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Abstrak :
The prevalence and severity of caries in children under three years old are constantly increasing. One of the cause is the increase consumption of cariogenic carbohydrate. Breast milk have buffer capacity that eventually able to prevent caries. The aims of this research are to discover the correlation between breastfeeding with the severity of Early Childhood Caries (ECC) in children under three years old, to provide information on prevalence and severity of caries in children under three years, and to explain factors influencing the incidence of ECC. This research designed cross sectionally and conducted upon 565 children aged 12-38 months, selected using multistage cluster random sampling. The ECC prevalence of children under three years in DKI Jakarta is 52.7%, with average score of def-t 2.85. Bivariate analysis showed that, variables which correlate with the level of ECC are; the way to deliver (p=0,012), frequency (p=0,002), duration (p=0,002), salivary buffer capacity (p=0.013), habitual consumption of sugary diet (p=0.005), child?s dental hygiene behavior (p=0.002), and mother?s education (p=0.001). Multivariate analysis showed that ECC can be explained by these variables: age, mother?s education, the way to deliver and frequency of breast milk complements/replacement of consumtions, child?s brushing habit, plaque pH, and salivary buffer capacity. Resulting determination coefficient 32.1%. There is no significant correlation between breastfeeding and the level of Early Childhood Caries (ECC). The role of protective qualities of breastfeeding are not shown because of bias in obtaining data influence the incidence of caries.

Abstrak :
ABSTRAK
Ruang Lingkup dan Metode: Pada murid kelahiran Palembang dievaluasi kebiasaan mengkonsumsi makanan tradisional dengan cuko (Kuah Asam Manis atau KAM), yang dikaitkan dengan latar belakang sosial demogratik dan perilaku kesehatan gigi. Risiko terjadinya karies yang meliputi multifaktor dianalisis dengan menggunakan univariat dan logistik regresi ganda. Respon aktivitas bakteri S. mutans, kecepatan aliran saliva dan kapasitas dapar saliva di analisis terhadap pemberian KAM. Untuk menetapkan peran KAM pada anak-anak berusia 12 tahun dengan karies ringan dilakukan perbandingan kejadian karies berdasarkan intensitas mengkonsumsi KAM di dua wilayah sekolah Ulu dan ilir. Evaluasi dilanjutkan dengau Kariogram dari Bratthall (1996) untuk mengetahui faktor-faktor yang berinteraksi pada terjadinya karies atau pencegahannya.

Hasil dan kesimpulanz: 75% murid yang biasa mengkonsumsi KAM mempunyai kejadian karies yang rendah, tetapi kejadian fluorosis yang dijumpai lebih tinggi. Dari analisis regresi logistik ganda diperoleh bahwa frekuensi mengkonsumsi KAM, fluorosis email, gender, asal orangtua, dan rasa takut pada perawatan gigi berhubungan dengan kejadian karies. Bakteri plak ternyata tidak memperlihatkan pengaruhnya pada kelompok yang mengkonsumsi KAM atau tidak. Sesudah 2 jam pemberian KAM, aktivitas bakteri cenderung menurun dan pada kelompok karies terlihat pH saliva lebih rendah dari sebelum pemberian KAM. Dari gambaran Kariogram diketahui bahwa lama mengkonsumsi KAM sejak usia sebelum gigi tetap erupsi merupakan faktor yang paling berperan terhadap karies. Pada model ini diperoleh kemungkinan untuk tidak karies sangat rendah, yaitu antara 1 - 13%. Faktor yang turut berperan terhadap kerentanan gigi yang fluorosis mungkin karena terdapat gula dan rendahnya pH dalam diet KAM yang meningkatkan demineralisasi email bila KAM dikonsumsi setiap hari. Frekuensi mengkonsumsi KAM merupakan faktor yang paling berperan terhadap rendahnya karies. Demikian juga pada kelompok dengan kebiasaan mengkonsumsi KAM atau tanpa KAM disertai karies atau tanpa karies, mempunyai kebiasaan jajan di antara waktu makan, jajan yang manis-manis, mempunyai orangtua asal Palembang.

