Special center at SNU offers dental care for the disabled
When 14-year-old Kim Jae-hoon was first diagnosed with cancer, he was only nine. Two operations followed by chemotherapy and radiotherapy left him with a brain lesion and damaged mouth. Kim’s parents took him to his regular dentist in their neighborhood, but because of the brain damage that made it impossible for Kim to control his body, the dentist determined he would require general anesthesia for treatment. But the dental clinic, like most neighborhood clinics, did not have the equipment for this.
Kim’s parents looked for a dental clinic in the region that treated disabled patients, but none had the necessary anesthesia equipment. Finally they found the National Dental Care Center for Persons with Special Needs at Seoul National University Dental Hospital (SNUDH) which had anesthesiologists as well as oral surgeons who could treat their son.
Although medical expenses for general anesthesia for dental treatment are high, Kim’s parents were informed by SNUDH that the National Health Insurance covered 30 percent of the expenses of dental care for the disabled.
“As parents of a child with a disability, visiting a regular dentist is a difficult task itself, but we were relieved when we first visited here and found there were experts who could take care of our son,” Kim’s parents said.
The center at SNUDH opened last month, as the central dental care center for the disabled among 10 regional clinics across the country. It will play the role of a medical hub establishing the relevant systems and guidelines for the dental treatment of people with disabilities and educating experts to do this.
“People with autism, brain damage such as cerebral palsy and other development disorders usually face obstacles in receiving adequate and timely dental care. On top of their other challenges, the most common illness they suffer from is periodontal disease whereas a cold is the most common disease for non-disabled people,” said Kum Kee-yeon, a professor and director of SNUDH.
People with disabilities often have difficulty in cooperating with a dentist for routine dental care, and the center works with them as outpatients, Kum said.
“Many dentists avoid treating those patients. Or even if they are willing to do, a lack of systems and skills is the problem. Many patients with disabilities are unable even to cope with regular dental checkups or simple cleaning, so general anesthesia is needed,” Kum said.
Many individuals with disabilities have difficulty in maintaining their own dental hygiene, so these people have a high chance of suffering dental diseases, according to government data.
Among 2.55 million disabled people registered with the Ministry of Health and Welfare in 2017, 834,780 or 32.8 percent suffered dental problems. But only 41,279 received treatment at the nine regional centers that year before the one at SNUDH was set up.
More than 79 percent of people suffering from dental diseases said they don’t go to see a dentist because of the financial burden. But Kum said the accessibility for dental care specialized for them also matters — among 17,627 dental clinic across the country, only 333, or 1.9 percent of the total, were registered to treat disabled people as of 2017.
Especially patients with developmental disorders do not fully understand the dental care procedures, he said.
“In many cases, those patients need extra efforts to get familiar with the environment of the dental clinic, or just to sit down in the dental chair. Sometimes extra appointments are needed for them to get accustomed to procedures and minimize their anxiety, which can also reduce the need for general anesthesia,” said prof. Chang Ju-hae of SNUDH.
“But of course, there is no alternative to anesthesia in cases like Kim.”
As to the financial burden, the health ministry covers 10 percent to 50 percent of the dental medical expenses for disabled people who are subject to the government’s basic living subsidies, including the cost of general anesthesia. The cost for general anesthesia can be a financial burden for the patients, because it is usually charged per hour.
Even before the center was established, SNUDH had been supporting regional centers since 2011. Last year, 45,474 patients visited the regional centers, with the number soaring more than 22 times from 2011’s 1,992.
Kum said, however, support from the government and the hospital is not enough for patients. To improve their financial situation, Kum said the country has to cultivate a culture of donating.
“The health ministry earmarks 500 million won ($418,600) a year for the dental medical cost coverage, but the budget usually runs out during the first half of the year. The Smile Charity Foundation, a private body, supports the cost of anesthesia, but it is still insufficient,” Kum said.
Kum said medical centers for disabled people are doomed to run a deficit, so it is hard to hire more medical workers even though they always suffer from staff shortages.
“Both government- and private sector-level support is definitely needed to establish a more settled system when it comes to medical care for the disabled. The expansion of a donation culture would be one of the ways to solve this problem, I believe.”