The target to be achieved in this study is elementary school students have good behavior to clean their teeth and mouth. Brushing teeth can prevent caries and periodontal disease. The purpose of this study was to analyze the effectiveness of education through videos and lectures about brushing teeth plaque accumulation in elementary school children. This type of research is a quasi-experimental study with a pretest-posttest group with a control design. The population is all students in the Elementary School Jl. Balam Sei Sikambing B, Medan Sunggal sub-District with a total of 252 students. While the research sample is class IV and V with a total of 74 students, according to the inclusion criteria. Plaque Index measurements were carried out before and after the intervention. Univariate data analysis, to see the description and characteristics of each variable while the bivariate data using paired-sample t-test and independent-sample t-Test. The results showed in the intervention group through video the difference before and after was 1.73 while the intervention group with a lecture was 0.23. To find out the difference in the average before and after the intervention the t-test was conducted. The statistical test obtained value p= 0,000 (p <0.005) meaning that there is a significant difference between the plaque index before and after the intervention. Education through video reduces the Plaque Index more than education through lectures. Need special attention to instill good and right behavior about brushing teeth in elementary school students.
According to the World Health Organization (WHO) in 1947 in [23], said that health is a perfect state, both physically, mentally, socially, and not only free from disease or weakness. Health Law No.36 of 2009 provides a limitation: healthy is a healthy condition both physically, mentally, spiritually, and socially that allows everyone to live productively socially and economically. In the Law of the Republic of Indonesia number 36 of 2009 concerning Health it is described that health is a human right and one of the elements of welfare that must be realized in accordance with the ideals of the Indonesian people as referred to in the Pancasila and the 1945 Constitution of the Republic of Indonesia. It was further explained that everything that caused health problems to the people of Indonesia would cause huge economic losses for the country, and every effort to improve the degree of public health also meant investment in the country's development [1, 3, 5].
Based on the results of the [20], it states that the proportion of dental and mouth problems in Indonesia is 57.6% and those receiving services from dental medical personnel are 10.2%, while the proportion of teeth brushing behavior is 2.8%. In the age group of 5 (five) to 9 (nine) years as many as 93.2% who do toothbrush behavior every day, but only 1.4% who do toothbrush with good and right time. Oral health is part of the reflection of overall body health. Dental and oral health are important for general health and well-being and greatly affect the quality of life, including speech, mastication, and self-confidence. Dental and oral health problems will have an impact on one's performance. In Indonesia, oral and dental diseases, especially caries and periodontal disease, still suffer a lot, both by children and adults. Most oral and dental health problems can be prevented. There are many ways to reduce and prevent dental and oral diseases with various approaches that include prevention that starts in the community, self-care and professional care [19].
Prevention (preventive) can be defined as preventing the emergence or development of a disease or restore bodily functions that become lost or reduced due to disease. Prevention can be divided according to the level of the disease and grouped into primary, secondary, and tertiary prevention. Primary prevention is to prevent someone affected by a disease [17]. This is in accordance with the vision of the Department of Dental Nursing of the Poltekkes Medan, which is: to become the Dental Nursing Department of the Ministry of Health of Medan as a center of excellence in producing Dental Nursing Associates who are skilled in conducting Dental and Oral Nursing Care in the field of promotive and preventive fields that meet national standards in 2018. Prevention efforts Dental caries in children can be done by taking into account the factors of hard tissue disease [6-10].
Education or education is an important part of the national development process as one of the determining sources in a country's economic growth. According to Law No. SISDIKNAS 20 of 2003, states that education is an effort made consciously and planned to realize the atmosphere and the learning process so that students are actively able to develop the potential that exists within themselves to have religious-spiritual strength, good personality, self-control, noble character, intelligence and skills needed by himself and the community. The purpose of education in Indonesia has been explained in the 1945 Constitution, the provisions of the MPR, the Law on the National Education System and other provisions.
