Bahasa Ingggris

Karya Tulis Ilmiah

Dental Caries In Childerns

Nama : Merry Ayu Agustin

NIM : 201610101119

Kelas : Bahasa Inggris J

FAKULTAS KEDOKTERAN GIGI

UNIVERSITAS JEMBER

2021
 DENTAL CARIES IN CHILDRENS

BACKGROUND

Health is an important part of human life. Healthy can be balanced with spiritual and
physical. However, it is different from children because parents want their children to grow and
experience optimal development. A healthy body can realize that. It needs to be considered in
addition to health in the body, also oral and dental health. Thus, oral health is an integral part of
overall body health that cannot be separated from overall body health. Periodic maintenance is
carried out to achieve good dental and oral health.

Treatment can start by paying attention to food intake, don't overeat that contains sugar and
sticky foods. It will cause the appearance of plaque or food debris that is between the teeth. So
what you have to do is clean your teeth by brushing your teeth, techniques, and methods not to
damage the shape of the teeth themselves. When cleaning the area of the mouth and teeth, one
example is the cleaning of tartar and filling cavities by experts, not forgetting to remove teeth that
cannot be preserved anymore and are part of the focal infection. Regular visits to the dentist every
six months whether there are complaints or no complaints.

There are serious problems concerning oral and dental health; namely, dental caries is a
non-communicable disease found at all ages, especially in children. The 2018 Basic Health
Research (Riskesdas) results show that the prevalence of children in Indonesia who experience
caries in primary teeth is 90.2%. The deft index, which is used to measure the level of caries in
primary teeth, shows a mean deft score for 5-year-olds at 8.3 for boys and 8.0 for girls, which
means that each child has about 8 primary teeth. Who has caries? 1 Primary dental caries also
affect the general health of the child's body, especially disorders of the masticatory function that
interfere with the absorption and digestion of food. Therefore, dental caries can eventually interfere
with the child's nutrition, causing malnutrition. Malnutrition that lasts for a long time or is chronic
causes children to become stunted, namely a condition of stunted growth due to chronic
malnutrition so that children are too short for their age.
LITERATUR REVIEW

Dental caries

Dental caries is a disease caused by demineralization of enamel and dentin which is closely
related to the consumption of cariogenic foods. Dental caries is a disease of the hard tissues of the
teeth, namely enamel, dentin, and cementum, which is caused by the activity of a microorganism
in a fermentable carbohydrate. In general, the occurrence of dental caries is influenced by four
factors, namely host or tooth factors, agents or microorganisms, substrate, and time. To assess the
severity of caries in permanent teeth, a measurement indicator is used, namely the DMF-T Index.
Basic health research (Riskesdas) in 2007 stated that the prevalence of active caries in Indonesia
was 46.5%. According to Riskesdas data in 2007, the province of North Sulawesi has a DMF-T
index of 5.01 (Taupek Rahman, 2014).

According to Dida (2019), caries is a disease of the hard tissues of the teeth, namely
enamel, dentin, and cementum, caused by the activity of a microorganism in a carbohydrate that
can ferment. The sign is the demineralization of the teeth' hard tissue, followed by the destruction
of organic matter. As a result, there is an invasion of bacteria and pulp and the spread of infection
to the periapical tissue, which can cause pain, however, given the possibility of remineralization
occurring at a very early stage. The following are some of the causes of caries, according to Dida
(2019), which are irregular teeth and saliva, which make it easier for caries to occur. The presence
of bacteria called Streptococcus and Lactobacillus. Next is the food we consume, easily sticky and
sticks to the teeth, such as candy and chocolate, making caries easier. These foods will cause dental
plaque. Dental plaque is a sticky substance that contains bacteria and their products on all surfaces
of the teeth. This accumulation of bacteria does not occur by chance but is formed through stages.
 Next is the role of dietary carbohydrates, which require a minimal amount of time for
plaque and carbohydrates that adhere to teeth to form acids and are capable of causing
demineralization of enamel. These carbohydrates provide a substrate for acid production for
bacteria and the synthesis of extracellular polysaccharides. However, not all carbohydrates are
equally cariogenic. After this, susceptibility of the tooth surface, meaning that the plaque that
contains bacteria is the beginning of the formation of caries. Therefore, a dental area that facilitates
plaque attachment is likely to be attacked by caries. Areas susceptible to caries are the occlusal
pits and fissures of the molars and premolars, the smooth surface in the approximal area is slightly,
and the last is caries at the edges in the neck area of the tooth slightly above the gingival margin.

