ORIGINAL ARTICLE

Bali Medical Journal (Bali Med J) 2018, Volume 7, Number 1: 56-60

P-ISSN.2089-1180, E-ISSN.2302-2914

Correlation between dental health maintenance

behavior with Dental Caries Status (DMF-T)
Published by DiscoverSys CrossMark
Made Ayu Lely Suratri,1 Indirawati Tjahja N,1 Vivi Setiawaty2*

ABSTRACT

Background: The maintenance of oral and dental health is closely Results: The result showed that the respondents with dental caries
related to the people’s behavior. Behavior or habits that may influence more than the respondent without dental caries (92.60%). There was
the development of dental caries is the eating habits as well as oral a significant relationship between hygienic behavior with dental caries
hygiene such as brushing the teeth regularly and adequately. Dental status (P = 0.004; OR = 1.426; 95% CI = 1.123-2.810). However, there
caries status is a condition that describes a person’s experience of was no significant relationship of behaviors/habits of eating fruits and
dental caries which is calculated by the index DMF-T. vegetables with dental caries status (P = 0.145; OR = 1.107; 95% CI
Objective: The study aims to determine the relationship between = 0.966-1.270). But, there was a significant relationship between
the behavior or habit of maintaining the teeth and mouth with dental habitual physical activity with dental caries status (P = 0.000; OR =
caries status of communities in Indonesia. 1.443; 95% CI = 1.350-1.543).
Methods: It was an observational study with cross-sectional study Conclusion: There is a significant relationship between physical
design. The samples were household members aged ≥ 15 years with activity and hygiene behavior with dental health maintenance related
the number of 173,828 people. Data were collected by interview and to dental caries status. However, the behavior of eating fruits and
examination of the teeth and mouth. vegetables has no significant relationship with dental caries status.

Keywords: Behaviors or habits, Dental Health Maintenance, Dental Caries Status

Cite This Article: Suratri, M.A.L., Tjahja, N.I., Setiawaty, V. 2018. Correlation between dental health maintenance behavior with Dental Caries
Status (DMF-T). Bali Medical Journal 7(1): 56-60. DOI:10.15562/bmj.v7i1.836

1
Research and Development INTRODUCTION
Center of Health Resources and
Services, NIHRD, Jakarta, Indonesia The prevalence of dental caries in developed countries dental and oral problems is in the 35-44 years and
2
Research and Development is decreasing, while in underdeveloped and developing 45-54 years age group (30.5% and 31.9%, respec-
Center of Biomedical and Basic countries, the prevalence is on the rise.1 Dental caries tively). This situation shows that the dental and oral
Health Technology, NIHRD, Jakarta,
Indonesia status is a condition that describes a person’s dental problems may occur in the productive age group.5
caries experience and calculated by the DMF-T Index World Health Organization (WHO) in 2010 has
(Decayed, Missing, Filled).2 Dental caries is one of the been targeting the DMF-T index is 1.0 while devel-
teeth and mouth problem that caused by demineral- oping countries set caries index was 1.2. Various
ization of enamel and dentine which closely related to indicators have been determined by WHO for dental
the consumption of cariogenic foods.3 Dental caries is caries. Among others, 90% of 5 years old children
a multifactorial problem, and to be the occurrence of a should be free of caries, children aged 12 years have
process of dental caries; it needs the interaction of four index DMF-T for 1, people aged 18 years have no
factors such as the host, microorganisms, substrates, extracted tooth (M = 0), and people aged 35-44 years
and period of time. These four factors must work have at least 20 teeth function by 90%.6
together to make the process of dental caries. The According to Bahar in Warni L. (2009), one of the
process of dental caries begins with the presence of main factors that influence dental and oral health
plaque on the tooth surface.4 population in developing countries is the behavior or
The severity degree of dental caries in Indonesia habit. Behaviors that can affect the development of
*
Correspondence to: Vivi Setiawaty, is very high. The National Basic Health Research dental caries is the eating habits such as eating fruits
Research and Development Center
of Biomedical and Basic Health (Riskesdas) in 2013 described the prevalence of the and vegetables and maintenance of dental and oral
Technology, NIHRD, Jakarta, Indonesian population who has problems with the hygiene, for example, regular brushing.7 The 2013
Indonesia dental and the mouth is 25.9%. The average dental National Health Research reported that people’s
[email protected] caries as measured by the DMF-T index is 4.6 which behavior on the maintenance of dental health in
means an average population of Indonesia has expe- the population groups ≥ 10 years with daily tooth
Received: 2017-09-05 rienced tooth decay as much as 5 teeth and who brushing proportion was 93.8%, but the habits of
Accepted: 2017-09-30 received dental care from dental medical personnel the Indonesia population brush their teeth correctly
Published: 2017-10-7 by 31.1%.5 The highest proportion of people with (after breakfast and before bedtime) was only 2.3%.5

