Effect of Quality of Dental Health Services to Patient Satisfaction in Indonesia 2019: Importance-Performance Analysis

ABSTRACT Objective: To determine the effect of the quality of dental health services based on dimensions of empathy and responsiveness to patient satisfaction in urban and rural areas in Bone District, Indonesia. Material and Methods: This survey used an analytical observational method with a pilot pathfinder survey design. The total of participants included in this survey was 442, with 223 in the urban area and 219 in the rural area. This survey was held on 25 February - 1 March 2019. The Mann-Whitney test was applied, adopting a significance level of 5%. Results: Empathy and responsive dimensions in urban (3.58 ± 0.94 and 3.50 ± 0.94) and rural (3.43 ± 0.99 and 3.63 ± 0.86) areas were in the moderate category. The administration staff was able to complete administrative procedures, and the Dental assistant responded promptly to the patient's request and needs. Conclusion: The quality of empathy and responsiveness dimensions in dental treatment fall in the moderate category for urban and rural areas; this means that empathy and responsiveness dimensions in dental service in hospital/public health need to be improved.

Factors that Influence the Use of Teledentistry in Indonesia During the COVID-19 Pandemic

ABSTRACT Objective: Evaluate the factors that influence the use of teledentistry during the COVID-19 pandemic in Indonesia. Material and Methods: An analytical observational study with a cross-sectional design with 163 respondents was conducted. The factors of using teledentistry studied in this study were knowledge, attitudes, beliefs, technology, benefits, and needs. The original questionnaire was constructed in English, later translated into Bahasa Indonesia, and modified to conform with Indonesian. Data analysis used univariate and bivariate (Chi-square test). Results: Respondents who have used teledentistry were 23.3%, while respondents who have never used teledentistry were 76.7%. There is no relationship between knowledge about teledentistry and the use of teledentistry (p>0.05). There is no relationship between the use of teledentistry and knowledge (p>0.05), attitudes (p>0.05), and beliefs (p>0.05). Conclusion: There were no factors associated with the use of teledentistry. The most influencing factor is the benefit of using teledentistry, which can affect the increase in the use of teledentistry during the COVID-19 pandemic.

Differences in Early Childhood Caries Status on Parental Stress Levels and Socioeconomic Status in Makassar City, Indonesia, During the COVID-19 Pandemic

Abstract Objective: To analyze the differences in early childhood caries status on parental stress levels and socioeconomic status in Makassar City, Indonesia, during the COVID-19 pandemic. Material and Methods: This type of analytical observational study with a cross-sectional design was conducted in North Rantepao, Toraja City, South Sulawesi Province, Indonesia. The research subjects of this study were parents who met the criteria, were willing to participate in the study, and had children aged 6-17 years. The questionnaire instrument with the criteria for assessing children's dental and oral health was assessed based on parents' perceptions. Each item is rated on a scale from 1 (never) to 5 (always). Then the total score was divided into three categories, namely low (score 3-6), moderate (score 7-10), and high (score 11-15). Comparative test analysis using Chi-Square test. Results: Parents with high-stress levels had more children with poor oral health. There is a significant difference according to the level of stress and socioeconomic status of the parents. Conclusion: There is a significant difference between caries status in early childhood based on socioeconomic status and parental stress level (AU).

Assessment of Patient Satisfaction Level to Dental Health Care Services in Indonesia

