 Overall, the English writing of this article is far from a good standard of English

medical scientific writing. I hope the English translator in the journal can pay more
attention and improve this article’s language.
 Its really hard to understand what are you trying to present in this article with the
poor English writing of this article. You might consider to submit the original
version (Bahasa version) of this article.

A COMPARISON OF THE NUMBER OF COLONIES OF BACTERIA OF SALIVA

AND pH ON THE TODDLER EARLY AND NON EARLY CHILDHOOD CARIES
AFTER CONSUMING INFANT FORMULA BY USING A BOTTLE (DOT)

Abstract
Keyword:
Objective : This study aims to determine the comparison
Early Childhood number of colonies of bacteria of saliva and pH on the toddler
Caries, Non Early early childhood caries (ECC) and non-early childhood caries
Childhood Caries, (non ECC) after consuming milk formula using a bottle (dot).
Bacterial Colonies,
pH. Method : This laboratory experimental (is it correct? ) study
used cross sectional approach. The subjects in this study was
the disciple of 2-4 year old PAUD Padang West Sumatera,
consist 15 children and the children of non ECC who consume
formula milk by using bottle (dot).(unclear sentence, the
grammar should be rewrite) From the 30 subjects were asked to
collect saliva into a sterile container provided. Statistical
analysis is using independent sample t-test.

Results : The results showed that there was difference of pH

and number of salivary bacterial colonies in under fives? early
childhood caries and non-early childhood caries after
consuming milk formula by using bottle (dot) significantly (p
<0,05). Significantly i.e. amount on toddler early childhood
caries higher with an average of 407.2 x 10- 4/ml whereas in
toddlers early childhood caries non lower average? 125.5 x 10-
4
/ml. Whereas pH saliva on toddlers early childhood caries acid
? with an average 6.2 and pH on toddlers early childhood caries
non normally with an average of 6.9.

Conclusion: There is a difference in the number of colonies of

bacteria of saliva on the toddler early childhood caries and non-
early childhood caries after consuming infant formula using the
bottle (dot).

Keywords: Early childhood caries, Non early childhood caries,

Bacterial Colonies, pH

1
INTRODUCTION
Dental and oral health problems in
Indonesia are health problems that exist in
the community, especially among children
who until now still need to get special
attention. The profile of dental and oral
health in Indonesia shows that dental and
oral diseases are included in the 10 ranks of
the most diseases suffered by people in
Indonesia.1 Dental and oral diseases
especially dental caries are still one of the
most problems often occurs in Indonesians,
not only in adults but also in children. 2
Dental health in infants should be noticed by
the elderly to avoid disorders or tooth
disorders and make teeth healthy, orderly,
neat, The beautiful. In fact, not all children's
teeth are healthy, especially during the first-
time tooth, there are many caries at the age
of preschool.3
Factors causing the caries
themselves consist of host factors or hosts,
agents or microorganisms, substrates or
dieters and coupled with time factors. The
first bacteria inhabiting the salivary pellicle
are mainly coccus-shaped and the most
widely-Streptococcus. These
microorganisms number more in the mouth
of the active caries than in the mouth of a
caries-free person.4 ECC is often associated
with a bad dietary habit when babies, but in
reality the mechanisms of incidence of this
disease are more complex because
apparently not all children who drink bottled
milk will suffer from ECC.4 In the caries
that often attack children of toddlers, there
are several factors that worsened caries,
including factors in the mouth that are
directly related to the technique of brushing
teeth, using bottles while drinking milk with
2
liquids containing many carbohydrates, time
drank milk bottles, the composition of the
addition of sugar in milk, the amount of
food and beverage frequencies that cause
caries as well as the degree of acidity saliva
related to the time of drinking milk.5
The high frequency, amount, and
time consumed foods and beverages
containing carbohydrates or sugars
especially sucrose. Based on some research
that has been done is known that there is a
very strong relationship between the
frequency of consuming sugar and the
increase in the prevalence of caries, but the
amount/quantity of sugar consumption does
not have a strong relationship to Increased
prevalence of caries. Children with ECC
usually prefer to consume sugar, such as
eating mainly in the form of fruit juices, and
other sweet foods.6
Saliva plays an important role in the
process of caries, an important Saliva
function in defense against caries.7 Saliva
itself is a protective fluid in the oral cavity,
when the secretion of saliva and buffer
capacity is low, it can cause decrease in
food scraping ability, acid neutralization
ability, and the ability to generate email
demineralization. A decrease in the speed of
saliva secretion can be followed by an
increase in the number of Streptococcus
mutans and Lactobacillus.8 The occurrence
of the role of bacteria microorganisms such
as Streptococcus mutans, Streptococcus
sanguis, Streptococcus mitis, Streptococcus
salivarius, Lactobacillus, as well as some
other strains.9
In general, the pattern of feeding the
milk using bottles (dot) is often done by
parents, especially in the elderly who have a
busy so that the child is not fussy.
Sometimes the feeding of the formula using
the bottle (dot) is a habit until the child is
asleep causing the formation of more acid
saliva that can damage the first tooth
because the formula milk in the bottle (dot)
is longer contact With the teeth. This pattern
of feeding of milk is what can lead to
progressive caries such as ECC.
bottles (dot) implemented throughout
PAUD In Padang and in the laboratory of
microbiology of Baiturrahmah University,
Padang. From the results of the saliva
gathering on both ECC and non-ECC
toddlers, the number of saliva colony-based
colonies listed in table 1.

