Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
BAB I PENDAHULUAN I.1
Latar Belakang
Kesehatan merupakan bagian terpenting bagi kehidupan manusia, sehat secara jasmani dan rohani tidak terkecuali anak-anak,setiap orang menginginkan anaknya bias tumbuh dan berkembang secara optimal, hal ini dapat dicapai jika tubuh mereka sehat. Kesehatan yang perlu diperhatikan selain kesehatan tubuh secara umum, juga kesehatan gigi dan mulut, karena kesehatan gigi dan mulut dapat mempengaruhi kesehatan tubuh secara menyeluruh. Dengan kata lain bahwa kesehatan gigi dan mulut merupakan bagian integral dari kesehatan tubuh secara keseluruhan yang tidak dapat dipisahkan dari kesehatan tubuh secara umum. Untuk mencapai kesehatan gigi dan mulut yang optimal maka harus dilakukan perawatan secara berkala. Perawatan dapat dimulai dari memperhatikan diet makanan jangan terlalu banyak makan yang mengandung gula dan yang lengket. Gigi merupakan bagian dari alat pengunyahan pada sistem pencernaan tubuh manusia, sehingga secara tidak langsung berperan dalam status kesehatan perorangan. Kebersihan gigi dan mulut merupakan hal yang sangat penting dalam mencegah dari terjadinya penyakit-penyakit rongga mulut. Jika ditinjau dari segi fungsinya, gigi dan mulut mempunyai peran yang besar dalam mempersiapkan makanan sebelum melalui proses pencernaan yang selanjutnya. Oleh karena gigi dan mulut merupakan salah satu kesatuan dari anggota tubuh yang lain. Kerusakan pada gigi dan mulut dapat mempengaruhi kesehatan tubuh secara langsung atau tidak langsung. Selain itu, kebersihan gigi dan mulut juga berperan penting dalam menentukan gambaran dan penampilan diri seseorang tersebut, sekaligus berkaitan dengan kepercayaan atau keyakinan terhadap dirinya dirinya (Pratiwi, 2007). Masalah kesehatan gigi dan mulut merupakan masalah yang rentan dihadapi oleh kelompok anak usia sekolah dasar. Struktur gigi pada masa anakKKS PUBLIC HEALTH FAKULTAS KEDOKTERAN UNIVERSITAS MALAHAYATI BANDAR LAMPUNG
1
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
anak, terutama pada usia sekolah dasar, termasuk dalam jenis gigi bercampur, yaitu antara gigi susu dan gigi permanen yang rentan mengalami karies gigi. Permasalahan karies gigi pada anak usia sekolah dasar menjadi penting, karena menurut Situmorang (2006), karies yang terdapat pada gigi merupakan indikator keberhasilan upaya pemeliharaan kesehatan gigi pada anak. Menurut world health organitation (WHO), penyakit rongga mulut yang sering dihadapi oleh anak-anak umumnya adalah penyakit gigi berlubang (Dental Cavity) Cavity) atau karies gigi dan penyakit periodontal (penyakit jaringan penyangga gigi). Banyaknya faktor penyebab karies gigi pada anak menyebabkan usia anak sekolah dasar merupakan kelompok yang rentan terhadap karies gigi. Suwelo (1992) menyampaikan, anak pada usia sekolah dasar umumnya kurang rajin dan kurang teliti dalam membersihkan gigi. Keasaman (ph) air ludah ( saliva ( saliva)) anak pada usia ini juga ikut berpengaruh sehingga bisa memperburuk kesehatan gigi dan mulut. Kira-kira 60-90% anak-anak sekolah diseluruh dunia mengalami karies gigi dan penyakit periodontal dijumpai pada 5-20% usia dewasa muda, walaupun angka kejadiannya sedikit berbeda pada kawasan geografi yang berbeda. Untuk kanker mulut, insidensinya diperkirakan antara 1 hingga 10 kasus bagi setiap 100.000 populasi dikebanyakan Negara diseluruh dunia (WHO 2010). Hasil Riset Kesehatan Dasar (Depkes RI, 2007) memperlihatkan, terdapat 72,1% masyarakat Indonesia yang memiliki masalah gigi berlubang dan 46,5% di antaranya adalah karies aktif yang belum dirawat. Depkes RI (2006) menunjukkan prevalensi karies gigi di Indonesia sekitar sekit ar 90% dari 238 juta penduduk Indonesia dan jumlah anak-anak usia 15 tahun ke bawah yang menderita karies gigi mencapai 76,5%. Hasil penelitian Siagian and Barus (2008) menemukan bahwa 95% anak sekolah dasar mempunyai kesehatan gigi dan mulut yang buruk