Abstract Objective: To know the level of patient satisfaction with dental healthcare services in Bantaeng, Indonesia. Material and Methods: This pilot pathfinder survey was conducted at Dental and Oral Health Services in Bantaeng and Pa'jukukang Sub-districts of Bantaeng Regency of South Sulawesi Indonesia. The Short-Form Patient Satisfaction Questionnaire (PSQ-18) scaled was used and it consists of 18 questions and seven subscales. The t-test and ANOVA were used with a significance level set at 5% (p<0.05). Results: The female participation (72.8%) was greater than the male (27.2). Regarding age, 74.6% were <40 years, 21.1% were between 40-60 years old and 4.4% were over 60 years old. On the subscale of technical quality, there was significant value in the age variable (p=0.45), education level (p=0.031), job (p=0.026), waiting time (p=0.46), distance to dentist=0.026), and location (p=0.007). There were significant values on the interpersonal aspect subscale that were present at age (p=0.016), education level (p=0.038), and occupation (p=0.007). The highest satisfaction score was found on the technical quality subscale (13.04 ± 1.75) and the lowest satisfaction score was seen on the general satisfaction subscale (4.11 ± 1.75). There was a significant difference between the value of patient satisfaction with age, education, and occupation. Conclusion: Patients from the District Bantaeng and Pa'jukukang Bantaeng regency of South Sulawesi were more satisfied with the service provided. The highest satisfaction score was found on the technical quality subscale and the lowest satisfaction score was found in the general satisfaction subscale (AU).

Analysis of the Total Level of Flavonoids in the Brown Algae ( Phaeophyceae ) Extract as Analgesic and Anti-Inflammatory Drugs

Abstract Objective: To determine the total level of flavonoids in brown algae extract Padina sp., Sargassum sp., and Turbinaria sp., which could serve as an analgesic and anti-inflammatory drug. Material and Methods: This is an experimental study with a one-shot case study research design. The study sample consisted of three species of brown algae, namely, Padina sp., Sargassum sp., and Turbinaria sp. The study samples were obtained from Saugi Island, Pangkep, Regency. The sampling method used was convenience sampling. The total flavonoid level in the three extracts of brown algae samples was determined at three concentrations (150 ppm, 300 ppm, and 450 ppm) with three replicates. The analysis used a colorimetric method, a spectrophotometer and aluminium chloride as the reagent. Results: The total level of flavonoids in Padina sp. was the highest at 0.894 ± 0.027%, compared to the levels of 0.786 ± 0.075% in Sargassum sp. and 0.745 ± 0.016% in Turbinaria sp. Conclusion: Padina sp. had the highest total flavonoid levels compared to Sargassum sp. and Turbinaria sp. Flavonoid compounds from brown algae have the potential to be used as analgesic and anti-inflammatory drugs.

Relationship Between Body Mass Index and Dental Age in 8-15-Year-Old Orthodontic Patients

Abstract Objective: To investigate the relationship between Body Mass Index (BMI) and dental age in 8-15-year-old orthodontic patients. Material and Methods: Forty-eight children (25 males, 23 females) aged 8-15 years requiring orthodontic treatment participated in this retrospective study. The dental development ages were determined using the Demirjian method and panoramic radiographs. Afterwards, chronological age, height, and weight were recorded. Using the standard equation developed by the Center for Disease Control and Prevention, BMI value was calculated and grouped according to BMI percentile classification according to age and gender. Data were analyzed using the Pearson correlation test. The level of significance was set at p<0.05. Results: Dental age was significantly accelerated in subjects with increased BMI percentile after adjusting for age and gender (p<0.05). The mean dental age among all subjects was 10.58 ± 2.40. The correlation coefficient (r) showed a strong correlation with a positive direction, which means that the dental age also accelerated by 44.6% in the subjects with increased BMI. Conclusion: There was a linear correlation between increased BMI with accelerated dental age. BMI value and dental age can be considered in determining orthodontic treatment time.

Differences in Quality of Life of Stunting Children based on Caries Status in Indonesia / Diferenças na qualidade de vida de crianças com nanismo baseado no status de cárie na Indonésia / Differences in Quality of Life of Stunting Children based on Caries Status in Indonesia

Objective: The aim of this study was to determine the difference in quality of life of stunting children in Enrekang District based on their caries status. Material and Methods: This study was an observational analitic study with a cross sectional design, conducted in Buntu Batu, Baraka, and Malua Sub-district of Enrekang District on April 29-May 3, 2019. Height measurements, def-t/DMF-T, pufa/PUFA assessment of stunting children 6-12 years old, and assessment of quality of life related to oral health of children 8-12 years using the CPQ questionnaire. Data were collected, 123 children suffered from stunting. Results: Based on the Mann Whitney Test, p value < 0.05 showed that there were differences that statistically significant on def-t and pufa to quality of life of 8-10 years. The p value > 0.05 indicates that there are no significant differences in def-t/ DMF-T and pufa/PUFA to quality of life of 11-12 years stunting children. Conclusion: There are differences in caries of primary teeth between stunting children aged 8 -10 years to their quality of life. At the age of 11-12 years there is no difference in caries to quality of life in Enrekang District.(AU)