Kesimpulan penelitian adalah: (1) Kejadian karies di Ulu lebih rendah daripada di Ilir; (2) KAM menghambat tenjadinya karies yang dikonsumsi setiap minggu dan setiap bulan; (3) Kelompok bebas karies tidak bergantung pada perilaku kesehatan gigi yang diperoleh di sekolah; (4) KAM tidak menyebabkan terjadinya fluorosis bila dikonsumsi sesudah usia 8 tahun; (5) Kebiasaan mengkonsumsi KAM berhubungan dengan faktor tempat lahir pada latar belakang sosial demografik; (6) Fluorosis berhubungan dengan faktor tingkat pendidikan orangtua pada latar belakang sosial demografik; (7) Kemungkinan tidak karies tidak bergantung pada frekuensi mengkonsumsi KAM semata, tetapi lebih bergantung pada saat anak mulai mengkonsumsi KAM. Faktor yang paling lemah dalam model Kariogram ini adalah diet KAM dan kerentanan gigi karena fluorosis. Dengan model Kariogram ini dapat dikembangkan berbagai model sesuai dengan ciri-ciri individu, sehingga perlu observasi lanjutan dengan latar belakang yang sama agar dapat disusun strategi penyuluhan dan intervensi pencegahan karies yang spesifik. Selain itu perlu dilakukan pemetaan fluor di masyarakat, dan penelitian lanjut agar dapat menjelaskan mekanisme karies pada kelompok dengan fluorosis.

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Abstract
Field of study and Methods. Children born in Palembang were evaluated to detect their habitual KAM consumption, social demographic backgrotmd, and oral hygiene practice. The risks involving preventive factors were calculated using univariant and multiple logistic regression analysis. Response to KAM administration was analysed on S- mutans activities, salivary flow rates, and the change of salivary pH. The role of KAM in high caries risk children was determined by comparing caries experience and the intensity of KAM consumption using two different school locations (Ulu and Ilir). A cariogram model was used to evaluate the interaction among all factors in caries development or prevention.

Result and Conclusions. Seventy five percent of children that regularly consumed KAM had a lower caries occurrence, but higher enamel fluorosis. Multiple logistic regression analysis disclosed that the frequency of KAM consumption, enamel iluorosis, gender, parental origin, and fear of dental procedures were associated with the development of dental caries. Dental plaque bacterial activity was not significantly different between KAM consumers and non-consumers. After administering KAM in both regular and non-regular KAM consumers, bacterial activity tended to decrease and in the caries group after two hours the salivary pH slightly decrease. Cariograms revealed that the period of fluoride intake from KAM before the age of eight was the most significant factor in caries, neither a daily or a weekly basis. They appeared to have a very low chance of avoiding caries, i.e. between 1 to 13%. The other factors that influence dental caries might be explained by the sugar content and low pH of the KAM. The low pH may increase enamel demineralization when used on a daily basis to influence the susceptible tooth which was a hypomineralised enamel. They were also constant in KAM and non KAM users as well as carious or caries free children either frequents intake of snacks between meals, or sweets, and parents origin of Palembang were additional factors to increase the caries risk.

The conclusions of the study were: (1) Caries occurrence in Ulu were less than in llir; (2) KAM inhibits caries when consumed on a weekly or monthly basis. (3) Caries free children were not dependant on the preventive oral hygiene methods taught in schools. (4) KAM did not induce fluorosis when constuned after the age of eight. (5) KAM consumption was related to the birth location of the social demographic factors. (6) Fluorosis was related to the parents education level of the social demographic factors. (7) The chance for not having caries was not only dependant on how frequent, but more on when the children started consuming KAM. Vulnerable factors shown in Cariogram was correlated to particular diet KAM and fluorosis as a susceptible tooth. More Cariogram model can be developed due to the individual characteristics, therefore observation in a similar background is needed to determine a particular strategy for health promotion and preventive intervention. There is also a need to have a fluoride mapping in community, and iilrther investigation to explain the mechanism of caries in fluorosis group.