Moestopo International Review on Societies, Humanities, and Sciences (MIRSHuS)

http://mirshus.moestopo.ac.id/index.php/mirshus
ISSN: 2775-9601

ONLINE VIDEO GAME: THE INNOVATION OF DENTAL

HEALTH EDUCATION TOOLS FOR CHILDREN DURING
COVID-19 PANDEMIC
Yufitri Mayasari*
Department of Dental Public Health, Faculty of Dentistry
Universitas Prof. Dr. Moestopo (Beragama)

Belanita
Department of Prosthodontia. Faculty of Dentistry
Universitas Prof. Dr. Moestopo (Beragama)

Elin Hertiana
Universitas Prof. Dr. Moestopo (Beragama)

*Correspondence: [email protected]

ARTICLE INFO ABSTRACT

Article History: COVID-19 has presents unprecedent challenge in many aspects of
received: 09/09/2020 dentistry include oral health promotion. Oral health promotion is
revised: 12/11/2020 recognized an essential component to prevent the oral disease
accepted: 13/01/2021 during pandemic. As we know, dental caries is the most common
dental and oral health problem suffered by children due to
Keywords: behaviour of maintaining oral health which is often ignored and
Covid-19; dental health based on poor knowledge. One way to change the behaviour is
education; video games. through health education using the right media or tool to make it
more effective and efficient. Research objectives are to explain
DOI: knowledge disparity of dental and oral health among students
before and after education video game. Pre experiment study with
one group pretest until post-test design was taken from a sample of
fourth-grade students of SDN 03 Pesanggrahan. The sampling
technique was total sampling with a sample size of 66 respondents.
Kolmogorov Smirnov test was used for normality test and Wilcoxon
test was used for analysing the data. The result obtained from the
statistical test of the differences in dental and oral health knowledge
among students before and after education through a video game
was p-value = 0.001.

INTRODUCTION being infected during pandemic.(Hu et al.,

The Corona Virus Disease-19 2020) School-aged children are groups that
pandemic has an influence for all aspect are prone to oral health problems, especially
especially the social life. The interaction dental caries and periodontal
between human is limited by distance that disease.(Amelia Nurfalah, Emma
called social distancing. Social distancing is Yuniarrahmah, 2014; Komara et al., 2019) In
the important key to minimize the spread of 2012, the World Health Organization (WHO)
SARS-CoV 2 inter human. Learning method announced that dental caries is the most oral
for dental education should be innovated to disease that happens among school-age
keep on the learning process but away from children, reaches 60-90%.(Alhayek et al.,
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2018) The Center for Disease Control and education. Dental and oral health education
Prevention (CDC) reported that dental caries is carried out based on health needs with the
is a dental problem with the highest aim of being able to change old behaviours
prevalence among children.(Alhammad & into new ones that further improve
Salama, 2011) Based on Basic Health children's health status.(Amelia Nurfalah,
Research (RISKESDAS) in 2018, the Emma Yuniarrahmah, 2014; Kantohe et al.,
prevalence of dental caries among children 2016; Nazri Yanti et al., 2017) In the process
in Indonesia in the 5-9 years age group was of dental and oral health education, the use
92.6% and in the 10-14 years age group was of appropriate educational tool is very
73.4%. The prevalence of bleeding gums in important for children to increase their
the 5-9 years age group was 9.6% and in the knowledge.(Amelia Nurfalah, Emma
10-14years age group was Yuniarrahmah, 2014; Nazri Yanti et al.,
14.3%.(Riskesdas, 2018) This indicates that 2017) Thus, the media is a tool to send the
there are still many dental and oral problems health messages.(Gejir et al., n.d.;
among children and requires special Notoatmodjo, 2012) Broadly speaking, the
attention from health workers.(Kantohe et media is divided into visual aids, audio aids,
al., 2016; Razi, P., & Rosmawati, 2018)Oral and audio-visual aids. Based on its function
health disease can interfere with a child's as health message delivery tool, educational
quality of life. Dental problems that are not media is divided into print media, electronic
treated will cause pain, which can interfere media and board media.(Gejir et al., n.d.;
with the chewing function. This situation can Notoatmodjo, 2012)Selecting of educational
affect the growth and development of media that is effective and involves many
children because it can interfere with eating senses will affect the success of
habit and nutritional intake which results in understanding educational targets.(Kantohe
other health problems. In addition, this et al., 2016; Nazri Yanti et al., 2017; Razi, P.,
condition can affect the function of speech, & Rosmawati, 2018) One of the educational
smile, and the psychosocial media for children's dental and oral health is
environment.(Alhayek et al., 2018; Kantohe through video.(Olubunmi & Olushola, 2013)
et al., 2016) One of the causes of this disease Video can be used for oral health
is bad behaviour to maintain oral hygiene. education along with technological
This is based on the poor knowledge of oral advances. This media can send health
health. Knowledge of the causes and ways of messages that are more interesting and easy
controlling them are needed to maintain to understand because they can be played
children's dental health. Most of dental over and over again through visualization of
caries and periodontal disease are caused by text, images, and sound so that they are more
plaque, so it is necessary to control plaque dynamic and effective.(Nazri Yanti et al.,
mechanically such as brushing teeth, 2017; Supriyanto et al., 2019) Broadly
cleaning interdental, cleaning the tongue speaking, this electronic media is included in
and using toothpaste and also chemical the category of audio-visual aids because
cleanings such as the use of toothpaste and this media stimulates two senses at the same
mouthwash. (Arianto et al., 2014; Halaris & time, namely sight and hearing, so it is easy
Wyche, 2019) Because of this poor to deliver information to the brain and
knowledge, it is necessary to increase affects both short-term and long-term
knowledge to change bad into good memory if supported by other factors such
behaviour. as attention, motivation, and prior
Knowledge is the result of "knowing" knowledge.(Jumilah et al., 2013; Kantohe et
that is obtained after human sensing of an al., 2016) However, to use this media
object or stimulus.(Notoatmodjo, 1997) requires a lot of money, this media also
Increasing the knowledge in school-age requires special skills in operating it and the
children can be done through oral health user does not actively participate in

