Social Learning Theory on Factors Associated with Dental Caries among Mentally Disabled School Children in Surakarta, Central Java


  • Anggia Rahmah Nursani Masters Program in Public Health, Sebelas Maret University, Surakarta
  • Bhisma Murti Masters Program in Public Health, Sebelas Maret University, Surakarta
  • Eti Poncorini Pamungkasari Faculty of Medicine, Sebelas Maret University, Surakarta


Background: Mentally disabled adolescents have limitations that make them are at greater risk of dental caries. There is a lack of studies on the factors associated with dental caries in adolescents using Social Learning Theory. This study aimed to determine factors associated with dental caries among mentally disabled adolescents using Social Learning Theory.

Subjects and Method: This was an analytic observational study using cross-sectional design. The study was conducted at several special schools for disabled children (SLB) Surakarta, including: SLB C Setya Darma, SLB C YPSLB, SLB CG YPPCG Bina Sejahtera, and SLB C1 YSSD, in Surakarta, Central Java, from June to July 2017. A sample of 150 mentally disabled school children were selected for this study  by purposive sampling.  The dependent variable was caries dental status. The independent variables were parenting time, maternal oral health knowledge, maternal attitude towards oral health, maternal oral hygiene practice, child oral hygiene practice, maternal sweet food intake, child sweet food intake. Dental caries status was measured by decay, missing, filled-teeth (DMF-T) index. The other data were collected by questionnaire. The data were analyzed by path analysis.

Results: Dental caries was directly and positively associated with sweet food intake (ƅ= 0.27, SE= 0.09, p= 0.002), poor child oral hygiene practice (ƅ= 0.09, SE= 0.04, p= 0.018), and poor maternal oral health knowledge (b= 0.36, SE= 0.10, p<0.001). Maternal oral hygiene practice was associated with maternal attitude towards oral health (ƅ= 0.33, SE= 0.13, p= 0.012) and maternal oral health (ƅ= 0.18, p<0.001). Child oral hygiene practice was associated with maternal oral hygiene practice (ƅ= 0.33, SE= 0.06, p= 0.012),  maternal oral health knowledge (ƅ= 0.91, SE= 0.18, p<0.001), and parenting time (ƅ= 1.39, SE= 0.18, p<0.001).

Conclusion: Dental caries is associated with sweet food intake, poor child oral hygiene practice, and poor maternal oral health knowledge. Maternal knowledge, attitude, and practice in oral hygiene have an important role on dental caries in mentally disabled adolescents.

Keywords: dental caries, adolescents, maternal oral health practice, social learning theory

Correspondence: Anggia Rahmah Nursani. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36A, Surakarta, Central Java.  Email: Mobile: +6287738923404.

Journal of Epidemiology and Public Health (2017), 2(3): 201-215


American Psychiatric Association (2013).

Diagnostic and Statistical Manual of Mental Disorder, 5th Ed. “DSM-5”. Washington DC: American Psychiatric Publishing.

Bandura A. (1977). Social Learning Theory. New Jersey : Prentice Hall.

Barton J, Parry Jones W. (2000). Oxford Textbook of Public Health: The Practice of Public Health. 4th ed. Oxford : Oxford University Press.

Bozorgmehr E, Hajizamani A, Mohammadi TM. (2013). Oral Health Behavior of Parents as a Predictor of Oral Health Status of Their Children. ISRN Dent. 2013: 1-5.

BPDIKSUS Jateng. Data Statistik Siswa. Diakses pada tanggal 4 Februari 2017.

Chance P. (2009). Learning and Behavior: Active Learning Edition, 6th Ed. United States of America : Wadsworth Cencage Learning.

Chu C, Ho P, Lo ECM. (2012). Oral Health Status and Behaviours of Preschool Children in Hong Kong. BMC Public Health. 12: 767.

de Castilho AR, Mialhe FL, Barbosa TS, Puppin-Rontani RM. (2013). Influence of Family Environment on Children's Oral Health: A Systematic Review. J Pediatr (Rio J). 89(2):116–23.

Depkes RI. (2007). Riset Kesehatan Dasar. Jakarta: Badan Penelitian dan pengembangan Kesehatan Kementerian Kesehatan RI.

Depkes RI. (2013). Riset Kesehatan Dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan RI.

Depsos RI. (2015). Pelayanan Penyandang Disabilitas Dalam Menggunakan Berbagai Sarana Aksebilitas. www. Diakses pada tanggal 14 Desember 2016.

Diaz Garrido N, Lozano C, Giacaman RA. (2016). Frequency of Sucrose Exposure on the Cariogenicity of a Biofilm Caries Model. Eur J Dent. 10(3): 345–350.

Dostalova T, Seydlova M. (2010). Dentistry and Oral Diseases for Medical Students. Jakarta : Grada.

Felton A, Chapman A, Felton S. (2014). Basic Guide to Oral Health Education and Promotion. 2nd Ed. West Sussex : Wiley Blackwell.

Goldberg JS, Carlson MJ. (2014). Parents’ Relationship Quality and Children’s Behavior in Stable Married and Cohabiting Families. J Marriage Fam. 76(4):762-777.

