Indonesian dentists' views on providing oral health care for older adults.

BACKGROUND: With demographic changes in aging populations, dentists require special care protocols to treat older adults with diverse and complex oral health needs and problems. Knowledge, positive attitudes, and sufficient practice experience are essential components for promptly treating older adults. However, many dentists encounter multiple barriers influencing their willingness to provide care for older adults. This study assessed Indonesian dentists' knowledge, attitudes, and practices (KAP) in providing oral health care (OHC) for older adults, including their willingness and barriers. METHODS: A cross-sectional survey was conducted with 392 dentists employing an online questionnaire between April and June 2022. The respondents' KAP was categorised utilising a modified Blooms' cut-off point of ≥60%. Data were analysed using descriptive statistics, the x2 test, and logistic regression. RESULTS: Most dentists demonstrated adequate knowledge (62.2%), a positive attitude (95.4%), sufficient practice experience (91.6%), and a high willingness (98%) to provide OHC services for older adults. However, 91.4% encountered barriers primarily related to interpersonal communication, disease complexity and polypharmacy, and patient functional status. Significant associations were found between dentists' attitudes toward practices and willingness to attend geriatric dentistry training with knowledge. CONCLUSION: Implementation of continuing professional development (CPD) in geriatric dentistry, the inclusion of geriatric dentistry into the undergraduate curriculum, and enhancing clinic accessibility for older adults may improve dentists' preparedness and benefit the future provision of OHC for older adults in Indonesia.

Correlates of dental visits in children with hearing loss: An application of the theory of planned behaviour.

BACKGROUND: Maintenance of oral health of children with special needs requires the involvement of caregivers who are also responsible for ensuring adherence to professional recommendations, including dental visits. AIM: This study aimed at exploring the correlates of dental visits of children with hearing loss (CWHL) in Indonesia using the theory of planned behaviour (TPB). DESIGN: This cross-sectional study involved purposive sampling methods, conducted via an online survey administered to mothers of CWHL who were aged 5-12 years. Constructs of the TPB model were collected, including the mother's attitudes, subjective norms, perceived behaviour control (PBC) and intention towards dental visits for CWHL. Dental visits were measured by asking whether their children had a dental visit within the last 12 months. Data were analysed using SPSS for descriptive and bivariate analyses. The significance level was set as p < .05. Partial least square structural equation modelling (PLS-SEM) was used to analyse measurement and structural TPB models. RESULTS: A total of 254 mothers participated in this study. The final TPB model explained 35.4% and 9.2% of the variance in mothers' intention and behaviour towards their children's dental visits, respectively. Of all the included constructs from the TPB model, only PBC was significantly associated with intention and behaviour (p < .05). The mother's attitude and subjective norms did not significantly predict intention (p > .05). Intention did not significantly predict the mother's behaviour towards children's dental visits (p > .05). CONCLUSION: The TPB model revealed a construct associated with dental visit intention and behaviour in CWHL. This study suggested that effective promotion intervention should focus on the mother's PBC to increase parents' adherence to preventive dental visits in CWHL in Indonesia.

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.

Measuring the interprofessional collaborative competencies of health-care students using a validated Indonesian version of the CICS29.

The objectives of this study are to validate an Indonesian version of the Chiba Interprofessional Competency Scale (CICS29) and measure the interprofessional competencies of undergraduate health-care students following their completion of an interprofessional education (IPE) course. This study used a cross-sectional design and was preceded by a cross translation of the instrument and a confirmatory factor analysis (CFA), which confirmed that the Indonesian-version CICS29 has good internal consistency comparable to the original model. The Indonesian version was then administered to 723 health-care students who had completed a community-based IPE course. Based on data gathered from 707 respondents (97.8%), it was found that their interprofessional competency was relatively good (mean score: 127.9 out of 145, 88.2%). The dental students scored consistently lower compared to students of other faculties, both in the overall CICS29 and all five of its subscales, three of which are specifically related to teamwork. The study has provided support for cross-cultural validity of undergraduate health-care students' interprofessional competency measures using CICS29. Further efforts are necessary to ensure that the students understand their roles and internalize the collaborative values and practices of all health professions.

An assessment of the impacts of child oral health in Indonesia and associations with self-esteem, school performance and perceived employability.

BACKGROUND: Previous surveys have indicated that a majority of Indonesian children have poor oral health. However, little detailed information is available on underlying causation and none that examine impacts of oral health on child self-esteem, school performance and perceived employability. The aim of this study was to determine levels of child oral health in primary school children in Indonesia, the prevalence of key causal factors; and, to determine relationships between oral health, self-esteem and school academic performance. METHODS: Cross-sectional epidemiological study in a sample (n = 984) of children aged 6-7 and 10-11 years old attending three public schools in Indonesia. A dental visual impact study was conducted, in which teachers reported their perceptions of the impact of child oral health on school academic performance. Oral health behaviors, self-esteem, and school performance were assessed. The children were clinically examined to measure dental caries and oral cleanliness. RESULTS: Teachers believe that children with visually poor oral health and impaired smiles are more likely to perform poorly at school, be socially excluded and have lower job prospects than their peers with visually good oral health and healthy smiles. The percentages of children with decayed teeth were 94 and 90% in the 6-7- and 10-11-year age groups, respectively. Families reported high levels of child consumption of sugar-containing foods and drinks; many had irregular use of fluoride toothpaste. Children with substantial plaque on their teeth achieved significantly lower levels of school performance than their peers with clean teeth. Significant associations were found between school performance and self-esteem for these children. CONCLUSIONS: The study findings highlight the need for preventive care programs to improve the oral health of children in Indonesia and prospective determination of associations between child oral health; self-esteem and school academic performance.

