Perceptions of Online Learning Implementation in Dental Education during the COVID-19 Pandemic: A Cross-Sectional Study of Dental School Faculty Members in Southeast Asia.

OBJECTIVE: To assess the perceptions of faculty members from dental schools in Southeast Asian countries regarding the implementation of online learning during the COVID-19 pandemic. METHODS: A previously implemented questionnaire comprising 43 questions was utilized in this study. Lecturers from four universities in Southeast Asia were invited to participate in the study. STATISTICAL ANALYSIS: The data were analyzed using SPSS version 25.0 through several types of comparative and correlation analyses. RESULTS: There were 183 lecturers who participated in the study. The overall responses suggest that the perceived effectiveness of online learning in dentistry was centered on a neutral value. The participants faced challenges when implementing online learning during the COVID-19 pandemic, with the lack of interaction being the most challenging factor. They agreed that online learning had many advantages, specifically in time flexibility and communication. The participants had stronger perceptions relating the advantages and opportunities of online teaching, and recognized that the effectiveness of offline teaching alone was limited. CONCLUSION: The perceptions of Southeast Asian dental school faculty members were inclined toward a positive outlook on blended learning for implementation in dentistry, as a means of providing opportunities to use online learning beyond COVID-19 in the future.

Awareness, Attitudes, and Perceptions of Oral Healthcare among First Year Dental, Medical, and Nursing Students.

BACKGROUND: It has been reported that poor oral health can worsen general health conditions. Good collaboration between health professionals is important to provide proper oral healthcare. Thus, there is a need for oral healthcare interprofessional education (IPE). This study aimed to determine the baseline level of awareness, attitudes, and perceptions of oral healthcare among first-year students of dentistry, medicine, and nursing at Universitas Indonesia. METHOD AND PARTICIPANTS: A cross-sectional descriptive analytical study using a previously published questionnaire was conducted involving 442 students, consisting of dental students (DS), medical students (MS), and nursing students (NS) in Universitas Indonesia. RESULTS: Most students have shown good oral healthcare awareness, attitudes, and perception with no statistically significant difference between the groups (p < 0.05). The majority of the students did not perceive that (1) geriatric and nursing knowledge are required to practice oral care, (2) oral healthcare should be provided in cancer hospitals, and (3) oral healthcare can prevent cardiovascular disease and improve anorexia. CONCLUSIONS: This study showed that there were aspects of oral healthcare that should be improved in all student groups. Thus, oral healthcare IPE should be given to all students working in healthcare to develop knowledge and interprofessional collaboration in oral healthcare.

Awareness and Attitudes of Dental Students toward Older Adults in Indonesia.

In this study, we aimed to analyse the awareness and attitudes of dental students (DS) toward older adults (OAs) in Indonesia. Compromised oral health (OH) among OAs is a significant public health problem that is a global health burden. Furthermore, appropriate education can provide DS with information about strategic and efficient treatments for OAs. An online invitation was provided to every dental student in Indonesia in the third to sixth year of study to answer a web-based questionnaire as a part of a survey on awareness and attitudes (14 questions) towards OAs. From 1288 valid forms submitted, it was evident that most students (87%) expressed a positive attitude toward OAs. Female students showed a more positive attitude compared to males, with an odds ratio of 1.539 (p = 0.036), and students who had a connection to an older adult demonstrated a more positive attitude than those who did not (OR = 2.076; p < 0.001). The majority of the DS (98%) were conscious of the importance of geriatrics in dentistry, with female students showing more awareness than their male counterparts (OR = 2.553; p = 0.033). Positive awareness and attitudes must be accompanied by knowledge so that DS can offer appropriate and effective oral care to geriatric patients.

Indonesian Dentists' Perception of the Use of Teledentistry.

INTRODUCTION: Teledentistry is the use of information and communication technology to provide dental services from distant locations. The use of teledentistry is highly beneficial in the COVID-19 pandemic era. OBJECTIVE: This study aimed to explore Indonesian dentists' perceptions of the use of teledentistry in their daily practice and the benefits for patients. METHODS: This was a descriptive cross-sectional study comprising an electronic survey of Indonesian dentists. We used a cross-cultural, adapted questionnaire that consisted of 26 items and 5-point Likert scale questions that evaluated dentist perception in the following 4 domains: usefulness of teledentistry for dental practice, usefulness of teledentistry to improve practices, usefulness of teledentistry for patients, and dentists who had concerns about the use of teledentistry. RESULTS: A total of 652 dentists from 34 provinces in Indonesia participated in this study. The majority of respondents agreed about the usefulness of teledentistry in dental practice, especially for saving time, compared to referral letters (87%). Most respondents recognised the utility of teledentistry for improving dental practice and its benefits for patients. Nevertheless, most of the dentists had concerns about teledentistry in terms of digital forgery concern (74.2%) and technical incompatibility (71.8%). CONCLUSIONS: Indonesian dentists reported their positive perception of the usefulness of teledentistry for improving dental practice and benefits for patients, although some concerns were still present. Further studies on the application of teledentistry in Indonesia are still needed.