Research related to dental caries and children

In an article from the dental faculty of the University of Muhammadiyah Sumatra Utara, it
is explained that tuning in children has the following characteristics: Failure to thrive in children
under five according to age, slowed growth, delayed tooth growth, poor performance on tests of
attention and learning memory. Teeth are formed when the fetus is 4 months in the womb. Thus,
pregnant women are strongly encouraged to consume enough fluoride and calcium supplements
to support the growth and development of their child's teeth later. However, it does not stop during
pregnancy; the mother needs good nutrition but must continue until the mother is breastfeeding
and the child is in the stage of complementary feeding (MPASI). Untreated dental caries will
develop into rampant caries and invade the entire tooth crown by involving many front and back
teeth leading to premature loss of primary teeth. This condition will hurt the child's ability to eat
and get good nutrition. As a result, if the child has difficulty eating because of dental caries, he
will have inadequate daily nutritional intake, a weakened immune system, and are more likely to
experience malnutrition and illness. Several studies have stated that poor and unbalanced nutrition
has a positive relationship to the severity of dental caries or cavities and tends to have a higher
number of teeth with caries than children with adequate nutrition. In addition, children with poor
nutritional conditions will have atrophic salivary glands, whereas saliva (saliva) has an important
role in cleaning teeth and mouth and preventing dental caries. That is why dental caries are so
closely related to stunting in children.

Furthermore, Aviva's (2020) research explains that stunting dental caries in children is still
a global problem, including in Indonesia. Malnutrition at critical times can cause stunting in
children and abnormal tooth development so that children's teeth are more susceptible to caries.
Stunting itself occurs due to has unhealthy living behavior and poor diet since the child is born,
especially in the first 1000 days of life. Stunting itself can cause new problems such as short across
generations. For example, primary dental caries also affect the child's general health, especially
the function that disrupts the digestive absorption of food. Thus, dental caries ultimately cause
nutritional disorders in children, resulting in malnutrition. Malnutrition that lasts for a long time
or is chronic causes children to become stunted, namely a condition of stunted growth due to
chronic malnutrition so that children are too short for their age.

Stunting
Stunting is a condition in which a person's height is abnormal based on age and gender.
The presence of stunting indicates a lack of nutritional status (malnutrition) in the long term
(chronic) to years. A person who experiences stunting from an early age can experience mental,
psychomotor, intelligence disorders, and even dental and oral health.

The number of stunting problems in Indonesia is still very large, with more than 250
million people. The prevalence of stunting in children under five in Indonesia was 30.8% in 2018
according to Riskesdas. Meanwhile, prevalence data collected by the World Health Organization
(WHO), Indonesia is the third country with the highest average in the Southeast Asia region. The
average prevalence of stunting under five in Indonesia in 2005 - 2017 was 36.4%
 Based on the diagram above, it can be concluded that the prevalence of stunting in
Indonesia compared to other countries in Asia occupies the 3rd highest position. The province with
the highest prevalence is Aceh, while the lowest is DKI Jakarta. (Aryu, 2020).

DISCUSSION

The study results from the literature review showed that the caries rate of primary teeth
was higher in stunted children than in normal children. Research by Rahman et al. di in Banjar
Regency found that the average deft score for stunting children was 8.23, almost three times higher
than the normal group of children with an average of 3.3.

It is in line with research by Nabila and Pintauli12 in Langkat Regency, which reported
that the average deft score of stunting children was 14.03±6.16, two times higher than the normal
group of 7.47±3.74. The study by Dimaisib-Nabuab et al. 11 also found that the PUFA and data
scores of stunted children were significantly higher than normal children in Indonesia at the age
of 6-7 years, namely the mean it was 9.6±4.6 in stunted children and 7.9±4,4 in normal children.
The mean PUFA of stunting children was 4.1±3.6, and normal children were 3.0±3.0.

Stunting children who suffer from primary dental caries, with an average caries severity
level of moderate to high and slightly low. Based on the research results Simorangkir et al. In Deli
Serdang Regency, there were 87% of stunting children who had high caries, and 13% who had low
caries, as well as research by Ningtias et al. in Brebes Regency found that 81.25% of stunting
children had moderate to high caries and 18.75% who had low caries. Low caries occur because
malnutrition is a cost factor associated with caries lesions, especially abnormalities in tooth
structure and salivary glands. Dental structural abnormalities, namely hypoplasia, can make the
oral cavity atmosphere cariogenic due to the increased demineralization process of thin protective
enamel. Caries in stunted children tends to be more severe due to the development of atrophic
salivary glands so that the buffering and self-cleaning functions are reduced.

