Volume 9, Issue 7, July – 2024 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUL677

Denta Go Model: An Effective Approach to

Improving Tooth Brushing Skills and Dental
Hygiene Status of Preschool Children
1
Kholifah Nur Ijazati ; 2Supriyana; 3Endah Aryati Eko Ningtyas
Ministry of Health Polytecnic Health Semarang
Jl. Tirto Agung, Pedalangan, Banyumanik, Semarang

Abstract:- Background: According to Riskesdas, 63.7% with their growth process. Therefore, keeping children's tooth
of children aged 5 years have a dental caries experience healthy as early as possible is a key asset to ensuring their
number (def-t) ≥6 which is included in the category of development and well-being[2].
severe early childhood caries. One of the factors that
influence this is the low behavior in maintaining and Oral health problems, especially dental caries, are a
maintaining oral hygiene. Therefore, through the common condition experienced by half of the global
innovation of the “Denta Go” Model, it is hoped that it population, which is around 3.58 billion individuals. Based
can improve the tooth brushing skills and dental hygiene on the results of the Basic Health Research (Riskesdas) in
status of preschool children. Research Objective: To 2018, it was found that the most common dental health
produce a “Denta Go” Model that is effective and feasible problem in Indonesia was cavities, which reached a level of
to implement in an effort to improve tooth brushing skills 45.3%[3]. Dental caries is damage to tooth caused by various
and dental hygiene status of preschool children. Methods: factors, one of which is the complex relationship between
Research and Development (R&D) method with 5 stages, tooth and saliva as a host, bacteria in the oral cavity, and food
namely identification of needs, design, expert validation, that quickly ferments[4]. Dental health problems in
feasibility test 1, and feasibility test 2. This study used a preschool children tend to occur more often than in
pre-experiment design with a one group pre-post test elementary school children, this is due to the limited ability
design. The sampling technique was purposive sampling of children to carry out tooth brushing activities
which was given an intervention for 21 days with 3 stages, independently[5]. Maintaining children's dental health from
namely introduction, repetition, and practice. Results: an early age is the best step to ensure that the mouth and
The validity results of the “Denta Go” Model show that tooth remain in a healthy condition. Dental care is important
the model is feasible as a dental health education model (p from infancy to toddlerhood (age 5 years) to avoid dental
0.000). The “Denta Go” model is effective in improving decay and disease as adults. In general, children tend to like
tooth brushing skills (p 0.000) with a mean pretest score sugary foods such as cotton candy and sweets, which are
of 59.06 and posttest 94.64. The “Denta Go” model is known as substrates favored by bacteria and can cause the
effective in improving dental hygiene status (p 0.000) with dissolution of tooth structure[6]. The impact of caries is that
a mean pretest score of 2.64 and posttest of 1.16. more than 50 million hours per year are lost due to children
Feasibility test 2 showed that the model is feasible to be missing school. This situation can have a negative impact on
used independently by kindergarten teachers (p 0.000). the level of intelligence and decrease the child's academic
Conclusion: The “Denta Go” model is effective and achievement.
feasible to use as an effort to improve tooth brushing
skills and dental health status of preschool children. Caries that often occurs in preschool children is called
Early Childhood Caries (ECC), which is a dental hard tissue
Keywords:- Education Model, Denta Go, Preschool, Tooth disorder that attacks baby tooth at preschool age. Milk tooth
Brushing Skills, Dental Hygiene. have a thinner enamel layer than permanent tooth, making
them more susceptible to caries development. Early
I. INTRODUCTION childhood dental caries (ECC) is a very common chronic
disease, with nearly 1.8 billion new cases each year
Oral health is an important aspect of overall health. This worldwide. ECC commonly affects approximately 55% of
means that when a person experiences health problems in the preschool children from low-income and minority
tooth and mouth, the impact can extend throughout the body, backgrounds in the United States, resulting in both short- and
affecting things like speech, diet, school performance and long-term harmful effects on health and quality of life[7].
work productivity. Oral health problems can include a range
of conditions, from cavities and gum disease to the risk of According to the Riset Kesehatan Dasar (Riskesdas)
oral cancer[1]. The importance of dental health in children is 63.7% of children aged 5 years have a dental caries
significant, as their baby tooth play a key role in the experience number (def-t) ≥6 which is included in the severe
development of permanent tooth. Children's dental health can early childhood caries category. The incidence of caries at
impact their ability to digest food properly and can interfere the age of 5-6 years is still very high at 93%, meaning that