Indonesian Dental Students' Attitudes, Knowledge, Preparation, and Willingness to Treat HIV/AIDS Patients.

OBJECTIVE: To assess the Indonesian dental students' knowledge of HIV/AIDS in terms of transmission and oral manifestation, the attitudes toward people living with HIV/AIDS (PLWHA), the preparedness in infection control, and willingness to treat PLWHA, and assess the factors for willingness to treat PLWHA. MATERIALS AND METHODS: A modified version of a questionnaire used to assess dental students' knowledge, attitude, preparedness, and willingness to treat PLWHA in China was used. The questionnaire was cross-culturally adapted into Indonesian and had been pre-tested for face validity and test and retest reliability. The dental students from 32 dental schools in Indonesia were invited to participate in the study. RESULTS: A total of 1,280 dental students from 23 dental schools participated in the study. This study found that only 63% of students scored higher than 70% for knowledge of HIV/AIDS, and the mean score for knowledge was 15.02 (2.4). Higher than 80% of students had a positive professional attitude toward PWLHA; however, 80% of students worried about possible disease transmission in the dental office by PLWHA and 70% of students overestimated the occupational risk when treating PLWHA. The dental students had good preparedness for infection control with a mean score for preparedness of 3.19 (0.4). The mean score for willingness was 2.5 (0.9). Willingness to treat significantly differed by the type of universities, gender, age, and clinical experience. This study showed that knowledge about HIV/AIDS correlated with the willingness to treat PLWHA among dental students. CONCLUSION: Dental students who have good knowledge about HIV infection tend to have a good willingness to treat PLWHA. The knowledge would in turn affect their attitude, preparedness, and willingness to provide care for PLWHA with confidence and comfort. This study suggests that the improvement of dental training may play an important role in changing students' perception of willingness to treat PLWHA.

Knowledge and Practice Regarding Oral Cancer: A Study Among Dentists in Jakarta, Indonesia.

OBJECTIVE: To assess Indonesian dentists' knowledge of risk factors and diagnostic procedures related to oral cancer (OC) and to determine the factors that influenced their level of knowledge. METHODS: A modified version of a questionnaire that had been used to assess dentists' knowledge regarding OC in Canada was used. A total of 816 dentists were invited to participate in the study. RESULTS: The total response rate was 49.2%; however, the number of dentists from 5 regions in Jakarta were equally represented. Use of tobacco or alcohol and history of previous OC were the top 3 risk factors that were answered correctly by dentists, but there was a high proportion of dentists who considered some without any evidence as risk factors. Almost half of the dentists did not know the early signs of OC and that erythroplakia and leukoplakia were associated with increased risks of developing OC. Only about 27% of dentists had a high level of knowledge of risk factors and fewer dentists demonstrated a good knowledge of diagnostic procedures. Dentists' age group, year of graduation, and experience of continuing education significantly influenced the level of knowledge of diagnostic procedures (P < .05). CONCLUSION: Dentists in Jakarta had a considerable level of knowledge of major risk factors of OC, although some gaps in their knowledge, especially in diagnostic procedures, were present. Increasing these competencies may aid in the prevention and early detection of OC.

The validity and reliability of the Indonesian version of the Summated Xerostomia Inventory.