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
Menurut Srigupta (2004), karies gigi adalah pembentukan lubang pada permukaan gigi yang disebabkan oleh kuman. Terbentuknya pada permukaan gigi yang terbuka, yaitu mahkota gigi yang sangat terkait dengan perilaku pemeliharaan kesehatan gigi yang dipengaruhi oleh faktor dalam diri dan di luar individu. Faktor dari dalam individu yang menyebabkan karies gigi pada anak, di antaranya adalah faktor di dalam mulut yang berhubungan langsung dengan proses terjadinya karies gigi, antara lain struktur gigi, morfologi gigi, susunan gigi-geligi di rahang, derajat keasaman saliva, kebersihan mulut yang berhubungan dengan frekuensi dan kebiasaan menggosok gigi, jumlah dan frekuensi makan makanan yang menyebabkan karies (kariogenik). Faktor dari luar individu yang berpengaruh antara lain status ekonomi, keluarga, pekerjaan, fasilitas kesehatan gigi, pendidikan kesehatan gigi yang pernah diterima (Budiharto, 2000). Akses terhadap pelayanan kesehatan gigi memiliki kontribusi dalam kesehatan gigi dan mulut. Peningkatan akses pelayanan dengan mendekatkan jarak pelayanan di antaranya dilakukan pemerintah pemerinta h melalui pengembangan Upaya Kesehatan Gigi Sekolah (UKGS). Teori Precede Proceed (Green et al , 1980) menyebutkan bahwa akses pelayanan memegang peran sebagai faktor pemungkin dari sebuah perilaku kesehatan. Dengan demikian, faktor akses bisa menjadi salah satu pendorong untuk perubahan perilaku, dalam hal ini adalah perilaku kesehatan gigi dan mulut. Lingkungan keluarga khususnya orang tua, sangat besar peranannya dalam mengembangkan perilaku positif terhadap kesehatan gigi dan mulut (Suwelo,1992). Douglas (2003) menyampaikan, cara untuk memperbaiki kesehatan gigi dan mulut adalah orang tua harus turut memperhatikan perilaku anak berkaitan dengan kesehatan gigi dan mulut dan pola makan anak dengan
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
Keterlibatan orang tua dalam mengembangkan pola perilaku positif dalam pemeliharaan kesehatan gigi dan mulut diimplementasikan kepada anaknya dalam kehidupan sehari-hari baik dalam bentuk langsung maupun tidak langsung. Proses transfer perilaku dipengaruhi oleh pengetahuan, sikap, sosial ekonomi dan kebiasaan atau perilaku orang tua terhadap kesehatan gigi dan mulut. Sosial ekonomi orang tua akan berkontribusi terhadap perilaku kesehatan. Semakin baik baik status sosial ekonomi orang tua, semakin baik perilaku kesehatan yang dilakukan oleh orang tua (Depkes RI, 2000). Pengetahuan ibu terhadap kesehatan gigi dan mulut anak akan memberikan pengaruh kepada status kesehatan gigi anak. Pengetahuan berperan penting dalam perilaku kesehatan, karena pengetahuan merupakan awal dari perubahan perilaku. Pengetahuan tentang pencegahan karies gigi pada orang tua merupakan komponen yang penting sebagai pencegahan karies gigi. Demikian halnya dengan sikap orang tua (ibu) yang positif terhadap kesehatan gigi dan mulut. Menurut Saunders and Roberts (1997), upaya untuk mewujudkan perilaku kesehatan diperlukan predisposisi pengetahuan dan sikap yang baik. Perilaku ibu dalam kesehatan gigi dan mulut berpengaruh pada status kesehatan gigi dan mulut pada anak usia masa sekolah. Perilaku ibu yang positif dalam kesehatan gigi dan mulut setidaknya mendapatkan dukungan keluarga lainnya seperti suami dan dukungan keluarga lainnya. Hasil penelitian Rumaropen (2005) menemukan bahwa sebagian besar orang tua anak-anak di wilayah Kabupaten Fak-Fak belum memiliki tingkat pengetahuan yang cukup baik dalam kesehatan gigi dan mulut sebagai perilaku pencegahan karies gigi. Kasus karies gigi terjadi pada anak-anak khususnya kelas I, II dan III anak sekolah dasar. Rendahnya pengetahuan dan sikap yang mendukung mendukung perilaku orang tua terhadap pengendalian karies gigi menyebabkan perlunya peningkatan promosi tentang kesehatan gigi dan mulut.