Objetivo: O objetivo deste estudo foi determinar a diferença na qualidade de vida de crianças com nanismo no Distrito de Enrekang, com base no status de cárie. Material e métodos: Este estudo foi um estudo analítico observacional com um desenho transversal, realizado no Subdistrito de Buntu Batu, Baraka e Malua, no Distrito de Enrekang, de 29 de abril a 3 de maio de 2019. Medidas de altura, def-t/DMF-T, pufa/PUFA de crianças com nanismo de 6 a 12 anos, e avaliação da qualidade de vida relacionada à saúde bucal de crianças de 8 a 12 anos usando o questionário CPQ. Os dados foram coletados e 123 crianças sofriam de nanismo. Resultados: Com base no teste de Mann Whitney, o valor de p < 0,05 mostrou que houve diferenças estatisticamente significantes em def-t e pufa entre a qualidade de vida de 8 a 10 anos com nanismo em crianças com impacto e aquelas sem impacto, enquanto os valores de p = 0,05 e 0,295 apresentaram diferenças não significativas no DMF-T e no PUFA. O valor de p> 0,05 indica que não há diferenças significativas em def-t / DMF-T e pufa / PUFA entre a qualidade de vida de 11 a 12 anos com nanismo em crianças com impacto e aquelas que não têm impacto. Conclusão: Existem diferenças na cárie de dentes decíduos entre crianças com nanismo entre 8 e 10 anos que causam impacto e aquelas que não têm impacto na qualidade de vida. No entanto, não há diferença nos dentes permanentes. Na idade de 11 a 12 anos, não há diferença na cárie entre dentes decíduos e dentes permanentes entre aqueles que causam impacto e aqueles que não causam impacto.(AU)

Effect of Scaling and Root Planing Treatment on Levels Hs-CRP in Indonesian Patients with Risk of Cardiovascular Disease

Objective: To determine the effect of scaling and root planning treatment on levels of hs-CRP (C-reactive protein) in patients with risk of cardiovascular disease. Material and Methods: This research is an experimental research with one group pre- and post-test design. This research was performed to the periodontal patients who came to the clinic and have risk of cardiovascular disease. Medical evaluations included measurement of blood pressure and body mass index were performed. Blood samples were obtained from each subject after over night fasting, highsensitivity C-reactive protein was measured as an index of inflammation. Blood samples were analysed two times before treatment (scaling and root planning) and three weeks later. Statistical analysis used Paired t-test. The level of significance was set at 5%. Results: Means-CRP levels before and after treatment in scaling and root planning were 3.16 ± 2.37 and 2.18±1.56 (p=0.007). Conclusion: There are significant differences between hs-CRP levels before and after treatment.

Factors Affecting Dental Center Service Quality in Indonesia

Objective: To identify factors affecting dental center service quality in Bantaeng Regency, Indonesia. Material and Methods: This study used a pilot pathfinder design and analysed a sample of 114 subjects. Data were collected using a questionnaire designed for the study based on model of service quality which consists of two parts: the subject's demographic characteristics and a 30 item questionnaire to measure the five dimensions of the service quality, include tangibility (7 question), reliability (9 question), responsiveness (6 question), assurance (4 question) and empathy (4 question). Five points Likert Scale were used to evaluate all dimension in questionnaire (1= strongly disagree, 5=strongly agree). The data were analyzed using SPSS 24.0 and Amos 18.0 to get the mean, standard deviation and confirmatory factor. Results: The most important thing of each dimensions were "the clinic employees should be clean, neat, tidy and appropriate to their professions"(4.08) on tangibility, "The dentist should give patients useful and necessary advice for preventing them from other diseases" (4.12) on reliability, "A secretary should always be accountable for arranging the time of treatment session by phone or in person" (4.06) on responsiveness, "In a good dental clinic, the employees should always behave towards patients with respect and courtesy and ensure their privacy" (4.11) on assurance and "The clinic employees should pay particular attention to each patient's costs of dental services and should be assured that they are affordable for patients" (4.22) on empathy. Results showed that tangibility, reliability, and assurance have the highest effect on dental service quality in Bantaeng District. Meanwhile, the responsiveness dimensions have the lowest effects. Conclusion: Assurance, reliability, tangibility/physical condition are the factors affecting dental service quality in Bantaeng Regency.

