October-December 2017Number 4Volume 8

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Indian Journal of Public Health Research and Development

Scopus coverage years: from 2010 to 2016 Publisher:

R.K. Sharma, Institute of Medico-Legal Publications

ISSN:0976-0245E-ISSN: 0976-5506 Subject area: Medicine:

Public Health, Environmental and Occupational Health

CiteScore 2015- 0.02

SJR 2015- 0.105

SNIP 2015- 0.034

Number 1

Cite Score 2017- 0.03SJR 2017- 0.108SNIP 2017- 0.047

January 2019Volume 10

Efforts to Improve Knowledge of Dental and Oral of Sangging in Mepandes Ceremony in Kerambitan District Bali Province,

Indonesia

Sagung Agung Putri Dwiastuti1, Dewi Supariani1, Ida Ayu Dewi Kumala Ratih1, Anwar Mallongi2

1Dental Hygienest Departement, Polytechnic of Health, Ministry of Health, Denpasar Indonesia; 2Department of Environmental Health, Faculty of Public Health, Hasanuddin University Makassar

ABSTRACT

Oneof theuniquecultureandloadedwithreligiousmeaningsthatneedtobepreservedisa toothfilingceremony.Cuttingteeth(Mepandes)isaritualthatmustbeperformedbysomeonewhoisHindu.Atthisceremony isno treatment that iscuttingmeasuresor leveling the four incisorsand twocanines leftandrightintheupperjaw,threetimeschiselled,honedandleveled.FromthoseactionsraisedcomplaintsandnoaccesstothespreadofdiseaseashealthprofessionalsneedtothinkabouthealthmeasurestopreventthespreadofthediseaseandreducecomplaintsaftercuttingteethBasedonsuchthought.Researchersareinterestedinexaminingeffortstoimprovetheknowledgeoforalhealthofthesanggingatthetimeoftoothfilingceremony(Mepandes).Thestudydesignwithpretest-posttestcontrolgroup(pretest-posttestwithcontrolgroupDesign)withalargesampleusedinthisstudywere15peopleoneach-eachtreatmentandcontrolgroup,wereselectedbysimplerandomsampling,theresultsofthedataanalyzedusinganalysisofMan-Whitney.Basedonsuchthought,researchersinterestedinexaminingeffortstoimproveoralhealthknowledgeofthesanggingatthetimeoftoothfilingceremony(Mepandes).

Basedonthecomparisonastherearenosignificantdifferencesinknowledgebetweencontrolandtreatmentgroups(p>0.05)beforebeinggiventreatment.Butafterbeinggiventreatment/training,thetreatmentgrouphadanaveragescorehigherthancontrols(p<0.01).Theassessmentresultsinthetreatmentgroupthemeanscoreof48atthebeginningofthestudyandincreasedto74.6.Basedontheresultsoftheirresearchneedseducationaboutoralhealthwithamorecomprehensivemethodwithacombinationofmediaoutreach.

Keywords: knowledge, dental health, sangging

Corresponding Author:SagungAgungPutriDwiastutiDentalHygienestDepartement,PolytechnicofHealth,MinistryofHealth,DenpasarIndonesiaPhone:+6281547128650Email:sagungagungputri@yahoo.co.id

INTRODUCTION

Cutting teeth (Mepandes) is a ceremony to beperformedtosomeoneHindu.Thepurposeofmepandesceremonycontainsthemeaningofpurificationofachildasitreturnstoadultnature,sothatitcanunderstandtheessenceofbeinghuman.Thisceremonyisanobligationasparentstogivetheirchildrenmoralmessagethatistokill sixenemies (Sad Ripu) in thehumanbeingwhich

isevilandenough tobeconsideredevenasanenemywithin oneself. At this ceremony, cutting or levelingfourincisorsandtwoleftandrightcanineteethontheupperjaw,sculpturedthreetimes,honedandleveledbya sangging 1,2.

Accordingstimulireceivedbytheteethintheformof excessive heat when the teeth cut and usingmetalobjectsrubbedonteethmustleavetraumaonperiodontaltissue3. Riskesdas data shows dental and oral healthproblems,especially theperiodontal tisuue thatcausedbytartarinBaliprovince,is68.6%,whichishigherthantheincidenceinIndonesiaat67.2%4.

