JRSSEM 2022, Vol. 01, No. 8, 1061 1071
E-ISSN: 2807 - 6311, P-ISSN: 2807 - 6494
DOI : 10.36418/jrssem.v1i8.132 https://jrssem.publikasiindonesia.id/index.php/jrssem/index
TEACHERSKNOWLEDGE ABOUT DENTAL TRAUMA AND
ITS MANAGEMENT IN PRIMARY SCHOOLS IN JAKARTA,
INDONESIA
Yufitri Mayasari1*
Rahayu Dwi Setia Wibowo2
Department of Dental Public Health, Faculty of Dentistry, Universitas Prof. Dr. Moestopo
(Beragama), Jakarta
Faculty of Dentistry, Universitas Prof. Dr. Moestopo (Beragama), Jakarta
e-mail: yufitrimayasari@dsn.moestopo.ac.id
*Correspondence: yufitrimayasari@dsn.moestopo.ac.id
Submitted: 23 February 2022, Revised: 04 March 2022, Accepted: 15 March 2022
Abstract. Traumatic dental injuries often occur in children aged 7-12 years during school hours.
However, most teachers are not aware of first aid for traumatic dental injuries. There are 2 types of
elementary schools, namely public elementary schools and private elementary schools. This study
aims to explain the difference in knowledge about traumatic dental injury and its first aid
management between public and private school teachers. Analytical research was conducted using
a cross sectional approach and the sampling method was carried out using purposive sampling.
Questionnaires in the form of Google Forms were used to collect data. Data were statistically
analysed using Chi-square test for any correlation. Based on the results of the study that there is
no significant difference in knowledge between public and private school teachers. The highest p-
value is 0.752 and the lowest p-value is 0.102 (p > 0.05). So it can be concluded that this study did
not find a significant difference in knowledge about first aid for traumatic dental injuries between
public and private school teachers.
Keywords: public primary school teachers; private primary school teachers; traumatic dental
injuries.
Yufitri Mayasari, Rahayu Dwi Setia Wibowo | 1062
DOI : 10.36418/jrssem.v1i8.132 https://jrssem.publikasiindonesia.id/index.php/jrssem/index
INTRODUCTION
Dental trauma is an injury that affects
the hard tissues of the teeth and
periodontal tissue due to the impact of a
hard object (Dewi, Jeddy, & Badruzzaman,
2021). One of the most common dental
injuries is the avulsion or removal of the
entire tooth out of the socket and often
occurs in children aged 7-12 years usually
affecting the lips, gingiva, tongue, jaw and
should be treated quickly. If not, the tooth
can become infected and caused the
forming of abscess which causes pulp
death (Chandukutty, Peedikayil,
Premkumar, Narasimhan, & Jose, 2017);
(Nirwan, Syed, Chaturvedi, Goenka, &
Sharma, 2016); (Al-Zaidi & Al-Asmari,
2017).
The World Health Organization (WHO)
declared the prevalence of dental trauma
varies depending on the country (Al-Zaidi
& Al-Asmari, 2017); (Santos et al., 2010).
Reported the prevalence of dental trauma
in Brazil is around 16.5%. Study conducted
by (Wardhana et al., 2017); (Louis et al.,
2016) reported the prevalence of dental
trauma in Indonesia is around 11.4%.
Traumatic dental injuries in children
occur most often in school, thus, this is the
place with the greatest prevalence of
traumatic dental injuries (Zaleckiene,
Peciuliene, Brukiene, & Drukteinis, 2014);
(Balkhair, Al-Maghrabi, & Baakdah,
2020).,Common causes of traumatic tooth
injuries that often occur at school are falls,
bumping into friends, fighting or pushing
between friends. Therefore, teachers have
an important role in handling traumatic
tooth injuries first aid in children
(Chandukutty et al., 2017); (Sreelakshmi et
al., 2016). In general, public and private
school teachers receive P3K (First Aid)
training in their curriculum. First aid for
accidents at public schools is managed by
the health centre and provided with
guidance for teachers, while first aid for
accidents in private schools is managed by
the foundation.
