Ronen Shika Igaku
Online ISSN : 1884-7323
Print ISSN : 0914-3866
ISSN-L : 0914-3866
Current issue
Displaying 1-9 of 9 articles from this issue
Review Articles
Clinical Report
  • Miki Aoshima, Takeshi Kikutani, Hiroyuki Yamada, Yujiro Nakazawa, Taka ...
    2024 Volume 39 Issue 3 Pages 156-161
    Published: December 31, 2024
    Released on J-STAGE: January 24, 2025
    JOURNAL FREE ACCESS

     Objective:The Nippon Dental University, Tama Oral Rehabilitation Clinic treats approximately 10,000 patients per year, many of whom are older and have multiple comorbidities in addition to underlying diseases. Approximately 60% of first-time patients are 75 years of age or older, and 17% of patients have dementia. As dementia becomes more severe, the degree of independence in oral hygiene management and the ability to manage dentures decrease. In addition, some behavioral adjustment is necessary when refusing to engage in dental treatment. At our clinic, we provide dental treatment to older patients with dementia by intravenous sedation as a drug behavior adjustment. In this study, we conducted a retrospective survey of 20 older patients with dementia who underwent dental treatment under intravenous sedation between April 2017 and December 2023 with the aim of clarifying an overview of the patients and the actual conditions of the treatment.

     Methods:Based on medical and anesthesia records, we investigated patient information, treatment details and treatment time, intravenous sedation drugs used, and the amount of intravenous sedation used.

     Results and Discussion:Of the dental procedures performed under intravenous sedation, 90% were tooth extractions, and 80% involved extraction of two or more teeth. All scheduled procedures were performed under intravenous sedation, and there were no intraoperative or postoperative incidents. In addition, many of the patients were able to continue to receive denture-making, preservation treatment, periodontal treatment, etc., indicating the usefulness of dental treatment under intravenous sedation.

    Download PDF (747K)
Reports on Survey
  • Shoko Tomooka, Shinsuke Mizutani, Hiroaki Tabuchi, Saori Oku, Ryosuke ...
    2024 Volume 39 Issue 3 Pages 162-170
    Published: December 31, 2024
    Released on J-STAGE: January 24, 2025
    JOURNAL FREE ACCESS

     Japan has one of the worldʼs highest rates of population aging. Therefore, it is necessary for dentists to acquire a broad understanding of older adults. They are also required to learn to interact with older adults through gerodontology clinical practice and homebound dentistry practice. However, several students could not receive such training due to the COVID-19 pandemic. Therefore, this study aimed to investigate changes in attitudes toward older adults and the self-assessment of knowledge in dentistry among older adults before and after clinical practice in gerodontology from 2019 to 2021. The study used a questionnaire on required competencies, consisting of behavioral and achievement goals for older adults and the Japanese version of the Attitudes Towards the Elderly(ATE), which represents emotional attitudes toward older adults. The results demonstrate that students self-rated their abilities more positively after clinical practice and homebound dentistry practice than before(p<0.01). Attitudes toward older adults also changed more favorably(p=0.012). However, when comparing the amount of change in each survey item based on experience of home-based dentistry practice and the duration of interruption of clinical practice, no statistically significant differences were observed between the groups. This study showed changes in attitudes toward older adults and self-evaluation of required competencies through clinical practice. The evaluation of changes in attitudes toward older adults and self-evaluation of knowledge in gerodontology may help to confirm the effectiveness of training in gerodontology and to improve the content of future education.

    Download PDF (762K)
  • Yuji Sato
    2024 Volume 39 Issue 3 Pages 171-177
    Published: December 31, 2024
    Released on J-STAGE: January 24, 2025
    JOURNAL FREE ACCESS

     Objective:With the aging of society, the importance of medical and dental cooperation has been recognized, and health insurance includes items such as comprehensive medical management surcharge(CMMS)and medical management fee for dental treatment(MFDT). In addition, a medical information cooperation sharing fee(MICSF)and medical information provision fee 1(MIPF1)have been set for information-sharing and provision. Therefore, this study aimed to clarify the insurance calculation status of these items.

     Method:From the statistics on social medical treatment procedures in June 2023, the number of CMMS, MFDT, MICSF, and MIPF1 were extracted for each clinic and hospital, divided into general medical care and advanced care, and the number of cases per medical institution and the calculation rate per patient were calculated.

     Results:Per medical institution, the number of CMMS and MFDT cases in hospitals was about twice that of clinics, but the number of MIPF1 and MICSF cases was more than 20 times. The proportion of advanced care was about half in both cases, but only MIPF1 was around 20%, and advanced care was low.

     The billing rate for CMMS was under 1% and that for MFDT was under 5%, both of which were more common in advanced care, with no significant difference between clinics and hospitals. For MIPF1, there was no significant difference between general medical care and advanced care at clinics, with rates under 1%, but it was higher at hospitals, and was more common in general medical care. For MICSF, rates were more common in advanced care and hospitals, but all were very low.

     Discussion and conclusions:Billing for CMMS, MFDT, MIPF1, and MICSF was low, revealing that medical-dental cooperation is insufficient. The fundamental reason for this is that billing for MICSF, which is a referral to the medical department, is particularly low, suggesting the need for countermeasures.

    Download PDF (1272K)
Health Activity Report
feedback
Top