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
I.2
TAHUN 2013
Perumusan Masalah
Berdasarkan latar belakang diatas, maka yang menjadi rumusan masalah dalam peneltian ini adalah : Bagaimana Gambaran pengetahuan dan sikap siswa SDN 015920 kelas III, IV, dan V tentang perawatan gigi dan mulut di Desa Air Genting Kecamatan Air Batu Kabupaten Asahan. I.3
Tujuan Penelitian
I.3.1
Tujuan Umum
Untuk mengetahui Gambaran pengetahuan dan sikap siswa SDN 015920 kelas III, IV, dan V tentang perawatan gigi dan mulut di Desa Air Genting Kecamatan Air Batu Kabupaten Asahan I.3.2
Tujuan Khusus
a.
Untuk mengetahui tingkat pengetahuan siswa-siswi tentang perawatan kesehatan gigi dan mulut.
b.
Untuk mengetahui sikap siswa-siswi terhadap perawatan kesehatan gigi dan mulut.
I.4
Manfaat Penelitian
I.4.1
Bagi Peneliti
Sebagai pengalaman langsung bagi peneliti dalam pelaksanaan penelitian dan sekaligus menjadi sarana aktualisasi ilmu yang telah diterima di bangku perkuliahan dengan penelitian dilapangan dalam bentuk karya tulis ilmiah.
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
I.4.2
TAHUN 2013
Bagi Sekolah
Siswa dapat lebih memahami pentingnya menjaga kesehatan gigi dan mulut dan menjadi motivasi bagi siswa untuk melakukan kebiasan merawat kesehatan gigi dengan baik dan benar. Sebagai masukan bagi guru agar dapat memberikan pendidikan tentang perawatan kesehatan gigi dan mulut kepada siswa-siswi dalam rangka untuk meningkatkan kesehatan gigi dan mulut di sekolah. I.4.3
Bagi Puskesmas Hessa Air Genting Dan Instansi Terkait
Sebagai bahan masukan untuk meningkatkan kinerja Puskesmas Hessa Air Genting pada umumnya dan Unit Kesehatan Gigi pada khususnya dalam rangka peningkatan kesehatan gigi dan mulut anak. I.4.4
Bagi Dinas Kesehatan Kesehatan
Penelitian ini diharapkan menjadi bahan informasi bagi Dinas Kesehatan dalam program peningkatan kesehatan gigi dan mulut masyarakat pada umumnya dan kesehatan gigi gigi dan mulut anak-anak pada khususnya. I.4.5
Bagi Peneliti Lainnya
Sebagai bahan perbandingan dan masukan untuk melakukan penelitian selanjutnya yang berkaitan dengan pemahaman kesehatan gigi dan mulut dan kebiasaan menggosok gigi pada anak usia sekolah dasar.
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
BAB II TINJAUAN PUSTAKA 2.1
Pengetahuan
Dalam kamus bahasa indonesia, pengetahuan diartikan segala sesuatu yang diketahui berkenaan dengan hal. Menurut Notoatmodjo (2007), pengetahuan pengetahuan merupakan hasil dari tahu, dan ini terjadi setelah orang melakukan penginderaan terhadap suatu objek tertentu. Penginderaan terjadi melalui panca indera manusia, yakni indera penglihatan, pendengaran, penciuman, rasa, dan raba. Sebagian besar pengetahuan manusia diperoleh melalui mata dan telinga. Pengetahuan atau kognitif merupakan domain yang sangat penting dalam membentuk tindakan seseorang. Dari pengalaman dan penelitian terbukti bahwa perilaku yang didasari oleh pengetahuan akan lebih bermakna dari pada perilaku yang tidak didasari oleh pengetahuan. Pengetahuan merupakan dasar terbentuknya suatu prilaku. Seseorang dikatakan kurang pengetahuan apabila dalam suatu kondisi ia tidak mampu mengenal, menjelaskan, dan menganalisis suatu keadaan. Notoatmodjo (2007) menjelaskan bahwa pengetahuan dalam domain kognitif memiliki enam tingkatan, antara lain : a. Tahu (Know) Tahu merupakan tingkatan yang paling rendah. Sesorang dapat dikatakan tahu
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
c. Aplikasi (Aplication). Aplikasi diartikan sebagai kemampuan untuk menggunakan materi yang telah ia pelajari pada situasi atau kondisi sebenarnya. Misalnya seorang anak akan melakukan gosok gigi setiap hari ketika ia telah memahami materi kesehatan gigi. d. Analisis (Analysis). Seseorang dikatakan mencapai tigkat analisis ketika ia mampu menjabarkan materi kedalam komponen-komponen, tetapi masih dalam struktur yang sama dan berkaitan satu sama lain. Ia mampu membedakan, memisahkan, mengelompokan, dan lain sebagainya. e. Sintesis (Synthesis). Sintesis merupakan kemampuan untuk meletakan atau menghubungkan bagian bagian di dalam suatu bentuk keseluruhan yang baru. Seseorang mampu menyusun
formulasi-formulasi
baru
misalnya
anak
dapat
menyusun,
merencanakan, menyesuaikan terhadap suatu teori dan rumusan yang telah ada. f. Evaluasi (Evaluation). Merupakan kemampuan untuk melakukan justifikasi atau penilaian terhadap suatu materi. Misalnya membandingkan antara anak yang rajin menggosok gigi dengan yang tidak.