56 Open access: www.balimedicaljournal.org and ojs.unud.ac.id/index.php/bmj

 ORIGINAL ARTICLE

Dental and oral health status is very closely Inclusion criteria included all members of house-
related to the behavior or habits of the dental and holds aged ≥ 15 years and has signed an agreement
oral health maintenance. According to Antisari to be the respondents. Exclusion criteria were the
in Wahyu et al. (2013) behavior plays a major subject of severe pain and incomplete data.
role in influencing dental and oral health status. In this study, the age was divided into two groups,
Therefore, the importance of influencing behavior ≤ 30 years of age and > 30 years of age. Furthermore,
in dental and oral health status can affect both the education was divided into two groups, higher
poor dental and oral hygiene including the scores and lower (higher > junior high school; lower ≤
of caries and periodontal disease.8 This study aims junior high school). Socio-Economic Status was
to determine the relationship between behavior or divided into two groups, poor and not poor. The
habits with dental caries status in the Indonesia National Basic Health Research 2013 was approved
community. by NIHRD Ethics Committee, Ministry of Health,
Republic of Indonesia No. 01.1206.207.9
The data samples were complex with include
METHODS
strata (variable age, education, and socioeconomic
It was an observational study by using cross-sec- status) and Primary Sampling Units (dental caries,
tional design. The data of dental and oral exam- hygienic behavior, eating fruits and vegetables,
inations were collected from the National Institute and physical activity). Analysis techniques were
Health Research and Development (NIHRD), performed using univariate, bivariate, then followed
Ministry of Health of the Republic of Indonesia by logistic regression.10
through the National Basic Health Research in The implementation of data collection of dental
2013. The study population was the Indonesia and oral health through interviews (for the behav-
population from 33 provinces and 497 district/ ior or habits) and observations (Index DMF-T) by
cities.4 The samples criteria were all members of using the mouth mirror instruments with the help
the household with aged ≥ 15 years (because since of sunlight lighting (flashlight).
the age of 15 years permanent teeth have grown
up until the second molar teeth). Total sample RESULTS
size was 173.828 respondents. The selection of the
sample was using census block sample frame from The study showed that about 92.60% of respondents
the National Institute Central of Statistics (BPS). with age ≥ 15 years has Dental Caries (Table 1). In
addition, table 1 also shows that the number of respon-
dents without dental caries who had aged ≥ 30 years
Table 1  Characteristics of Respondent
are more than < 30 years (12.602 vs 188), and the male
Dental Caries respondents without the dental caries are more than
Variable N % No Yes female respondents (7.033 vs 5.757). Furthermore,
Age
the analysis of the education respondents without
< 30 years (young) 62.445 35.90 188 62.257 dental caries found that lower education had more
≥ 30 years (old) 111.383 64.10 12.602 98.781 dental caries than higher education (11.535 vs 1.255).
Besides, the respondents with dental caries who work
Total 173.828 100 12.790 161.038
are more than not work (6.773 vs 6.017)
Gender In table 2, the study shows that there is a signif-
Male 85.917 49.40 7.033 80.878
icant relationship between Hygienic behavior
Female 87.911 50.60 5.757 80.160
and dental caries (P = 0.004; OR = 1.426; 95%
Total 173.828 100 12.790 161.038 CI = 1.123-2.810). The hygienic behavior has a
Education significant relationship with dental caries where
Higher 55.789 32.10 1.255 54.534 the absence of hygienic behavior was contributed
Lower 118.039 67.90 11.535 106.504 1.43 times higher for dental caries.
Total 173.828 100 34.504 161.038 However, there is no significant relationship
Occupation between the behavior of eating fruit and vegeta-
Work 104.189 59.90 6.773 97.415 bles with dental caries status based on Table 3 (P =
Not Work 69.639 40.10 6.017 63.623 0.145). This situation indicated that there is no
Total 173.828 100 12.790 161.038 significant relationship between the behavior of
eating fruit and vegetables ≥ 5 portions/day and < 5
Socioeconomic
Poor 58.085 33.40 5.889 52.146 portions/day with dental caries status (OR = 1.107;
Not Poor 115.743 66.60 6.901 108.842 95% CI = 0.966-1.270)
In addition, Table 4 shows a significant rela-
Total 173.828 100 34.505 161.038
tionship between physical activity behavior and

Published by DiscoverSys | Bali Med J 2018; 7(1): 56-60 | doi: 10.15562/bmj.v7i1.836 57

ORIGINAL ARTICLE

Table 2  Relationship of Hygienic Behavior with Dental Caries Status

Dental Caries
No Yes
OR
Hygienic Behavior n % n % (Odds Ratio) p Value
Yes 153 4.0 3.679 96.0 1,426 0,004
No 10.859 8.7 114.009 91.3
Total 11.012 8.6 117.688 91.4

