PUFA Index Assessment of Dental Caries Severity in Children Living in Wetland Environments

Renie Kumala Dewi*  -  Department of Pediatric Dentistry, Faculty of Dentistry, Lambung Mangkurat University, Banjarmasin, Indonesia., Indonesia
Qurratul Aina  -  Co-Assistant of the Faculty of Dentistry, Lambung Mangkurat University, Banjarmasin, Indonesia., Indonesia
Ika Kusuma Wardani  -  Department of Public Dental Health, Faculty of Dentistry, Lambung Mangkurat University, Banjarmasin, Indonesia., Indonesia

(*) Corresponding Author
Background: Dental caries is a multifactorial disease that is a health problem in children. Children 5-9 years old have the highest caries prevalence. Untreated dental caries can be measured using the PUFA/pufa index. Sungai Kupang Village has acidic water with pH values ranging from 3.09-6.45 and an iron (Fe) content above the maximum allowable level of 1.044mm/ltr. Most people use wetland water in their daily lives, including for gargling after brushing their teeth. Brushing teeth with acidic water can reduce the surface hardness of tooth enamel, thereby increasing the risk of dental caries. Method: The study used a descriptive, cross-sectional design. The sampling technique used was purposive sampling. The sample of 148 children aged 5-9 years was visually examined with a dental mirror to assess the severity of dental caries using PUFA/pufa index criteria, including pulp involvement (P/p), ulceration (U/u), fistula (F/f), and Abscess (A/a). The research data were analyzed descriptively and presented as frequencies, percentages, and average PUFA/pufa. Result: PUFA/pufa index of untreated dental caries in the form of pulp involvement (P/p) was 3.0; ulceration (U/u) was 0.06; fistula (F/f) was 0.1, and abscess (A/a) was 0.02. The caries severity of untreated dental caries based on the PUFA/pufa index was 3.1. The 7-year-old age group and female gender had the highest average PUFA index. Conclusion: According to the average PUFA/pufa index, children 7 years old and female have the most severe untreated dental caries. 

Keywords: Dental caries in children, PUFA/pufa index, Sungai Kupang district, Wetland