Based on the results of a study
conducted by Bayram M et al. in 2017
reported the knowledge of traumatic tooth
injury first aid between public and private
teachers is unsatisfactory. Therefore, first
aid training should be carried out to
increase the knowledge of public and
private teachers about first aid for
traumatic dental injuries (Bayram,
Koruyucu, & Seymen, 2017). First aid is an
immediate assistance to people who are
sick or injured who need basic medical
treatment before getting help from a
medical professional. The main purpose of
first aid is to prevent infection, prevent
more severe conditions and prevent death
(Qureshi, Khalid, Nigah-e-Mumtaz, Assad,
& Noreen, 2018); (Anggraini et al., 2018).
Based on the background explanation
above, there is a lot of study about
comparing teacher’s knowledge but there’s
no study that using the real case picture to
assess the differences in teacher’s
knowledge about it between public and
private school in Jakarta. The purpose of
this study is to explain the differences in
knowledge about dental trauma and its
management between public and private
school teachers.
1063 | TeachersKnowledge About Dental Trauma and Its Management in Primary Schools in
Jakarta, Indonesia
METHODS
We conducted analytical study for this
study. Questionnaires were personally
handed to 40 teachers from 1 public school
and 1 private school in Jakarta. The study
sample is part of the teacher population
who met the inclusion criteria and were at
the school when data collection was held.
The inclusion criteria are teachers who
teach at public school and private school in
Jakarta and are willing to fill out a
questionnaire in the Google Forms. Whilst
the exclusion criteria are teachers who sign
the informed consent in the Google Forms,
but they are not at the school when filling
out the questionnaire in the Google Forms
and do not complete the questionnaire in
the Google Forms.
Ethical clearance
Ethical approval was obtained from the
Scientific Research Commission of the
Faculty of Dentistry, Prof. Dr. Moestopo
(Beragama) with No.
021/KIP/FKGUPDMB/VIII/2020.
RESULTS AND DISCUSSION
This study was conducted to determine
differences in knowledge about traumatic
tooth injury first aid between public and
private school teachers. The study was
conducted on twenty public primary school
teachers and twenty private primary school
teachers. The questionnaire was divided
into two parts, namely the frequency
distribution presented in eight questions
and the teacher's knowledge about first aid
dental injuries presented in nine questions.
Table 1 shows 16% of female teachers
and 10% of male teachers in the public
schools, while private schools have 35%
female teachers and 15% male teachers.
Based on teaching experience, 25% of
teachers in public schools have teaching
experience of more than 30 years and 45%
of teachers in private schools have 10-20
years of teaching experience. 47.5% of
public and private school teachers teach in
the academic section and only 2.5% teach
in the physical education section.
Based on having attended the first aid
training, 37.5% of public school teachers
have attended first aid training and 50% of
private school teachers have attended first
aid training. 20% of public school teachers
participated in first aid training including
material on the management of traumatic
tooth injuries and 25% of private school
teachers attended first aid training
including material on traumatic dental
injuries.
On average, 40% of public school
teachers have never experienced traumatic
tooth injuries, while 30% of private school
teachers have experienced traumatic tooth
injuries. Based on the experience of seeing
the traumatic tooth injury, on average 25%
of public teachers have seen it first hand
and 27.5% of private teachers have never
seen traumatic dental injury.
Table 1. Frequency Distribution of Respondents (N = 40)
Public
School
Private
School (%)
Yufitri Mayasari, Rahayu Dwi Setia Wibowo | 1064
Table 2 shows that on average 22.5% of
public teachers sought for dentist’s
treatment first and 17.5% of private
teachers contacted the school dental clinic
first if their students had traumatic tooth
injuries. Based on the results of the study,
table 3 shows that on average there is no
difference in knowledge about first aid
traumatic dental injuries between public
and private school teachers.