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interacting with the stimulus given and that was selected in a certain way and was
individuals must be able to remember the considered as representative of the
details of each short video playback population by meeting the inclusion and
process.(Hanif & Prasko, 2018; Munir, 2017; exclusion criteria. The inclusion criteria
Nazri Yanti et al., 2017; Razi, P., & were fourth-grade students of SDN 03
Rosmawati, 2018) One example of a video Pesanggrahan who have received approval
that educates dental and oral health is a from their parents to participate in this
video game. research and students who can operate their
Video as a medium for dental and oral devices properly and have adequate internet
health education has been widely used access. Meanwhile, the exclusion criteria
among children. Study in Nigeria has shown were students who had not watched the
that videos that adapt to local culture and video completely and the students who step
language can improve the oral hygiene of down from the research process.
school-age children in low socio-economic The participant was taken by the
groups. (Olubunmi & Olushola, 2013) total sampling method, where the entire
Kantohe in 2016 reported that video was population was the research sample because
effective in increasing knowledge of dental the population was less than 100
and oral health.(Kantohe et al., 2016) people.(Sari, 2016) Students were given a
However, a study by Hermina in 2010 questionnaire pre-test through Google
explained that video was not effective in Forms to measure their dental and oral
educating children aged 6-7 years on how to health knowledge before the intervention,
brush their teeth.(Vera, 2010) then the dental and oral health education
Therefore, a study was carried out to was done by educating them about
evaluate knowledge disparity of dental and characteristics of healthy and unhealthy
oral health among students. Based on the teeth, types of teeth, frequency of brushing
description above, the media of dental health including proper brushing movements
education is one of the important things to which were presented in a video game that
make children understand about dental was connected to Google Drive and
health message. Knowledge disparity is one distributed through WhatsApp group chat.
of the measurement to prove that media is The last step was doing post-test by
an effective methode. This study aims to distributing electronic questionnaires
knowledge disparity of dental and oral through Google Forms to the students after
health among students before and after giving the oral health education. All
education video game at SD Negeri 03 procedures for the pre-test, post-test, and
Pesanggrahan. watching educational videos were directly
supervised by the parents of the students.
METHOD Data analysis used was Kolmogorov Smirnov
The study is pre eksperiment study test as a normality test and the Wilcoxon test
with one group pretest-posttest design. The as a test for differences in student’s
participants are all fourth-grade students of knowledge before and after giving education
SDN 03 Pesanggrahan, Jakarta Selatan through a video game.
(N=66). Children around 6 to 12 years old or This research has limited conditions
school-aged children are still less aware of that cannot be controlled due to the distance
how to maintain oral hygiene. The efforts to education process and it needs good
maintain oral health should be done from an cooperation between researchers, teachers,
early age. Primary school age is an ideal time and parents. There were also technical
to give children dental health education. One obstacles such as internet data and
of the efforts in improving oral health is electronic devices so that electronic
modification of health education media. The questionnaire collection could not be done
research sample was a part of the population simultaneously. We suggest to use media

18
that stimulates many senses for further
research and it is necessary to conduct RESULT AND DISCUSSION
further research by comparing oral health The participant consisted of 45% male
education with other types of media so that and 55% female, nine percent is 9-year-old.
it can be seen which types of media are best 10-year-old by 67% and 11-year-old by
for dental and oral health education 24%.
activities.