  1. Meyer F, Wiesche ES, Amaechi BT, Limeback H, Enax J. Aries Etiology and Preventive Measures. Eur JDent. 2024;18:766–776. DOI https://doi.org/ 10.1055/s-0043-1777051.
  2. Wening GRS. Epidemiology, Etiology, and Prevention of Dental Caries: A Host-Agent-Environment Perspective from Indonesia and Global WHO Data. Airlangga University Faculty of Dentistry. DOI: 10.13140/RG.2.2.20207.70567
  3. Apriani A, Mandalas HY, Khoe W. Saliva Acidity Level Toward Application of Casein Phosphopeptide-Amorphous Calcium Phosphate For Children Aged 8-9 Years. ODONTO Dental Journal. 2022;8(2):91-96. DOI: 10.30659/odj. 8.2.91-96
  4. Issrani R, Alnusayri SAF, Alderaan DAA, Alruwaili SR, Almufarri RAS, Alkhershawy LHS. Risk Factors for Caries in Children and Adolescents: A Systematic Review. The Open Dentistry Journal. 2025:1-15. DOI: 10.2174/0118742106412149250923073046
  5. Pérez-Reyes A, Beccerra-Ruiz J, Guzmán-Flores JM. Influence of Behavioral and Sociodemographic Factors on Dental Caries in Mexican Children. Pediatr. Rep. 2025, 17(2), 40; https://doi.org/10.3390/pediatric17020040
  6. Dewiyani S. Paath SL, Febrianti F. Comparison on Fluoride Concentration In Fluoride Varnish And Glassionomer Cement. ODONTO Dental Journal. 2022;9(1):28-33. DOI: DOI: 10.30659/odj.9.1.28-33.
  7. Ozler CO, Tekcicek MU, Ozdemir P, Dogan PBG. PUFA Index Results Of Untreated Dental Caries Among 3-6 Year Olds, Turkey. 2016;33(4):1-11. Doi:https://doi.org/10.1177/0265539X2016033004076.
  8. Nurtyawan R, Hendarna EM. Pemetaan Wilayah Lahan Basah Berdasarkan Data Penginderaan Jauh Optik Dan Radar. Rekayasa Hijau: Jurnal Teknologi Ramah Lingkungan. 2020; 4 (2): 49.
  9. Sudrajat ASE. Subekti S. Pengelolaan Ekosistem Gambut Sebagai Upaya Mitigasi Perubahan Iklim di Provinsi Kalimantan Selatan. Jurnal Planologi. 2019; 16(2).
  10. Said F, Salamah S. Hubungan Konsumsi Air Sungai (Fe) Dengan Rata-Rata Angka Dmf-T Pada Masyarakat Desa Mekar Sari, Kecamatan Tatah Makmur, Kabupaten Banjar, Provinsi Kalimantan Selatan. J Skala Kesehat. 2017;8(1):1-13. DOI: https://doi.org/10.31964/jsk.v8i1.204.
  11. Sudrajat ASE. Subekti S. Pengelolaan Ekosistem Gambut Sebagai Upaya Mitigasi Perubahan Iklim di Provinsi Kalimantan Selatan. Jurnal Planologi. 2019; 16(2).
  12. Sumual I, Pangemanan D, Wowor V. Keparahan karies gigi yang tidak dirawat pada siswa SD GMIM 31 Manado berdasarkan indeks PUFA. J E-GiGi. 2016;4(2).
  13. Tarigan KI, Hutagalung MHP. Pengaruh Pekerjaan, Pendapatan, dan Pendidikan Orang Tua Terhadap Penderita PUFA/pufa. 2020;7:1-11.
  14. Listrianah. Indeks Karies Gigi Ditinjau Dari Penyakit Umum Dan Sekresi Saliva Pada Anak Di Sekolah Dasar Negeri 30 Palembang 2017. JPP J Kesehat Plb. 2017;12(2).
  15. Dewi RK, Firdaus IWAK, Hakim AQ. Pemberdayaan Kaporagi Dalam Mengurangi Angka Kejadian Karies Gigi Balita Di Lahan Basah. Prosiding PKM-CSR. 2020;3:283-290.DOI: https://doi.org/10.37695/pkmcsr.v3i0.753
  16. Adiatman M, Yuvana AL, Nastasia AA, Rahardjo A, Maharani DA, Zhang S. Dental and Periodontal Status of 5 & 12Year Old Children in Jakarta and its Satellite Cities. J Dent Indones. 2016;23(1):5–9.
  17. Prisinda D, Wahyuni IS, Andisetyanto P, Zenab Y. Karakteristik karies periode gigi campuran pada anak usia 6-7 tahun di Kecamatan Tanjungsari, Sumedang. Padjajaran Jurnal Dental Res Student. 2017;1(2).
  18. Winahyu KM, Turmuzi A, Hakim F. Risiko Kejadian Karies Gigi Ditinjau dari Konsumsi Makanan Kariogenik pada Anak Usia Sekolah di Kabupaten Tangerang. 2019;5.
  19. American Academy of Pediatric Dentistry. Policy on Early Childhood Caries (ECC): Consequences and Preventive Strategies. Oral Health Policies: ECC: Consequences & Preventive Strategies. 2025:96-100.
  20. Fonseca PG, Ramos-Jorge ML, Bittencourt JM, Santos KK, Soares MEC, Campos PSL, Bendo CB, Fernandes IB. Extensive Dental Caries in Childhood: Association with Socioeconomic Status, Dietary and Daily Toothbrushing Frequency, and Sleep Disorders. Int J Environ Res Public Health. 2025 Dec 28;23(1):43. doi: 10.3390/ijerph23010043.
  21. Utami NK, Andrestian MD, Insana A. Salıva pH, Carıes and OHI-S Score in Stuntıng Pre-School Chıldren in The Swamp Area. Medical Laboratory Technology Journal. 2025;11(2):208-219.
  22. Vasavan, Kumar S, Retnakumari N. Assessing consequences of untreated dental caries using pufa/PUFA index among 6–12-year-old schoolchildren in a rural population of Kerala. Journal of Indian Society of Pedodontics and Preventive Dentistry 40(2):p 132-139, Apr–Jun 2022. DOI: 10.4103/jisppd.jisppd_342_21
  23. Suwargiani AA, Aripin D, Susilawati S, Suryanti N, Putri FM, Yolanda Y, Maulidia AH, Yusof ZYM. The severity of untreated caries in the deciduous and permanent teeth among children aged 6-12 years using PUFA and PUFA index: a cross-sectional study. Padjadjaran Journal of Dentistry. 2023;35(3):267-273.DOI: https://doi.org/10.24198/pjd.vol35no3.51048.
  24. Goren BD, Derelioglu SS, Yilmas S. Assessing the Clinical Consequences of Untreated Caries in 8- to 10-Year-Old Children with Pufa Index. Journal of Advanced Oral Research. 2022;13(1): 1-11. DOI: https://doi.org/10.1177/23202068221075964.
  25. Dewi RK, Azizah PA, Azizah A. Tingkat Pengetahuan Dokter Gigi Terhadap Penggunaan Vaksin Karies Gigi Di Lahan Basah. Jurnal Sosial dan Teknologi (SOSTECH). 2023;3(10):819-824. DOI: https://doi.org/10.59188/jurnalsostech.v3i10.945.
  26. Valdivia ADCM, Sánchez MAV, Cortés DEA, Cortez EG. Oral Health: Fundamentals, Importance, and Perspectives. IntechOpen. 2023:1-16. DOI: 10.5772/intechopen. 111610.

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