Dentists' knowledge and attitudes regarding PFPT: A single study in East Java, Indonesia.

Objective: Pigmented fungiform papillae of the tongue (PFPT) are infrequently encountered and inadequately documented pigmented lesions that pose challenges in diagnosis and subsequent treatment planning. The study was aimed at analyzing dentists' knowledge and attitudes regarding PFPT morphologies, to determine diagnosis and subsequent treatment planning. Methods: A cross-sectional study was conducted among dentists in East Java through an online questionnaire. Four clinical photographs of PFPT were presented, accompanied by seven questions assessing dentists' knowledge of PFPT, including lesion types, tongue structure involvement, Holzwanger classification, lesion patterns, suspected diagnoses and the nature of the lesion (benign or malignant). Additional questions to evaluate attitudes included prior experience with PFPT in practice, potential malignant transformation, diagnostic investigation and required treatment. Knowledge-associated attitude differences were statistically analyzed with the Mann-Whitney test with a threshold of p < 0.05. Result: A total of 117 dentists participated, most of whom were women (69.23%) and were 26-30 years of age (44.44%). Dentists 41-50 years of age had superior knowledge to those 20-30 years of age (p = 0.005). Practitioners with 1-5 years of experience showed significant differences in knowledge regarding PFPT (p < 0.05). No significant differences in knowledge level and attitudes were observed, particularly regarding PFPT treatment and supporting investigation (p > 0.05). However, prior encounters with PFPT cases were significantly associated with treatment decisions and supporting investigations for diagnosis (p < 0.05). Conclusion: Most participating dentists had substantial knowledge of PFPT cases. Dentists' understanding, as reflected in their attitudes toward investigating and treating PFPT, was notably influenced by prior encounters with PFPT cases.

Dentin-derived alveolar bone graft for alveolar augmentation: A systematic review.

Introduction: Application of alveolar bone graft (ABG) in alveolar augmentation is done to prevent excessive bone resorption due to tooth extraction, missing teeth, or other diseases/conditions affecting the alveolar bone. The use of autogenous dentin-derived ABG has been considered as the composition of dentin appears to be nearly analogous to that of bone. Objective: This systematic review aims to assess the efficacy of dentin-derived ABG for alveolar augmentation of post-extraction sockets or other alveolar bone defects by evaluating volume gain and histomorphometric data. Material and methods: A search of systematic literature was conducted in Pubmed, Scopus, Web of Science, and Embase from database inception to October 2023. The review included both randomized controlled trials (RCT), pilot studies, clinical trials, and retrospective studies reporting on dentin-derived ABG use for alveolar augmentation. Results: Overall, 298 articles were obtained from the initial search. From these articles, 21 articles met the inclusion criteria and were included for descriptive analysis. All of the studies indicated low risk of bias. Studies of dentin-derived ABG, which used bone-derived grafts as the control group, have shown significantly higher percentages of new bone formation, gain in vertical and horizontal dimensions, and less reduction in dimensions. Conclusions: Dentin-derived ABG was effective in volume maintenance, indicating promising results via histomorphometric and radiographic analysis.

The Use of Internet of Things (IoT) Technology to Promote Children's Oral Health: A Scoping Review.

Dental treatments and oral health promotion are now more mobile and versatile thanks to the Internet of Things (IoT)-based healthcare services. This scoping review aims to compile the available data and outline the aims, design, assessment procedures, efficacy, advantages, and disadvantages of the implementation of IoT to improve children's oral health. Articles for this review were gathered from PubMed, Scopus, and Ebscohost databases to identify and construct the keywords and primary research topic. The selected studies were published between 2000 and 2022 and focused on children aged 1 to 18 and/or parents/caregivers of children who received oral health promotion and/or dental disease preventive treatments utilizing the IoT. Each study topic required data extraction. A total of nine papers were included in this review. Two of the nine publications were quasi-experimental, while the remaining six papers were randomized control trials. The nine papers considered in this appraisal have a range of interventions and follow-up periods. Mobile-Health (m-Health), home healthcare, hospital/clinical management, and electronic-Health applications (e-Health) are the most common IoT architecture used as interventions. Three studies assessed oral health knowledge and behavior scores, whereas the bulk of studies (6/7) used m-Health treatments focusing on dental plaque buildup as well as gingival health evaluation to assess oral hygiene. IoT is one of the mediums or instruments that might be used to encourage children's dental health. The studies suggest that the use of IoT could help in improving oral hygiene and oral health, which can further improve children's oral health.

