicapped patients,

11. Conditions needing immediate attention were found in many cases with a

slightly higher number in the multiply handicapped.

12. The incidence of caries in primary teeth did not very different among the

handicapped groups and the indices of restoration were ve교 low.

13. The incidence of caries in permanent teeth was net different among the groups

of the handicapped, the indices of mining teeth were high in the younger mentally

retarded and they younger multiply handicapped, and generally, the indices of

restoration were very low.