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Volume 9, Issue 7, July – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUL677

only 7% of Indonesian children are free from dental caries. dental health messages are not conveyed effectively, and
The incidence of caries in children aged 5-6 years in Central poster media that are static or less interactive so that users are
Java is around 53.3%[8]. This indicates that children of this not fully involved in the material presented[5],[15]. In
age are very vulnerable to oral and dental diseases and are at addition to the selection of appropriate educational media, the
risk of caries[9]. This figure is still far from Indonesia's target selection of methods that support the learning process is very
to achieve caries-free status by 2030[10]. important as well as programs that support children in
changing their oral health behavior such as routine brushing
Oral health conditions are influenced by various factors, activities every day at school[16].
both internal and external. Internal factors include aspects
such as physical, biological, and social conditions, known as There are methods that can be easily understood, more
the Host. In addition, streptococcus mutans bacteria acts as interesting, and fun for children, namely using educational
an Agent in causing oral problems. The quality of drinking games (learning while playing). Learning while playing is
water used by the community falls under the Environmental one of the effective methods to increase children's
category. On the other hand, external factors involve oral knowledge. Games are activities that are fun, interesting and
health maintenance behavior owned by individuals[11]. carried out voluntarily without coercion with the aim of
Efforts made in the world and Indonesia in suppressing getting excitement during play. Involvement in play has an
problems related to oral health are still not effective. because important role in child development so providing
behavior in maintaining oral health is still lacking. Behavior opportunities and means for play activities while learning is
has a considerable influence on health status, which is as very important for children[17].
much as 30%-35%. Oral health problems in the community
are influenced by low behavior in maintaining and One of the efforts in improving tooth brushing behavior
maintaining oral hygiene[12]. that can be done is the innovative development of tooth
brushing programs in preschool children with the “Denta
Behavior is an individual response to external stimuli Go” Model, which is a learning media that involves children
which is divided into three aspects, namely knowledge, as subjects in the game. In this case the child acts as part of
attitude, and action. Improved knowledge, attitudes and skills the game who is required to perform actions according to the
have a significant impact on children's oral hygiene. The way rules of the game. The model is designed to improve the
a person takes care of their oral health affects the actions cognitive, affective, and psychomotor aspects of preschool
taken to maintain oral health. Therefore, it is very important children with the hope of improving tooth brushing skills and
to shape this behavior from an early age. dental hygiene status supported by the school tooth brushing
program.
The right strategy for preschool children in an effort to
change behavior is to provide dental health education using The “Denta Go” model was tested at Putra Bangsa
learning methods and customized media development[5]. Kindergarten in Tanjung, Jepara. Based on direct
Media has a significant role in influencing the course of the observation, students are quite enthusiastic in the learning
health education process. As a tool, media facilitates the process and the material can be understood easily. This is
delivery of material, especially in the context of oral health relevant to the results of interviews with dentists at Pakis Aji
education. It is important to arrange the learning media Health Center, Jepara Regency that preschool children are
carefully, well-organized, interesting and involve many happier to learn if they are actively moving compared to
senses so that the information is easier to remember. The sitting listening to the material. From the results of the trial,
accuracy and suitability of the use of methods and media several shortcomings were still found so it is necessary to
greatly affect the effectiveness and efficiency of the oral develop the “Denta Go” Model through research.
health education process. Media not only acts as an
information provider, but must also be able to provide Based on this background, the researcher is interested in
experience to students[13]. This principle is in accordance proving that the innovative “Denta Go” model can improve
with Dale's Cone of Experience theory, which says that tooth brushing skills and dental hygiene status of preschool
involving various senses in the educational process makes the children.
material easier for students to accept and remember[14].
II. RESEARCH METHODS AND SAMPLE
Several media have been used as dental health
education media for preschool children, such as pillow books This research uses the Research and Development
(books made of dacron cloth), dental health puzzles, and (R&D) method of the ADDIE model through 5 steps,
posters. However, these media still have shortcomings such namely: 1) Analysis, 2) Design, 3) Development, 4)
as pillow books that have limited space to convey Implementation, and 5) Evaluation. The samples in this study
information so that it can make it difficult to cover all aspects were 35 students and 6 teachers as end users at TK III
of dental health in depth, puzzle media that some people may Pertiwi, Tembalang, Semarang.
have difficulty understanding or solving puzzles so that

