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.

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.

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 relationship between parents' oral hygiene knowledge and children with Down Syndrome's oral hygiene via OHI-S.

Background: Down Syndrome (DS) is a genetic disorder responsible for mental and development retardation. DS occurs when a person has an extra chromosome (47 instead of 46), the third copy of the Trisomy 21 chromosome. This causes structural and functional anomalies in the human body and some degree of intellectual disability. Children with DS have poor oral hygiene as they are unable to understand and are unaware of its importance. Oral hygiene problems commonly found in children with DS are gingivitis, periodontal problems, pain, infection, and problems with the masticatory system. This study explored the relationship between parents' knowledge and maintenance of the oral hygiene of children with DS through the OHI-S (Oral Hygiene Index Simplified) Index Score. Method: This study was conducted by distributing 25 questions via Google Form to 100 subjects that belong to POTADS (Down Syndrome Parents Association. The participants were children diagnosed with Down Syndrome and their parents. Questionnaires were used to assess parents' knowledge about their child's oral hygiene. To assess the children's oral hygiene, dental exams were performed with the OHI-S on six tooth surfaces. To calculate the OHI-S score for each individual, the debris and calculus scores from the 6 surfaces of the teeth were totalled and divided by six. Results: The relationship between parents' knowledge and the maintenance of oral hygiene of children with DS was found by conducting a linear regression analysis and hypothetical test. The equation of Y = 77.734 + (-7.377) X was achieved through linear regression analysis, and indicated that a 1% increase in parents' knowledge caused a reduction in OHI-S score to 7.377. The hypothetical test showed that parents' knowledge affected their children's OHI-S score significantly. Conclusion: There was a significant contradictive relationship between parents' knowledge and the maintenance of oral hygiene of children with DS .

Low Levels of Tumor Necrosis Factor-α will Prevent Periodontitis Exacerbation in Type 2 Diabetes Mellitus.

OBJECTIVES: Diabetes mellitus (DM) is a major risk factor for periodontitis. Susceptibility to periodontitis increases approximately three times in people with DM. There is a clear relationship between the degree of hyperglycemia and the severity of periodontitis. This study aimed to analyze the reduction of tumor necrosis factor-α (TNF-α) in diabetics who came for periodontitis examination to prevent exacerbations. MATERIALS AND METHODS: This was an analytic observational study using a cross-sectional approach at health centers in Surabaya, Indonesia. Measurement of periodontal status used the community periodontal index of treatment needs by measuring bleeding at probing and pocket depth. TNF-α was measured using enzyme-linked immunosorbent assay, and behavior and lifestyle using a questionnaire. STATISTICAL ANALYSIS: The Kolmogorov-Smirnov test was performed to identify data normality (p < 0.05). A nonparametric test was used to measure the degree of association between different characteristics and the incidence of periodontitis in type 2 DM patients with and without periodontitis. Spearman's test was done to examine the correlation between TNF-α level and severity of periodontitis in diabetics. The significant level was at p <0.05. RESULTS: There was a correlation between age, predisposing factors, reinforcing factors, drug consumption, and TNF-α levels in patients with type 2 DM and the incidence of periodontitis. CONCLUSIONS: Poor glycemic control can induce oxidative stress on the gingiva, thereby aggravating damage to periodontal tissue. An important factor in preventing periodontitis for type 2 DM patients is controlling blood sugar levels through regular consumption of drugs and regular maintenance of oral cavity health. Knowledge is a predisposing factor that affects adherence of people with type 2 DM to consuming drugs regularly, which can be strengthened by family support. These will ultimately play a role in reducing TNF-α levels.

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.

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.

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.

Husband's Support and Wife's Decision to Children's Dental Visit: Is There Any Relationship?