Demographic and economic correlates of health security in West Sumatra province - Indonesia.

OBJECTIVES: Access to health insurances could indicate the degree of health security among communities. Indonesia made a commitment to attain universal health insurance coverage by the end of 2019. However, until today it has not reached the goal of 100% coverage. Therefore, there is a need to portray the demographic and economic correlates of health insurance coverage in an area to improve health security achievement. METHODS: This secondary analysis was based on the 2017 Indonesian national socio-economic survey conducted in the West Sumatra province. Multivariable models using logistic regression were used to estimate the odds ratios (OR) for being uninsured. RESULTS: The results showed that health security, in terms of insurance coverage, was influenced by demographic and economic factors. Young and middle-aged individuals were more likely to be uninsured than older ones (OR = 1.49 and OR = 1.21, respectively). People from a lower educated family, or with lower consumption per capita have higher risk of being uninsured (OR = 3.00 and OR = 1.26, respectively). CONCLUSION: Insurance coverage was influenced by demographic and economic factors. Policymakers should consider demographic and economic factors related to the implementation of universal health coverage. Campaign about the importance of universal health coverage should reach all citizens.

The Association between Dental Pain and Psychological Symptoms: Evidence from a Population-Based Study in Indonesia.

OBJECTIVES: This study aimed to determine the prevalence and distribution of dental pain and its association with psychological symptoms: stress and depression. MATERIALS AND METHODS: The 2014 Indonesia Family Life Survey data were used for the abovementioned purposes. Records of self-reported dental pain and stress as well as the occurrence of depression based on the 10-item Center for Epidemiologic Studies-Depression scale were analyzed. Multivariable ordinal regression models were fitted to test the hypothesized associations between dental pain and each of the psychological symptoms, controlling for age, sex, education, wealth, and religiosity. RESULTS: Dental pain prevalence among Indonesian population was approximately 15%. The adjusted odds ratios (ORs) from the ordinal regression models indicated that dental pain was related to the increase of the stress and depression level (OR: 1.31, 95% confidence interval [CI]: 1.14-1.49 and OR: 1.59, 95% CI: 1.41-1.79, respectively). Higher education, higher wealth, and being male are risk factors for stress. However, higher wealth and being male are protective factors for depression. Furthermore, higher religious level was a protective factor for both stress and depression. CONCLUSION: Dental pain was associated with a higher level of stress and a higher score of depression, even after being adjusted with age, sex, education, wealth, and religiosity.

Effect of Socioeconomic Status on Teeth and Dental Care - Evidence from a Population-based Study in Indonesia.

PURPOSE: Education is well-known as a determinant of oral health and dental behaviours in high-income countries, but much less is known for countries with lower incomes. This study aimed to identify the extent to which education affects oral health and dental behaviours in Indonesia. MATERIALS AND METHODS: This study used data from the Indonesian Basic Health Survey 2013. From this nationally representative sample of 945,057 people 5-100 years old, a series of mixed-effects Poisson regression models that accounted for sampling weights estimated the effect of educational attainment on edentulism, dental care utilisation, and toothbrushing behaviour. RESULTS: Consistent educational gradients were found for all outcomes and across all model specifications. People without a formal educational degree had a 1.03 (95% CI: 1.03-1.04) times higher risk of not utilising any dental care, a 3.15 (95% CI: 2.47-4.02) times higher risk of being edentulous, and a 15.6 (95% CI: 12.76-19.02) times higher risk of having low toothbrushing frequency than people having a university degree or higher. CONCLUSIONS: Stark and consistent educational gradients were observed in the dentate status, dental services utilisation, and toothbrushing in Indonesia. Educational inequalities were much larger for toothbrushing behaviours than for dental care utilisation. Intervention points for health policy should urgently prioritise public health interventions to promote overall educational attainment, preventive services, and dental care targeted at those with lower educational attainment.