Hallscullin E, Goldthrope J, Milsom K, Tickle M. (2015). A Qualitative Study of the Views of Adolescents on Their Caries Risk and Prevention Behaviours. BMC Oral Health. 15: 1-10.

Horowitz AM, Kleinman DV. (2008). Oral Health Literacy : The New Imperative to Better Oral Health. Dent Clin North Am. 52(2): 333-344.

Lalic M, Aleksic E, Gajic M, Malesevic D. (2013). Oral Health Related Knowledge and Health Behavior of Parents and School Children. Med Pregl. 66(1-2):70-9.

Liu Z, Yu D, Luo W, Yang J, Lu J, Gao S, Li W, Zhao W. (2014). Impact of Oral Health Behaviors on Dental Caries in Children with Intellectual Disabilities in Guangzhou, China. J Environ Res Public Health. 11(10): 11015-11027.

Lukacs JR, Largaespada LL. (2006). Explaining Sex Differences in Dental Caries Prevalence : Saliva, Hormones, and “Life-History” Etiologies. Am J Hum Biol. 18(4): 540–555.

Marulanda J, Betancur JD, Espinosa S, Gomez JL, Tapias A. (2011). Oral Health for the Disabled. CES Odontologia. 4(1): 71-76.

McCabe IB. (2015). A History of Global Consumption: 1500 – 1800. New York : Routledge.

Mobley C, Marshall TA, Milgrom P, Cold-well SE (2009). The Contribution of Dietary Factors to Dental Caries and Disparities in Caries. Acad Pediatr. 9(6): 410-414.

Nourijelyani K, Yekaninjas MS, Eshragian MR, Mohammad K, Foroushani AR, Pakpour A (2014). The Influence of Mothers’ Lifestyle and Health Behavior on Their Children: An Exploration for Oral Health. Iran Red Crescent Med J. 16(2): e16051.

Okada M, Kawamura M, Kaihara Y, Matsuzaki Y, Kuwahara S, Ishidori H, Miura K. (2002). Influence of Parents’ Oral Health Behaviour on Oral Health Status of their Schoolchildren: An Exploratory Study Employing A Causal Modeling Technique. Int J Paediatr Dent. 12: 101-108.

Peres M, Peres K, Barros A, Victoria C. (2007). The Relation between Family Socioeconomic Trajectories from Childhood to Adolescence and Dental Caries and Associated Oral Behaviors. Journal Epidemiol Community Health. 61: 141-145.

Piovesan C, Mendes FM, Ferreira FV, Guedes RS, Ardenghi TM. (2010). Socioeconomic inequalities in the distribution of dental caries in Brazilian preschool children. J Public Health Dent. 70(4):319-26.

Poduval J, Poduval M. (2009). Working Mothers: How Much Working, How Much Mothers, And Where Is The Womanhood?. Mens Sana Monographs. 7(1):63-79.

Poutanen R, Lahti S, Tolvanen M, Hausen H. (2006). Parental Influence on Children’s Oral Health Related Behavior. Acta Odontologica Scandinavica. 64: 286-292.

Purkait SK. (2011). Essentials of Oral Pathology. New Delhi: Jaypee Brother Medical Publishing.

Rajendran A dan Sivapathasundharam B. (2012). Shafer's Textbook of Oral Pathology, 7th Ed. New Delhi : Elsevier.

Sa’adu L, Musa OI, Abu-Saeed K, Abu-Saeed MB. (2012). Knowledge and Practices on Oral Health among Junior Secondary School Students in Ilorin West Local Government Area of Nigeria. E J Dent. 2(2): 170–175.

Saied-Moallemi Z, Virtanen JI, Ghofranipour F, Murtomaa H. (2008). Influence of mothers' oral health knowledge and attitudes on their children's dental health. Eur Arch Paediatr Dent. 9(2): 79-83.

Tasse MJ, Luckasson R, Nygren M. (2013). AAIDD Proposed Recommendations for ICD–11 and the Condition Previously known as Mental Retardation. Intellect Dev Disabil. 51(2): 127-131.

Vadiakas G, Oulis CJ, Tsinidou K, Mamai-Homata E, Polychronopoulou A. (2011). Socio Behavioural Factors Influencing Oral Health of 12 and 15 Year Old Greek Adolescents. A National Pathfinder Survey. Eur Arch Paediatr Dent. 12(3): 139-45.

WHO. (2011). World Report on Disability. Diakses pada tanggal 22 Februari 2017.

WHO. (2012). Oral Health. Diakses pada tanggal 16 Januari 2016. Xavier. (2015). Correlation between Dental Caries and Nutritional Status: Preschool Childrenin a Brazillian Municipality. Rev Odontol UNESP. 42(5): 378-383.




How to Cite

Nursani, A. R., Murti, B., & Pamungkasari, E. P. (2017). Social Learning Theory on Factors Associated with Dental Caries among Mentally Disabled School Children in Surakarta, Central Java. Journal of Epidemiology and Public Health, 2(3), 201–215. Retrieved from




Most read articles by the same author(s)

<< < 1 2 3 4 5 6 7 8 9 10 11 12 13 14 > >>