(%)
Gender
Male
Female
10
16
15
35
Teaching Experiences
10-20 years
12.5
45
20-30 years
12.5
2.5
> 30 years
25
2.5
Subject taught
Academic
47.5
47.5
Physical Education
2.5
2.5
Have attended first aid
training
Yes
37.5
50
No
12.5
0
Have had first aid training
including material on the
management of
traumatic dental injuries
Yes
20
25
No
12
25
Have had a traumatic
tooth injury
Yes
10
30
No
40
20
Have seen a traumatic
tooth injury first-hand
Yes
25
22.5
No
25
27.5
Yufitri Mayasari, Rahayu Dwi Setia Wibowo | 1065
DOI : 10.36418/jrssem.v1i8.132 https://jrssem.publikasiindonesia.id/index.php/jrssem/index
Table 2. Frequency Distribution Based on First Contactedto Get the Treatment (N
=40)
Table 2 shows that on average 22.5% of
public teachers soughtdentist’s treatment
firstand 17.5% of private teachers
contacted the school dental clinic first if
their students had traumatic tooth injuries.
2.5% public teachers contacted the public
health centre and 2.5% of private teachers
contacted the School Health Service (UKS)
to be checked and referred to the nearest
hospital.
Based on the results of the study, table
3 shows that the highest p-value of 0.752
(p > 0.05) means that there is no difference
in knowledge about traumatic dental injury
first aid between public and private school
teachers and the lowest p-value is 0.102 (p
> 0.05) means that there is no difference in
knowledge about first aid for traumatic
tooth injuries between public and private
school teachers.
Table 3. The Differences in Knowledge about The First Aid Management of Traumatic Tooth
Injury Between Public and Private School Teachers
Question
Public School
Private School
P value
Correct
Correct
Incorrect
Case A1
9
10
10
0.752
Correct Answer:
Finding the part of the
tooth that is cracked to be
sent immediately to the
school nurse or dentist
(45%)
(50%)
(50%)
Case A2
5
10
10
0.102
Correct Answer:
Yes
(25%)
(50%)
(50%)
Case B1
7
9
11
0.519
First Contacted to Get the
Treatment
Public
School
(%)
Private
School (%)
Medical doctor
2.5
2.5
Dentist
22.5
12.5
General Hospital
7.5
7.5
Dental Hospital
0
2.5
School dental clinic
12.5
17.5
Giving care on site
2.5
5
Others
2.5
2.5
Yufitri Mayasari, Rahayu Dwi Setia Wibowo | 1066
Correct Answer:
I will tell them to go to the
dentist if they experience
pain later
(35%)
(45%)
(55%)
Case C1
17
14
6
0.256
Correct Answer:
I will move the teeth with
my fingers and take them
immediately to the dentist
(85%)
(70%)
(30%)
Case D1
2
5
15
0.212
Correct Answer:
Ask them to bite a
handkerchief to control the
bleeding
(10%)
(25%)
(75%)
Case D2
1
2
18
0.548
Correct Answer:
Immediately
(5%)
(10%)
(90%)
Case D3
10
17
3
0.110
Correct Answer:
Rinse the tooth with tap
water
(50%)
(85%)
(15%)
Case D4
12
5
15
0.519
Correct Answer:
The tooth is placed in the
liquid
(60%)
(25%)
(75%)
Case D5
2
0
20
0.147
Correct Answer:
Milk
(10%)
(100%)
TOTAL
65
72
108
2.807
Based on the gender in public schools
and the private schools, the percentage of
female teachers who are the samples of the
study is more compared to the male
teachers. Based on the data of teachers in
DKI Jakarta Kemendikbud 2020, the
number of female teachers was 46,972
people and the number of male teachers
was 23,727.
Most of the samples in this study have
had teaching experience for 10-20 years.
This is in line with the source of the 2003
labour law which describes the working
period of teachers up to the age of 60
years . Based on the subjects taught, the
teachers who teach in the academic section
were higher than teachers who teach in the
physical education section, both in public
and private primary schools.
