Dental Care Flip Model: Dental Health Education To Improve Dental Health Maintenance Behavior of Elementary School Students
Dental Care Flip Model: Dental Health Education To Improve Dental Health Maintenance Behavior of Elementary School Students
Abstract: Background: One of the risk factors causing high oral health problems is knowledge, attitudes, and actions. To
overcome these problems, media is used as a tool, with the Dental Care Flip model. It is hoped that it will be a solution to
facilitate the education process so that it can help elementary school children to improve their knowledge, attitudes, and
actions to maintain oral health: Produce a Dental Care Flip model that is feasible and effective in changing the knowledge,
attitudes, and actions of primary school children's dental and oral health maintenance Methods: The study used the research
and development (R&D) method: to create a feasible model with a research design using quasi-experimental (pre-post with
control group design) to determine the effectiveness of the model. The sampling technique used purposive sampling,
consisting of 31 intervention group children using the Dental Care Flip model and 31 control group children using flipchart,
which was given for 10 days. Data were analyzed using the interclass correlation coefficient test, normality, Wilcoxon, and
Mann-Whitney. Results: The Dental Care Flip model is feasible as a model in improving knowledge, attitudes, and oral
health maintenance actions of elementary school children with a p-value = 0.000. This model is effective in improving
knowledge (p=0.001), attitudes (p=0.000), and actions (p=0.000) compared to the control group Conclusion: The Dental Care
Flip model is feasible and effective in improving the knowledge, attitudes, and oral health actions of elementary school
children.
Keywords: Dental Care Flip Model, Primary School Children, Oral Health.
How to Cite: Afifah Ayestina Pelingga; Sukini; Marsum (2025) Dental Care Flip Model: Dental Health Education to Improve
Dental Health Maintenance Behavior of Elementary School Students. International Journal of Innovative Science and Research
Technology, 10(7), 2453-2460. https://doi.org/10.38124/ijisrt/25jul1569
affect the development of permanent teeth. If not properly The right strategy to support changes in school children's
cared for, permanent teeth are at risk of decay even before they behavior in maintaining dental health is to provide education
are fully erupted, so it is important to maintain the health of using learning methods and adapted media[14]. Media has a
primary teeth to prevent negative impacts on permanent teeth significant role in influencing the course of the health
in the future[7]. education process. as a tool, media facilitates the delivery of
material, especially in oral health education. Media that is well
Dental health problems in elementary school children are designed and involves various senses will make it easier for
influenced by improper brushing habits and high consumption students to understand and remember information. In addition,
of cariogenic foods. As many as 53% of children do not brush the media must be arranged attractively so that it can increase
their teeth properly and 83% do it at the wrong time such as student interest in learning and involvement in the educational
during morning and afternoon showers. This reduces the process[15].
effectiveness of tooth cleaning coupled with consumption
patterns of sweet and sticky foods such as candy and cookies The appropriate use of methods and media greatly affects
that encourage the growth of caries-causing microorganisms. the effectiveness of dental health education. In accordance
As a result, 43% of children have poor oral hygiene which with Dale's Cone of Experience theory, the use of media that
increases the risk of tooth decay[8],[9]. can involve many senses provides a richer experience so that
information is more easily accepted and remembered. Media
The high prevalence of dental caries, which reaches is not only a provider of information, but also a means of
79%, is closely related to the consumption of cariogenic foods, providing direct experience to students, helping them
of which 59% of children are fond of consuming. understand the importance of maintaining oral health in a more
Classification of food by microorganisms produces lactic acid in-depth and enjoyable way[16].
which damages tooth enamel, accelerating decay. Children
with high sugar intake have a 92% greater risk of caries. Low Several media have been used in dental health education.
understanding of the correct technique, frequency and timing One of them is flip chart media. However, this media still has
of brushing exacerbates this situation, so intensive education shortcomings, namely that it is static because it only presents
and behavior change are needed to reduce caries rates in information in visual form without any interactive or dynamic
children[10]. elements so that students are more often passive recipients of
information. This limitation makes it difficult for students to
The Ministry of Health has established the National be actively involved in the learning process, both cognitively,
Action Plan for Dental and Oral Health Services Towards a affective, and psychomotor. In addition, conventional
Caries-Free Indonesia 2030, in accordance with WHO flipcharts are not designed to stimulate discussion, critical
recommendations[11]. However, achieving this target faces a thinking or hands-on activities that engage students, making
big challenge considering the high prevalence rate and low them less effective in creating a well-rounded learning
knowledge of oral health maintenance such as how and the experience[17].
