Perception of Special-Care Dentistry among Dental Students at Universitas Indonesia: A Cross-Sectional Study.

OBJECTIVE: To assess the perceptions of special-care dentistry (SCD) among dental students in the Faculty of Dentistry, Universitas Indonesia, Indonesia. METHODS: This cross-sectional study used a self-administered online questionnaire, and all preclinical and clinical students were invited to participate. The survey items comprised four domains related to participants' characteristics, perceptions of SCD, perceptions of managing patients with special needs, and perceptions of SCD education. The chi-square test and Mann-Whitney test were used in the analysis. RESULTS: A total of 572 students participated in this study. The findings showed that the clinical students were more familiar with SCD than the preclinical students were (p = 0.008). A statistically significant relationship was found between the study program and the ability to work independently with special-needs patients after graduation (p < 0.001), the ability to refer special-needs patients to specialists (p = 0.042), the perception of postgraduate training-program needs (p < 0.001), and the opportunity to consider postgraduate training (p = 0.004). CONCLUSION: Most of the respondents had a favorable perception of SCD. Thus, an improved SCD curriculum and SCD training for undergraduate and postgraduate students should be provided to develop the knowledge and skills needed to provide care to special-needs patients.

Determinants and inequality of recurrent aphthous stomatitis in an Indonesian population: a cross sectional study.

INTRODUCTION: Recurrent Aphthous Stomatitis (RAS) is the most common type of ulceration in the oral cavity which can occur due to several factors. AIMS: To determine the factors related to the incidence of RAS and examine the social class inequality in RAS among the Indonesian population using data from the fifth wave of the Indonesian Family Life Survey (IFLS5) in 2014. METHODS: This study is a descriptive study with a cross-sectional design using secondary data from IFLS5 data in 2014 (n = 28,410). Socio-economic position (SEP) was calculated by Adult Equivalent Scale and categorized into 4 classes. Outcome is RAS. Mediating factors were psychosocial (stress), eating behavioral (food consumption), and systemic diseases. Descriptive analysis, chi-square and a series of logistic regressions were performed to analyze the data. Odds ratio (OR) and 95% confidence interval (CI) were used to report the results. RESULTS: Only 18.39% of IFLS5 respondents experienced the incidence of recurrent aphthous stomatitis in 2014. The bivariate (chi-square) results showed that there was a relationship between the incidence of RAS and the related independent variables. Logistic regression showed the highest possibility of RAS in respondents aged 18-34 years, female, unmarried, high school education level, living in the city, having frequent stress levels, having food habits that frequently drinking soda, sweet foods, chili sauce, fried food and has systemic diseases such as, asthma, cancer, rheumatism, and digestion. The lowest SEP group had the highest probability of occurrence of RAS over the other groups among the different models. CONCLUSIONS: There are several factors that determine the incidence of RAS. There was a monotonic gradient of inequality in RAS according to SEP group. This study might be useful to provide information regarding the relationship of determinants factors with the incidence of RAS to prevent it and promote oral health in the future.

Validation of self-reported oral health among Indonesian adolescents.

BACKGROUND AND AIM: With the recognition of health as a subjective state, self-reported oral health has been applied in many epidemiological studies. However, the validity of self-reports may vary across different age groups and socio-cultural backgrounds and by using different tools. This study aimed to assess the validity of self-reported oral health of 15-year-old Indonesian adolescents. MATERIALS AND METHODS: This study used data from the Indonesian National Oral Health Survey, a part of the Indonesian Basic Health Survey 2018. The study included 572 15-year-old Indonesian adolescents. We compared the presence of clinically assessed dental caries, tooth loss, and fillings following the World Health Organization Basic Health Survey method and questionnaire-based self-reported oral conditions using McNemar test. The sensitivity (Sn), specificity (Sp), and likelihood ratios (LRs) of self-reports were calculated using clinical assessment as the reference standard. The overall accuracy of self-reports in identifying the clinical condition was assessed using the area under the curve (AUC) of a receiver operating characteristic curve. RESULTS: Self-reports significantly underestimated the clinical presence of caries (39.3% and 67.1%) and overestimated the clinical presence of tooth loss (9.3% and 4.2%) and filling (4.7% and 2.4%, p < 0.05). All self-reported conditions had higher Sp (at least 70.3%) than Sn (max 54.2%) and the AUC for all self-reported conditions were < 0.7. Self-reporting the presence of fillings had the highest LR+ = 11. CONCLUSIONS: Self-reporting oral health in Indonesian adolescents had low accuracy. Further studies of other methods of self-reporting are needed before they can be used to assess adolescents' oral health in epidemiological surveys.

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.

The Relationships Among Oral Health Practices, Early Childhood Caries, and Oral Health-related Quality of Life in Indonesian Preschool Children: A Cross-Sectional Study.