In this study, it was found that most of
the teachers in both schools had attended
first aid training, even all of the private
1067 | TeachersKnowledge About Dental Trauma and Its Management in Primary Schools in
Jakarta, Indonesia
teachers had attended this training. Based
on Law no. 23 of 1992, concerning Health
states that the School Health Service (UKS)
is compulsory to be held in schools. On
average, only UKS teachers are required to
follow first aid training because they can do
first aid if students have an accident. The
prevalence of traumatic tooth injury cases
in Indonesia is quite large, namely around
11.4% at primary school age. This is
different from the study conducted by
Mergany NN et al. in 2016, the results of the
study showed that teachers in Sudan had
attended less first aid training compared to
teachers who had never attended first aid
training (Mergany, Ibrahim, & Abuaffan,
2016).
Meanwhile, the results also show that
the first aid training that was followed by
the study sample mostly included material
management of traumatic dental injuries.
According to the study conducted by
Sharma R et al. in 2016 teachers in
Bangalore City stated that only 5.7% of
teachers who received material about the
management of traumatic dental injuries
were included in the first aid training
materials they attended (Sharma, Mallaiah,
Kadalur, Verma, & Mallaiah, 2016). The
reason is that teeth are part of the body as
a whole and the number of emergency
cases injures the tooth and the mouth is
quite high, as many as 37.5% of children
aged 7-12 years.
The results show that fewer teachers
had experienced a traumatic tooth injury
such as a broken tooth or a tooth
protruding from the gum compared to
teachers who had never experienced a
traumatic tooth injury. Meanwhile, the
number of teachers who had directly
witnessed the occurrence of traumatic
dental injuries was higher than the number
of teachers who had never directly
witnessed traumatic dental injuries.
Teachers who have seen first-hand the
occurrence of traumatic tooth injuries have
the experience. Traumatic dental injury
cases often occur in schools because most
teachers have seen first-hand the
occurrence of traumatic tooth injuries.
Based on this study, most of the study
samples stated that the first contact to seek
treatment when students had dental
injuries was the dentist. The results
obtained are consistent with the study
conducted by Bayram M et al. in 2017
which stated that public and private
primary school teachers would first contact
a dentist if students suffered traumatic
tooth injuries (Prathyusha et al., 2015).
According to a study conducted by Islam F
et al. in 2017 stated that dentists can take
the right action in dealing with injured
students teeth compared to other health
personnel.
In this study, when a male student
broke his upper front tooth due to being hit
by a ball from the baseball, what the
teacher did dominantly was to give warm
drinks and immediately contact his parents.
This is different from the study conducted
by Baharin F et al. in 2019 which stated that
the teacher would contact his parents and
ask them to take him to the dentist
(Baharin, Osman, & Adnan, 2019).
Based on the results of this study, most
of the teachers believed that a broken
tooth could not heal by being reattached.
This is in line with a study conducted by
Anand A et al. in 2016 which stated that
teachers argued that a broken tooth could
Yufitri Mayasari, Rahayu Dwi Setia Wibowo | 1068
not be reconnected. This reflects the lack of
knowledge of teachers about first aid
dental injuries.
In this study, it is stated that when a
female student's tooth hit a chair, there was
not much damage but slightly had mobility
on the tooth and a little bleeding in the
gums of the upper front teeth, most of the
teachers immediately sent these students
to the dentists, both public and private
primary school teachers. According to the
study by Tzimpoulas N et al. in 2019, the
highest results were obtained, namely,
teachers did not take any action and
immediately sent students to the dentist,
then some teachers controlled the bleeding
before sending students to the dentist.
Controlling the bleeding is important to
avoid large amounts of blood loss because
if you lose large amounts of blood, it can
cause the body to become limp.
The results show that when students hit
their friends while running and the teacher
realized that their upper left front teeth
were detached from the palate, most of the
teachers thought that they should not
touch their teeth and took them to the
dentist immediately. This is different from
the results of the study conducted by
Krishnan R et al. in 2018 which declared
that the teacher of public and private
schools believe that teachers will replant
the tooth which has fallen out of the socket.