Assessment of Indonesian-Language Orthodontics-Related YouTube Video as a Source of Information.

OBJECTIVES: Health-seeking behavior through social media including orthodontics treatment has become popular among community in Indonesia. However, the characteristics of uploaded video in term of quality, reliability, and usefulness are unknown. This study aims to analyze the characteristics of Indonesian-language orthodontic-related YouTube videos uploaded. MATERIALS AND METHODS: This study adopted cross-sectional design and analyzed 300 videos as the sample. A final 100 related videos were included for analysis of the quality, usefulness, and reliability of the video uploaded as well as viewers' interaction in term of popularity and visibility. Mann-Whitney's test was used for the statistical analysis. RESULTS: The majority of the videos were uploaded by individual users (60%) with moderate quality, usefulness, and reliability. Statistical analysis showed that orthodontics-related YouTube videos uploaded by individuals have lower popularity and reliability compared with health professional (p < 0.05). CONCLUSION: Most of the Indonesian-language orthodontic-related YouTube videos have moderate quality, usefulness, and reliability. There is a need from health professional to contribute more related video as main source of health information for the general to make healthy health-seeking behavior.

Teledentistry and Online Referral System in Indonesian Primary Health Care Center During the COVID-19 Pandemic: A Narrative Review.

Aims: This review aims to map the needs and challenges in the application of teledentistry and online referral system encountered by dental health care professionals in Indonesian primary health care centers (puskesmas) to provide safe dental health service to the population during the COVID-19 pandemic. Materials and Methods: Literature search was undertaken of both in Indonesian and overseas context related to teledentistry. Narrative review of the literature was written to present the challenges, solutions, and application of teledentistry at Puskesmas to optimize oral health services during the COVID-19 pandemic. Results: Online referral system and teledentistry are options to help dental health service delivery in the pandemic era. While it has been adopted in many private clinics, there are many challenges to adopt it at the puskesmas level due to a lack of infrastructure, human resources, and budget allocation. While the Indonesian government has plans to support the digitization in the education and health sector, this pandemic shall pose an opportunity for Indonesian health department to develop and facilitate the use of teledentistry and online referral system. During this situation, health cadres can bridge the relationship between Puskesmas and the poor community through the help of teledentistry. Conclusions: The government commitment in applying online referral system and teledentistry in Puskesmas is needed. Dental education institutions can help to supply human resources, who are capable of developing and carrying out the most suitable teledentistry application for all stakeholders.

The expression of TNF-α in recurrent aphthous stomatitis: A systematic review and meta-analysis.

OBJECTIVE: The pathogenesis of recurrent aphthous stomatitis (RAS) is related to an increase of pro-inflammatory cytokine, namely tumor necrosis factor α (TNF-α). This cytokine plays an important role in the development of ulcer lesions, both in saliva, tissues and blood. This systematic review analyzed the differences of TNF-α in lesions, salivary and blood and can be used as a reliable method of diagnosis for RAS. METHODS: A comprehensive search of PubMed, Scopus databases, Web of Science, Scielo, Google Scholar and Embase with keywords. The inclusion criteria were studies that assessed the saliva, serum, and RAS lesion, with the outcome reporting the mean of saliva, serum and tissue expression of TNF-α. The risk of bias was also assessed. RESULT: Healthy individuals showed significantly lower TNF-α than RAS (SMD = -1.517, 95% CI [-2.25, -0.78]). Although there is a significant difference between sample (i.e., saliva, serum) and detection type (i.e., cytometry bead array, ELISA), both methods can detect a significant difference in TNF-α between healthy individuals and RAS patients. CONCLUSIONS: The TNF-α is a useful diagnostic marker for RAS. We encourage saliva to detect changes in TNF-α during ulceration as it provides accuracy, reliability, and non-invasive procedure compared to a blood draw.