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
Dari segi biologis, perilaku adalah suatu kegiatan atau aktivitas organism (makhluk hidup yang bersangkutan). Dalam kamus bahasa indonesia, perilaku adalah tanggapan atau reaksi individual terhadap rangsangan atau lingkungan. Perilaku adalah totalitas penghayatan dan aktivitas seseorang, yang merupakan hasil bersama antara berbagai faktor internal maupun eksternal. Menurut Bloom, seperti dikutip Notoatmodjo (2007), membagi perilaku itu di dalam 3 domain (ranah/kawasan), meskipun kawasan-kawasan tersebut tidak mempunyai batasan yang jelas dan tegas. Pembagian kawasan ini dilakukan untuk kepentingan tujuan pendidikan, yaitu mengembangkan atau meningkatkan ketiga domain perilaku tersebut, yang terdiri dari ranah kognitif, ranah afektif, dan ranah psikomotor. Dalam perkembangan selanjutnya oleh para ahli pendidikan dan untuk kepentingan pengukuran, hasil, ketiga domain itu diukur dari pengetahuan (knowledge), knowledge), sikap (attitude (attitude)) dan tindakan ( practice). practice). Penelitian Rogers (1974) mengungkapkan bahwa sebelum orang mengadopsi perilaku baru, didalam diri orang tersebut terjadi proses yang berurutan, yakni : 1. Kesadaran ( Awareness), Awareness), dimana orang tersebut menyadari dalam arti mengetahui terlebih dahulu terhadap stimulus (objek). 2. Merasa tertarik ( Interest Interest ) terhadap stimulus atau objek tersebut. Disini sikap subjek sudah mulai timbul. 3. Menimbang-nimbang ( Evaluation) Evaluation) terhadap baik dan tidaknya stimulus
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
dimana didasari oleh pengetahuan, kesadaran dan sikap yang positif maka perilaku tersebut akan bersifat lama ( Long Long Lasting ). ). Sebaliknya apabila perilaku itu tidak didasari oleh pengetahuan dan kesadaran akan tidak berlangsung lama. Pengukuran pengetahuan dapat dilakukan dengan wawancara atau angket yang menanyakan tentang isi materi yang ingin diukur dari subjek penelitian atau responden. Kedalaman pengetahuan yang ingin kita ketahui atau kita ukur dapat kita sesuaikan dengan tingkat-tingkat tersebut diatas. 2.2
Gigi.
Gigi merupakan salah satu organ pengunyah, yang terdiri dari gigi-gigi pada rahang atas dan rahang bawah, lidah, serta saluran-saluran penghasil air ludah. 2.2.1
Anatomi gigi.
Gigi terdiri dari beberapa bagian, yaitu: 1.
Email, yaitu lapisan terluar gigi yang meliputi seluruh corona, dalam bahasa Inggris disebut crown artinya mahkota. Email merupakan bagian paling keras dari seluruh bagian gigi bahkan lebih keras dari tulang. Email tersusun atas air 2,3 %, bahan organik 1,7 %, bahan anorganik 96%.
2.
Dentin, yaitu bagian yang terletak di bawah email, merupakan bagian terbesar dari seluruh gigi. Dentin tersusun atas 13,2 % air, 17 % bahan organik, dan 69 % bahan anorganik.
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
Gambar 2.2.1 Penampang gigi 2.2.2
Fungsi Gigi.
Gigi berdasarkan fungsinya dibagi menjadi 4 kelompok, yaitu: 1.
Gigi Seri ( Incisivus). Incisivus). Gigi seri ada 4 buah di atas dan 4 buah di bawah, sehingga keseluruhannya berjumlah 8. Tugas gigi seri adalah memotong memotong dan menggiling makanan.
