Differences in Early Childhood Caries Status on Parental Stress Levels and Socioeconomic Status in Makassar City, Indonesia, During the COVID-19 Pandemic


  • Ayub Irmadani Anwar
  • Fuad Husain Akbar
  • Selviawaty Sarifuddin Panna


Dental Care for Children, Parent-Child Relations, Stress, Psychological, Socioeconomic Factors


Objective: To analyze the differences in early childhood caries status on parental stress levels and socioeconomic status in Makassar City, Indonesia, during the COVID-19 pandemic. Material and Methods: This type of analytical observational study with a cross-sectional design was conducted in North Rantepao, Toraja City, South Sulawesi Province, Indonesia. The research subjects of this study were parents who met the criteria, were willing to participate in the study, and had children aged 6-17 years. The questionnaire instrument with the criteria for assessing children's dental and oral health was assessed based on parents' perceptions. Each item is rated on a scale from 1 (never) to 5 (always). Then the total score was divided into three categories, namely low (score 3-6), moderate (score 7-10), and high (score 11-15). Comparative test analysis using Chi-Square test. Results: Parents with high-stress levels had more children with poor oral health. There is a significant difference according to the level of stress and socioeconomic status of the parents. Conclusion: There is a significant difference between caries status in early childhood based on socioeconomic status and parental stress level.


Anil S, Anand PS. Early childhood caries: prevalence, risk factors, and prevention. Front Pediatr 2017; 5:157. https://doi.org/10.3389/fped.2017.00157

Percival T, Edwards J, Barclay S, Sa B, Majumder MAA. Early childhood caries in 3 to 5 year old children in Trinidad and Tobago. Dent J 2019; 7(1):16. https://doi.org/10.3390/dj7010016

Ivančević V, Tušek I, Tušek J, Knežević M, Elheshk S, Luković I. Using association rule mining to identify risk factors for early childhood caries. Comput Methods Programs Biomed 2015; 122(2):175-81. https://doi.org/10.1016/j.cmpb.2015.07.008

Strömberg U, Holmn A, Magnusson K, Twetman S. Geo-mapping of time trends in childhood caries risk--a method for assessment of preventive care. BMC Oral Health 2012; 12:9. https://doi.org/10.1186/1472-6831-12-9

Fatmasari M, Widodo W, Adhani R. Hubungan Antara Tingkat Sosial Ekonomi Orang Tua dengan Indeks Karies Gigi Pelajar SMPN di Kecamatan Banjarmasin Selatan. Dentin 2019; 1(1):62-67. [In Indonesian].

Zhang K, Li J, Lu Z. The prevalence of dental caries in primary dentition in 3- to 5-year-old preschool children in northern China. Biomed Res Int 2020; 2020:5315236. https://doi.org/10.1155/2020/5315236

Azizi Z. The prevalence of dental caries in primary dentition in 4- to 5-year-old preschool children in northern palestine. Int J Dent 2014; 2014:839419. https://doi.org/10.1155/2014/839419

Suryani L. Hubungan Tingkat Pendidikan dan Penghasilan Kepala Keluarga dengan Karies Gigi Anak pada Masyarakat Desa Seubun Ayon Kecamatan Lhoknga Aceh Besar Tahun 2019. Jurnal Aceh Medika 2020; 4(1):85-93. [In Indonesian].

Purwati DE, Almujadi A, Suyatmi D. Efek Pendapatan Keluarga Terhadap Jumlah Karies Gigi Pada Anak Sekolah Dasar. J Oral Health Care 2018; 6(2):49-53. https://doi.org/10.29238/ohc.v6i2.334 [In Indonesian].

Ngantung RA, Pangemanan DH, Gunawan PN. Pengaruh tingkat sosial ekonomi orang tua terhadap karies anak di TK Hang Tuah Bitung. e-GiGi 2015; 3(2). https://doi.org/10.35790/eg.3.2.2015.10319 [In Indonesian].

Ningsi SW, Salmah U, Noor N, Maidin A. Risk factors of the occurrence of diarrhea in children under five years old in Indonesia (Riskesdas 2013 and 2018 Data Analysis). Indian J Public Health Res Dev 2022; 13(1):385-94. https://doi.org/10.37506/ijphrd.v13i1.17379

Gazzaz AZ, Carpiano RM, Aleksejuniene J. Parenting stress as a mediator in the oral health of children and adolescents: A stress process model. Community Dent Oral Epidemiol 2020; 48(4):288-95. https://doi.org/10.1111/cdoe.12531

Hapka M, Susi S, Fransiska A. Hubungan Perilaku Orang Tua dengan Early Childhood Caries Pada Anak Usia 2-3 Tahun di Kota Padang. Andalas Dent J 2021; 9(1):29-37. https://doi.org/10.25077/adj.v9i1.99 [In Indonesian].