Analysis of Quality, Usefulness, Reliability, Visibility, and Popularity of Videos about Dental Caries on YouTube: A Cross-sectional Analysis.

Objectives: YouTube is the most popular social media and is widely used to access dental and oral diseases information. Nonetheless, the quality of online health information remains a problem. This study aimed to analyze the quality, usefulness, reliability, visibility, and popularity of YouTube videos about dental caries as a source of information. Materials and Methods: The study design was a cross-sectional analytical study. Here, 300 videos that were uploaded in September 2019-2020 were screened, and total duration, number of views, number of likes, number dislikes, uploader category (individual users or health professionals), and upload date of the videos were recorded. One hundred videos were analyzed in terms of their quality, usefulness, reliability, visibility, and popularity using the Global Quality Scale, usefulness score, DISCERN, viewing rate, and interaction index, respectively. Results: Videos were 78% uploaded by individual users. Videos uploaded by health professionals showed high scores in quality, usefulness, and reliability. Videos that were greater than 6 min long exhibited both better quality and higher popularity. Video with good-quality showed high visibility and popularity. In addition, videos with better usefulness and reliability showed high visibility; however, their popularity was low. Conclusions: Information about dental caries on YouTube is limited in quality. YouTube videos have a potentially important role in oral health education.

Mouse periodontitis models using whole Porphyromonas gingivalis bacteria induction.

INTRODUCTION: Due to the increasing prevalence of periodontitis within the general population, it is important to study the progress and stages of periodontal disease and the efficacy of periodontal treatment through in vitro and in vivo experiments. Mouse periodontitis models are important in many in vivo studies. This study presents the findings from a scoping review of the current literature regarding the available method to produce mouse periodontitis models using whole Porphyromonas gingivalis (P. gingivalis) bacteria. METHODS: The scoping review was carried out based on the methodology described by Arskey and O'Malley. An electronic literature search was conducted in the PubMed database. Inclusion and exclusion criteria were established. The data were collected on a purpose-made data extraction table for descriptive analysis. RESULT: The researchers identified 11 articles that met the inclusion criteria for the review. Factors most considered in the literature relating to this topic are the vehicle to induce periodontitis, the type of strain for mice and P. gingivalis, the region of application, sacrifice day and the detection method used to measure the parameters. CONCLUSION: The most frequently used vehicle to induce a mouse periodontitis model is the combination of P. gingivalis with ligature. Future research on different types of vehicles and bacteria for inducing more effective and more time-efficient periodontitis models is needed to guide future researchers on this topic.

Clinical utility of dermoscopy on diagnosing pigmented papillary fungiform papillae of the tongue: A systematic review.

INTRODUCTION: The practice of dermoscopy in dental and oral examination is low due to less popularity and not well established of the diagnostic tool in dental practice. The dermoscopy examination provides a specific dermoscopes details for pigmented papillary fungiform of tongue (PPFT) as cobblestone appearance and rose-petal appearance. With this dermoscopes details serves as a non-invasive diagnostic tool and prevents biopsy procedure. OBJECTIVE: We performed a systematic review to evaluate the published papers related to pigmented papillary fungiform on the tongue, aiming to understand the diagnostic role of dermoscopy examination in pigmented papillary fungiform. DATA SYNTHESIS: Initial result was 136 studies. Final exclusion of 27 articles was made based on the following factors: reports with no clinical images, studies that did not confirm the diagnosis of PPFT and studies that did not use the dermoscopes details. Finally, seventeen studies with nineteen cases, reported of pigmented papillary fungiform of the tongue. Six studies (consist six cases) reported the dermoscopy and histopathology diagnosis of pigmented papillary fungiform, eleven studies (consist thirteen cases) reported only the dermoscopy. The dermoscopy examination presented cobblestone appearance is 47.37% and rose petal appearance is 52.63%. The comparation study by histopathology diagnosis was done, revealed no specific appearances. CONCLUSIONS: The clinical appearance and dermoscopy is the key for diagnosis of the papillary fungiform on the tongue. Further research is needed for determining the etiology and predisposing factor in papillary fungiform so that the possibility of developing this condition can be predicted and proper treatment could be performed.