Table 1. Average knowledge value of pre-test and post-test health education with a video game (N = 66)

Mean Standard Deviation

Pre-test 39.52 3.014
Post-test 40.68 3.324
Source: analyzed by author, 2021.

Table 1 shows the average value before intervention is 39.52 and after intervention is
40.68.

Table 2. Dental health education through a video game (N = 66)

Increase Decrease Constant

Knowledge 37 (56%) 15 (22,73%) 14(21,21%)

Source: analyzed by author, 2021.

Table 2 shows 37 children have been knowledge score and 14 children did not
increasing their knowledge score, 15 experience a change in their knowledge
children have been decreasing their score.

Table 3. The result of the pre-test and post-test knowledge test for health education through a video game (N = 66)
Median (minimum-maximum) p value
Pre-test 39 (33-45)
Post-test 40 (33-45) 0,001*
*p ≤ 0.05, CI 95%, Wilcoxon test
Source: analyzed by author, 2021.

Table 3 shows there is a significant prevention. One of the most effective steps to
difference between before and after prevent oral disease is doing oral health
education through a video game where p promotion. Oral health promotion during
<0.05. this pandemic has several obstacles,
including the lack of direct contact to the
Discussion target due to social distancing regulations,
On March, 2020, Persatuan Dokter the delivery of oral health education
Gigi Indonesia (PDGI) recommended that materials must be done over a long distance.
dental practices postpone elective dental In children's groups, it is also necessary to
procedures until the pandemic is done, and use interesting educational teaching aids,
provide emergency-only dental services to one of which is by using video games. This
help keep patients from burdening hospital study explains the differences in oral dental
emergency departments. The COVID-19 health knowledge before and after education
pandemic presents an opportunity for the using an innovative dental and oral health
dental profession to shift from an approach education tool, video games.
focused on curative intervention to

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 The knowledge about dental and oral Delivering health messages through video
health based on data analysis obtained a games as electronic media is proven to
high average of knowledge before the increase children's knowledge. This is
education through a video game was given consistent with the classification of the
(Table 1), this data explains that before media as of channelling health messages
receiving education about dental and oral along with print and board media.(Gejir et
health, at least they already know the things al., n.d.; Notoatmodjo, 2012) In several
that cause dental and oral health disease. In studies such as a study by Kantohe in 2016
SD Negeri 03 Pesanggrahan is an elementary which stated that electronic media is more
school that the dental health education is effective in increasing knowledge of dental
given with manual method through Usaha and oral health compared to print media
Kesehatan Gigi Sekolah program. This is in (flipchart).(Kantohe et al., 2016) However, it
line with a study by Wulandari in 2018 is not in line with a study by Majid in 2020
which stated that support from teachers and which stated there was no difference in
schools resulting in the behaviour of knowledge between the health education
maintaining good oral health as well, in group with printed media (educational
other words, it is based on adequate comics) and electronic media (animated
knowledge.(Sari et al., 2019) This is also videos).(Majid et al., 2020) The increased
strengthened by Ikenasya in 2017 reported value of student knowledge can also be
that schools with UKGS together with good influenced by video as a audio-visual aids
knowledge of the teachers in line with the which is superior to a visual aids and audio
low dental caries status category for aids. This hearing aids is proven to be
students.(Farahiyah Ikenasya & Novita, superior because it can stimulate more than
2017) one of the five senses, namely the sense of
The increase in knowledge value sight and the sense of hearing.(Majid et al.,
based on the results of data analysis showed 2020) This is in line with a study by Sitanaya
that most children have been increasing in 2019 which reported that audio-visual
their knowledge value (Table 2). This is due aids are more effective than visual media
to several factors such as the use of this tool (flipchart) in increasing students'
in the educational process, education knowledge about dental caries.(Sitanaya,
through electronic media, the use of audio- 2019)Besides, this is in line with a study by
visual aids in the educational process and Papilaya in 2016 which stated that audio-
the animated elements found in the video visual aids are better than audio aids in
game. The delivery of health messages improving the behaviour to maintain
through the media is proven increasing children's oral and dental health, in other
knowledge of students, this is by the essence words, the increased behaviour is based on
of the educational media itself, as an better knowledge.(Papilaya et al., 2016)
intermediary in sending health messages to According to Maulana quoted by Kuswareni,
educational target, because of this eyes are one of the five senses that have
intermediary, the information can reach the major influence in delivering knowledge to
educational target.(Gejir et al., n.d.; the brain (approximately 75-87%) then the
Notoatmodjo, 2012) Also, this is in line with other 13-25% are conveyed by the other five
a study by Jumilah in 2015 where there was senses.(Kuswareni et al., 2016) In this
no difference between the pre-test and post- educational aid, video stimulates the visual
test knowledge in the group that did not use sense by 75% and the sense of hearing by
the media.(Jumilah et al., 2013) Apart from 13%.(Majid et al., 2020) This is also under
the use of media to distribute health the principles of making educational aids,
messages, the increased value of knowledge knowledge is accepted by the five senses so
is also influenced by the electronic media that the more senses are stimulated the
factor as an educational media in this study. more knowledge that can be absorbed by

