Model development of patient's dental and oral health care in raden mattaher hospital, Jambi Province

Introduction

Caries is a disease of the hard tissues of the teeth, including enamel, dentin, and cementum, caused by the activity of decaying carbohydrate deposits.1, 2 The hallmark is the demineralization of the hard tissues of the teeth, followed by destruction by organic matter. As a result, bacterial invasion, pulp death, and the spread of infection to the periapical tissue can cause pain. However, at a very early stage, the disease can be stopped, given the possibility of remineralization.1, 3

Although rare, dental disease can also cause death. Untreated cavities will be a source (focal) of infection and can affect other organs.4, 5 There are several cases of kidney to heart damage and failure associated with dental disease.6 Dental bacteria can contribute to the formation of heart disease that causes death.7, 8

The status of dental and oral caries can be measured by the severity of dental and oral disease in the community; for this reason, World Health Organization indicators and assessment standards are needed, such as dental health and periodontal status. The indicator of dental caries status that can and is often used is the DMF-T index.9, 10

The results of the 2018 Basic Health Research (BHR) on the dental health conditions of the Indonesian people, 57.6% of the population experienced dental and oral problems, and only 10.2% received medical treatment. In the population aged 35 to 44 years, on average, seven teeth in adults experience problems or cavities. It is also known that only 2.8% of the Indonesian population brush their teeth properly. 11

Dental and oral health services at Raden Mattaher Hospital Jambi Province are carried out at the Dental Polyclinic. Dental health services are provided by Specialist Dentists, General Dentists, and Dental and Oral Therapists (DOT). This hospital is a level II referral health service in Jambi province; specialist dentists mainly carry out dental health services but still involve DOT. DOT's dental and oral health services are under the Minister of Health Regulation no. 37 of 2019. In addition to collaborative activities with specialist dentists, dental and oral health care activities are carried out for patients at the dental clinic and in the inpatient room.

Several dental and oral therapists (DOT) stated that there was no model/form of dental and oral health care services used by Raden Mattaher Hospital Jambi Province, especially at the Dental Polyclinic. Therefore, it is necessary to conduct research on developing a dental and oral health care model for patients at the dental clinic at Raden Mattaher General Hospital, Jambi Province. The author expects that DOT can use this model in the dental polyclinic to improve dental and oral health services for patients.

The absence of a dental oral health care model will compromise the provision of oral health care for patients, especially mental patients. This study aims to develop a dental and oral health care model for patients in the dental polyclinic of Raden Mattaher Hospital, Jambi Province.

Materials and Methods

Ethical Consideration

No economic incentives were offered or provided for participation in this study. The study protocol matched the Declaration of Helsinki ethical guidelines for clinical studies. This research has been approved by the Health Research Ethics Commission of the Health Polytechnic of the Jambi Ministry of Health with the number LB.02.06/2/18/2022.

Findings

Distribution of the characteristics of the informants in the study consisted of gender, years of service, education and functional positions.

Table 1 shows that all of the informants are female, with a length of work >10 years, dominantly with associate education, and proficient functional positions.

The next step is to identify the problems and needs of the dental and oral health care model. Only 11 dental nurses were included in the respondents.

Table 2 shows that most dental nurses have good knowledge about the duties and functions of dental nurses, but there are still few dental nurses who understand the stages of dental nursing care, SOPs for oral health services are not available, the implementation of oral health service education is still very rare, and documentation has not been maximally implemented.

The name HELISIDI comes from pieces of the names of the research team, including HEndry boy, Linda marlia, SukarsIh, and MuliaDi. The HELISIDI model was validated by two expert teams of academics and practitioners. Two expert validators are Yanti Rahayu, S.ST, and Dr. Bedjo Santoso, S.ST., M.Kes. This validation was carried out to obtain data that was used as a basis for revising the developed media product in the form of a dental and oral health care status card. The recapitulation of the expert's assessment can be seen in Table 3 below.

Table 3 shows that the HELISIDI model is feasible but with revisions. Next, the team made revisions according to the validator's inputs and reassessed it. The results of the final validation of the Helisidi model showed that it was feasible without revision.

Table 4 shows that the HELISIDI status card is feasible but with revisions. Furthermore, the researcher revised, according to the advice of the validator, then retested. The results of the final validation of the Helisidi status card showed that it was feasible with the revision.

The HELISIDI model was tested on Dental and Oral Therapists and people with a mental health conditions. The first stage of the trial was on ordinary informants, as many as 13 people and the second stage conducted trials on people with a mental health condition, as many as 13.

Table 5 shows that the total score of the informants related to the HELISIDI dental and oral health care model is 546, with a presentation of 76% based on the eligibility criteria; this means the HELISIDI Status Card Model is eligible without revision. The questionnaire results were filled out by respondents related to the HELISIDI dental and oral health care status card. The total score was 546, representing 87% based on the eligibility criteria. According to the respondent, the HELISIDI Status Card Model was feasible without revision.