OBJECTIVES: This study aimed at evaluating the relationships among oral health practices, early childhood caries (ECC), and oral health-related quality of life (OHRQoL) in five-year-old children in Indonesia. MATERIALS AND METHODS: Overall, 266 parent-child pairs (PCPs) from preschools in Jakarta participated in a cross-sectional study. The ECC was clinically assessed by two calibrated screeners using the decayed, missing, and filled teeth (dmft) and the pufa index, which records the presence of severely decayed teeth with visible pulpal involvement (p), ulceration caused by dislocated tooth fragments (u), fistula (f), and abscess (a). The parents of the participating children completed the self-administered questionnaire comprising SOHO-5p and their oral health practices. The SOHO-5c questionnaire was used to interview the children. RESULTS: The prevalence of ECC was 88.7%, with 35% having pufa index scores greater than 0. There were significant relationships among oral health practices, ECC, and the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) scores. There was also a significant relationship between cariogenic food consumption and the dmft and SOHO-5p scores. There was a significant relationship between ECC and the SOHO-5 scores. All the SOHO-5p variables except smile avoidance because of appearance had a significant relationship with the dmft and pufa variables. Eating and sleeping difficulties were significantly related to the dmft and pufa scores. CONCLUSION: OHRQoL was found to be related to the dmft and pufa scores, and the parents' perceptions were more strongly correlated than the children's. No significant difference was found in the perceptions indicated by the SOHO-5p and SOHO-5c scores. This suggests that parents can be used as proxies regarding their children's OHRQoL.

Impact of a 7-Day Field Training on Oral Health Condition in Japan Ground Self-Defense Force Personnel.

INTRODUCTION: In the Japan Ground Self-Defense Force (JGSDF), personnel periodically perform intensive training that mimics the conditions seen in battle and during natural disasters. Military training involves intensive, stressful conditions, and changes in immune responses have been found in personnel following training. Good oral condition is important for military personnel to fulfill their duties; however, they have difficulty performing daily oral care under training conditions. In this study, we investigated the impact of a 7-day field training on the oral health status of JGSDF personnel by comparing their oral condition before and just after training. MATERIALS AND METHODS: The participants were 59 male and 3 female JGSDF personnel undergoing a 7-day field training. All personnel provided informed written consent to participate, and this study was approved by the ethics committee of the Kagoshima University Graduate School of Medical and Dental Sciences. Oral health behaviors before and during the training period were surveyed using a self-administered questionnaire. Dental caries was assessed before training in terms of decayed, missing and filled teeth (DMFT), and periodontal condition was examined before and immediately after training using the community periodontal index (CPI). The presence of eight species of bacteria in dental plaque, including commensal streptococci that are early colonizers on the tooth surface, cariogenic bacteria, and periodontopathic bacteria, was determined using real-time polymerase chain reaction. We also assessed antibacterial factors and a stress marker in saliva samples. Sample collection was performed before and just after training. In addition to difference analysis between groups, logistic regression analysis was performed to examine the association between each health behavior and periodontal deterioration. RESULTS: The frequency of toothbrushing decreased, and snacking increased during the training period. Thirty-five personnel (56.5%) showed an increase in individual CPI code, and 57 personnel (91.9%) showed deterioration in the CPI code in 1 or more sextants after training (Figure 1). Toothbrushing frequency was significantly associated with CPI deterioration; the odds ratio in subjects who did not brush their teeth was 7.51 compared to those who brushed at least once during the training period. Severe periodontal deterioration was observed in the high-DMFT group (Figure 2), and toothbrushing frequency during the training period decreased more in this group compared to the low-DMFT group. The percentages of Streptococcus sanguinis and Streptococcus gordonii increased significantly after the training period suggesting dental plaque maturation, and an increase in S. sanguinis was associated with toothbrushing frequency. The lactoferrin concentration in saliva increased significantly after training. CONCLUSIONS: We demonstrated periodontal deterioration in JGSDF personnel after a 7-day training. Behavioral changes, especially discontinuation of regular toothbrushing, fostered dental plaque maturation, resulting in inflammatory changes in participants' periodontal condition. The results indicate the importance of performing toothbrushing at least once over a 7-day training period for prevention of periodontal deterioration. The regimen could be applicable to evacuees from disasters because they are under conditions of stress that may limit oral hygiene activity.

Recombinant Sox Enzymes from Paracoccus pantotrophus Degrade Hydrogen Sulfide, a Major Component of Oral Malodor.

Hydrogen sulfide (H2S) is emitted from industrial activities, and several chemotrophs possessing Sox enzymes are used for its removal. Oral malodor is a common issue in the dental field and major malodorous components are volatile sulfur compounds (VSCs), including H2S and methyl mercaptan. Paracoccus pantotrophus is an aerobic, neutrophilic facultatively autotrophic bacterium that possesses sulfur-oxidizing (Sox) enzymes in order to use sulfur compounds as an energy source. In the present study, we cloned the Sox enzymes of P. pantotrophus GB17 and evaluated their VSC-degrading activities for the prevention of oral malodor. Six genes, soxX, soxY, soxZ, soxA, soxB, and soxCD, were amplified from P. pantotrophus GB17. Each fragment was cloned into a vector for the expression of 6×His-tagged fusion proteins in Escherichia coli. Recombinant Sox (rSox) proteins were purified from whole-cell extracts of E. coli using nickel affinity chromatography. The enzyme mixture was investigated for the degradation of VSCs using gas chromatography. Each of the rSox enzymes was purified to apparent homogeneity, as confirmed by SDS-PAGE. The rSox enzyme mixture degraded H2S in dose- and time-dependent manners. All rSox enzymes were necessary for degrading H2S. The H2S-degrading activities of rSox enzymes were stable at 25-80°C, and the optimum pH was 7.0. The amount of H2S produced by periodontopathic bacteria or oral bacteria collected from human subjects decreased after an incubation with rSox enzymes. These results suggest that the combination of rSox enzymes from P. pantotrophus GB17 is useful for the prevention of oral malodor.