Insisiva Dental Journal: Majalah Kedokteran Gigi Insisiva, 12(1), May 2023, 1-6 1

Research Article
The Overview of Eating Patterns and Dental Caries Status of The
Community of Pendul, Argorejo, Bantul Yogyakarta
Sri Utami1*, Retnaningtyas Pinastika2, Novitasari Ratna Astuti1, Arya Adiningrat3
1
Department of Dental Public Health, Faculty of Dentistry, Universitas Muhammadiyah Yogyakarta, Indonesia
2
Faculty of Dentistry, Universitas Muhammadiyah Yogyakarta, Indonesia
3
Department of Oral Biology, Faculty of Dentistry, Universitas Muhammadiyah Yogyakarta, Indonesia

Received date: May 20th, 2022; revised date: January 7th, 2023; accepted: May 15th, 2023
DOI: 10.18196/di.v12i1.14749

Abstract

The primary caries etiology factors are hosts (teeth), agents (microorganisms), substrates, and time. Individual
characteristics can be influenced by caries' risk factors, such as age, education level, economic status, and diet.
The high frequency of food and snack consumption, especially cariogenic food, is riskier of being caries affected.
This study aims to describe the eating pattern and dental caries status of the Pendul community in 2018. This
research is a descriptive observational study with a cross-sectional approach. It was held from December 2018 to
January 2019 in the Pendul district of Bantul. The subject of this research was selected using the accidental
sampling method with 138 respondents. The research instrument employed the Food Frequency Questionnaire
and DMFT index. The result showed that the higher the consumption of cariogenic foods is, the higher the caries
index will be. The highest frequency of cariogenic foods consumption was snacks, with a mean DMFT index of
8,02. The highest frequency of cariogenic beverage consumption was sugar tea, with a mean DMFT index of each
respondent was 8 teeth. The highest frequency of cariogenic consumption per week lay in snacks and packaged
tea. Apart from the four etiological factors, such as agent, host, substrate, and time, caries can also be caused by
other determinant factors such as gender, age, education level, and socioeconomic status.

Keywords: dental caries; diet role; DMFT index; food frequency questionnaire

INTRODUCTION lactic acid and acetic acid. Factors causing

National health development also caries include host factors (teeth and
focuses on equitable distribution of health, saliva), substrate factors, microorganism
protection of health resources, factors (bacteria), and time factors. Caries
improvement of nutritional health status, occur when these four factors interact with
and public health services1, such as dental each other.2 Apart from these four factors,
and oral health services. Dental and oral individual characteristics can also influence
health problems in Indonesia still require the occurrence of caries, such as age,
special attention from the government. The education level, economic status, and daily
most common dental and oral health eating patterns.4
problem is dental caries.2 According to An eating pattern is related to the
RISKESDAS data in 2018, the prevalence frequency of food consumption, food
of dental caries.3 portion, and daily food quality.5 The high
Dental caries occurs due to frequency of consumption of food and
bacteria's activity in the oral cavity, snacks, especially cariogenic ones, causes a
especially Streptococcus mutants, which person to be susceptible to caries.2
ferment carbohydrates into acids, especially Cariogenic foods are high in carbohydrates,
*
Corresponding author, e-mail: [email protected]
 2 Sri Utami, Retnaningtyas Pinastika, Novitasari Ratna Astuti, Arya Adiningrat| The Overview of Eating Patterns and
Dental Caries Status of The Community of Pendul, Argorejo, Bantul Yogyakarta

sticky, and easily chewed in the oral Table 1 shows that the dental caries
cavity.6 This study aims to describe eating status of the Dusun Pendul community
patterns and the dental caries status of the assessed by the DMFT index has a mean of
people in Pendul in 2018. 7.89.