BACKGROUND: Early childhood caries (ECC) is the most common dental caries in children. The 2013 Indonesian basic health survey showed that there were still many children in developmental age affected by dental caries. Parents' participation is very necessary in guiding, giving understanding, reminding, and providing facilities so that children can maintain their overall oral hygiene. Hence, parents can prevent plaque accumulation and the occurrence of caries in children. OBJECTIVE: This study aimed to determine the effect of husbands' support on the decision of mothers to take their children to the dentist. SUBJECTS AND METHODS: This study used a cross-sectional method. The samples from this study were 95 mothers from 3 kindergartens in Surabaya. Ninety-five mothers were randomly chosen as research respondents and filled out the research questionnaires. The data obtained were processed using statistical analysis to determine the correlation. RESULTS: Research respondents with low husband support (subjective norms) who did not take their children to the dentist had a significant value (p = 0.004) compared to the study respondents with high husband support who did not bring their children to the dentist (p = 0.093). CONCLUSION: Mothers with low support from husbands tend to have the attitude not to take their children to do routine dental and oral examinations.

Factors influencing the severity of dental caries among Indonesian children with autism spectrum disorder - a pilot study.

AIM: To assess the prevalence of dental caries among autism spectrum disorders (ASD) children in Surabaya, Indonesia, and to explore the association between oral health-related behaviors comprising toothbrushing, snacking and dental visiting and the severity of caries. METHODS: The prevalence and severity of caries were assessed using DMF-T/dmf-t and PUFA/pufa indexes for mixed dentitions. The parents or carers' responses were collected to identify the oral health-related behaviors that were associated with caries severity. RESULTS: This study shows that almost 79% of ASD children in Surabaya were experiencing caries and 47.1% had untreated caries with pulp involvement or more severe conditions. Oral health behaviour factors associated with the severity of dental caries experienced by children with autism were brushing frequency (Β [95% CI] =2.46 [0.09-4.83] and 2.03 [0.78-3.28]), brushing time (Β [95% CI] =3.76 [1.32-6.20] and 2.03 [0.74-3.32]) and cleansing after snack (B [95% CI] = 2.04 [0.20-3.89] and 1.21 [0.23-2.18]) in DMF-T/dmf-t and PUFA/pufa indexes, respectively. CONCLUSIONS: The prevalence of caries among children with autism in Surabaya was high. The severity was associated with brushing and snacking behaviors. Caries in children with autism should be paid attention, and research in modifying daily activities are needed to allow them to adopt more healthy oral health-related behaviors.

Root caries incidence and increment in the population - A systematic review, meta-analysis and meta-regression of longitudinal studies.

OBJECTIVES: Previous meta-analyses of root caries incidence and increment studies reported different estimates due to the limited number of studies, heterogeneity and variations in studies included. Currently, new publications and approaches to handle heterogeneity are available. This research aims to systematically review and meta-analyse root caries incidence and increment, and use meta-regression to analyse heterogeneity. SOURCES: PUBMED and EMBASE databases were searched systematically. STUDY SELECTION: Longitudinal studies on root caries incidence and increment, published in English language prior to 2017, were independently checked by two authors. A pooled incidence and increment of decayed/filled root surfaces (DFS) was estimated and meta-regression analysis was performed by length of follow-up (<2 years; 2years; 3-4years and ≥5years) and study type (observational population-based and clinical trial). DATA: Of 737 articles, 20 were included for meta-analysis. The annualised root caries incidence and increment were 18.25%[CI = 13.22%-23.28%] and 0.45[CI = 0.37-0.53] root DFS respectively. Length of follow-up influenced the estimates, but not the study type. The annual root DFS incidence and increment from studies <2years were 32.95%[CI = 29.13%-36.77%] and 0.64[CI = 0.38-0.89] root surfaces respectively. Studies with 5+years follow-up, the annualised root caries incidence and increment were 9.4%[CI = 3.32%-15.48%] and 0.43[CI = 0.21-0.64] root surfaces respectively. CONCLUSIONS: Length of follow-up influenced root caries estimates due to a bias towards relatively healthier older adults retained in the study. Root caries increased over time even among the healthier older adults. CLINICAL SIGNIFICANCE: The increase in root caries, even among the healthier older adults, should be considered by both clinicians and healthcare planners/policy makers in their provision of services.