Quality and Reliability of Halitosis Videos on YouTube as a Source of Information.

Halitosis is a common condition that adversely affects quality of life. Through YouTube, people access oral health information. This study aimed to analyze the quality and comprehensiveness of the content, and reliability of halitosis videos hosted on YouTube. In total, 300 videos were collected based on three search keywords, and the number of likes, dislikes, views, duration, interaction index, viewing rate, and source category. Subsequently, the video score, which represents the content quality and comprehensiveness was used to categorize videos as poor, good, and excellent. DISCERN score was used to assess video reliability. Of the 105 videos analyzed, 68 (64.8%) were uploaded by personal users. In general, videos were categorized as poor and have low reliability. Videos sourced from healthcare professionals showed the highest quality, comprehensiveness of the content, and reliability (p < 0.05). There was no difference in the number of viewers for video duration less than or more than 4 min (p > 0.05). YouTube users prefer low-quality videos over high-quality ones, indicating that viewers cannot differentiate between reliable and potentially biased content. It is critical to enable viewers to critically assimilate information hosted on YouTube to make effective oral healthcare decisions.

Effectiveness of the school-based oral health promotion programmes from preschool to high school: A systematic review.

BACKGROUND: Schools offer an opportunity for oral health promotion in children and adolescents. The purpose of this study was to conduct a systematic review of the influence of school-based oral health promotion programmes on oral health knowledge (OHK), behaviours (OHB), attitude (OHA), status (OHS), and quality of life (OHRQoL) of children and adolescents. METHODS: A systematic search on the PubMed and Embase databases was conducted to identify eligible studies. The last search was done on April 24th, 2020. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tools. RESULTS: Of the 997 articles identified, 31 articles were included in this review. Seven studies targeted students in preschools, seventeen in elementary schools, and seven in high schools. Most of these studies revealed positive outcomes. Some studies showed that the school-based oral health promotion programmes showed better OHK, OHB, OHS, and OHRQoL. CONCLUSION: Positive results were obtained through oral health promotion programmes in schools, especially those involving children, teachers, and parents.

Calcium Hydroxide Increases Human Umbilical Cord Mesenchymal Stem Cells Expressions of Apoptotic Protease-Activating Factor-1, Caspase-3 and Caspase-9.

PURPOSE: Calcium hydroxide is a gold standard dental material generally used for pulpal and periapical therapy including regenerative endodontic procedures because of its positive properties. However, evaluation about this material on stem cells is limited. Human umbilical cord mesenchymal stem cells (HUCMSCs) are potential to be used in regenerative therapy. Regenerative therapy needs a sustainable cell supply to maintain its regenerative capacity. The aim of this study was to ascertain the apoptosis result of calcium hydroxide on HUCMSCs through the expression of apoptotic protease-activating factor-1 (APAF-1), caspase-3, and caspase-9. MATERIALS AND METHODS: This study used a thawed frozen stock of passage 5 HUCMSCs, grown in minimum essential medium (MEM) alpha containing calcium hydroxide at concentration of 0.1 microgram/mL for 1, 3 and 7 days. Polyclonal antibody with fluorescence isothiocyanate (FITC) label was used to evaluate the expressions. APAF-1, caspase-3, and caspase-9 expressions were recorded and compared on every observation day using fluorescence microscope. Analysis of variance was performed to analyze the significance among the results of treatment groups. The results were concluded significant if p<0.05. RESULTS: The addition of calcium hydroxide in MEM alpha medium increases HUCMSCs expression of APAF-1, caspase-3 and caspase-9 significantly, compared to the control group without calcium hydroxide (p<0.05) in all the times. Day 1 showed the lowest increase followed by higher expressions on day 3 and day 7. CONCLUSION: HUCMSCs express increased APAF-1, caspase-3 and caspase-9 after in-vitro calcium hydroxide exposure. This should be considered when using calcium hydroxide on HUCMSCs for regenerative procedures with regard to other positive properties.