OBJECTIVE: To validate and determine the reliability of the Indonesian version of the Summated Xerostomia Inventory (SXI-ID) questionnaire. BACKGROUND: Xerostomia is a common problem in older people, and the SXI is increasingly being used to measure it. MATERIALS AND METHODS: The SXI questionnaire was cross-culturally adapted to create an Indonesian version (SXI-ID), which was assessed for validity and reliability in a cross-sectional study of older adults living in nursing homes in Jakarta, Indonesia. Each participant signed an informed consent and was interviewed with the SXI-ID. A subset of participants was interviewed again after two weeks. A standard question was used to check criterion-related validity, by plotting the mean SXI-ID scale scores against the ordinal response categories of the standard question. The reliability check included Cronbach's alpha, total and inter-item correlation, and intraclass correlation for internal consistency, along with test-retest reliability. RESULTS: A total of 110 older adults participated. Cronbach's alpha value for the SXI-ID was .85, and the intraclass correlation coefficient value for test and retest in 15 participants was .9. The SXI-ID total score showed a strong positive correlation (.87) with the global question. There was a consistent ascending gradient in mean SXI-ID scores across the ordinal response categories of the global item. CONCLUSION: The SXI-ID is psychometrically valid and reliable for measuring xerostomia in the Indonesian population.

Student perspective of classroom and distance learning during COVID-19 pandemic in the undergraduate dental study program Universitas Indonesia.

BACKGROUND: The COVID-19 pandemic has become a global health issue and has had a major impact on education. Consequently, half way through the second semester of the academic year 2019/2020, learning methods were delivered through distance learning (DL). We aimed to evaluate the student perspective of DL compared to classroom learning (CL) in the undergraduate dentistry study program at the Faculty of Dentistry Universitas Indonesia. METHODS: An online questionnaire was sent at the end of the semester. A total of 301 students participated in the study. RESULTS: Duration of study influenced student preference. Higher number of first-year students preferred DL compared to their seniors (p < 0.001). Students preferred CL for group discussion, as DL resulted in more difficult communication and gave less learning satisfaction. Only 44.2% students preferred DL over CL, although they agreed that DL gave a more efficient learning method (52.6%), it provided more time to study (87.9%) and to review study materials (87.3%). Challenges during DL included external factors such as unstable internet connection, extra financial burden for the internet quota and internal factors such as time management and difficulty to focus while learning online for a longer period of time. CONCLUSION: Despite some challenges, dental students could adapt to the new learning methods of full DL and the majorities agreed blended learning that combined classroom and distance learning can be implemented henceforth. This current COVID-19 pandemic, changes not only the utilization of technology in education but the pedagogy strategies in the future.

Mothers Knowledge and Behaviour Towards Oral Health During Pregnancy

Abstract Objective: To evaluate the knowledge and behaviour of mothers in maintaining their oral health during pregnancy. Material and Methods: This study included 167 women in five community primary health centres in Central Jakarta whose last child ranged between 0-59 months. The participants were asked to fill the questionnaire "Knowledge and Behaviour Towards Oral Health during Pregnancy" (KBOHP). This questionnaire assessed the knowledge and behaviour in maintaining oral health during pregnancy. Results: Almost 80% of participants reported that they had government dental health coverage. Only about 16% of participants reported that they visit dentist before pregnancy and only about 32% of the participants reported to have oral health problems during pregnancy. Although they have oral health problems, only 18% of them visited the dentists during pregnancy. Only 33% of the participants knew that the periodontal problems can affect pregnancy outcome, and 54.5% of participants had never heard of a possible connection between oral health and pregnancy. About 74% of participants reported that they never had specific oral health care instruction during pregnancy. Participants who received oral health instruction from their health providers also tend to have dental visit during pregnancy. Conclusion: Knowledge and behaviour towards oral health during pregnancy in this population was still low. A program that is developed to improve knowledge and behaviour in maintaining oral health during pregnancy is needed.

Psychometric Analysis of the European Medical Risk-Related History Questionnaire within Indonesian-Speaking Population.

OBJECTIVES: Medical complications during dental treatment are increasingly anticipated because advances in medical treatment have prolonged life expectancy. Therefore, a thorough analysis of medical history data to assess the medical risks that may occur before, during, and after dental procedures is required. The European Medical Risk-Related History (EMRRH) questionnaire has been used in 10 European countries to detect medical problems and determine the risks of complications. However, no similar questionnaire has been developed for Indonesian patients. This study aimed to develop an Indonesian version of the EMRRH questionnaire and analyze its psychometric properties. MATERIALS AND METHODS: The EMRRH questionnaire was utilized and processed for cross-cultural adaptation according to the Beaton guidelines. The final version was used after completing all of the steps of cross-cultural adaptation. The psychometric property analysis was performed by measuring the validity, reliability, sensitivity, and specificity of the questionnaire in 172 dental patients using cross-sectional survey at the National Drug Rehabilitation Center. RESULTS: The content validity was first measured by an internist and anesthesiologist, and the coefficient was 0.91. The construct validity assessment revealed significant associations for five of six global questions (P < 0.05). Cronbach's alpha coefficient for internal consistency was 0.790. The test-retest reliability results were excellent based on reevaluation in 17 patients (intraclass correlation coefficient = 0.846), including sensitivity and specificity values of 69.31% and 92.2%, respectively. CONCLUSION: The Indonesian version of the EMRRH questionnaire is valid, reliable, sensitive, and specific for this population. Further study to explore its use in larger Indonesian populations is needed.