frequency of brushing teeth and high consumption patterns of
cariogenic foods are the main obstacles. For this reason, more To improve the quality of message delivery, a Dental
intensive and sustainable educational efforts are needed to Care Flip model was developed that integrates visual and
increase understanding of the importance of maintaining oral audio elements to enrich the learning experience. This
health[10]. flipchart not only contains material about oral health
maintenance but is also equipped with interactive questions
A person's awareness in maintaining oral health can be that stimulate students' critical thinking (cognitive), build
influenced by knowledge, attitudes which are the domain of awareness and positive attitudes (affective), and encourage
behavior. Knowledge is mostly obtained through the senses of direct practice such as simulating brushing teeth with audio
the eyes and ears. Information captured by the eyes and ears is guidance (psychomotor). It is hoped that this innovation can
intended to change attitudes and requires repetition so that the create more holistic learning and actively involve students so
understanding process occurs in individuals. According to that information about oral health maintenance is easier to
Middle Cook, repetition of information can help change understand, remember, and apply in everyday life.
attitudes so that children can determine attitudes that can lead
to expected actions[12]. Based on the above background, one of the solutions that
will be carried out by the author to overcome the problem of
Improving dental health requires dental health education dental health maintenance in elementary school children as
to achieve changes in the behavior of individuals, families, and well as development innovations from previous media is
communities in maintaining healthy behavior and “Development of a dental care flip model as an effort to
environment, and playing an active role in improving health improve knowledge, attitudes, and dental health maintenance
status. In addition, this education aims to form healthy actions in elementary school students”.
behaviors that include physical, mental, and social aspects, so
as to reduce morbidity and mortality rates. According to
WHO, the purpose of health counseling is to change the
behavior of individuals or communities in the health sector to
achieve better conditions[13].
The study used the research and development (R&D) A. Univariate Analysis
method: to create a feasible model with a research design using The research subjects in this pilot phase totaled 62
quasi-experimental (pre-post with control group design) to primary school children in grades 4 and 5, consisting of 31
determine the effectiveness of the model. The sampling children from SDN Pedalangan 01 as the control group and 31
technique used purposive sampling, consisting of 31 children from SDN Pedalangan 02 as the intervention group.
intervention group children using the Dental Care Flip model An overview of the respondents is presented in the following
and 31 control group children using flipchart, which was given table:
for 10 days. Data were analyzed using the interclass correlation
coefficient test, normality, Wilcoxon, and Mann-Whitney.
Tabel 1 Frequency Distribution of Characteristics of Respondents in the Intervention and Control Groups
Intervention Group Control Group
No Variable
n (%) n (%)
1 Gender
Male 13 41,9 14 45,2
Female 18 58,1 17 54,8
2 Age
9 years old 2 6,5 3 9,7
10 years old 8 25,8 7 22,6
11 years old 15 48,4 13 41,9
12 years old 6 19,4 8 25,8
Table 1 shows the frequency distribution data of the characteristics of male subjects in the intervention and control groups,
which were 41.9% (13 students) and 45.2% (14 students), respectively, while female respondents in the intervention and control
groups were 58.1% (18 students) and 54.8% (17 students), respectively. Based on age, the frequency of respondents aged 9 years in
the intervention and control groups was 6.5% (2 students) and 9.7% (3 students), respectively, while respondents aged 10 years in
the intervention and control groups accounted for 25.8% (8 students) and 22.6% (7 students), respectively. respondents aged 11
years in the intervention and control groups were 48.4% (15 students) and 41.9% (13 students), respectively, and respondents aged
12 years in the intervention and control groups were 19.4% (6 students) and 25.8% (8 students), respectively.
B. Bivariate Analysis
A bivariate analysis was conducted to test the differences between two variables using paired and unpaired variable effectiveness
tests.
Normality Test
The normality test aims to determine whether the data collected for each variable is normally distributed or not. The normality
test in this study uses the Shapiro-Wilk method because the number of samples in this study is less than 50 samples.