According to the study of Alamsyah RM et
al. in 2018 showed the correct action,
namely moving the tooth that is separated
from the socket with the fingers but only
holding the crown because holding the
tooth at the root can damage the fibres of
the periodontal ligament.
In this study, the majority of the
teachers asked their students to bite a
handkerchief to control the bleeding when
the upper front tooth lost and bleeding
because the student fell from the stairs.
This is in line with the study of Attarzadeh
H et al. in 2017 which stated that the
highest result was the teachers asked their
students to bite a handkerchief to stop
bleeding.
The results of this study indicate that
the teachers think that they will
immediately see a dentist after the tooth is
removed from the socket where the tooth
is embedded and some teachers also think
that it will take 30 minutes to see a dentist.
According to the study by Halawany HS et
al. in 2014, the highest results were
obtained, namely, the teacher immediately
went to the dentist after the tooth fell out
of the socket. The tooth must be inserted
back into the socket within the minimum
time possible, which is less than 30 minutes
after the tooth has fallen out of the socket.
Based on the results of the data, if the
loose tooth was dirty and the teachers
decided to put it back in the tooth socket,
most of the teachers rinsed the tooth with
water. This is consistent with study
conducted by Francisco SS et al. in 2015
which showed the highest results that were
obtained, namely the teacher rinsing the
teeth using tap water if the loose tooth is
dirty and they decide to put it back in the
tooth socket.
The study conducted by Reynard E et al.
in 2016 stated that the right thing for
teachers to do is to clean teeth using
running water if the loose tooth is dirty
before being put back in the socket.
According to the guidelines of the
International Association of Dental
1069 | TeachersKnowledge About Dental Trauma and Its Management in Primary Schools in
Jakarta, Indonesia
Traumatology (IADT), the tooth that falls
out of the socket in a dirty state must be
rinsed for 10 seconds using running water
without brushing the teeth so that they do
not cause infection due to germs that stick
to the teeth.
In this study, the highest results were
obtained, namely tissue paper as a
container to bring the tooth to the dentist
and if the teacher could not return the
tooth to the socket and the liquid to bring
the tooth to the dentist is tap water. This is
in line with the study of Baharin F et al. 2019
which showed that most of the teachers
think of tissue paper as a container for
carrying teeth to the dentist and the liquid
used to bring teeth to the dentist is tap
water.
This is different from the study of
Reynard E et al. in 2016 which reported the
correct answer is the tooth is placed in the
liquid and the liquid used is milk. Milk is the
best storage medium because it has a
neutral pH to maintain the vitality of the
periodontal ligament.
According to study conducted by
Alamsyah RM et al. in 2018, there was a
significant difference between the
knowledge of public and private primary
school teachers because teachers in public
elementary schools went through a test
before being accepted to work in public
schools so that the quality of their teachers
was better than that of private schools.
A study by Shamarao S et al. in 2014
stated that there was no significant
difference in knowledge about first aid
traumatic tooth injuries between public
and private primary school teachers.
Therefore, it is necessary to include training
materials on first aid for traumatic tooth
injuries in the school curriculum and the
procurement of dental care facilities in
public and private primary schools.
In this study, it was found that private
primary school teachers answered more
correctly than public primary school
teachers. Meanwhile, more public primary
school teachers answered incorrectly than
private primary school teachers. This
proves that there is no difference in
knowledge about first aid for traumatic
tooth injury between public and private
school teachers.
CONCLUSIONS
Based on the results of this study, it can
be concluded that there is no difference in
knowledge between public and private
elementary school teachers. This is due to
various reasons, including the
ineffectiveness of the emergency health
service system in schools. The UKS or UKGS
in schools is not sufficient to provide first
aid for traumatic tooth injuries. Also, not all
teachers have received first aid training
materials for traumatic tooth injuries, so the
teachers do not have sufficient knowledge
in dealing with traumatic tooth injuries.
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(https://creativecommons.org/licenses/by-sa/4.0/).