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children.(Kantohe et al., 2016) Because it Games are something that children love,
stimulates several senses, it affects both games that adapt to the development of this
short and long-term memory in technology can attract children's attention to
children.(Majid et al., 2020) first impressions. This adjusts to the
In table 2 there are also children who characteristics of elementary school
experience a decrease in the value of children in general, that children still enjoy
knowledge. This is due to the child's playing. This is in line with a study by
attention that cannot be maintained because Santoso in 2019 which stated that the
there is no interaction in the form of playing Android-based monopoly game media was
games actively. Children tend to feel feasible and effective as a dental health
depressed because they did not do a physical education media.(Alhayek et al., 2018)
activity in return for something that
stimulates them, even though at that age CONCLUSION
children tend to be active in physical activity. From the study, it can be concluded that
This is in line with research conducted by using video games as an innovation tool for
Baboo in 2017 where children who play dental health education can be used as an
video games can increase the value of social alternative to promote the oral health of
behaviour, but if only watching video games, children during the Covid-19 pandemic.
it reduces the value of social behaviour in There is knowledge disparity of dental and
other words, it is based on insufficient oral health among students before and after
knowledge.(Baboo, 2017) education video game at SDN 03
In Table 3, it is shown that there is a Pesanggrahan, Jakarta Selatan. The process
significant difference between the value of of dental health education using video game
knowledge before and after being given is an effective way to increase
health education through a video game. This students’knowledge about dental health.
difference in knowledge is caused by the Animations on video game that attract
animation and game elements in the video. attention make children can increase the
In a video game, it is inseparable from the memory. Providing children with oral health
animated elements shown during video education through a interesting method,
playback. Moving images that are presented such as video games, might provide them
in various colours and inserted with oral with a positive media influence. In addition,
health material are able to attract children's parents are indeed going to be part of the
attention so that they can increase students' intervention in this study, as they will be
learning motivation.(Majid et al., 2020) required to guide the child through the
Animations that attract attention make game. Moreover, parents might learn
respondents remember and material so as to indirectly, as some evidence suggests that
increase memory.(Papilaya et al., 2016) This children can transmit knowledge to their
is in line with a study by Sari, 2017 which parents. We suggest, oral health care
states that videos that contain animation are providers must clearly communicate the
more effective than videos that do not importance of oral health and promote the
contain animation. This is also reinforced by oral disease prevention by using an
a study by Alhayek et al. in 2018 in Riyadh innovation tools such as video game for
which stated that animated video media and children during the pandemic. Video games
demonstrations were effective for conveying with other more interesting dental health
messages on dental health, but animated education materials can be developed in
videos had the advantage of using a short next study.
time in delivering dental health
information.(Alhayek et al., 2018) In
addition to animation elements, there are
also elements of Android games in the video.

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Acknowledgement Farahiyah Ikenasya, D., & Novita, F.
We thank for all of the students, teachers, (2017). Murid Sekolah Dasar
and parents at SDN 03 Pesanggrahan, dengan UKGS dan Tanpa UKGS
Jakarta Selatan. (Studi pada SDN 16 dan SDN 49
Banda Aceh). Caninus Denstistry,
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