Table 2 Normality Test of Data from the Intervention Group and Control Group
*p-value
Variable
Intervention Control
Pre-Test Knowledge 0,000 0,006
Post Test Knowledge 0,000 0,000
Attitude Pre-Test 0,068 0,000
Post-Test Attitude 0,000 0,001
Pre-Test Actions 0,004 0,000
Post Test Action 0,000 0,000
Table 2 shows that most of the normality test results in the intervention and control groups show p-values <0.05, namely in
the variables Pre-Test Knowledge, Post-Test Knowledge, Post-Test Attitude, and Pre- and Post-Test Actions, both in the intervention
and control groups. Only the Pre-Test Attitude variable in the intervention group showed a normal distribution with a p-value of
0.068 (>0.05). However, based on statistical analysis principles, if one or more variables do not meet the normality assumption, the
entire dataset is analyzed using non-parametric statistical tests. Therefore, the effectiveness test is analyzed using the non-parametric
Wilcoxon and Mann-Whitney tests.
Table 3 Test of Differences in Mean ± SD of Children's Knowledge Within and Between Intervention and Control Groups
Variable Group Mean ± SD Pre test Mean ± SD Post test Delta ± SD (Δ) p-value
Intervention 8,93 ± 0,77 12,80 ± 2,53 3,87 ± 3,03 0,000*
Knowledge 10,19 ±1,72 11,58 ± 1,05 1,38 ± 1,89 0,002*
Control
p = 0,001**
*Paired Test : *Wilcoxon
**Paired t-test : ** Mann Whitney
Table 3 shows that the results of the paired data test of children's knowledge in the intervention group reached a p-value of 0.000
(<0.05), which means that there was a difference in children's knowledge before and after education using the Dental Care Flip model.
In the control group, the p-value obtained was 0.002 (<0.05), indicating a difference in children's knowledge before and after education
using a flipchart. The results of the unpaired data test showed a p-value of 0.001 (<0.05), indicating that the Dental Care Flip model
is more effective in improving children's knowledge compared to the flipchart. This is evidenced by the average change (Δ) in the
intervention group being better than that of the flipchart used in the control group, with the intervention group at 3.87 and the control
group at 1.38.
Table 4 Test of Differences in Mean ± SD of Children's Attitudes Within and Between Intervention and Control Groups
Variable Group Mean ± SD Pre test Mean ± SD Post test Delta ± SD (Δ) p-value
Inttervention 66,87 ± 3,85 73,48± 2,21 6,61 ± 4,86 0,000*
Attitude 71,48 ± 2,17
Control 67,64 ± 4,66 3,83 ± 5,17 0,002*
p = 0,00**
Table 4. shows that the results of the paired data test of children's attitudes in the intervention group showed a p-value of 0.000
(<0.05), which means that there was a difference in children's knowledge before and after education using the Dental Care Flip model.
In the control group, the p-value obtained was 0.002 (<0.05), indicating a difference in children's knowledge before and after education
using a flipchart. The results of the unpaired data test show a p-value of 0.00 (<0.05), indicating that the Dental Care Flip model is
more effective in improving children's knowledge compared to the flipchart. This is evidenced by the average change (Δ) in the
intervention group being better than that of the flipchart used in the control group, with the intervention group at 6.61 and the control
group at 3.83.
Table 5 Test of Differences in Mean ± SD of Children's Actions within and Between Intervention and Control Groups
Mean ± SD Mean ± SD Delta ± SD (Δ)
Variable Group P-Value
Pre Test Post Test
Intervention 10,61± 2,52 13,54 ± 1,47 2,93 ± 2,95 0,000*
Action 11,03 ±1,19 12,06 ± 0,67 1,03 ± 1,35 0,001*
Control
p = 0,00**
*Paired test : *Wilcoxon
**Paired t-test : ** Mann Whitney
Table 5 shows that the results of the paired data test of IV. DISCUSSION
children's attitudes in the intervention group showed a p-value
of 0.000 (<0.05), which means that there was a difference in The model was tested on two groups in this study. The
children's knowledge before and after education using the intervention group consisted of 31 respondents, and the control
Dental Care Flip model. In the control group, the p-value group consisted of 31 respondents. The intervention group was
obtained was 0.01 (<0.05), indicating a difference in children's given treatment using the Dental Care model, while the control
knowledge before and after education using a flipchart. The group used flipcharts. The model was applied to both the
results of the unpaired data test show a p-value of 0.00 (<0.05), intervention and control groups to improve oral health
indicating that the Dental Care Flip model is effective in maintenance in elementary school children, including
improving children's knowledge compared to the flipchart. knowledge, attitudes, and toothbrushing practices. The
This is evidenced by the average change (Δ) in the intervention provision of materials on oral health is an activity planned
group being better than that of the flipchart used in the control through a learning process aimed at imparting knowledge,
group, with the intervention group at 2.93 and the control group instilling attitudes, and developing skills in children, so that
at 1.03. they can independently perform actions to maintain oral health
in their daily lives.