Improving one's behavior so that more concerned about the health of his teeth and mouth, several efforts need to be done. One effort that must be done is to provide dental health education to the community. The media will assist in health promotion so that health messages can be conveyed more clearly and the target community can receive the message clearly and precisely. With media people can understand health facts that are considered complicated [15].
Video is a system for delivering teaching messages where recorded video material is presented by computer control to students who not only hear and see video and sound, but also provide active responses and responses that will determine the speed and sequence of presentation [2].
Brushing teeth must be done properly and correctly so that debris or food scraps can be removed from the surface of the teeth. This debris if not cleaned will cause various problems, including plaque accumulation, tartar, cavities, bad breath and so on. How to brush teeth properly and correctly is done diligently, thoroughly and regularly. The best time to brush your teeth is after every breakfast and before going to bed at night. The important thing in maintaining oral and dental hygiene is awareness in the self-care behavior of each individual [19].
School-age is a time to lay a solid foundation for the realization of quality human beings and health is an important factor that determines the quality of human resources. The role of schools is very necessary in efforts to maintain dental and oral health of children, because of environmental factors, one of which is the school has a great power in determining the behavior of the habit of brushing teeth on children carried out in daily life without feeling forced.
Seeing the fact that there is education to maintain the condition of dental health still needs to be encouraged especially for elementary school students. One effort that is programmed is with promotive efforts. Elementary school students are generally very interested in watching videos, due to the pictures and sounds that attract their attention.
Initial survey of elementary school students Jl. Balam number 57 Sei Sikambing B Medan Sunggal sub-District, Medan shows that 18 people (90%) of 20 students did not brush their teeth on time and usually brushed their teeth in the morning and afternoon bath. Likewise, the methods/ways to brush teeth, in general, are not yet right. To prevent caries (tooth decay), disease supporting the teeth and other pathological conditions in the mouth it is necessary to instill positive behavior towards the dental health of elementary school children [11-14].
Based on the above background the researcher is interested in analyzing the effectiveness of education through videos and lectures about brushing teeth against plaque accumulation in elementary school students.
To analyze the effectiveness of educational video application about brushing teeth against plaque accumulation in elementary school students in Medan Sunggal sub-District.
To asse
To assess plaque accumulation (Plaque Index) after an education through a video about brushing teeth at elementary school students in Medan Sunggal sub-District.
To assess plaque accumulation (Plaque Index) before a lecture about brushing teeth at elementary school students in Medan Sunggal sub-District
To assess plaque accumulation (Plaque Index) after a lecture about brushing teeth at elementary school students in Medan Sunggal sub-District.
To analyze the effectiveness of education through videos and lectures about brushing teeth against plaque accumulation in elementary school students in Medan Sunggal sub-District.
The benefits of this research are:
As basic information about the condition of dental and oral hygiene of elementary school children in Medan Sunggal sub-District.
Foster a greater sense of care to maintain oral and dental hygiene that starts from an early age and the period of change of deciduous teeth (milk teeth) into permanent teeth [15-18].
Producing science and technology products and social media in the form of "video applications
Development of teaching materials, especially Dental Health Education (PKG) courses.
Type of research used is quasi-experiment with a pretest-posttest group design with control design, which can be described as follows:
The population in this research is the area that the researcher wants to study, according to Sugiyono [25] the population is a generalization area that consists of objects/subjects that have certain qualities and characteristics determined by the researcher to be studied and then conclusions drawn. The population in this study were all students at elementary school the fowl with the number 252.
According to [1], said that if the subject is less than one hundred, it is better to take all of it so that the research is population. But if a large number of subjects can be taken between 10-15% or 25% or more. If the sample is broken down into subsamples, the minimum sample size is 30 subjects for each category. This opinion is appropriate according to Roscoe in [25], a decent sample size in the study is between 30 to 500. Samples were taken in a total population of 74 children, namely students in grades IV and V with consideration of the ability to receive almost the same material [21-24].
In this study the data collected are primary data and secondary data. Primary data taken by researchers are Plaque Index data before and after the intervention. Primary data is carried out through direct measurement and filling in the inspection format. The data collection techniques are as follows:
The sample is divided into two (2), one group gets education through video and the other group through lectures.
