Development of A Clinical Decision Support System for Calculus Risk Prediction

Authors

  • Marlindayanti Marlindayanti Department of Dental Health, Poltekkes Kemenkes Palembang, Indonesia
  • Wahyu Jati Dyah Utami Department of Dental Health, Poltekkes Kemenkes Semarang, Indonesia
  • Annisa Baizan School of Computer Science, Universitas Bina Nusantara, Indonesia
  • Yasmin Tsaliza Muntazi Department of Dental Health, Poltekkes Kemenkes Palembang, Indonesia
  • Putri Sepriani Department of Dental Health, Poltekkes Kemenkes Palembang, Indonesia
  • Qori ’Atun Department of Dental Health, Poltekkes Kemenkes Palembang, Indonesia

DOI:

https://doi.org/10.31983/jkg.v12i1.13750

Keywords:

Calculus, Risk Prediction, health aplication, decison support system, early prevention

Abstract

Oral health in Indonesia remains a significant problem, with 57.6% of the population experiencing problems but only 10.2% accessing treatment. Dental calculus is one of the main etiologies of periodontal disease. Therefore, healthcare professionals require a rapid and standardized screening tool to efficiently identify high-risk patients. This study aims to report the development process and trial results of the "Calrisk Dentistry" application, a clinical decision support system for detecting risk levels and identifying the main causative factors of calculus. This study used a cross-sectional design to conduct a trial of the system on 60 respondents. The trial was conducted on 60 patients, where the data collection process was facilitated by dental hygiene students. Data were collected using the "Calrisk Dentistry" application that analyzes 13 risk variables to generate a risk score. The application successfully classified respondents into four risk categories: Low (15%), Moderate (40%), High (31.7%), and Very High (13.3%). The risk factors with the highest impact identified by the system were inappropriate brushing time, one-sided chewing, and the presence of caries. The trial results indicate that the developed "Calrisk Dentistry" application is a functional and effective tool for calculus risk screening. This system has the potential to become a technological tool to increase patient awareness and facilitate early prevention.

References

1] K. Ari Niken Ayu Renaningtyas, D. Risnawati, and W. Haryani, “The Effect of Dental Health Education with Video Media on Knowledge and Interest Odontectomy Procedures,” Jurnal Kesehatan Gigi, vol. 12, no. 1, pp. 17–22, 2025, [Online]. Available: http://ejournal.poltekkes-smg.ac.id/ojs/index.php/jkg/index

[2] F. N. Hugo, N. J. Kassebaum, W. Marcenes, and E. Bernabé, “Role of Dentistry in Global Health: Challenges and Research Priorities,” J Dent Res, vol. 100, no. 7, pp. 681–685, 2021, doi: 10.1177/0022034521992011.

[3] Kemenkes BKPK, “Survey Kesehatan Indonesia,” Jakarta, 2023.

[4] A. Łasica, P. Golec, A. Laskus, M. Zalewska, M. Gędaj, and M. Popowska, “Periodontitis: etiology, conventional treatments, and emerging bacteriophage and predatory bacteria therapies,” Front Microbiol, vol. 15, Sep. 2024, doi: 10.3389/fmicb.2024.1469414.

[5] S. K. Harrel, C. M. Cobb, L. N. Sheldon, M. P. Rethman, and J. S. Sottosanti, “Calculus as a Risk Factor for Periodontal Disease: Narrative Review on Treatment Indications When the Response to Scaling and Root Planing Is Inadequate,” Dent J (Basel), vol. 10, no. 10, p. 195, Oct. 2022, doi: 10.3390/dj10100195.

[6] Y. Wei et al., “Recent advances in the pathogenesis and prevention strategies of dental calculus,” NPJ Biofilms Microbiomes, vol. 10, no. 1, p. 56, Jul. 2024, doi: 10.1038/s41522-024-00529-1.

[7] C. M. Cobb, S. K. Harrel, D. Zhao, and P. Spencer, “Effect of EDTA Gel on Residual Subgingival Calculus and Biofilm: An In Vitro Pilot Study,” Dent J (Basel), vol. 11, no. 1, p. 22, Jan. 2023, doi: 10.3390/dj11010022.

[8] S. K. Harrel, A. Yoshimura, and C. M. Cobb, “The Reevaluation of Subgingival Calculus: A Narrative Review,” Dent J (Basel), vol. 13, no. 6, p. 257, Jun. 2025, doi: 10.3390/dj13060257.

[9] E. Raittio, R. Lopez, and V. Baelum, “Contesting the conventional wisdom of periodontal risk assessment,” Community Dent Oral Epidemiol, vol. 52, no. 4, pp. 487–498, Aug. 2024, doi: 10.1111/cdoe.12942.

[10] Dr. J. Bhuvaneswarri.MDS, Dr. JuliusAmaldas, and Dr. Ramya.V, “Risk Assessment in Periodontal Disease – A New Way of Predicting the Periodontal Disease Outcome,” Int J Life Sci Pharma Res, Sep. 2023, doi: 10.22376/ijlpr.2023.13.5.L228-L234.

[11] G. V. de O. Fernandes, G. Mosley, A. C. Cañizares, J. C. H. Fernandes, and R. Muller, “Standardizing clinical evaluations of periodontal condition to guide assessments and diagnoses using the Periodontal Assessment Protocol (GF-PAPro),” Advances in Clinical and Experimental Medicine, vol. 34, no. 7, pp. 1069–1077, Jul. 2025, doi: 10.17219/acem/207502.

