러버댐에 대한 소아 청소년 환자 및 보호자의 인식 조사

Abstract

Rubber dam is very useful technique for protecting patients and operators and producing good results when we treat children and adolescents patients. It has various advantages such that it isolates teeth from saliva and keeps surroundings of the teeth sterile so that it enables successful restorative and root canal treatments. And it lowers the chance for patients to absorb dental materials, instruments and foreign bodies, so it protects them. But, despite these many advantages, some children and adolescents patients think it negative and sometimes express their discomfort over their teeth and periodontal tissue's being pressed due to clamps. There are insufficient studies about degree of recognition of patients or their protectors about these advantages and degree of discomfort of them even if they have recognized already. It is thought that such data for research will helpful to clinical treatment of pediatric dentistry. Previous studies were restricted to correlation between patient's satisfaction and degree of recognition about wearing a rubber dam and its relation with local anesthesia or not, treatment time and rubber dam type. This study have researched about relation with various factors such as awareness and satisfaction, teeth, wearing frequency about rubber dam according to pediatric patient's age and protector's awareness, specific satisfaction and dissatisfaction items about rubber dam through survey. We conducted a survey targetting patients aged of 4~18 who visited to pediatric dental clinic, restorative dental clinic and student treatment dental clinic of chosun university college of dental hospital and were treated with rubber dam under non-sedation. We collected questionnaires through electronic medical records. We researched about these : 1) treatment factors such as gender, age, treatment procedure, teeth, anesthesia or not and treatment time 2) experience factors such as degree of recognition about rubber dam, experience existence or nonexistence, awareness about dental treatment and rubber dam, good things and uncomfortable things. We analyzed data using SPSS(SPSS 20.0, SPSS Inc., Chicago, IL, USA) program. In collected 87 questionnaires through EMR, subjects consisted of 40 boys(46.0%), and 47 girls(54.0%). And there average age was 9 years 11 months. 19.5% of them were early childhood, 54% of them were school age and 26.4% of them were adolescent. Awareness about general dental treatment showed average 2.31 point, treated with rubber dam at that day showed average 2.33 point and willing to be treated with rubber dam in next time showed average 2.52 point. For each of them, protectors showed respectively 3.07, 2.85, 3.07 point. Sealant was carried out in 16.1%, restorative treatment in 59.8% and pulp treatment in 24.1%. Patients treated without anesthesia took 55.2%, with infiltration anesthesia took 19.8%. and block anesthesia was carried out in 25.3%. Average treatment time was about 35 minutes. In classification according to treatment time, under 20 minutes took 23.0%, and 20~40 minutes took 54.0% and over 40 minutes took 23.0%. Distribution of treated tooth type was ; 9.2% of them were treated only incisors ; 86.2% of them were treated only molars ; 4.6% of them were treated both incisors and molars. 32.2% of patients were treated only deciduous teeth, and 62.1% of them were treated premanent teeth, and 5.7% of them were treated both of them. Patients treated only in upper dentition took 43.7%, only in lower dentition took 39.1%, and in both dentition took 17.2%. In classification according to knowledge and experience about rubber dam, patients who didn’t know about rubber dam were 51.7% and knew about the reason for wearing rubber dam were 48.3%. Patients who experienced rubber dam at first time were 24.1% and who experienced before were 75.9%. In classification according to operator, pediatric patients who received treatment from dentist were 86.2% and from school of dentistry student was 13.8%. Pediatric patients' favorite advantage of rubber dam (possibility of multiple choice) was 'water from instruments didn't drop into their mouth' which accounted for 30% among 174 answers , followed by 'I feel being protected during treatment'. In the category of disadvantages (possibility of multiple choice), 'tooth or gingiva was painful' accounted for 40% among 68 answers and 'mouth were filled with water and saliva' accounted for 37%. Through this study, we knew degree of recognition and satisfaction of children and protectors actually about rubber dam and assured that it is enough good technique as children feel. Also, considering that many experience and much recognition about rubber dam bring more satisfaction, if they understand the objective and advantages of rubber dam, we can expect that overall satisfaction about dental treatment will be improved as well.