Identification of Lead Exposure Through Saliva and the Occurrence of Gingival Pigmentation at Fuel Station Indonesian Officers

Objective: To identify the exposure of lead through saliva and the presence of gingival pigmentation in the risk group. Material and Methods: The type of this research is analytic observational with cross-sectional study design. The sample consisted of 40 subjects, who were divided into two groups of 20 each: G1: Gasoline Fuel Station and G2: Officer in Dental Hospital. To determine the level of leads in saliva is measured by atomic absorption spectrophotometry and assessment of the severity of lead-gingival lead line in this study based on the area of the gingival surface based on the number of dental areas. The data were analyzed with the t-test and Chi-square test. The level of significance was set at 5%. Results: The average lead content in saliva group exposed was 6.66 µg / ml and control group 4.72 µg / ml (p≤0.05). There is a correlation between gingival lead line incidence with exposure to lead (OR = 3.33; p = 0.001). Conclusion: The identification of exposure to lead poisoning can be determined by examination in saliva and ginggiva state, it is proven that the risk of gingival lead (Ginggival Lead Line) in the worker group at the gas station station is 3.3 times more risk than the control group. Occupational safety factors are important for workers at high risk of exposure to the element of lead for additional education on the importance of using masks to prevent the severity of the occurrence of lead effects on overall health.

Relationship Between Health Service Access to Dental Conditions in Urban and Rural Areas in Indonesia

Objective: To determine relationship between access to dental health services with dental health conditions of adult communities in urban areas represented by Somba Opu and rural districts represented by Patalassang subdistrict in Gowa subdistrict. Material and Methods: This was pilot pathfinder survey, conducted in Gowa District in April 2018 with 420 subjects. Data were collected using a CoHRE questionnaire. Information regarding gender, age and location (rural and urban), transportation (public and private), toothache in past one year, dental treatment in past one year, dental treatment frequency (regular and irregular), smoking, alcohol consumption, routine activity, drugs intake, oral problems, driving car, distance to health facility (near and far) were collected. The number of teeth was dichotomized to less than 20 and 20 or more. Data were analyzed using Chi-square test and the level of significance was set at 5%. Results: In the urban area there was an association between routine activities with dental health conditions (p=0.002). There is no significant association between distance or access to health care facility with dental condition in adult society in urban area (p>0.05). In rural area there is a significant association between distance or access to health care facility with dental condition (p=0.046). Conclusion: There is an association between access to dental health services with dental health conditions of adult communities in urban areas represented by Somba Opu and rural disparities represented by Patalassang subdistrict in Gowa district.

Gender and Age Differences in Patient Satisfaction with Dental Care in the Urban and Rural Areas of Indonesia: Pilot Pathfinder Survey

Objective: To know the difference of patient satisfaction to dental service based on gender and age in urban and rural area of Gowa regency of South Sulawesi, Indonesia. Material and Methods: This study used pilot pathfinder survey design, conducted in Gowa regency in April 2018. The sample consisted of 420 participants. Data were collected using a satisfaction III questionnaire that has been designed in accordance with a survey of fifty-one questions. Questionnaires are divided into seven subscales: General Satisfaction, Technical Quality, Interpersonal Aspect, Communication, Financial Aspect, Time Spent with Doctors, Access / Availability / Convenience. The level of satisfaction was analyzed using t independent test. The level of significance was set at 5%. Results: In dental and oral health services in urban areas there was a significant difference of satisfaction level between males and females group >35 years and in rural area there was difference of satisfaction level significant between mals and females based on communication aspect in age group ≤35 years and there is no significant difference of satisfaction level between urban and rural area. Conclusion: There is difference of satisfaction level between males and females based on technical and communication quality aspect and there is no difference of level of satisfaction between urban and rural area.