[12] L. J. Maciel, L. D. Boyd, L. J. Giblin-Scanlon, and J. Vineyard, “Utilization of Periodontal Risk Assessment Tools in the Clinical Setting: Knowledge, attitudes and practice behaviors of dental hygienists,” The Journal of Dental Hygiene, vol. 94, no. 6, pp. 16–24, 2020.

[13] L. Dwi Apriyanti, D. Fatmasari, T. Wiyatini, and M. Djamil, “Interactive Media with Android Based Sign Language as an Effort to Improve Dental Health Maintenance Behaviour and Decrease Debris Index in Deaf Children,” Jurnal Kesehatan Gigi, vol. 12, no. 1, pp. 1–7, 2025, [Online]. Available: http://ejournal.poltekkes-smg.ac.id/ojs/index.php/jkg/index

[14] O. Kalmus, K. Smits, M. Seitz, C. Haux, B.-P. Robra, and S. Listl, “Evaluation of a Digital Decision Support System to Integrate Type 2 Diabetes Mellitus and Periodontitis Care: Case-Vignette Study in Simulated Environments,” J Med Internet Res, vol. 25, p. e46381, Oct. 2023, doi: 10.2196/46381.

[15] M. T. G. Thanh, N. Van Toan, V. T. N. Ngoc, N. T. Tra, C. N. Giap, and D. M. Nguyen, “Deep Learning Application in Dental Caries Detection Using Intraoral Photos Taken by Smartphones,” Applied Sciences, vol. 12, no. 11, p. 5504, May 2022, doi: 10.3390/app12115504.

[16] T.-J. Lin et al., “Auxiliary Diagnosis of Dental Calculus Based on Deep Learning and Image Enhancement by Bitewing Radiographs,” Bioengineering, vol. 11, no. 7, p. 675, Jul. 2024, doi: 10.3390/bioengineering11070675.

[17] B. Khalili and A. W. Smyth, “SOD-YOLOv8—Enhancing YOLOv8 for Small Object Detection in Aerial Imagery and Traffic Scenes,” Sensors, vol. 24, no. 19, p. 6209, Sep. 2024, doi: 10.3390/s24196209.

[18] P. Lucchi et al., “Introducing the Index of Caries Risk (ICR): A Comparative Study on a Novel Tool for Caries Risk Assessment in Pediatric Patients,” Children, vol. 11, no. 10, p. 1166, Sep. 2024, doi: 10.3390/children11101166.

[19] S. R. Sahoo, D. B. Nandini, P. S. Basandi, M. Selvamani, and M. Donoghue, “A Comparison of Pre- and Postbreakfast Tooth Brushing in Caries Prevention through the Estimation of Streptococcus mutans Counts,” J Microsc Ultrastruct, vol. 10, no. 4, pp. 168–173, Oct. 2022, doi: 10.4103/jmau.jmau_90_21.

[20] S. S. Habibah, D. Danan, and R. Ulfah, “The Effect Of Young Coconut Water Mouth (Cocus Nucifera L) Against Dental Plaque,” Jurnal Kesehatan Gigi, vol. 10, no. 2, pp. 97–101, Dec. 2023, doi: 10.31983/jkg.v10i2.10356.

[21] G. Kitsaras, M. Goodwin, M. P. Kelly, and I. A. Pretty, “Bedtime Oral Hygiene Behaviours, Dietary Habits and Children’s Dental Health,” Children, vol. 8, no. 5, p. 416, May 2021, doi: 10.3390/children8050416.

[22] M. Funahara, R. Yamaguchi, H. Honda, M. Matsuo, W. Fujii, and A. Nakamichi, “Factors affecting the number of bacteria in saliva and oral care methods for the recovery of bacteria in contaminated saliva after brushing: a randomized controlled trial,” BMC Oral Health, vol. 23, no. 1, p. 917, Nov. 2023, doi: 10.1186/s12903-023-03676-7.

[23] T. S. Abbas, G. M. Al-hamdani, and K. A. Mahdi, “Impact of Unilateral Chewing Habit on Temporomandibular Joint Disorders: A Comparative Study,” Journal of Indian Academy of Oral Medicine and Radiology, vol. 37, no. 3, pp. 328–331, Jul. 2025, doi: 10.4103/jiaomr.jiaomr_160_25.

[24] A. Lertpimonchai, S. Rattanasiri, S. Arj-Ong Vallibhakara, J. Attia, and A. Thakkinstian, “The association between oral hygiene and periodontitis: a systematic review and meta-analysis,” Int Dent J, vol. 67, no. 6, pp. 332–343, Dec. 2017, doi: 10.1111/idj.12317.

[25] J. C. Ferreira, L. B. Elvas, R. Correia, and M. Mascarenhas, “Empowering Health Professionals with Digital Skills to Improve Patient Care and Daily Workflows,” Healthcare, vol. 13, no. 3, p. 329, Feb. 2025, doi: 10.3390/healthcare13030329.

[26] M. Senbekov et al., “The Recent Progress and Applications of Digital Technologies in Healthcare: A Review,” Int J Telemed Appl, vol. 2020, pp. 1–18, Dec. 2020, doi: 10.1155/2020/8830200.

[27] Sadhana Kandavel, Anita M, Vidhya Rehka U., and Sathyasri P, “Mobile Smartphone Apps Fororal Dental Health-Review Article,” European Journal of Molecular & Clinical Medicine, vol. 07, no. 2, p. 6755, 2020, doi: 10.2196/11432.

Downloads

Published

2025-12-16

Issue

Vol. 12 No. 2 (2025): December 2025

Section

Articles

License

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. that allows others to share — copy and redistribute the material in any medium or format and adapt — remix, transform, and build upon the material for any purpose, even commercially with an acknowledgment of the work's authorship and initial publication in this journal.