2.
Gigi Taring (Caninus (Caninus). ). Gigi taring ada 4 buah, diatas 2 dan di bawah 2. Gigi ini terletak di sudut mulut, bentuk mahkota meruncing, berfungsi untuk merobek makanan.
3.
Gigi Geraham Kecil ( Premolar ). ). Geraham merupakan pengganti gigi geraham sulung. Letak gigi ini di belakang gigi taring, berjumlah 8 yang tersusun 4 di atas dan 4 di bawah dengan 2 di kanan dan 2 di kiri. Fungsi gigi ini adalah bersama geraham besar be sar membantu menghaluskan makanan.
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
Gambar 2.2.2 Jenis-jenis gigi
2.2.3
Pertumbuhan Pertumbuhan Gigi Pada Anak Usia Sekolah.
Pertumbuhan gigi pada anak usia sekolah ditandai dengan tanggalnya
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
menentukan lengkung rahang. Gigi tetap berikutnya yang akan erupsi adalah gigi seri bawah yang akan erupsi lebih ke lingual dari gigi susu yang akan tanggal. Gigi tetap sama dengan gigi susu, terbentuk semasa di dalam rahim ibu. Bila gigi susu mengalami kalsifikasi selama di dalam rahim, kalsifikasi gigi permanen terjadi setelah kelahiran. Gigi tetap yang mengalami kalsifikasi pertama adalah gigi geraham pertama. Kalsifikasi akan berlangsung terus sampai usia 8 tahun (tidak termasuk gigi geraham tetap ketiga. Biasanya, gigi rahang bawah tumbuh lebih dahulu dari gigi rahang atas. Gigi tetap yang telah erupsi semua berjumlah 32 buah, terdiri atas 4 incisivus 9 (seri), 2 caninus (taring), 4 premolar, dan 6 molar (geraham) pada setiap rahang. Tabel 2.2.3 Perkiraan waktu erupsi gigi tetap
Gigi
Waktu Erupsi
Molar pertama
6 tahun
Incisivus medial
7 tahun
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2.2.4
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Penyakit Gigi Pada Anak Usia Sekolah.
Penyakit dapat didefinisikan sebagai perubahan pada individu-individu yang menyebabkan parameter kesehatan mereka berada di bawah kisaran normal. Pandangan subyektif seseorang mengenai penyakit berkaitan dengan gangguan kemampuan untuk melakukan aktivitas sehari-hari dengan nyaman. Dari prospektif piaget, pemahaman anak mengenai penyakit dan kesehatan berkaitan erat dengan perkembangan kognitif. Ketika perkembangan tersebut mencapai tingkat kematangan, penjelasan mereka tentang penyakit akan berbeda. Sebelum masa kanak-kanak pertengahan, anak-anak egosentris, mereka cenderung percaya bahwa penyakit secara ajaib dihasilkan oleh tindakan manusia seringkali merupakan tindakan mereka sendiri. Ketika anak-anak mendekati masa remaja, mereka melihat ada berbagai sebab penyakit, kontak dengan kuman tidak harus menjadi sakit, dan orang-orang dapat melakukan banyak hal untuk menjaga diri mereka tetap sehat. Namun Sigelman et al pada pada tahun (1996) mencoba untuk mengganti teori tersebut. Para pengembang program ini berkesimpulan bahwa apa yang kurang dalam diri anak kecil adalah pengetahuan tentang penyakit tersebut,
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
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gigi yang kemudian berinteraksi dengan bakteri yang banyak terdapat dalam mulut, seperti Streptococcus sp. sp. Plak akan melarutkan lapisan email pada gigi yang lama kelamaan lapisan tersebut menipis. Terjadinya plak sangat singkat, yaitu hanya 10-15 menit setelah makan. Plak yang menumpuk dapat menyebabkan berbagai penyakit seperti karies gigi, infeksi dontogen, dan abses periodontal. Karies gigi merupakan salah satu penyakit gigi dan mulut yang paling sering dijumpai di masyarakat. Proses terjadinya karies gigi dimulai dengan adanya plak di permukaan gigi, sukrosa (gula) dari sisa makanan dan bakteri berproses menempel pada waktu tertentu yang berubah menjadi asam laktat yang akan menurunkan pH mulut menjadi kritis (5,5) yang menyebabkan demineralisasi email, dan akan berlanjut menjadi karies gigi. Pada awalnya, lesi karies berwarna putih akibat dekalsifikasi, berkembang menjadi lubang berwarna coklat atau hitam yang mengikis gigi. Maka dari itu, plak harus dibersihkan secara teratur setiap hari har i untuk mendapatkan gigi dan gusi yang sehat. Gigi dan gusi yang bersih dari sisa makanan akan mengurangi jumlah dan pertumbuhan bakteri dan juga akan mengurangi pembentukan asam. Tindakan ini merupakan pencegahan dini agar gigi anak tidak sakit dan dia dapat melakukan me lakukan