This is supported by reasect about the complaintsthat occurred after mepandes in Bangli regency,such as: stiffened teeth aching (92.9%), pain after cut

DOI Number: 10.5958/0976-5506.2019.00227.4

Indian Journal of Public Health Research & Development, January 2019, Vol.10, No. 1 1249

(47.1%),teethchangedpositionsorrotated(5.3%),teethbecome tenuous (23.4%), tooth decayor discoloration(9.4%),andloosetooth(16.5%)4.Inadditiontodentalcomplaints,intheeraofglobalizationmanythingscanhappen, including the spread of diseases such as TB,hepatitis, andAIDS. Other risk factor that can effectactions of the individu are being a male, older age,comingfromanotwellofforpoorfamilybackground,tooth brushing,as smoking, diabetes, and hypertensionand malocclusion6.7.8

According)thespreadofthediseasecanbecalledthroughthebreath,saliva,blood9.

Sanggingisaverynobleprofession,passedonfromgenerationtogenerationwithouttraining,tothepresentwithout the monitoring of the unity of PHDI (HinduDharma Council of Indonesia).As professionals,theyshouldhaveknowledgeabouttheteeth,diseasesthatcanbetransmittedortransmittedthroughtoothcuttingandhowtoavoidtransmissionofdisease.

Knowledgeistheresultofknowingandthisoccursafter people make sensations to a particular object10. Almost all knowledge is obtained through the eyesand ears.With increased knowledge can also increasethebehaviorofapersoninactionbecauseaccordingtoGreen,behaviorisaffectedbythreepredisposingfactors,supporting factors and reinforcement factors11.

MATERIALS AND METHOD

ThestudywascarriedoutwithPretest-PosttestwithcontolgroupDesign.Thepopulationinthisresearchisallsangging inKerambitan sub-district,Tabanan regency.TocalculatethenumberofsamplesofresearchersusingtheformulaPocock12.

n x

n x x

n

��

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2

2 12

1510 5

13 44

2

1 0

2

2

2

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Thedatathathavebeencollectedthenstatisticallyanalyzed: paired data and the type of data is non-parametric then analyzed by Wilcoxon test. In orderto know the change of knowledge and behavior thathappenedbeforeandafterthetreatmentwasdoneMann-Whitneytest.

RESULTS

Table 1: Subjects Characteristics

CharacteristicsTreatment Controln % n %

Age38-49 1 6,7 1 6,750–61 12 80 11 73,362–72 2 13,3 3 20

Duration of sangging profession0-10 8 53,3 7 46,711-20 4 26,7 5 33,321–30 3 20 3 20

Level of educationElemntary 7 46,7 6 40Secondary 4 26,7 4 26,7High 4 26,7 5 33,3

In Table 1 can be seen that the sangging age isbetween50-61years,Duration of sangging being 1-10,withthemosteducationbeingelementaryeducation.

Table 2: Knowledge level distribution

Knowledge levelTreatment Control

n % n %Before

Fail 6 40 5 33,3Bad 3 20 4 26,7

Enough 4 26,7 4 26,7Good 1 6,7 1 6,7

Verygood 1 6,7 1 6,715 100 15 100

AfterFail 0 0 5 33,3Bad 4 26,7 4 26,7

Enough 2 13,3 4 26,7Good 2 13,3 1 6,7

Verygood 7 46,7 1 6,715 100 15 100

Table 2 shows that the level of knowledge beforetreatmentisbythefailknowledgelevelbutaftertrainingthe knowledge gained is very good,while the controlgroupthelevelofknowledgedoesnotchange.

1250 Indian Journal of Public Health Research & Development, January 2019, Vol.10, No. 1

Table 3: Distribution of dental and mouth health knowledge of sangging

Variable Mean Rank Sum of Rank Z Sig (p) (2-tailled)

TreatmentPreknowledge 8.00 120.00

-3.494 0.001Postknowledge 0.00 0.00

ControlPreknowledge 4.00 20.00

-1.134 0.257Postknowledge 4.00 8.00

Table3canbeseenthattheresultsofdentalandoralhealthknowledgeanalysisofsanggingknowledgecontrolgroupbeforeandafterthevalueofsign=0.257andintreatmentgroupsbeforeandafterthevalueofsign=0.001.