Maternal caries experience influences offspring's early childhood caries-a birth cohort study.

OBJECTIVE: To describe early childhood caries (ECC) patterns and evaluate the associations with maternal caries experience and other factors. METHODS: A secondary analysis was undertaken using data from the Study of Mothers' and Infants' Life Events Affecting Oral Health (SMILE), a population-based birth cohort study. It used data from 1040 mother/child dyads. Standardized oral examinations of the mothers and the children were conducted when children were 2-3 years old to determine the prevalence of ECC (main outcome) and maternal caries experience (main exposure variable). Maternal sociodemographic characteristics, time-restricting conditions (relationship status, work status and number of children in the household) and dental health behaviours (brushing frequency and sugary beverage consumption) served as covariates. Data on child dental health behaviours were collected at two years of age. Multivariable models were generated for ECC to estimate prevalence ratios (PR) for the association between ECC and maternal caries experience, controlling for the covariates. RESULTS: The prevalence of ECC among 2- to 3-year-old children was 10.6% (95%CI: 8.7%-12.5%). It was higher in children whose mothers had greater caries experience. Children whose mothers had higher caries experience had 86% (PR = 1.86 [1.27-2.72]) greater risk of having ECC than those whose mothers had low caries experience. Children whose teeth had not been brushed the night before had a higher risk of ECC (PR = 1.4 [1.01-1.9]) than their counterparts. Women born in Australia, New Zealand or the UK had offspring with lower risk of ECC. CONCLUSIONS: Maternal caries experience was an independent risk factor for offspring ECC. However, good oral health behaviours practised by mothers for their children may alleviate such risk. Mothers need to be supported to adopt good oral health behaviours and a healthy diet for their child.

Cytokines and Chemokines in Periodontitis.

Periodontitis is a common inflammatory periodontal disease affecting a wide range of population all over the world. The causing bacteria releases chemicals which activate the innate immune system to release proinflammatory cytokines contributing to more progression. This activates the acquired immune system leading to more progression of periodontitis. As the immune response goes on, released cytokines and chemokines can damage the periodontal ligaments, gingiva, and alveolar bone. There are many types of cytokines and chemokines in periodontitis. Cytokines are peptide mediators who are responsible for cell signaling and communication. Chemokines are a large subfamily of cytokines having the ability to coordinate leukocyte recruitment and activation. This paper is a narrative review of the literature.This review ensures that inflammatory mediators in the case of periodontitis can cause a noticeable damage in the whole apparatus of the periodontium. It causes soft tissue inflammation and bone damage affected by the mediators of both innate and acquired immune system.The inflammatory process is accompanied by large network of cytokines and chemokines. There is high expression of proinflammatory cytokines such as interleukin (IL)-1α, IL-1ß, IL-6, IL-12, tumor necrosis factor (TNF)-α, and regulatory cytokines such as IL-4, IL-1(RA) receptor antagonist, IL-10, and induced protein (IP)-10. There is also increased production of cytokines IL-10, IL-12, interferon-γ, IP-10, IL-1RA, and IL-4. Cytokines IL-17, IL-6, IL-1ß, TNF-α, macrophage colony-stimulating factor, and prostaglandin E2 trigger the osteoclast activity causing bone resorption.

The impact of oral health on physical fitness: A systematic review.