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
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makanan yang tersisa di gigi dan menimbulkan destruksi komponen organik yang akhirnya terjadi kavitasi atau pembentukan lubang gigi (Schuurs, 2009). Karies gigi merupakan penyakit yang paling banyak diderita anak-anak maupun orang dewasa. Anak usia 6-14 tahun merupakan kelompok usia kritis terkena karies gigi karena terjadi transisi dari gig susu ke gigi permanen. b. Maloklusi. Maloklusi terjadi jika gigi rahang atas dan rahang bawah tidak dapat berhubungan atau bertemu dengan tepat. Hal ini menyebabkan proses mengunyah makanan
menjadi
kurang
efektif
dan
menimbulkan
efek
yang
kurang
menyenangkan. Maloklusi gigi atau kelainan kontak pada gigi rahang atas dan bawah yang tidak diperbaiki dengan tetap dan sejak dini akan menyebabkan kelainan pada fungsi-fungsi lain. Jaringan penunjang gigi seperti gusi pun dapat rusak. Kondisi lebih berat akibat maloklusi adalah kerusakan pada sendi temporo mandibula (sendi antara tulang rahang dan tulang wajah) yang bisa menimbulkan sakit kepala yang terus menerus atau masalah pencernaan p encernaan (Potter & Perry, 2009).
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
Gambar 2.2.4 Macam-macam penyakit gigi
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
2.3
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Perawatan Kesehatan Gigi.
Kesehatan mulut tidak dapat lepas dari etiologi dengan plak sebagai factor bersama terjadinya karies. Penting disadari bahwa plak pada dasarnya dibentuk terus-menerus. Kebersihan mulut dapat dipelihara dengan menyikat gigi dan melakukan pembersihan gigi dengan benang pembersih gigi. Menyikat gigi adalah cara umum yang dianjurkan untuk membersihkan gigi dari berbagai kotoran yang melekat pada permukaan gigi dan gusi. Berbagai cara dapat dikombinasikan dan disesuaikan dengan kebiasaan seseorang dalam menyikat giginya. Jadi, tujuan dari menggosok gigi adalah untuk memperoleh kesehatan gigi dan mulut serta nafas menjadi segar.
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Sedangkan menggosok gigi sebelum tidur berguna untuk menahan perkembangbiakan bakteri dalam mulut karena dalam keadaan tidur tidak diproduksi ludah yang berfungsi membersihkan gigi dan mulut secara alami. a. Makanan Yang Menyebabkan Kerusakan Pada Gigi. Dalam hal makanan, anak usia sekolah sering konsumsi makanan manis seperti cokelat, permen, kue dan lain sebagainya. Makanan manis mengandung larutan gula yang memiliki konsentrasi tinggi. Larutan tersebut dapat menembus plak gigi dan dimetabolisasi dimetabolisas i untuk menghasilkan asam sebelum dinetralisasi oleh saliva. Konsumsi makanan tersebut apabila tidak dikontrol dengan perawatan gigi yang benar akan berisiko terkena karies gigi. Oleh karena itu, pada anak usia
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menurunkan produksi asam dan meningkatkan pembentukan mineral pada dasar enamel (Schuurs, 2007). Pasta gigi yang sekarang beredar mengandung 0,15 % fluoride yang sebelumnya mengandung 0,10 % (Houwink, 2007). Fluoride dapat ditemukan dalam berbagai bentuk. Pada Negara maju seperti Belanda dan Amerika, sebagian besar jumlah fluoride berasal dari air minum dengan konsentrasi 1 ppm (Anderson, 1989). Di Indonesia beredar fluoride dalam bentuk pasta gigi yang kadar fluoridenya sudah diatur. Berdasarkan standar SNI 16-47671998, pasta gigi anak mengandung kadar flour 500-1000 ppm. Penggunaan fluoride yang berlebihan dapat mengakibatkan perubahan warna pada enamel gigi (Potter & Perry, 2005) dental flossing cukup dilakukan satu kali dalam sehari.