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Volume 9, Issue 7, July – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUL677

III. RESULTS AND DISCUSSION

A. Validity Test
The validity test was conducted using the Interclass Correlation Coefisient (ICC) analysis to determine the feasibility of the
model as a dental health education model.

Tabel 1 Uji Validitas Model “Denta Go”

Validator N F (%) Rata-Rata ICC p-Value*
V1 10 96 %
V2 10 94 %
94,5 % 0,969 0,000
V3 10 94 %
V4 10 94 %

In table 1, the average feasibility value is 94.5% with a very feasible category. The expert vaidation results show that the p-
value = 0.000 which means that the model is declared feasible for trial. Based on the results of Average measures from the
Interclass Corelation Coefisient test, the result is 0.969 with the Excelent Reability category.

B. Univariate Analysis
The research subjects in this pilot stage totaled 35 children. The results about the characteristics of the research subjects are
presented in the following table:

Table 2 Data on Student Characteristics of TK III Pertiwi

No Variable N %
1 Gender
Male 21 60
Female 14 40
2 Umur
5 Years old 19 54,3
6 Years old 16 45,7

Table 2 shows the frequency distribution data of the characteristics of research subjects who are male by 60% (21 students)
and female by 40% (14 students). Meanwhile, based on age, the frequency of students aged 5 years was 54.3% (19 students) and
students aged 6 years was 45.7% (16 students).

C. Normality Test
The normality test in this study used the Shapiro Wilk test because the sample subjects in this study were less than 50.

Table 3 Normality Test of PHMP Score Data and Student's Tooth Brushing Skills
p-Value
Variable
Pre Test Post Test
PHPM index 0,016 0,001
Tooth brushing skills 0,000 0,000

Table 3 shows the results of the normality test for the PHPM index variable and students' tooth brushing skills have a p-value
<0.05, meaning that the data is not normally distributed so that the effectiveness test is analyzed using non-parametric tests.

D. Bivariate Analisys
Paired data analysis using the Wilcoxon test to determine the effectiveness of the model.

Table 4 Percentage of Results of the “Denta Go” Model Effectiveness Test on Improving Tooth Brushing Skills
Variabel Mean ±SD Pretest Mean ±SD Postest (Δ) P-Value*
Student,s tooth brushing skills 59,07 ± 7,81 94,64 ± 7,98 35,57 0,000

Table 4 shows that the results of the effectiveness test of paired data on student's tooth brushing skills with a p-value of 0.000
(p <0.05), meaning that the “Denta Go” model is effective in improving students' brushing skills. There was an increase in
students' skills before and after treatment, where before treatment the average value of student’s tooth brushing skills was 59.07
which fell into the "less" category, increasing to 94.64 which fell into the "very good" category. The difference between the initial
data (pretest) and the final data (posttest) of students' tooth brushing skills amounted to 35.57.

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Volume 9, Issue 7, July – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUL677

Table 5 Test Results of the Effectiveness of the “Denta Go” Model on Reducing the PHPM Index
Variable Mean ±SD Pretest Mean ±SD Postest (Δ) p-Value*
PHPM Index 2,64 ± 0,98 1,16 ± 0,40 1,48 0,000

Table 5 shows the results of the effectiveness test of paired data on students' PHPM index with a p-value of 0.000 (p <0.05),
meaning that the “Denta Go” model is effective in improving students' dental hygiene status. There was a decrease in students'
PHPM Index before and after treatment, where before treatment the average value of students' PHPM Index was 2.64 which was
included in the "moderate" category to 1.16 which was included in the "good" category. The difference between the initial data
(pretest) and the final data (posttest) of the PHPM Index examination is 1.48. The lower the child's PHPM Index indicates that the
better the dental hygiene status.