Salivary flow rate directly relates to caries occurrence through oral clearance, which helps
remove pathogens (viruses, bacteria, fungi) from teeth and mucosal surfaces. The buffer
neutralizes the pH after eating and minimizes the time for demineralization to occur. Below a
critical pH, the dental inorganic matter will dissolve. Lack of protein and deficiency of
micronutrients, such as vitamins, zinc, and iron, can affect the amount and composition of saliva,
thereby limiting the protective effect of saliva.

Dental caries can also be caused by a person suffering from stunting. Stunting is one of the
most common malnutrition conditions. By contracting stunting in a child, it will interfere with its
development, including the development of the oral cavity.

Children with stunting are more susceptible to dental caries because there will be changes
in salivary characteristics such as a decrease in salivary flow rate and pH. Because dental caries is
a disease caused by interactions that produce acid. The acid produced by the bacteria will lower
the pH over and over again. As a result of this decrease, there will be demineralization of the tooth
surface and the caries process will occur.

Malnutrition or stunting also hurts the oral cavity of children and causes the salivary flow
rate (secretion) to decrease. Saliva itself is very important in maintaining a healthy balance of the
oral cavity. A good salivary flow rate will help clean the oral cavity optimally. Saliva also has
antimicrobial components and maintains the pH balance of the oral cavity (buffer).

This lack of salivary flow can occur in stunted children due to reduced masticatory activity.
And if the child is infected with stunting and caries, then eating difficulties will occur. This is
because the masticatory function will be disturbed, so it will affect the intake of nutrients that
enter. Oral health is related to diet or food. Nutritional factors can affect teeth, and nutritional
deficiencies can exacerbate oral and periodontal disease. Increased tooth erosion related to food
acids.

CONCLUSION

Based on the explanation above, it can conclude that Indonesia still has stunted children
and has experienced primary dental caries regarding dental caries. The number is very large from
the high caries severity. In addition, caries in primary teeth and stunting in children have a mutually
influencing relationship. Not only that but children can also be affected while in the womb. It is
evidenced by the nutritional condition of the mother during pregnancy which is also associated
with the incidence of dental caries in children. The primary teeth begin to form at the 4th week of
the fetal growth period, and the mineralization process begins during the 12th week. It is a critical
phase because the matrix apposition process builds the hard tissue structure of primary teeth. In
addition to the lack of macronutrients, micronutrients also play an important role. Vitamin A is
important for epithelial integrity and differentiation. Vitamin A deficiency can affect the activity
of ameloblast cells in forming tooth enamel. Vitamin D is also required in the metabolism of
calcium and phosphorus, which are essential for the growth of teeth and bones. Other
micronutrients important in developing tooth enamel structure are calcium, phosphorus, and
magnesium. It is in line with the study results by Tanaka et al. in Japan. They reported an
association between higher maternal vitamin D intake during pregnancy and reduced risk of dental
caries in children. Research by Badruddin et al. in Depok City showed a significant relationship
between maternal nutritional status during pregnancy and primary dental caries in children.
REFERENCES

Avia, Novia N, dkk. 2020. Gambaran Karies Gigi Sulung Pada Anak Stunting Di Indonesia. E-
Gigi Volume 8 nomor 2 Halaman 73-78.

Aryu, C. 2020. Buku Epidemiologi Stunting. Semarang. Fakultas Kedokteran Universitas

Diponegoro. Cetakan 1.

Badan Penelitian dan Pengembangan Kesehatan. 2018. Hasil Utama Riskesdas 2018. Jakarta:
kemenkes RI; p.203-6,558-79.

Rahman T, Adhani R, Triawanti. 2016. Hubungan Antara Status Gizi Pendek (Stunting) dengan
Tingkat Karies Gigi. J Dentino 1 (1) : 88-93.

Simorangkir EA, Pintauli S, Sudaryati E. 2020. Relationship Between Caries Experience and Food
Intake with Stunting Among 6-8 Years Old of Elementary School at Pantai Labu District
in 2018. J Britain International of Exact Sciences. 2(1):313-9.

Trihono, Atmarita, Tjandrarini DH, Irawati A, Utami NH, Tejayanti T, et al. 2020. Pendek
(Stunting) Di Indonesia. Masalah dan 78 e-Gigi, Volume 8 Nomor 2, Juli-Desember
halaman 73-78.

Utomo BS. Bersama Cegah Stunting. 2018. Warta Kesmas (2 nd ed): Cegah Stunting itu Penting.
Jakarta: Kementrian Kesehatan RI,:p. 6-7.

Fkg Unimus. 2020. Karies Gigi bisa Menyebabkan Stunting.

http://fkg.unimus.ac.id/2020/12/karies-gigi-bisa-menyebabkan-stunting. Diakes pada 09
Desember 2021 Pukul 09.00 WIB.