台灣牙科門診鎮靜之人力挑戰

The Challenge of Manpower of Office-Based Dental Sedation in Taiwan

牙科門診鎮靜在日本、美國和英國相當盛行於牙科院所，但是，這類照護在台灣並不普及。我國的牙科門診鎮靜起始於對身心障礙者的口腔健康關注，但僅限於少數院所。幾十年來，我們大多仰賴有限的手術室麻醉人力，並沒有培育牙科門診鎮靜人力的配套政策，這將造成有鎮靜需求的一般民眾無法享有良好的口腔照護品質。日本、美國和英國為了提供牙科院所對門診鎮靜麻醉之需求，已發展出成熟卻適合國情的牙科門診鎮靜之教育和培訓體系。本文彙整國際經驗，並試圖提出可能的因應之道，以作為政府主管機關施政之參考。

Office-based dental sedation has been popular in dental clinics and hospitals in Japan, U.S.A, and England, but not in Taiwan. The development of dental sedation began in Taiwan from the interest in oral health care of physical and mental disabilities, though it has been practiced in few dental clinics there. Until now those who need dental sedation have relied on the limited human resources in anesthesia and been mostly treated with tracheal intubation under general anesthesia in operating room. Even until now there is no suitable policy to encourage and cultivate manpower in the practice of dental office sedation. The present policies do not make it possible for people with special needs of sedation to obtain good quality oral health care. The education and training systems for dental sedation and anesthesia in Japan, U.S.A, and England are mature but different. This article reviews international experiences and attempts to propose some applicable strategies to our government.