A. The Effectiveness of the Dental Care Flip Model on (2024), it was found that good knowledge about oral health,
Improving Knowledge of Dental and Oral Health combined with positive habits, has a significant influence and
Maintenance in Elementary School Children impact on oral health and overall health, thereby improving
Statistical analysis results and paired tests showed that quality of life.
the average knowledge score before the intervention group
treatment was 8.93, increasing to 12.80, with a p-value of The use of audio and visual media in the Dental Care Flip
0.000 (p<0.05). It can be concluded that the Dental Care Flip model integrates technology that can be accessed and used
model is effective in improving knowledge related to dental independently by children. This approach successfully attracts
and oral health care in elementary school children. their attention to the information being conveyed and makes
children more focused on the material. The media is designed
The average change (Δ) in the intervention group was to include elements that have been specifically tailored to the
higher at 3.87 compared to the control group, which had an developmental characteristics of elementary school children,
average change (Δ) of 1.38. The results of the unpaired test thereby supporting a more optimal and effective learning
showed a p-value of 0.00 (p<0.05), which means that the process.
Dental Care Flip model is more effective in increasing
knowledge related to oral health care than the control group. The use of technology that is designed according to
children's needs and is interactive allows children to be
Knowledge is the result of human perception of an object directly involved in the process of using it, which has been
through the five senses, which produces a specific response proven to increase attention and participation during the
[18]. A person's knowledge is obtained through stimuli that can delivery of information. Children's direct involvement in the
be provided through education or health education [19]. The use of technology-based educational media not only
increase in knowledge among the intervention group occurred strengthens their focus but also increases cognitive
because the Dental Care Flip education model was designed engagement, making the information conveyed easier to
based on the needs of the target audience and presented understand and remember for a longer period of time[23].
material that was easy to understand. The content of this model
includes information about foods that are good for dental B. Effectiveness of the Dental Care Flip Model on Improving
health, foods that can damage teeth, the right time to brush Oral Health Maintenance Attitudes Among Elementary
teeth, proper brushing techniques, and the importance of School Children
visiting a dentist for check-ups. Statistical analysis results and paired tests showed that
the average attitude score before the intervention group
The quizzes embedded in this educational model serve as treatment was 10.61, increasing to 13.54, with a p-value of
interactive activities that encourage student engagement, 0.000 (p<0.05). It can be concluded that the Dental Care Flip
thereby increasing their enthusiasm in completing each model is effective in improving attitudes related to dental and
question given. This statement is in line with Nissa's (2023) oral health care in elementary school children.
findings, which show that interactive, engaging, and easy-to-
understand educational media are suitable for use as learning The mean change values (Δ) in the intervention group
tools. Additionally, the repeated use of media in educational were higher at 2.93, while in the control group, the mean
activities has been proven to strengthen participants' change values (Δ) were 1.03. The results of the unpaired test
understanding of the material presented[20]. yielded a p-value of 0.00 (p<0.05), indicating that the Dental
Care Flip model is more effective in improving attitudes
Educational delivery that involves more than one sense toward oral health maintenance compared to the control group
has been proven to strengthen children's memory and using a flipchart.
understanding, so that the information conveyed is more
profound and lasting. In line with Edgar Dale's Theory, it states A person's attitude arises from the appropriateness of
that a person's level of understanding of information can their reaction to a stimulus in daily life, which reflects the
increase by 70–90% if learning involves various forms of compatibility between the individual's perception and the
stimulation or the use of several senses simultaneously, which stimulus received. The increase in positive attitudes among
in turn can improve children's understanding more optimally students occurred because the knowledge they gained not only
[16]. broadened their understanding but also fostered a belief in the
importance of practicing healthy behaviors in their lives [24].