Disclosing solution is applied to the entire surface of the respondent's teeth.
Tooth and mouth examination to get the initial Plaque Index value.
Intervene.
The target (respondent) is watching a video with a duration of 10 minutes
Frequency of watching video one (1) time in one (1) week for one month
Varying each image will intervene in
Lectures are held with a frequency of one (1) time in one (1) week for one month with a duration of 10 minutes.
After 4 (four) weeks re-examination of the Plaque Index on teeth and mouth in the treatment and control groups was recorded in the examination format.
Secondary data obtained from elementary school teachers Jl. Balam Medan Sunggal sub-District.
Analysis is performed by:
Univariate data analysis, to see the description and characteristics of each independent variable (free) and the dependent variable (bound).
Bivariate data analysis was used to determine the effect of the intervention through video and lecture methods on the Plaque Index of elementary school children before and after the intervention, the average paired sample t-test was performed. To find out the effectiveness of education on brushing teeth through video and the lecture is conducted utilizing the different independent sample t-test. If the data is not distributed normally, the test used is the Mann whiney test and the test Wilcoxon [26-30].
This study was obtained from the Health Ethics Commission of the Medan Health Ministry Polytechnic No. 291 / KEPK.POLTEKKES KEMENKES MEDAN / 2019
Carried out in State Elementary School No. 064018 with the address Jl. Balam Sei Sikambing B Medan Sunggal sub-District Medan. Ownership status is Local Government with School Establishment Decree: XX / 1975 dated July 1, 1975. Classrooms consist of 9 rooms, accreditation status B and curriculum in 2013. At present, the headmaster, Enniwati, S.Pd, has 16 teachers (1 male and 15 female). The total number of students is 252 people with the details of 130 men and 122 women. Not far from Elementary School No. 064018 there is a Madrasah Ibtidaiyah Negeri (MIN) school with a greater number of students.
Respondents included in this study were 74 people and according to the inclusion criteria.
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| 8 | 0 | 0 | 7 | 18,9 |
| 9 | 3 | 8,1 | 21 | 56,8 |
| 10 | 22 | 59,5 | 8 | 21,6 |
| 11 | 11 | 29,7 | 1 | 2,7 |
| 12 | 1 | 2,7 | 0 | 0 |
| Total | 37 | 100 | 37 | 100 |
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| Men | 21 | 56,8 | 17 | 45,9 |
| Women | 16 | 43,2 | 20 | 54,1 |
| Total | 37 | 100 | 37 | 100 |
From table 4.1. shows that in general children elementary school who were respondents were 9 years old (56.8%) in the lecture group and 10 years (59.5%) in the video group. The sex of respondents in the female lecture group was 20 people (54.1%) and in the video group the male group was more that is 21 people (56.8%).
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| Good | 3 | 8,1 | 15 | 40,5 |
| Medium | 9 | 24,3 | 20 | 54,1 |
| Poor | 25 | 67,6 | 2 | 5,4 |
| Total | 37 | 100 | 37 | 100 |
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| Good | 30 | 81,1 | 24 | 64,9 |
| Medium | 7 | 18,9 | 11 | 29,7 |
| Poor | 0 | 0 | 2 | 5,4 |
| Total | 37 | 100 | 37 | 100 |
From table 4.2. showed that the most plaque index criteria before video playback was bad criteria with 25 people (67.6%), after the most video playback with good criteria, 30 people (81.1%). Whereas education with the most lectures was with medium criteria, namely 20 people (54.1%) and after lectures was a good criterion of 24 people (64.9%).
Plaque accumulation is known by using the Plaque Index. Plaque Index measurement can be done by using a dye solution that is applied to the entire surface of the tooth and then examined. Each tooth was examined 4 surfaces namely mesial, distal, lingual, and facial surfaces and then the scores were calculated. If the score ranges from 0-1 is categorized as good, 1.1-2 is moderate and 2.1-3 is bad. From the results of the measurement of the Plaque Index of respondents obtained the results as presented in table 4.3. and table 4.4.