MATERIALS AND METHODS Table 2. Distribution of Dental Caries Status by

This study used a descriptive Gender
Gender Total Mean DMFT
observational research method with a cross-
Male 440 7.71
sectional design. This research was Female 650 8.02
conducted from December 2018 to January Table 2 shows that female
2019 in Pendul, Argorejo Village, Sedayu respondents have a higher mean DMFT
District, Bantul, Daerah Istimewa than male respondents, where the mean
Yogyakarta, Indonesia. DMFT of male respondents is 7.71, while
Based on the preliminary survey female respondents’ mean DMFT is 8. 02.
results, the total population was 730 people.
The sample in this study included the Table 3. Distribution of Dental Caries Status by
people of Pendul, Argorejo Village, Sedayu Age
District, whose minimum age was 5 years Age Total Mean DMFT
old. Based on the preliminary survey, it was 5-11 years 32 4.71
12-25 years 25 5.32
found that 660 people met these criteria. 26-45 years 27 7.25
This study used an accidental sampling 46-65 years 47 10.6
technique and obtained 138 people. The > 65 years 7 16
variables of this study were dental caries Table 3 shows that the dental caries
status and eating patterns. status's highest mean DMFT is at > 65 years
The operational variable of the old, namely 16.
dental caries status is the status of cavities
characterized by the presence of cavities Table 4. Distribution of Dental Caries Status by
when measured using a probe. A probe was Latest Education Level
Education Level Total Mean DMFT
measured using the DMF-T index (Decay,
Uneducated 34 5.17
Missing, Filled Teeth) in study subjects Elementary school 50 9.4
with permanent teeth and the DEF-T index Junior High School 21 8.57
(Decay, Exfoliate, Filled Teeth) in study Senior High School 31 7.61
subjects with primary teeth. An eating College 2 2
pattern is a habit of consuming food and Table 4 shows that the highest
drinks identified by filling out the Food number of respondents, 50 people (36.2%),
Frequency Questionnaire (FFQ) sheet to have an elementary school educational
calculate the type of food consumed and the background. Meanwhile, the lowest
frequency of eating habits per week in the number of respondents, 2 people (1.4%),
past month. The research instruments have a college degree as their latest
included an odontography, FFQ educational level.
questionnaire, oral mirror, probe, 70%
alcohol, and container. Table 5. Distribution of Dental Caries Status by
Socio-Economic
Occupation Total Mean DMFT
RESULT Laborer 52 9.78
Housewife 14 9.35
Table 1. Distribution of Dental Caries Status with Entrepreneur 8 11.37
DMFT Index Private Employees 5 3.8
DMFT Mean Unemployed 54 5.02
Total
D M F DMFT Other 5 11.2
702 381 7 1090 7.89
 Insisiva Dental Journal: Majalah Kedokteran Gigi Insisiva, 12(1), May 2023, 1-6 3

Table 5 shows that respondents who

work as entrepreneurs have the highest
mean DMFT of 11.37.

Table 6. Frequency Distribution of Weekly Cariogenic Consumption and Mean DMFT

Total
Cariogenic
Once 2-3 times >3 times Never
Beverage
n (DMFT) n (DMFT) n (DMFT) n (DMFT)
Packaged milk 9 16 4 89
Packaged tea 2 23 44 69
Packaged coffee 3 9 8 118
Packaged syrup 7 2 3 126
Packaged Juice 5 5 3 125
Ice cream 9 19 7 103
Soft drink 6 3 1 128
Isotonic 9 2 0 127

Table 6 shows that the higher the The highest cariogenic consumption was in
frequency of cariogenic foods such as snacks with a frequency of > 3 times per
bread, cakes, candies, and snacks are, the week, and the mean of DMFT was 9.29.
higher the average of dental caries will be.