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dengan gusi. Posisi sikat gigi kurang lebih 45 derajat di daerah perbatasan antara gigi dan gusi sehingga gusi gusi tidak terluka.
Gambar a.cara menggosok gigi
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
3.
TAHUN 2013
Menggosok permukaan gigi yang menghadap ke lidah. Pegang sikat gigi dengan posisi horisontal dan gerakkan ke depan dan ke
belakang secara bergantian.
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
gigi juga harus diperhatikan. Sikat gigi paling lama dipakai hanya selama dua bulan, karena pada saat tersebut banyak ujung bulu sikat sudah bercabang dan menjadi tajam, bila terus dipergunakan, gigi akan seperti digosok dengan sabut kasar, dapat melukai lapisan enamel.
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
prevalensi lebih tinggi dibandingkan dengan anak laki-laki. Hal ini disebabkan pertumbuhan gigi pada anak perempuan lebih awal dari pada anak laki-laki sehingga masa terpajan dalam mulut lebih lama (Cahyadi, 1997). 3.
Pengalaman.
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
menggosok gigi tanpa contoh yang baik dari orang tua (Potter & Perry, 2005; Mc Donald, 1994). Beberapa hal yang dapat dilakukan orang tua dalam perawatan gigi antara lain membantu anak dalam menggosok gigi terutama pada anak yang berusia dibawah 10 tahun, karena anak belum memiliki kemampuan motorik yang baik untuk menggosok gigi terutama
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
Misalnya anak yang orang tuanya berpenghasilan tinggi akan dibawa ke dokter gigi pribadi untuk merawat kesehatan giginya. Sebaliknya pada anak yang penghasilan orang tuanya rendah, tentunya akan melakukan perawatan sederhana yang dapat meminimalisasi pengeluaran. 5.
Sosial Budaya.
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
DAFTAR PUSTAKA Anderson, J.J.T., Hunsberger, M.M, & Foster, R.L.R (1981). (1981). Family centered nursing care of children . Philadelphia: W.B. Saunders Co. Andlaw, R. J., & Rock, W.P. (1982). Perawatan gigi anak (a manual of paedodontics) (drg. Agus Djaya, Penerjemah) Edisi 2. Jakarta: Widya Medika Anggriana, D., & Musyifah. (2005). Stimulating factor of parents’ motivation to take their children’s dental heath for treatment in the Faculty of Dentistry Airlangga University. Journal University. Journal of dental health. Atkinson ME, White FH. Principles of anatomy and oral anatomy for dental student . New York: Churcill Livingstone, 1992 Budisuari, W.H. (2010). Hubungan pola makan dan kebiasaan menyikat gigi dengan kesehatan gigi dan mulut (karies) di Indonesia. Jurnal Kesehatan, Vol. 13 No. I. Cahyadi, NS. (1997). Faktot-faktor yang berhubungan dengan status karies gigi anak sekolah dasar kelas 6 di Kecamatan Tanjung Priok Jakarta Utara tahun 1997, Tesis. Jakarta (tidak dipublikasikan). Carstensen, T.K. (2006, November). Periodontal (gum) disease. Januari 2, 2012. http://www.emedicineheath.com/periodontal_gum_disease/article_em.ht m di akses pada tanggal 7 April 2013 Chadwick, B.L., & Hosey, M.T. (2003). Child taming : how to manage children in dental practice. London: Quintessence Publishing Co.Ltd Colombia University Collage of Dental Medicine. Cleaning your’s child mouth and teeth. November 24, 2011. Dahlan, M. S. (2009). Besar sampel dan cara pengambilan sampel dalam penelitian kedokteran dan kesehatan. Jakarta: Salemba Salemba Medika. Dahlan, M. S. (2010). Langkah-langkah membuat proposal penelitian bidang kedokteran dan kesehatan. Jakarta: Sagung Seto. Dinas Kesehatan Kab.Asahan (20011). Profil (20011). Profil kesehatan wilayah kerja Puskesmas Rawang Pasar IV
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