Comparative analysis of stress level and coping strategies due to COVID-19 pandemics among dental students in Indonesia and Vietnam.

Objective: This study investigated and compared the perceived stress levels and coping strategies of dental students in Indonesia and Vietnam during the COVID-19 pandemic. Materials and methods: A cross-sectional survey was conducted online in 2022 for dental students from the University of Indonesia and Can Tho University, Vietnam (n = 304). Perceived stress levels and coping strategies were assessed using a self-administered questionnaire about student sociodemographic factors, learning experiences, coping strategies, stress-related factors, and stress levels. Data were analyzed using Mann-Whitney, Kruskal Wallis, and Spearman correlation tests. Results: This study showed the overall mean stress level was 23.9 (SD = 5.63), with a significant difference observed between Indonesian (24.44, SD = 5.14) and Vietnamese students (23.32, SD = 6.13) (p = 0.016), indicating potential variations in stress experiences. Key findings include a correlation between living arrangements and stress, as students living independently report higher stress (23.96, SD = 6.24) compared to those living with family (23.95, SD = 5.29) (p = 0.018). Fifth-year students exhibit lower stress levels (21.17, SD = 6.12) than other grades (p = 0.026). Multiple training sessions about COVID-19 are associated with better coping strategies (9.95, SD = 0.91, p < 0.001). The study also revealed different perceptions of COVID-19 learning experiences among dental students in Indonesian and Vietnamese dental students, with significant correlations observed between stress levels, coping strategies, and specific concerns such as graduation time and COVID-19-induced changes (p < 0.05). Conclusion: This study shows students experience moderate stress levels, but the significant differences in stress experiences and coping strategies between the two countries highlighted the need for tailored approaches. Providing social support from faculty, family, friends, and peer dental students was one of the students' strategies to cope and minimize stress levels.

Recommendations on Topical Fluoride Usage for Caries Management in East Asia.

Dental caries is a widespread oral health issue in Asia, affecting an estimated 30% to 90% of children and adults. Many caries cases remain untreated, resulting in pain and infection. In response, the Asian Academy of Preventive Dentistry (AAPD) emphasises comprehensive caries management and organised a fluoride workshop at the 15th International Conference of the AAPD in 2023. The AAPD invited a group of experts to form a fluoride working group to review existing literature and develop fluoride recommendations for stakeholders across Asian countries and regions. The working group assessed caries risk and identified commonly used topical fluoride products for home care, professional, and community settings in Asia. The working group concluded that fluoride is a safe and highly effective strategy to reduce caries prevalence and incidence. The working group provided key recommendations based on successful regional caries management practices: (1) use topical fluoride for prevention and control of dental caries; (2) encourage the use of fluoride toothpaste with a concentration of at least 1,000 ppm for effective caries reduction; (3) advise a 0.05% fluoride mouth rinse as soon as children can spit it out to prevent early childhood caries; (4) deliver professionally administered fluoride, such as 5% sodium fluoride varnish, 2% fluoride gel, or 1.23% acidulated phosphate fluoride preparations, to decrease dental caries in at-risk individuals; and (5) apply 38% silver diamine fluoride to arrest cavitated caries. These recommendations aim to help practitioners, health care providers, and parents/caregivers make informed decisions about fluoride use as part of comprehensive oral health care in the region.

Functional tooth units and nutritional status of older people in care homes in Indonesia.

OBJECTIVES: To investigate the relationship between functional tooth units (FTUs) and nutritional status. METHODS: One hundred females (mean age: 72.4 ± 8.2 years) at four private care homes in Jakarta, Indonesia were interviewed and clinically examined. The oral examination included the assessment of teeth, prosthetic status, and number of FTUs. The total number of FTUs was further divided by tooth composition: natural tooth against natural tooth (NN-FTUs), natural tooth against denture (ND-FTUs), and denture against denture (DD-FTUs). Nutritional status was evaluated using the body mass index (BMI) and the Mini Nutritional Assessment (MNA). RESULTS: The mean numbers of teeth present, NN-FTUs, ND-FTUs, DD-FTUs, and total FTUs were 13.1 ± 10.4, 1.7 ± 3.0, 1.2 ± 3.3, 0.4 ± 1.2 and 3.3 ± 4.4, respectively. The mean BMI and MNA scores were 24.8 ± 5.0 and 22.6 ± 2.8, respectively. Subjects with a normal BMI had a significantly higher total number of FTUs (3.6 ± 4.6) compared with underweight subjects (0.1 ± 0.3). Subjects with a normal MNA had a significantly higher number of NN-FTU (2.6 ± 3.7) compared to those who were at risk or in a state of under-nutrition (1.2 ± 2.4). CONCLUSION: This study revealed significant relationships between the number of FTUs and nutritional status. Keeping the posterior occlusion should be emphasized in order to maintain good nutritional status in older subjects.