Table 3  Relationship Behavior of Eating Fruits and Vegetables with Dental Caries Status
Dental Caries
No Yes
Behavior of Eating Fruits OR
and Vegetables n % n % (Odds Ratio) p-Value
≥ 5 portions/day 10,081 94.1 631 5.9 1.107 0.145
< 5 portions/day 140,434 92.9 10.775 7.1
Total 150,515 93.0 11.406 7.0

Table 4  Relationship of Physical Activity Behavior with Dental Caries Status

Dental Caries
No Yes
OR
Physical Activity Behavior n % n % (Odds Ratio) p-Value
Adequate 3,807 6.9 51,747 93.1 1,443 0,000
Inadequate 8,983 7.6 109,291 92.4
Total 12,790 7.4 161,038 92.6

Table 5  T
 he Logistical Regression Analysis of Dental Caries Status by Behavior or Habits Hygienic, Eating Fruits and
Vegetables, and Physical Activity
OR OR (Odds Ratio) p Value
(Odds Ratio) (95% CI) p Value (95% CI) p Value
Behavior or Habits Initial Model Final Model
Hygienic 1.402 (1.096-1.793) 0.007 1.426 (1.123-1.810) 0.004
Eating Fruits and Vegetables 1.107 (0.966-1.270) 0.145 - -
Physical Activity 1.434 (1.334-1.541) 0.000 1.443 (1.350-1.543) 0.000

dental caries status (P = 0.000; OR = 1.443; 95% In addition, the female respondents also encoun-
CI = 1.350-1.543). Physical activity behavior has tered more than male respondents, as well as the
a significant relationship with dental caries status, lower education respondents, have more dental
where the inadequate of physical activity behavior caries than the highly educated respondents.
was having 1.44 times higher risk for dental caries. Costa SM et al. reported the study results in
In Table 5, the hygienic behavior and physical adults that the socioeconomic, education, and
activity have a significant relationship with dental occupation effect on dental caries, whereas people
caries status (P < 0.05), meanwhile the behavior of with low socioeconomic found that having more
eating fruits and vegetables has no significant rela- severe dental caries.11 In low-income families, the
tionship with dental caries status (P > 0.05) severity of dental caries greater than high-income.12
Zemaitiene M et al. in 2016 conducted a study
in Lithuania found that the prevalence of dental
DISCUSSION
caries was relatively high, and the different experi-
About 161.038 of 173.828 respondents (92.60%) ences in dental caries between people in urban and
had dental caries where the number of respondents rural areas were influenced by their socioeconomic
who aged ≥ 30 years were more than age <30 years. differences. In rural areas, the DMF-T was higher

58 Published by DiscoverSys | Bali Med J 2018; 7(1): 56-60 | doi: 10.15562/bmj.v7i1.836

 ORIGINAL ARTICLE

than urban areas, whereas the DMF-T according COMPETING INTERESTS

to the gender were higher in male compared with
female.13 The authors declare that there are no competing
The results of this study showed a significant interests.
relationship between hygienic behavior with
dental caries status (P = 0.004; OR = 1.426; 95% AUTHORS’ CONTRIBUTIONS
CI = 1.123-2.810). The respondents with hygienic
behavior showed having a lower incidence (4.0%) Made Ayu Lely Suratri, and Indirawati Tjahja N
for dental caries in compared with unhygienic participated in the design and data collection and
behavior (8.7%). participated in data analysis and interpretation.
The study which was conducted in India about Vivi Setiawaty also participated in the data analysis,
the positive attitudes and behaviors of dental interpretation, and drafting of the manuscript. All
and oral hygiene associated with the positive authors read and approved the final manuscript.
outcome for a dental and oral health condition.14
Bozorgmehr E et al. reported that the behavior of ACKNOWLEDGMENTS
the dental and oral health of parents like brushing
is essential, due to as a determinant of behavior The authors would like to express gratitude to
in their children. So by increasing the knowledge, Head of National Institute of Health Research and
attitudes and behavior of parents can also influence Development, Ministry of Health, who has given
the behavior and status of dental and oral health in permission to create analysis articles by using the
their children.15 data of National Basic Health Research 2013. They
The relationship between behaviors/habits also would like to thank the Director of Research
of eating fruits and vegetables with dental caries and Development Center of Health Resources and
status is not significant, with a value of p> 0.05 Services, NIHRD, at last, they also would like to
(p = 0.145). Accordingly, it means there is no rela- thank their colleagues in the mandatory laboratory
tionship between behavior/habit of eating fruits who checked and provided the data.
and vegetables with dental caries status (OR =
1.107; 95% CI = 0.966-1.270). Decker et al. (2003)
reported that eating raw fruits or vegetables can
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