Nelson S, Lee W, Albert JM, Singer LT. Early maternal psychosocial factors are predictors for adolescent caries. J Dent Res 2012; 91(9):859-64. https://doi.org/10.1177/0022034512454434

Masterson EE, Sabbah W. Maternal allostatic load, caretaking behaviors, and child dental caries experience: a cross-sectional evaluation of linked mother-child data from the third national health and nutrition examination survey. Am J Public Health 2015; 105(11):2306-11. https://doi.org/10.2105/AJPH.2015.302729

Liu H. The quality-quantity trade-off: evidence from the relaxation of China’s one-child policy. J Popul Econ 2014; 27(2):565-602. https://doi.org/10.1007/s00148-013-0478-4

Hatton TJ, Martin RM. Fertility decline and the heights of children in Britain, 1886–1938. Explor Econ Hist 2010; 47(4):505-19. https://doi.org/10.1016/j.eeh.2010.05.003

Simo Fotso A. Child disability and siblings' healthcare expenditures in a context of child fostering. Soc Sci Med 2017; 182:89-96. https://doi.org/10.1016/j.socscimed.2017.04.016

Skreden M, Skari H, Malt UF, Pripp AH, Björk MD, Faugli A, et al. Parenting stress and emotional wellbeing in mothers and fathers of preschool children. Scand J Public Health 2012; 40(7):596-604. https://doi.org/10.1177/1403494812460347

Cortés DE, Réategui-Sharpe L, Spiro Iii A, García RI. Factors affecting children's oral health: perceptions among Latino parents. J Public Health Dent 2012; 72(1):82-9. https://doi.org/10.1111/j.1752-7325.2011.00287.x

Northridge ME, Schrimshaw EW, Estrada I, Greenblatt AP, Metcalf SS, Kunzel C. Intergenerational and social interventions to improve children's oral health. Dent Clin North Am 2017; 61(3):533-48. https://doi.org/10.1016/j.cden.2017.02.003

Jewers M, Ku L. Noncitizen children face higher health harms compared with their siblings who have US Citizen status: study compares citizen and noncitizen siblings living in mixed-status families to determine differences in health insurance coverage and access to medical care. Health Affairs 2021; 40(7):1084-9. https://doi.org/10.1377/hlthaff.2021.00065

Byrd T, Pasupathy R. Public Health in Your Practice: Sex and Gender Considerations in Intimate Partner Violence, Access to Healthcare, and Immunizations. In: Jenkins M, Newman C. How Sex and Gender Impact Clinical Practice: Elsevier; 2020. p. 277-87. https://doi.org/10.1016/B978-0-12-816569-0.00013-9

Schwendicke F, Dörfer CE, Schlattmann P, Foster Page L, Thomson WM, Paris S. Socioeconomic inequality and caries: a systematic review and meta-analysis. J Dent Res 2015; 94(1):10-8. https://doi.org/10.1177/0022034514557546

Chen L, Hong J, Xiong D, Zhang L, Li Y, Huang S, et al. Are parents' education levels associated with either their oral health knowledge or their children's oral health behaviors? A survey of 8446 families in Wuhan. BMC Oral Health 2020; 20(1):203. https://doi.org/10.1186/s12903-020-01186-4

Van den Branden S, Van den Broucke S, Leroy R, Declerck D, Hoppenbrouwers K. Oral health and oral health-related behaviour in preschool children: evidence for a social gradient. Eur J Pediatr 2013; 172(2):231-7. https://doi.org/10.1007/s00431-012-1874-6

Sen B, Blackburn J, Morrisey MA, Kilgore ML, Becker DJ, Caldwell C, et al. Effectiveness of preventive dental visits in reducing nonpreventive dental visits and expenditures. Pediatrics 2013; 131(6):1107-13. https://doi.org/10.1542/peds.2012-2586

Lebrun-Harris LA, Canto MT, Vodicka P. Preventive oral health care use and oral health status among US children: 2016 National Survey of Children's Health. J Am Dent Assoc 2019; 150(4):246-58. https://doi.org/10.1016/j.adaj.2018.11.023




How to Cite

Anwar, A. I., Akbar, F. H., & Panna, S. S. (2022). Differences in Early Childhood Caries Status on Parental Stress Levels and Socioeconomic Status in Makassar City, Indonesia, During the COVID-19 Pandemic. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 22, e220014. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/1605



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