Table 4: Distribution of Dental and Mouth Health Behavior of Sangging

Variable Mean Rank Sum of Rank Z Sig (p) (2-tailled)

TreatmentPrebehavior 8.00 120.00

-3.494 0.000Postbehavior 0.00 0.00

ControlPrebehavior 2.00 6.00

-1.732 0.83Postbehavior 0.00 0.00

FromTable4canbeseenthatbehavioralanalysisofdentalandmouthbehaviorofsanggingbehaviorcontrolgroupbeforeandafterwithsigvalue=0.83andtreatmentgroupbeforeandaftervalueofsig=0.000.

Table 5: Knowledge distribution

Variable Mean Rank Sum of Ranks D P Value

PreknowledgeTreatment 15.03 225.50

0.769Control 15.97 239.50

PostknowledgeTreatment 20.07 301.00

0.004Control 10.93 164.00

InTable5canbeseenthattheknowledgebeforetreatmentmeanRanktreatmentgroupandcontrolgroupisequaltop=0.769,butaftertreatmentthereisdifferenceofcontrolgroupknowledgeandtreatmentwithvalueofsign=0.004.

Table 6: Behavior distribution

Variable Mean Rank Sum of Ranks D P Value

PrebehaviorTreatment 14.60 219.00

0.503Control 16.40 246

PostbehaviorTreatment 22.93 344.00

0.000Control 8.07 121.00

Table 6. It can be seen that the behavior beforetreatment of Rank Rank of treatment group and control groupisequaltop=0.503,butaftertreatmentthereisdifferenceofcontrolgroupbehaviorandtreatmentwithvalueofsign=0,000

DISCUSSION

Sangging is a person who cut the teeth duringmepandes ceremony.A sangging is usually hereditary

regardlessofeducationlevelandlevelofability.Theagedistributionofthesanggingisolder,theaveragebeingsangging0-10yearsold,themostisbasicorelementaryeducation13.

Knowledge of sangging followed by behavioralchanges. It can be seen that there is difference ofmean score of behavior on before and after treatmentgroup (p <0,01). Interview and counseling approachto sangging give positive result to the increasing of

Indian Journal of Public Health Research & Development, January 2019, Vol.10, No. 1 1251

sangging behavior. The results of this study closelymatchtheopinionofHoslandwhichstatesthatbehaviorchange isessentially thesameas the learningprocess.The learning process in the individual consists of: thestimulus given to the individual, if the stimulus hasreceived attention (accepted) then proceeded to thenext process of processing the stimulus so that thereis a willingness to act (attitude) with the support offacilities and encouragement from the environmentthenthestimulushastheeffectactionsoftheindividual(behaviorchange)11.Jackatallwrotethatcollaborativerelationships between researchers and health exension-makers, initiated early and maintained throughout aresearchproject,promoteboththeefficientconductofastudyandincreasethelikelihoodofknowledgetransferandexchange14-17.Intheexperimentalgroup;6monthsof intervention achieved improvements in HIV/AIDSrelatedknowledge.After12months;HIV/AIDS-relatedknowledge reached nearmaximal scores.Attitude andmostbehaviorsscoresweresignificantlyimproved18-21.

The professionalism of a sangging increases withunderstanding of health before taking action to otherssuchasmaintainingpersonalhygieneandself-protectionso as not to infect or infecting others. If the cuttingprocess is carried out in accordance with the healthmethod,thenthereisnofearanddoubttocuttheteethsothatthetraditionofcuttingteethcanbeestablishedinBaliandBalineseculturecanbesustainable20-23.

CONCLUSION

The training package that is accompanied bycounseling to increase the knowledge and behavior ofthe sangging in performing the cuttings significantlyimproves theknowledgeandbehaviorof thesanggingin the cutting process. In the control group therewasnosignificantchangeintheknowledgeandbehaviorofsangginginthecuttingprocess.Attheendofthestudythetreatmentgroupwashigherthanthecontrolgroup.

Conflict of Interest: All author declare that there isno any conflict of interest within this research andpublicationincludingthefinancialagency.

Ethical Clearance: Obtained from the Universitycommitee and respondent agreement

Source of Funding:IndonesiaMinistryofHealth

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