Oral Cancer Knowledge among a Sample of Elderly People in Depok City, West Java, Indonesia

Objective: To determine the level of knowledge concerning oral cancer among a sample of elderly people with various sociodemographic characters, behavior, and dental visits in Depok City, Indonesia. Material and Methods: A cross-sectional study of oral cancer awareness was conducted among 100 elderly people in Depok City using an intervieweradministered questionnaire. We collected information regarding sociodemographic data regarding age, gender, marital status, education, health insurance, risk factors and early signs of oral cancer, and questions related to lifestyle factors relevant to oral cancer, including smoking, drinking alcohol, tobacco chewing, betel quid chewing, and dental visits. Data were analyzed through the Statistical Package for Social Sciences and presented through descriptive and inferential statistics. Statistical significance level was set at p<0.05. Results: 64% of respondents have poor knowledge of the oral cancer risk factors, while only 25% of respondents have sound knowledge of the early signs of oral cancer. There was a significant difference in the level of oral cancer knowledge according to gender (p=0.01), level of education (p=0.008), smoking behavior (p=0.03), and dental visits (p=0.01). Conclusion: The oral cancer knowledge among elderly people in Depok City is still lacking. Further, some sociodemographic factors influence the level of oral cancer knowledge.

Saliva-Based Screening of High-Risk Human Papillomavirus Strains: Detection in Female Indonesian and Thai Dental Students.

BACKGROUND: Currently it is believed that human papillomaviruses (HPV) are associated with the development of some oral/oropharyngeal cancers. It has been suggested that these viruses influence carcinogenesis in both smokers and non-smokers. Data on the prevalence of HPV in healthy adults are thus needed to estimate the risk of oral/oropharyngeal cancer. The aim of this study was to assess the prevalence of oral HPV in healthy female adults in Indonesia and Thailand. MATERIALS AND METHODS: Healthy female students from the Faculties of Dentistry of Universitas Indonesia and Chiang Mai University were asked to participate in this pilot study. DNA was extracted from saliva specimens and screened for HPV16 and HPV18 using PCR. RESULTS: The age, marital status and sexual experience of the subjects between the two countries were not significantly different. Eight (4%) and 4 (2%) samples were positive for HPV16 and HPV18, respectively. Fisher's Exact test found a significant difference between HPV16 positivity in subjects who were married and had sexual intercourse but not for HPV18. CONCLUSIONS: This study successfully detected presence of HPV16 and HPV18 DNA in a number of saliva samples from female dental school students. Marital status, experience of sexual intercourse and safe sexual practice are related to the possibility of finding HPV DNA finding in saliva. Dentists, physicians and other health care professionals may gain significant value from the findings of this study, which provide an understanding of the nature of HPV infection and its risk to patient health and disease.

Oral mucosal ulceration caused by the topical application of a concentrated propolis extract.

Propolis is a resinous mixture that is collected by honey bees from tree buds, sap flow, and other botanical sources. Propolis has been extensively used in medicine, dentistry, and cosmetics; however, unwanted effects have been reported. This paper reports a case of oral mucosal burn in a 50-year-old patient, who used an overnight application of concentrated propolis to overcome a throbbing pain in the right upper posterior mucosa. The patient was otherwise healthy and was not receiving any medication. She presented with painful shallow multiple irregular ulcers measuring 0.3-1 cm in diameter that were located on the right buccal mucosa and hard palate mucosa, in addition to the gingival mucosa surrounding tooth 17. Propolis-induced oral mucosal burn was diagnosed. The ulcer cleared after the prescription of tetracycline mouthwash, accompanied with Doloneurobion. The patient was further treated with carbamazepine to address the persistent throbbing pain in the affected area, which was suspected to be trigeminal neuralgia. This report provides another alert to clinicians about the potential adverse effects of propolis use for the treatment of oral diseases, despite its natural origin.