Table 7. Frequency Distribution of the Weekly Cariogenic Drinking Patterns and Mean DMFT
Total
Cariogenic Food Once 2-3 times > 3 times Never
n (DMFT) n (DMFT) n (DMFT) n (DMFT)
Bread 24 (7.65) 31 (8.29) 27 (12.1) 54 (5.6)
Cake 16 (7.68) 16 (8.81) 11 (11.3) 95 (7.42)
Candy 13 (8.15) 9 (8,11) 24 (8.25) 92 (7.91)
Chocolate 7 (10.7) 15 (7.46) 7 (11,4) 109 (7.55)
Snacks 8 (7.75) 21 (8.47) 34 (9.29) 75 (7.12)

Table 7 shows that the most frequency of > 3 times per week with a
frequently consumed cariogenic beverage mean DMFT of 9.27.
is packaged tea, with a consumption

DISCUSSION present systematic review, an association

This study indicated that the highest was found between the time spent by
frequency of cariogenic food consumption preschool and school-aged children
per week was snack consumption, with a watching TV and poor diet quality,
frequency of > 3 times by 34 respondents. characterized by higher fat and sugar
It had a mean DMFT of 9.29. consumption with fewer fruits and
Furthermore, this study also vegetables and increased intake of sugar-
revealed that the higher the frequency of sweetened beverages; therefore,
respondents consuming bread, cakes, representing a potentially cariogenic diet.7
candies, and snacks is, the higher the The results of this study align with
respondents' mean DMFT will be. Certain the previous research, revealing that the
bacteria can ferment food consumption higher the consumption of sweets is, the
high in sucrose and glucose into acids that higher the caries severity will be.8 Previous
can damage tooth enamel and lead to caries. research also revealed evidence to support
The high frequency of consumption of the use of sugar-free gum in controlling
cariogenic foods and snacks causes a Streptococcus mutans counts, which relate
person to be prone to caries.5 Based on the directly to caries progression in children
4 Sri Utami, Retnaningtyas Pinastika, Novitasari Ratna Astuti, Arya Adiningrat| The Overview of Eating Patterns and
Dental Caries Status of The Community of Pendul, Argorejo, Bantul Yogyakarta

and adults. Chewing sugar-free gum age is, the lower the awareness of
reduces the load of Streptococcus mutants maintaining dental and oral health will be.12
in the oral cavity compared to non-chewing The results of dental caries status
controls.9 based on the educational background
Furthermore, the highest frequency showed that the highest mean DMFT lay in
of cariogenic beverage consumption per respondents who had elementary school as
week was packaged tea, with a their latest educational level, with a total of
consumption frequency of > 3 times by 44 50 respondents and a mean DMFT of 9.4.
respondents with a mean DMFT of 9.27. The level of education affected the status of
The sucrose content in packaged tea can dental and oral hygiene and dental caries
accelerate extra cells so that status. The lower the level of education is,
microorganisms in the oral cavity quickly the higher the caries rate will be suffered.13
convert them, causing a decrease in pH. Dental caries risk factors included higher
Consuming sweet, sticky or sour food consumption of snacks, lower maternal
causes persistent acidity, making saliva education level, and socioeconomic status.
difficult to increase the pH; low pH causes The population with lower income and
dental caries. It is in line with the previous lower educational level are the most
research, which found a relationship affected, independently of the evaluated
between the frequency of consumption of indicator such as untreated dental caries,
cariogenic foods and beverages with the access to dental care services and hygiene
level of dental caries.10 habits.14 Parental educational background
In terms of DMFT, this study frequently determines income, thus
revealed that the mean DMFT of the Pendul controlling access to home or professional
community was 7.89. It indicated that each preventive means such as toothpaste, dental
respondent had an average of caries in 8 floss, low caloric sugar-reduced diets, or
teeth. The high rate of dental caries can be privately paid dental sealants.15 Educational
influenced by many factors, such as gender, background affects nonmaterial
age, education level, socioeconomic status, characteristics such as health literacy and
environment, and culture.2 behavior, including dietary and tooth
Based on the study results, it can be cleaning habits or health service utilization
seen that female respondents had a higher frequency and patterns.16 Mother’s level of
mean DMFT than male respondents. The education increases the awareness of oral
mean DMFT of female respondents was health-related issues. Educating mothers on
8.02, while the mean DMFT of male child dental care will promote lifelong good
respondents was 7.71, with the caries level oral hygiene habits and considerably reduce
categorized as very high. The high dental the prevalence of oral diseases.17
caries in women can be caused by a faster Based on socioeconomic status, the
dental eruption than in men. The prevalence results showed that the highest mean
of dental caries in women was higher than DMFT was in entrepreneurs, with a total of
that of men.11 8 respondents and a mean DMFT of 11.3.
In addition, the results of this study In this study, the high mean DMFT was
also indicated that the dental caries status related to the behavior level in maintaining
based on age category in the age group of > dental and oral health, which was included
65 years had a higher mean DMFT than the in the poor category.
age group below it. The mean DMFT in the Apart from the four etiological
age group > 65 years was 16. The high factors, such as agent, host, substrate, and
dental caries in the elderly can be time, caries can also be caused by other
influenced by a decrease in self- determinant factors such as gender, age,
independence, resulting in a decreased level education level, and socioeconomic status.
of dental and oral hygiene. The older the This research demonstrated that the mean
 Insisiva Dental Journal: Majalah Kedokteran Gigi Insisiva, 12(1), May 2023, 1-6 5