Table 6 shows that the total score of the respondents is 467 with a presentation of 89% which includes the very feasible criteria without revision.

The results of the respondent's questionnaire were 620 with a presentation of 87% with very decent criteria without revision.

In the HELISIDI model trial, the researchers also made observation sheets when respondents performed dental and oral health care stages according to the HELISIDI model. The results of the observations show that for the assessment stage, the respondents can carry out according to the stages, even though determining the diagnosis of dental health depends on the manual. The planning stage is to provide a checklist on the status card, which is not a problem for the respondents. The implementation stages are collaborative with dentists, then dental health education and the practice of brushing teeth are carried out to patients in dental chairs. The evaluation results during observation (promotive) counseling to patients can be given while the patient is waiting in the waiting room but has been assessed until the examination of vital signs. The respondent can do Stages Evaluation as part of the final stage by asking questions to the respondent.

Discussion

Dental and oral health care is the main task and authority of the Dental and Oral Therapist (DOT) as a dental health worker, under the professional standards of the dental and oral therapist 12 and the functional position of Dental and Oral Therapist.13 The implementation of dental and oral health care is aimed at individuals, groups, and communities so that the degree of dental and oral health is optimal. Dental and oral health care services are provided by DOT, which provides health services both at the Public Health Center (PHC) and at the Hospital.14

The dental and oral health care implementation at the dental clinic of Raden Mattaher Hospital has not been under the professional standards of the dental and oral therapist (DOT). The services provided are seen from the stages of care services. There are only the assessment and implementation stages in the form of dental health counseling. DOT has not carried out the stages of dental and oral health care in planning and evaluation. The implementation stage is only in the form of dental and oral health counseling, which is also not supported by adequate facilities such as learning media.

Providing dental and oral health care needs to be supported by adequate DOT knowledge, learning media facilities for dental health education, and documentation of care, including status cards and operational standards of dental and oral health care.15, 16 Cooperation with other health workers, especially general dentists and specialists at Raden Mattaher Hospital, is also necessary. In addition, this hospital has become a teaching hospital. The need for a model of dental and oral health care at Raden Mattaher Hospital is mandatory for DOT to be able to work under their authority and competence.

According to Dengler et al.17 Action research may facilitate continuous development involving related parties. This study involved DOT and dentists working at the dental clinic of Raden Mattaher Jambi Hospital in developing dental and oral health care that could be applied in the dental clinic. The HELISIDI model of dental and oral health care designed by the researcher was submitted to DOT and dentists and then tested.

The HELISIDI model was developed based on the theory of The Dental Hygiene Process of Care by Darby and Walsh,18 including the diagnosis of dental and oral health based on the diagnosis of basic human needs for dental and oral health. The HELISIDI model describes the stages of assessment, diagnosis, planning, implementation, and evaluation and is equipped with a dental health status card as a medical record filled out by the DOT and the patient's or patient's family signature as informed consent or approval of care actions. Models and Status Cards of HELISIDI dental and oral health care after being designed by researchers, then expert validation tests and trials were carried out by respondents with criteria based on the criteria of a model by Pahrur Razi et al.14

The results of expert validation regarding the feasibility of the HELISIDI model of dental and oral health care were initially 69%, with criteria eligible for revision. Then revisions were made and re-validated by experts to 87% with criteria eligible for models to be used without revision. The HELISIDI status card by expert validation was initially 69% with criteria eligible for revision, then revised and re-validated by experts to 77% being eligible criteria for revision. The dental and oral health care status card was revised to make it easier for DOT to write.

Models and Status Cards of HELISIDI dental and oral health care were assessed at the initial introduction to respondents (DOT and Dentist). The results of the respondent's questionnaire for the HELISIDI Model are 79% with criteria eligible for revision, while for the HELISIDI status card, it is 76% with criteria eligible for revision. After DOT carried out revisions and trials, there were changes in the feasibility results of the HELISIDI Model and Status Card; for the HELISIDI model, it became 89% with eligible criteria without revision. For the HELISIDI Status Card, it became 87% with eligible criteria without revision. All respondents conducted this test.

HELISIDI, a dental and oral health care model, has shown the feasibility of being used by DOT in the dental clinic. Using the HELISIDI model can provide better dental and oral health care for patients seeking treatment at the dental clinic at Raden Mattaher Jambi Hospital. The HELISIDI model provides instructions on how dental and oral therapists carry out 5 (five) stages in dental and oral health care services19 under working conditions in the dental clinic of Raden Mattaher Hospital. The HELISIDI status card as documentation of dental health care is evidence of the implementation of care by DOT. The stages in dental and oral health care are listed in the HELISIDI status card.

Conclusion

The HELISIDI model and status card, developed as a dental and oral health care model and tested on dental and oral therapists (DOT), shows its feasibility for use in the dental clinic of Raden Mattaher Jambi Hospital.

Authors’ Contribution 

All authors equally contributed to preparing this article.

Source of Funding

This study has no finansial support from any party.

Conflict of Interest

None.