Dirjen Pelayanan Medik Direktorat Kesehatan Gigi. (1996). Pedoman pelaksanaan UKGS. Jakarta: Depkes RI. Fitriana, R. (2006). Perawatan kesehatan gigi anak. Desember 23, 2011. http://www.kharisma.de/?q=node/297 di akses pada tanggal 7 april 2013 Ginanjar, A.M. (2011). Cara menggosok gigi yang benar. Desember 23, 2011. Green, L. (1980). Healt education planning diagnostic approach. approach . California: Mayfield Publishing Company. Grupte, S. (1991). Panduan perawatan anak, edisi 1, hal 166. (Pustaka Populer Obor, Penerjemah). Jakarta: Pustaka Populer Obor. Hockenberry, M. J., & Wilson, D. (2007). Wongs nursing care infants and children. St. Louis: Mosby Elsevier. Houwink, B. (1993). Ilmu kedokteran gigi pencegahan, pencegahan , hlm.125. (Sutatmi Suryo, Penerjemah). Yogyakarta: Gadjah Mada University Press. http://definisi-pengertian.blogspot.com//2011/01/pengertian-ptk-penelitiantindakan.html diakses pada tanggal 16 april 2013 http://definisi-pengertian.blogspot.com/201101/pengertian-ptk-penelitiantindakan.html di akses pada tanggal 20 April 2013 http://staff.uny.ac.id/sites/default/files/penelitian/Kartika%20Ratna%20Pertiwi,% 20MD,%20M.%20Biomed.%20Sc/Makalah%20Kartika%20Ratna%20U NY.pdf diakses NY.pdf diakses pada tanggal 22 april 2013 http://www.pdgionline.com/v2/index.php?option=com_content&task=view&id=2 5&Itemid=I di akses pada tanggal 9 April 2013 Kawuryan, U. (2008). Hubungan pengetahuan tentang kebersihan kebersi han gigi dan mulut dengan kejadian karies anak anak SDN kleco II kelas V dan VI laweyan Surakarta. Surakarta. Skripsi. Surakarta: Universitas Muhammadiyah Surakarta. Lubis, P., &Nugrahaeni, M. (2009, september). Sudahkah anda menyikat gigi dengan benar. Oktober 4, 2011. http://kosmo.vivanews.com/news/read/90266-sudahkah-anda-menyikatgigi-dengan-benar di gigi-dengan-benar di akses pada tanggal 9 April 2013 Lukihardi, A. (2011, September). Sekitar 85 persen anak usia sekolah menderita
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Gambaran Pengetahuan dan Sikap Siswa SDN 015920 Kelas III, IV, dan V Terhadap Perawatan Gigi dan Mulut di Desa Air Genting Tahun 2013
TAHUN 2013
hidup/info-sehat/11/09/12/Irevhf-sekitar-85-persen-anak-usia-sekolahmenderita-karies-gigi di akses pada tanggal 9 April 2013 McDonald, R.E., & Avery, D.R (1994)/. Dentistry for the child and adolescent, ed 6 .St. .St. Louis: Mosby. Minata, H. (2011, November). Penyebab utama karies gigi. Desember 1, 2011. http://kesehatan.kompasiana.com/medis/2011/11/16/penyebab-utamakaries-gigi Notoatmodjo S. Promosi S. Promosi kesehatan dan ilmu perilaku. Jakarta: Rineka cipta; 2007 Potter, P.A., & Perry, A.G (2005). Fundamental nursing : Concept, proses, and practice (6th practice (6th ed). St. Louis: Mosby Year Book. Ratih Ariningrum. Beberapa cara menjaga kesehatan gigi dan mulut . Jakarta: Hipocrates, 2000 Santrock, J.W.(2008). Life J.W.(2008). Life span development (12th (12th ed). Newyork: McGraw hill Schuurs, A.H.B. (19920. Patologi gigi-geligi: kelainan-kelainan jaringan keras gigi, hlm.135. (Sutatmi Suryo, Penerjemah). Yogyakarta: Gadjah Mada University Press. Suwelo, l.S (1992). Karies gigi pada anak dengan berbagai faktor etilogi . Jakarta :IGC Suwelo, L.S. (19970. Peranan (19970. Peranan pelayanan kesehatan gigi anak dalam menunjang kualitas sumber daya manusia indonesia di masa mendatang . mendatang . Disertasi. Jakarta: Universitas indonesia. Tambun, L.E> 92002). Penyuluhan kesehatan gigi pada anak. Skripsi. Medan: Universitas Sumatera Utara. Tampubolon NS. Dampak karies gigi dan penyakit periodontal terhadap kualitas hidup. hidup. Majalah kedokteran gigi universitas airlangga, edisi khusus temu ilmiah nasional IV, ISSN 0852-9027, agustus 2006 (artikel) Tarigan R. Karies R. Karies gigi. gigi. Jakarta: Hipocrates, 1992 www.duniapsikologi.com/sifat-pengertian-definisi-faktor-yang-mempengaruhi/. www.duniapsikologi.com/sifat-pengertian-definisi-faktor-yang-mempengaruhi/. diakses pada tanggal 16 april 2013