dental caries of each respondent was 8 J. At A Glance, Pediatric Dentistry.

teeth. The highest frequency of cariogenic 2014. Jakarta: Erlangga.
consumption per week lay in snacks and 6. Rois, F. Hubungan Perilaku
packaged tea. Mengkonsumsi Makanan Manis
Parents should be advised that they dengan Kejadian Karies Gigi Pada
are role models able to set eating behaviors Anak Usia Sekolah di SD Negeri
at home by providing high-quality meals Harjodowo Kecamatan Kuwarasan
and having fruits, vegetables, and other Kabupaten Kebumen. 2017. pp 34-35
healthy foods available as snacks.18 7. Shqair, A.Q., Pauli, L.A., Costa, V.P.P.,
High sugar consumption, low Cenci, M., Goettems, M.L. Screen time,
maternal education, and low socioeconomic dietary patterns and intake of
status increase the risk of dental caries.19 potentially cariogenic food in children:
Higher maternal education on tooth A systematic review. J. Dent. 2019.
brushing, limiting sugars, and improving 86:17-26.
oral health education, are essential for https://doi.org/10.1016/j.jdent.2019.06.004
reducing the prevalence of dental caries.20 8. Pramono, G, A. Hubungan Asupan
Makanan Kariogenik dengan Tingkat
CONCLUSION Keparahan Rampan Karies. Universitas
The people in Dusun Pendul had an Muhammadiyah Yogyakarta: 2011.
average of caries of 8 teeth per person. Yogyakarta.
Furthermore, the highest eating pattern was 9. Nasseripour, M., Newton, J.T.,
in the consumption of snacks, with a mean Warburtonz, F., Awojobi, O., Giorgio,
DMFT of 9.29, and the highest cariogenic S.D., Gallagher, J.E., and Banerjee, A.
drinking consumption was packaged tea. A systematic review and meta-analysis
of the role of sugar-free chewing gum
ACKNOWLEDGMENT on Streptococcus mutans, BMC Oral
We would like to thank the Health. 2021. 21:217, 2-11.
participants who participated in this study. https://doi.org/10.1186/s12903-021-
01517-z
REFERENCE 10. Rosidi A. Hubungan Antara Konsumsi
1. Ministry of Health of the Republic of Makanan Kariogenik dengan Kejadian
Indonesia. Balanced Nutrition Karies Gigi pada Anak SDN 1
Guidelines 2015-2019 Health Gogodalem Kecamatan Bringin
Development Strategic Plan. 2019. Kabupaten Semarang. 2013. 7(1):10-
Jakarta 12.
2. Kidd, E. A. dan Bechal, S. J. (2012). https://doi.org/10.47575/jpkm.v1i1.188
Dasar Dasar Karies Penyakit dan 11. Dewi R.O. Gambaran Status Karies
Penanggulangannya. 2012. Jakarta: Gigi (Indeks DMF-T) pada Pasien
EGC. pp 12-16 Thalasemia Beta Mayor di Rumah Sakit
3. Ministry of Health of the Republic of Umum Daerah Dr. Zainoel Abidin
Indonesia. Guide to Balanced Nutrition. Banda Aceh. 2017. 2(2): 71-77
2013. Jakarta 12. Listian, N.P. Perilaku Menggosok Gigi
4. Worotitjan, I., Mintjelungan, C. N. dan Kebiasaan Makan dan Minum Tinggi
Gunawan, P. Pengalaman Karies Gigi Sukrosa dengan Kejadian Karies Gigi
Serta Pola Makan dan Minum Pada Pada Siswa Di MIN Jejeran, Jurnal
Anak Sekolah Dasar di Desa Kiawa Poltekes Kemenkes RI. 2017. pp 8-12
Kecamatan Kawangkoan Utara. Jurnal 13. Lakoro. Pola Konsumsi Air, Susu, dan
e-GiGi (eG). 2013. 1(1): 59-68. Produk Susu, Serta Minuman Manis
https://doi.org/10.35790/eg.1.1.2013.1931 Sebagai Faktor Resiko Obesitas pada
5. Duggal, M., Cameron, A. and Toumba, Anak Sekolah Dasar Di Kota
6 Sri Utami, Retnaningtyas Pinastika, Novitasari Ratna Astuti, Arya Adiningrat| The Overview of Eating Patterns and
Dental Caries Status of The Community of Pendul, Argorejo, Bantul Yogyakarta