Patient Safety Culture in Dentistry Analysis Using the Safety Attitude Questionnaire in DKI Jakarta, Indonesia: A Cross-Cultural Adaptation and Validation Study.

OBJECTIVES: This study aimed to analyze a cross-cultural adaptation of the Safety Attitude Questionnaire (SAQ) for Indonesian dentists. METHODS: A cross-sectional study was conducted on 250 general dentists in health services in Jakarta, Indonesia. The first step included cultural adaptation and translation, which was followed by the development of the tested questionnaire through expert agreement and by validity and reliability analysis using Spearman correlation coefficient, Cronbach α , and interclass correlation coefficient. The SAQ consisted of 30 items and 6 dimensions (safety climate, teamwork climate, job satisfaction, stress recognition, perception of management, and working conditions).Respondents were members of the Indonesian Dental Association who voluntarily filled out a Google-based questionnaire from September to October 2020. RESULTS: A total of 250 respondents with a response rate of 16.4% demonstrated a total Cronbach α value of 0.897, whereas the value per item ranged from 0.890 to 0.905, which suggested an acceptable and good to very good internal consistency. The interclass correlation coefficient value varied from 0.840 to 1.000, which meant almost perfect agreement. The correlation coefficient of 30 questions items resulted in a total SAQ score ranging from 0.422 to 0.699 (moderate to strong correlation) and between 6 dimensions to total SAQ score ranging from 0.648 to 0.772 (strong correlation). CONCLUSIONS: The Indonesian version of the SAQ exhibited good validity and very good reliability and potential to be used for evaluating dentists' patient safety culture in Indonesia.

Cross-cultural adaptation and psychometric properties of the Indonesian version of theory of planned behavior questionnaire to measure dental attendance of children with hearing loss: A pilot study.

AIMS: To translate and evaluate the validity and reliability of the Indonesian version of the Theory of Planned Behavior (TPB) questionnaire concerning mother's behavior related to children's dental attendance. METHODS AND RESULTS: The cross-cultural adaptation was tested in mothers with children aged 5-12 years old who have hearing loss. The validity and reliability of the online questionnaire were measured among 31 mothers of children with hearing loss in communities and Special School for Children with Hearing Loss in several regions in Indonesia. All indicators of attitude, subjective norms, and perceived behavior control (PBC) on mothers' behavior towards children's attendance was valid (p < .05). The overall Cronbach's alpha of the questionnaire for internal consistency was 0.773. The test-retest reliability results were based on repeated administration in the same participant mother, measured at one-week interval; the interclass correlation coefficient (ICC) was 0.903. CONCLUSION: The Indonesian version of the TPB questionnaire concerning mother's behavior related to children's oral health has shown adequate validity and reliability for investigating the dental attendance of children with hearing loss.

The Evaluation of Root Fracture with Cone Beam Computed Tomography (CBCT): An Epidemiological Study.

BACKGROUND: The aim of this study was evaluation of the cone-beam computed tomography (CBCT) image of 50 patients at the ages of 8-15 suspecting root fracture and root fracture occurred, exposed to dental traumatic. In additionally, this study was showed effect of crown fracture on root fracture healing. MATERIAL AND METHODS: All of the individuals included in the study were obtained images with the cone-beam computed tomography range of 0,3 voxel and 8.9 seconds.(i-CAT®, Model 17-19, Imaging SciencesInternational, Hatfield, Pa USA).The information obtained from the history and CBCT images of patients were evaluated using chi-square test statistical method the mean and the distribution of the independent variables. RESULTS: 50 children, have been exposed to trauma, was detected root fracture injury in 97 teeth. Horizontal root fracture 63.9% of the 97 tooth, the oblique in 31.9%, both the horizontal and oblique in 1.03%, partial fracture in 2.06% ,and both horizontally and vertical in 1.03% was observed.The most affected teeth, respectively of, are the maxillary central incisor (41.23% left, right, 37.11%), maxillary left lateral incisor (9.27%), maxillary right lateral incisor (11.34%), and mandibular central incisor (1.03%). CONCLUSIONS: Crown fractures have negative effects on spontaneous healing of root fractures. CBCT are used selected as an alternative to with conventional radiography for diagnosis of root fractures. In particular, it's cross-sectional image is quite useful and has been provided more conveniences seeing the results of diagnosis and treatment for clinician. Key words:Root fracture, CBCT, Epidemiolog.