The more knowledge a person has, the better their ability
to absorb and respond to information, which leads to more Behavioral transformation in children is closely related
positive attitudes and actions. Adequate knowledge is an to an increase in knowledge, from ignorance to deep
important factor in promoting healthy behavior, while a lack understanding, which forms the foundation for the formation
of knowledge can trigger various dental and oral health of new attitudes. This understanding influences children's
problems [21]. awareness in maintaining optimal dental and oral health. An
educational approach that utilizes appropriate educational
Knowledge plays a key role in preventing and media to facilitate attitude change can stimulate children's
overcoming various problems, where one of the influencing cognitive and affective engagement more effectively in
factors is the extent to which individuals accept information. building sustainable healthy living habits [25]
Knowledge is also an important part that can shape a person's
attitudes and behavior [22]. In a study conducted by Antonio
Providing education through the Dental Care Flip model been learned and believed is called health practice, or more
can improve understanding of a subject so that children specifically known as overt dental health behavior [29]. This
understand how to maintain dental health. The understanding is clarified by the theory of behavioral change proposed by
formed from this educational process encourages children to Notoatmodjo (2010), where action or practice is the actual
internalize information more easily, making them more likely response of an individual to a stimulus or object after going
to adopt a positive attitude. through the stages of knowledge, attitude, and acceptance [26].
This is in line with the opinion that attitude is a form of A child's ability to brush their teeth correctly does not
individual evaluation of an object or stimulus received. After a appear suddenly, but is the result of a learning process that
person gains an understanding of the stimulus given, the next involves increasing knowledge and forming attitudes [30].
process is to form an assessment that reflects their attitude Knowledge is acquired through education, whether from
towards health knowledge. This shows that health attitudes are teachers, parents, or learning media. Education delivered using
also in line with health knowledge. Attitudes towards oral appropriate methods can help children understand the
health care are formed after a person learns about brushing their importance of maintaining oral hygiene and the correct steps
teeth [26]. for brushing their teeth [31].
Knowledge or cognition is a very important domain in As their knowledge grows, children begin to form
shaping a person's overt behavior. Increased knowledge can positive attitudes toward healthy behaviors, including
change perceptions, habits, and form a person's beliefs, which brushing their teeth regularly and properly. These attitudes
in turn shape attitudes. Behavior based on knowledge, will become the basis for children's internal motivation to
awareness, and positive attitudes will last longer than behavior brush their teeth independently in their daily lives, without
that is not based on knowledge and awareness [27]. always needing to be directed. Brushing teeth is a concrete
manifestation or realization of the knowledge and attitudes
Attitude is an individual's tendency to respond to certain they have acquired to maintain dental and oral health [29].
objects, situations, or individuals. These responses contain
values that reflect positive or negative views toward the stimuli The effectiveness of the Dental Care Flip model is
received. In line with the view that attitude formation is effective in improving tooth brushing habits. This
influenced by various factors, such as personal experiences, the effectiveness can be explained through the approach used,
significant role of others, cultural values, exposure to namely an interactive, visual, and engaging approach. This
information from the media, and moral learning obtained educational media is designed not only to convey information,
through educational institutions, religion, and an individual's but also to encourage active participation from children
emotional state [28] through a combination of audio and visual stimuli, both of
which play an important role in the learning process.
Changes in attitudes toward oral health care among
elementary school children are the result of efforts to absorb The Dental Care Flip model utilizes a visual approach,
and internalize information, which has a positive impact when such as pictures or illustrations of the correct steps for
repeated using the Dental Care Clip model. The positive values brushing teeth, attractive colors, and communicative designs
contained in the model can transform negative habits into that can be captured directly by the eyes, as well as
positive ones. explanations through audio. Children in elementary school are
in a stage of cognitive development where effective learning
C. Effectiveness of the Dental Care Flip Model on Improving is facilitated by media that engage more than one sense. For
Oral Health Maintenance Attitudes Among Elementary example, visuals that they can see and observe. By looking at
School Children images or the sequence of steps for proper tooth brushing,
Statistical analysis results and paired tests showed that children find it easier to understand and remember the
the average value of actions before the intervention group information [32].