E. Feasibility Test 2 End User Use of Model

Table 6 Feasibility Test 2 of Using the “Denta Go” Model by End Users
Subject N F (%) Average ICC p-value*
G1 18 86,11 %
G2 18 84,72 %
G3 18 86,11 %
85,41 % 0,984 0,000
G4 18 87,5 %
G5 18 84,72 %
G6 18 83,3 %

Based on the results of the assessment of 6 TK III correctly because the “Denta Go” model is not only a
Pertiwi teachers obtained an average feasibility value is learning medium but also an evaluation medium.
85.41% with a very feasible category. The feasibility test
results show that the p-value = 0.000 which means that the Implementation of the “Denta Go” Model and brushing
model is declared feasible to be used independently by tooth together is done twice a week at school and brushing
kindergarten teachers as end users. This is in accordance with tooth twice a day at home which is done every day by filling
the results of observations made objectively during the out a tooth brushing calendar. This took place within a span
application of the “Denta Go” Model. Based on the results of of 21 days. Behavior change theory reveals that it takes 21
Average measures from the Interclass Corelation Coefisient days to change a person's habits, so a constant period of
test, the result is 0.984 with the Excelent Reability category. conditioning is needed for the person to change their
habits[19].
IV. DISCUSSION
C. Effectiveness of Denta Go Model on Improving Dental
A. “Denta Go” Model Trial Hygiene Status of Preschool Children
The trial in this study was conducted on 35 preschool The results of statistical test analysis, paired test showed
students using the “Denta Go” Model to improve tooth the average value of students' PHPM scores before and after
brushing skills and dental hygiene status of preschool treatment from 2.64 to 1.16 with a p-value of 0.000
students. The following is a description of the tests that have (p>0.005). The lower the students' PHPM index indicates that
been conducted by researchers the better their dental hygiene status. Based on these results,
it can be concluded that the “Denta Go” Model is effective
B. Effectiveness of the “Denta Go” Model on Improving in improving the tooth brushing skills of preschool children
Student’s Tooth Brushing Skills so that it can have an impact on the dental hygiene status of
Children's tooth brushing skills have increased because children.
the intervention model “Denta Go” is a game that involves
children directly as subjects in the game. Giving quizzes Relevant research states that the better the tooth
during the game can provide quick feedback and remain safe brushing skills, the better the oral hygiene, which will reduce
even if mistakes occur, because if the child answers dental problems[20]. Brushing tooth is a mechanical way to
incorrectly it will be corrected directly by the teacher who clean plaque on the tooth. Brushing tooth aims to clean soft
acts as a facilitator in the game. deposits on the surface of the tooth and is a preventive
measure towards optimal oral hygiene. The ability of children
Relevant research states that other advantages of board to brush their tooth properly and correctly is a very important
games provide direct feedback to children, this feedback is factor in maintaining oral hygiene[21].
done by discussing the answers to the questionnaires that
have been given in order to evaluate the answers of each
respondent so that the truth of the information received by
respondents can be immediately understood and digested[18].
In the process of the game, children become more responsive
to information about dental health and how to brush well and

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ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUL677

D. Feasibility of the “Denta Go” Model for Independent use [8]. Kementerian Kesehatan Republik Indonesia, Laporan
by Kindergarten Teachers Nasional Riskesdas 2018. Jakarta: Badan Penelitian dan
After the teacher conducts dental health education using Pengembangan Kesehatan, 2019.
the “Denta Go” Model for a period of 21 days, the feasibility [9]. Badan Penelitian dan Pengembangan Kesehatan 2019,
test of the model is carried out to be used independently by Laporan Provinsi Jawa Tengah RISKESDAS 2018.
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