Yogyakarta dan Kabupaten Bantul. S., Sarfraz, A., Sarfraz, Z., and Cherrez-
2013. 1(2): 102-109. Ojeda, I. Individual, Family, and
https://doi.org/10.21927/ijnd.2013.1(2) Socioeconomic Contributors to Dental
.102-109 Caries in Children from Low- and
14. Probst, L.F., Pucca Junior G.A., Middle-Income Countries, Int. J.
Antonio Carlos Pereira, A.C., De Carli, Environ. Res. Public Health. 2022.
A.D., 2019, Impact of financial crises https://doi.org/10.3390/ijerph19127114
on oral health indicators: an integrative
review of the literature. Cient Saude
Colet. 2019. 24 (12).
https://doi.org/10.1590/1413-
812320182412.23132019
15. Anouti, F.A., Abboud, M., Papandreou,
D., Haidar, S., Mahboub, N and Rizk,
R. Oral Health of Children and
Adolescents in The United Arab
Emirates: A Systematic Review of The
Past Decade, Frontiers in oral health.
2021. 29; 2;744328
https://doi.org/10.3389/froh.2021.744328
16. Schwendicke, F., C.E. Dörfer, C.E.,
Schlattmann, P., Foster Page, L.,
Thomson, W.M., and Paris, S.,
Socioeconomic Inequality and Caries:
A Systematic Review and Meta-
Analysis, Journal of Dental Research,
https://doi.org/10.1177/002203451455
7546
17. Carta, G., Cagetti, M.G., Sale, S.,
Congiu, G., Strohmenger, L., Oleari, F.,
Bossù, M., Lingström. Oral health
inequalities in Italian schoolchildren - a
cross-sectional evaluation Community
Dental Health. 2014.31, 123–128,
doi:10.1922/CDH_3300Carta06
18. Nembhwani, H.V., Indu Varkey, I.
Caries Experience and Its Relationship
with Mother’s Educational Level and
Occupational Status: A Cross-sectional
Survey, International Journal of
Clinical Pediatric Dentistry.
https://doi.org/10.5005/jp-journals-
10005-2163
19. Mobley, C., Marshall, T.A., Milgrom,
P., Codwell, S.E. The Contribution of
Dietary Factors to Dental Caries and
Disparities in Caries. Acad Pediatr.
2009. 9(6): 410–414.
https://doi.org/10.1016/j.acap.2009.09.008
20. Madiha Yousaf, M., Aslam, T., Saeed,