treatment was 10.61, increasing to 13.54, with a p-value of
0.000 (p<0.05). It can be concluded that the Dental Care Clip In addition, the audio approach used in this model also
model is effective in improving actions related to tooth plays an important role. Information or explanations about the
brushing in elementary school children. steps for brushing teeth are conveyed through audio recordings
on the media. Hearing is one of the most effective channels for
The mean change (Δ) in the intervention group was receiving information in children, especially when combined
higher at 2.93, while the control group had a mean change (Δ) with visual stimuli. When the ears and eyes work together to
of 1.03. The results of the unpaired t-test on the data yielded a receive information, the understanding process becomes much
p-value of 0.00 (p<0.05), indicating that the Dental Care Clip stronger because it involves the two primary sensory systems
model is more effective in improving toothbrushing-related [33].
behaviors compared to the control group using a flipchart.
This is supported by previous research that shows the use
An action is an act or activity performed by an of learning media that combines audio and visual elements has
individual. After a person becomes aware of a stimulus or a significant impact on improving children's toothbrushing
object related to health, they will then make an assessment or skills. Audio media, such as narration or educational sounds,
opinion, and the next step is to apply that knowledge and can help children understand the correct steps for brushing
attitude in their daily life. The implementation of what has their teeth through repetitive and enjoyable listening.
Meanwhile, visual media such as images, text, or illustrations [12]. R. I. Fatmasari D, Ningtyas EAE, Wiyatini T, Arwani,
of proper toothbrushing movements can provide visual stimuli “Compatibility Of Sodium Fluoride Patch as an
that make it easier for children to imitate and practice the Innovation Model of Transferring Fluoride in Dental
movements accurately [34]. Care: a Quantitative Study Using in Vitro & in Vivo
Rabbit Skin,” Indian J Public Heal Res Dev, vol. 9, no.
The Dental Care Flip model not only functions as an 9, pp. 42–46, 2018.
educational tool, but also as a learning medium that can shape [13]. Salfiyadi T, Manajemen Pendididkan Kesehatan : Untuk
healthy habits through comprehensive visual and audio Sekolah Dasar. NEM, 2021.
stimulation. This approach is in line with children's [14]. dan F. D. Purnama T, Rasipin, Santoso B, Suwondo A,
developmental needs and has been proven effective in “Tedi’s behavior change model as an efforts for
encouraging real change, namely an increase in children's brushing teeth behavior in preschool children,” Int. J
ability and consistency in brushing their teeth independently ournal A llied M edical S ciences C linical R esearch (
and correctly. IJAMSCR ), vol. 7, no. 3, pp. 715–721, 2019.
[15]. M. Santoso B, Anwar MC, “Monopoly Game As
CONCLUSION Android-Based Dental Health Education Media,” J.
Appl. Heal. Manag. Technol., vol. 1, no. 1, pp. 7–15,
The Dental Care Flip model is effective in improving 2019, doi: 10.31983/jahmt.v1i1.5305.
children's knowledge, attitudes, and actions regarding oral [16]. Sari P, “Analisis Terhadap Kerucut Pengalaman Edgar
health care compared to the control group. Dale dan Keragaman dalam Memilih Media yang Tepat
dalam Pembelajaran,” J. Manaj. Pendidik., vol. 1, no. 1,
REFERENCES pp. 42–57, 2019.
[17]. Rahim B, Media Pendidikan. Jakarta: PT. Raja Grafindo
[1]. Kemenkes RI., Undang-undang Kesehatan. 2009. Persada, 2020.
[2]. dan D. N. Susilawati, “Karakteristik Pasien dengan [18]. Notoatmodjo S, Promosi Kesehatan Dan Ilmu Perilaku.
Keputusan Pembelian Jasa Layanan Kesehatan Gigi dan Rineka Cipta, 2007.
Mulut,” J. Keperawatan Silampari, vol. 4, no. 1, pp. 83– [19]. Haris Hawari Maharudin and Iryanti, “Pengaruh
91, 2020, doi: 10.31539/jks.v4i1.1472. Edukasi Media Poster Terhadap Pengetahuan
[3]. S. L. Nurwita T, Fatmasari D, Sukini, Santoso B, Masyarakat Usia 19 – 30 Tahun Tentang Covid-19,” J.