Knowledge and Self Perception about Preventive Dentistry among Indonesian Dental Students

Objective: To investigate the knowledge and self-perception of Indonesian dental students in giving oral health education and preventive treatment. Material and Methods: This was a cross sectional study, with 208 clinical students (54 males and 154 females). Knowledge and self-perception of preventive dentistry was assessed using multiple choice questionneire based on a four-point likert scale written in Indonesia, at Dental Hospital of Hasanuddin University. Assessment of preventive dentistry knowledge on clinical students by answering 14 questions, while self-perception in providing oral health education and preventive treatment was assessed using general questions. Statistical evaluation was done using Chi-squared test and t test. The significance level was set at 5%. The analyses were performed with SPSS 12 statistical package. Results: Both male and female students are reported to have high competence in giving oral health education and preventive treatment (94-99%), but there was no significant difference between genders (p>0.05). Almost all questions were answered by agree or strongly agree. 75% of study participants disagreed with the statement that the use of fluoride toothpaste is more important than the brushing technique for dental caries prevention (PK2, p<0.05). Conclusion: The perceptions of clinical students participating in the study have high competence (94-99%) in providing education and preventive care to their patients, but there is still a lack of prevention knowledge.

Relationship Between Stress Level, Fatigue Symptoms, and Sleep Quality with Oral Health Behavior among Preclinical Student Faculty of Pharmacy, Indonesia

Objective: To determine the association of the stress level, fatigue symptoms, and sleep quality with oral health behavior of preclinical pharmacy students. Material and Methods: Observational analytic study surveyed the students of the Faculty of Pharmacy of Hasanuddin University. From the total 205 sample of pharmacy students, 77 students drawn from the 2017 year of study, 68 students from the 2016 year of study, and 60 students from the 2015 year of study. The study consisted of 4 questionnaires, which are Perceived Stress Scale, Fatigue Assessment Scale, Karolinska Sleep Questionnaire and questions that assess oral health behaviors reported per individual. Data were collected and analyzed statistically using Chi-square test and Fisher's exact test. The level of significance was set at 5%. Results: The percentage of oral health behaviors in terms of the frequency of tooth brushing, use of dental floss, use of tongue cleaner and use of mouthwash increase as the year of study. In contrast to the percentage of stress level, awakening difficulties symptoms, sleep disturbance symptoms, daytime sleepiness symptoms and fatigue symptoms tended to decrease according to the year of study. Significant associations found among students who are under stress with the frequency of dental floss (p<0.05). However, no significant association was found between the fatigue symptoms, awakening difficulties symptoms, sleep disturbance symptoms, and daytime sleepiness symptoms with oral health behavior (p>0.05). Conclusion: There is an association between stress levels with the use of dental floss.

Evaluation of Patient Satisfaction on Quality of Public Dental Health Service from Different Dimensions in Indonesia

Objective: To verify user satisfaction with oral public health services in different treatment dimensions and relate them to demographic conditions. Material and Methods: This study using pilot pathfinder design, conducted in Bantaeng Regency in January 2018. The sample consisted of 114 participants. Data were collected using structured questionnaires, which have been designed according to this survey which has eighteen questions corresponding to the object, with response patterns: satisfied, more or less and dissatisfied. Questions about satisfaction with services are grouped into five domains - 'physical structure', 'relationships and communication', 'information and support', 'health care' and 'service organization'. Satisfaction was analyzed by using Chisquare test. Significance level set at 5%. Results: In dental and oral health centers in Bantaeng District the physical structure dimension showed the highest level of satisfaction, while the dimensions of dental and oral health care showed the lowest satisfaction. Conclusion: Communities in Bantaeng and Pa'jukukang Sub-districts of Bantaeng Regency are mostly satisfied with dental and oral health services based on health service dimensions. On the physical structure dimension shows the highest level of satisfaction, whereas the dimension of dental and oral health care shows the lowest satisfaction.