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| Plaque Index Before | 2,258 | 0,700 | 0,000* | 37 |
| Plaque Index After | 0,528 | 0,512 |
From table 4.3. The average value of the Plaque Index in the video group before the intervention was 2.258, while after the intervention it became 0.5280, with 37 respondents. The statistical test conducted obtained
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| Plaque Index Before | 1,165 | 0,496 | 0,027* | 37 |
| Plaque Index After | 0,935 | 0,392 |
From table 4.4. can be seen as the average value of the Plaque Index in the lecture group before the intervention of 1.165 while after the intervention of 0.935, with 37 respondents. The statistical test obtained p = 0.027 there is an average difference between the Plaque Index before and after the lecture intervention given, meaning that there is an influence of lecture in decreasing the Plaque Index on respondents.
Analysis of educational effectiveness of video applications and lectures about brushing teeth against plaque accumulation in elementary school students.
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| Plaque Index Before Intervention | 2,258 | 1,165 | 0,0001 |
| Plaque Index After Intervention | 0,528 | 0,935 | |
| Difference in Plaque Index Before and After the intervention | 1,73 | 0,23 |
From Table 4.5. shows the difference in the average Plaque Index before and after the intervention descriptively proves the decrease in plaque index. In the intervention group via video the difference before and after was 1.73 while the intervention group with a lecture was 0.23. To find out the difference in the average before and after the intervention the t-test was conducted. The statistical test obtained value
Elementary school students usually have an age range from 6 to 12 years. Education in elementary schools is an educational level that has a very important role in efforts to improve the quality of human resources (HR). Judging from the theory of cognitive development of elementary school students entering a concrete operational stage, elementary school students like to feel or do/demonstrate something directly. In psychosocial development the concentration power of students grows in large classes of elementary schools. They can spend more time on chosen assignments, and often they are happy to complete it. This stage also includes the growth of independent action, collaboration with groups and acting in ways that are acceptable to their environment. They also began to care about the honest play [24]. According to [13], elementary school students like things that arouse their imagination. Learning will be effective when the learning atmosphere is fun. The atmosphere, the state of the room will show the arena of learning that is influenced by emotions.
Based on the analysis of data collected from 74 elementary school students aged 10 years (59.5%) more in the video group, while in the 9-year-old lecture group (56.8%). The sex of respondents in the male video group was more that is 21 people (56.8%) while the group of female lectures was 20 people (54.1%).
One of the factors that influence plaque accumulation on the surface of one's teeth is knowledge about brushing their teeth. According to [15], Knowledge is the result of understanding after a person has inflicted a certain object. The sensing occurs through the five senses owned by humans, namely the sense of hearing, sight, smell, and touch. Most of the knowledge obtained by humans is through the sense of sight and hearing. Knowledge about tooth brushing can be obtained from various sources such as radio, television, print media or through formal channels such as education. In this study, all respondents were given education about brushing their teeth with different media, namely one group through video and one group with a lecture method that aims to provide education to elementary school students.
Improving one's behavior so that more concerned about the health of his teeth and mouth needs to be done several efforts. One of the efforts made is to provide education to students. In health education or education, it is known that media is one of the supporting facilities for activities that can be used to channel dental health messages to the target. The delivery of messages through the media can stimulate the thoughts, feelings, concerns, and interests of the recipient of the material. Media functions to facilitate the reception of messages about brushing teeth for students, so that the message delivered is more understandable and easier to remember, [21].
From table 4.3. The average value of the Plaque Index in the video group before the intervention was 2.258, while after the intervention it became 0.5280, with 37 respondents. The statistical test conducted obtained p= 0,000 there was an average difference between the Plaque Index before and after the video intervention given, meaning that there was a video effect in reducing the respondents' plaque index.
The use of video as an educational tool is now being developed in line with current technological advances. Video is a set of tools that can project a moving image which is a blend of image and sound forming the same character as the original object [11].