“Media Edukasi ‘Dende Mission’ Permainan Kesehat. Siliwangi, vol. 2, no. 1, pp. 251–257, 2021, doi:
Tradisional Berbasis Android Terhadap Peningkatan 10.34011/jks.v2i1.683.
Perilaku Menggosok Gigi Pada Anak Siswa SD,” 2023. [20]. Notoatmodjo S, Promosi kesehatan dan perilaku
[4]. World Health Organization, Global oral health status kesehatan, vol. 5, no. 3. Jakarta: PT. Rineka Cipta, 2012.
report, vol. 57, no. 2. 2022. [21]. A. S. Meidina, S. Hidayati, and I. C. Mahirawatie,
[5]. Kemenkes RI, “Laporan Tematik Survey Kesehatan “Systematic Literature Review: Pengetahuan
Indonesia,” Jakarta, pp. 157–162, 2023. Pemeliharaan Kesehatan Gigi dan Mulut Pada Anak
[6]. Kemenkes RI, “Survei Kesehatan Indonesia,” Jakarta, Sekolah Dasar,” Indones. J. Heal. Med., vol. 3, no. 2, pp.
vol. 01, pp. 1–68, 2023. 41–61, 2023.
[7]. dan S. Sadimin, Prasko, Sariyem, “Dental Health [22]. Y. Laudasarni, N. M. Dinatha, L. L. Teang, B. A. Dedo,
Education to Knowledge about PHBS How to Maintain and Made Dewi Sariyani, “Pendidikan Kesehatan
Dental and Mouth Cleanliness at Orphanage Tarbiyatul Terhadap Pengetahuan Perilaku Hidup Bersih Dan
Hasanah Gedawang, Banyumanik, Semarang City,” J. Sehat Siswa Smp,” J. Edukasi Citra Olahraga, vol. 4, no.
Kesehat. Gigi, vol. 8, no. 1, pp. 1–5, 2020. 1, pp. 10–19, 2024, doi: 10.38048/jor.v4i1.3471.
[8]. dan M. Y. Nugroho LS, Femala D, “Perilaku Menyikat [23]. R. Resti, R. A. Wati, S. Ma’Arif, and S. Syarifuddin,
Gigi terhadap Oral Hygiene Anak Sekolah,” Dent. Ther. “Pemanfaatan Media Pembelajaran Berbasis Teknologi
J., vol. 1, no. 1, pp. 44–51, 2019, doi: sebagai Alat Untuk Meningkatkan Kemampuan Literasi
https://doi.org/10.31965/DTJ. Digital Siswa Sekolah Dasar,” Al Madrasah J. Pendidik.
[9]. dan C. O. Maharani S, “Makanan Manis Sebagai Faktor Madrasah Ibtidaiya, vol. 8, no. 3, p. 1145, 2024, doi:
Risiko Karies Gigi Pada Anak Di Sd Negeri Buni Bakti 10.35931/am.v8i3.3563.
04,” J. Kesehat. Tambusai, vol. 4, no. 3, pp. 1852–1859, [24]. E. C. Watulangkow et al., “Hubungan Antara
2023. Pengetahuan Dan Sikap Dengan Perilaku Hidup Bersih
[10]. Hamzah A, “Pola Konsumsi Makanan Kariogenik Dan Sehat Pada Peserta Didik Di Sd Inpres Lemoh
dengan Kejadian Karies Gigi pada Anak Sekolah Dasar Minahasa,” J. KESMAS, vol. 9, no. 1, pp. 169–175,
Ariogenic Food Consumption Pattern with the incidence 2020.
of dental caries in elementary school children,” [25]. E. Nurizza, B. Santoso, R. Rasipin, M. Marsum, and T.
DoharaPublisherOpenAccesJournal, vol. 1, no. 01, p. Wiyatini, “Android-Based Educational Model Cross
15, 2021. Puzzle to Improve Dental Health Behavior among
[11]. Kemenkes RI, Rencana Aksi Nasional : Pelayanan Elementary Schools,” Int. J. Nurs. Heal. Serv., vol. 5,
Kesehatan Gigi dan Mulut Tahun 2015-1019. 2015. no. 6, pp. 464–474, 2022, doi: 10.35654/ijnhs.v5i6.643.
[26]. Notoatmodjo S, Pendidikan Dan Perilaku Kesehatan.
Rineka Cipta, 2018.