BACKGROUND: Oral health problems may have numerous effects on general health, including physical fitness and performance. In this review, we aimed to systematically review the available evidence to assess the effect of oral health on general physical fitness. METHODS: We systematically performed a literature search in two different databases (PUBMED and EMBASE) without restriction to the year of publication. Articles were included if the subjects were humans and the primary aim was to assess the effects of dental and/or oral health problems on physical activity using either objective physical measurements or physical performance tests. The quality of the studies was then assessed using a Joanna Briggs Institute (JBI) Critical Appraisal tool. RESULTS: A total of 2651 articles were initially retrieved from the systematic search of the literature. Of these, a final total of 11 articles following the inclusion criteria were included in the review. All of the 11 articles included in the review had good methodological quality. Of the 11 articles, ten articles suggested a correlation between dental and oral condition toward physical fitness, body balance, cardiorespiratory function, and also cognitive function. Only one article found contradictory results, which showed that periodontal conditions did not correlate with the cardiorespiratory function. Malocclusion, including the number of remaining teeth, was reported in five studies (45.4%), periodontal disease was evaluated in six studies (54.5%), along with slight evaluation of periapical inflammation. CONCLUSION: This review suggests that there is a negative effect of poor dental and/or oral health on physical fitness and performance.

Depression symptoms and recurrent aphthous stomatitis-Evidence from a population-based study in Indonesia.

OBJECTIVES: This study aims to report the prevalence and distribution of recurrent aphthous stomatitis (RAS) among Indonesian adults and to test the relationship between symptom of depression and RAS. METHODS: Data from the 2007 Indonesia Family Life Survey (IFLS 2007) were analysed to assess the association between symptom of depression and RAS. The prevalence of RAS in the previous month was self-reported. Symptom of depression was measured using the 10-item Center for Epidemiologic Studies Depression (CES-D) scale. The distribution of RAS according to age, sex and level of stress was also presented in the bivariate analysis. Multivariable logistic regression models were fitted to test associations between symptom of depression and RAS, controlling for age, sex and the stress level. RESULTS: The previous month prevalence of RAS in Indonesian population was 12%. The adjusted odds ratios (ORs) from the logistic regression models indicate that, for each unit increase in the CES-D depression score (range: 0-30), there was a 9% increase in the odds of having RAS (OR: 1.09, 95%CI: 1.08-1.10). Being older and being male was related with lower prevalence of RAS. CONCLUSIONS: A higher score of depression was related to a higher prevalence of RAS. This association was persistent even after controlling for age, sex and the level of stress.

Factors influencing the utilization of dental services in East Java, Indonesia.

Background: Despite high levels dental issues and insurance coverage in the East Java province Indonesia, the utilization of dental services is still low. This research aims to test whether certain individual-level sociodemographic, behavioural, and clinical characteristics influenced the current level of dental services utilization by East Java residents. Methods: A secondary analysis was undertaken using data on the East Java province from the Indonesian Basic Health Research 2013, which included 90,551 randomly selected respondents aged 5-100 years old. Socio-demographic characteristics (age, sex, education and residential location), dental behavior (tooth brushing habit), and clinical (dental) condition were self-reported through a questionnaire. Multivariable models were generated to estimate prevalence ratios (PR), and 95% confidence intervals (95% CI). Results: Prevalence of dental service utilization during the last 12 months in East Java province is only 9 %. Respondents 25-<50 years old showed the highest utilization of dental services. Being male, having lower education and living in a district (as opposed to municipalities) were indicators for having lower utilization of dental treatment (PR [95% CI] = 0.81 [0.79-0.84], PR [95% CI] = 0.89 [0.86-0.93] and PR [95% CI] = 0.91 [0.88-0.95], respectively). Respondents with poor tooth brushing habit showed lower utilization of dental services. Having teeth was associated with higher utilization of dental treatment (PR [95% CI] = 1.39 [1.16-1.66). Conclusions: Age, sex, education and residential location influence the utilization of dental services among Indonesia's East Java residents. Poor tooth brushing habits and being edentulous are also indicators of lesser utilization. These results call for urgent public health interventions to increase equitable dental care services utilization.