The students studied were between 8 to 12 years old, were at this age children tend to eat sweet, sticky foods. According to [19], the speed of cleaning food debris from the oral cavity varies according to the type of food and the individual. Liquid food is easier to clean than solid food. The sugar eaten in the liquid state is left in the saliva for 15 minutes, while the sugar eaten in the solid-state is left in the saliva until 30 minutes after mastication. Sticky foods like bread, bonbon, and caramel, which are generally favored by children, can stick to the surface of the teeth for more than an hour, while rough foods like raw carrots, apples will clean up immediately. Cold food will be cleaned faster than hot food.
The value of plaque accumulation can be determined by using the Plaque Index. How to check plaque can be done using a disclosing solution or without using disclosing, if a small amount of plaque cannot be seen except by disclosing solution. Dental plaque is a soft deposit that is firmly attached to the surface of a tooth, consisting of microorganisms that multiply in the intercellular matrix if someone ignores the cleanliness of their teeth and mouth. If the plaque builds up it will look gray, yellowish gray, and yellow. Dental plaque cannot be cleaned only by gargling or spraying water and can only be cleaned thoroughly by mechanical means such as a toothbrush [19].
The most popular learning method in Indonesia and even in other countries is the lecture method. The lecture method is a method of giving a description or explanation to many students at a certain time and place. This lecture method only relies on the sense of hearing as the most dominant learning tool. In other words, this method is a method of teaching by conveying information and knowledge orally to many students who generally follow passively [3]. In this study, researchers used the lecture method as a control method that is often used in health education. The material given during the lecture was almost the same as the material contained in the video which is about brushing teeth.
From table 4.4. can be seen the average value of the Plaque Index in the lecture group before the intervention of 1.165 while after the intervention of 0.935, with 37 respondents. The statistical test obtained p= 0.027 there is an average difference between the Plaque Index before and after the lecture intervention given, meaning that there is an influence of lecture in decreasing the Plaque Index on respondents. From the lecture process that has been done, approaching 10 minutes the students have begun to focus, inviting their friends to joke and talk. These obstacles allow many children to still not understand the material about brushing their teeth.
Improving one's behavior so that more concerned about the health of his teeth and mouth needs to be done several efforts. One of the efforts made is to provide education to students in this research education through videos and lectures.
To analyze the effectiveness of education through videos and lectures about which tooth brushing is more effective against the plaque accumulation (Plaque Index) of respondents, conducted independent t-test was. From table 4.5. shows the difference in the average Plaque Index before and after the intervention descriptively proves the decrease in plaque index. In the intervention group via video the difference before and after was 1.73 while the intervention group with a lecture was 0.23. To find out the difference in the average before and after the intervention the t-test was conducted. The statistical test obtained value p= 0,000 (p <0.005) meaning that there is a significant difference between the plaque index before and after the intervention, meaning that education through video reduces Plaque Index more than education through lectures. This is in line with the research of [12], which states that there is a decrease in the plaque index of children in the counseling method with video, where the research compares with the demonstration method. Likewise, the research result of [14], with the title of the role of education by using video to improve the behavior of mothers in brushing their teeth shows that videos play an effective role in education to improve the behavior of mothers in brushing their teeth.
According to [2], the benefits of using video can include describing a process that can be witnessed repeatedly if deemed necessary, while encouraging and increasing video motivation to instill attitudes and other effective aspects, videos that contain positive values can invite thought and discussion in student groups. Video can present a dangerous event when viewed directly such as the result if you do not brush your teeth, will be hollow (caries) and become sick.
From the research that has been carried out, it can be concluded that
Plaque accumulation value (Plaque Index) before education about tooth brushing through video is 2, 26 and after it is done, the average Plaque Index becomes 0, 53.
Plaque accumulation value (Index Plaque) before education about brushing teeth with an average lecture was 1.17 and after it was done, the average Plaque Index became 0, 94.
Education about brushing through videos was more effective compared to the lecture method on the Plaque Index (
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