RESEARCH METHODS
The type of research used in this
study is experimental laboratories with a
crosssectional approach. The research was
conducted throughout the PAUD in North Table 1. Comparison of the average number of
Padang sub-district and in the Microbiology salivary bacterial colony in infants ECC and non
Laboratory of Baiturrahmah University ECC after consuming formula milk using a
Padang, West Sumatera, and was held in bottle (dot).
December 2017. The subject of this study is Number of bacterial colonies
a student of PAUD aged 2-4 years and 15 Non Early
Early Childhood
Childhood Caries
children of ECC and 15 children of Non -4
Caries (10 /ml)
(10-4/ml)
ECC who consume formula milk using a 992 80
bottle (dot). Out of the 30 subjects were 352 186
asked to collect saliva into a sterile 278 164
390 170
container provided.
335 13
Saliva that has been accumulated 305 229
each of them carried out 10-3 dilution and 126 108
planted in the media to the blood by using 315 54
626 134
the 10-1 calibration ose, then the media
355 136
incubated for 24 hours at the temperature of 335 118
37oC then done counting the number of 454 109
bacteria colonies With manual calculations. 440 95
362 143
To find out if there is a The difference in the 443 144
number of saliva colonies in infants ECC ** Expression is
and non ECC after consuming formula milk ** Expression is faulty ** x 10-
-4 4
using a bottle (dot) is used t-test with a level faulty ** x 10 /ml /ml
of 0.05.
In table 3, it can be seen that the
RESULTS number of bacterial colonies that can be
Research has been done regarding the isolated from infant saliva early childhood
number of bacterial colony comparisons and caries and non-early childhood caries
the pH difference of saliva in early consecutively higher number of bacterial
childhood caries and non-early childhood colonies in early childhood caries toddlers
caries after consuming formula milk using with an average of 407.2 x 10-4/ML while

3
on balita non early childhood caries are
lower with an average of 125.5 x 10-4/ml.
The result of table 3 can be concluded that
the total number of bacterial colonies is on a
group of early childhood caries toddlers.

4
Table 2. pH saliva toddlers early childhood Table 3. Test normality tests normality
caries and non early childhood caries after number of infant bacteria colony Early
consuming formula milk using bottles (dot). Childhood Caries and Non Early Childhood
Caries after consuming Formula milk using
Toddler Saliva pH
bottles (dot).
Non
Early Group Statistic df Sig.
Early
No Childhood
Childhood
Caries Early
Caries
childhood
1 6 7.5 caries 0,781 15 0,002
2 6.5 7
3 7 7 Non early 0,988 15 0,998
4 6 7 childhood
5 7 7 caries
6 6 6
7 5.5 7.5
8 7 6.5 In table 5 can be concluded that on
9 5.5 5.5 the number of bacterial colonies in early
10 6 7 childhood caries obtained an abnormal
11 5.5 7.5 distribution of data due to the value (p =
12 6 7 0.002 p < 0.05) so as to see if there is a
13 5.5 6.5 difference in the number of bacterial
14 7 7 colonies in early infants childhood caries
15 6 7 and non-early childhood caries used test
Average 6,2 6,9 Mann-Whitney.

In table 2 visible difference of pH Table 4. Results of test Mann-Whitney

saliva toddler early childhood caries and
non early childhood caries after consuming
formula milk by using a bottle (dot). In
early childhood caries group toddlers gained
11 people with pH acid (pH < 6.8) and as
much as 4 people with a normal pH (pH
6.8-7.2). In infants group non early
Childhood caries only 3 people with pH
acid (pH < 6.8) and as many as 12 people
with normal pH (pH 6.8-7.2). Thus in table
2 It can be concluded that the pH of saliva
in early childhood caries group toddlers is
more acidic than the pH saliva in infants
group non early childhood caries.
Results of the research data
obtained, here in after tested normality.
differences in number of bacterial colonies
in infants early childhood caries and non
early childhood caries after consuming
formula milk using bottles (dot).
Colony
Bacteria
Mann-whitney U 8,000
Z -4,335
Asymp. Sig. (2-
0,000
tailed)
From the Mann-Whitney test results
on the number of bacterial colonies acquired
significance value 0.000 (p < 0.05) means
there is a difference in the number of
bacterial colonies in early childhood caries
and non early childhood caries after
consuming formula milk with Using bottles

5
(dot) significantly with the most number of
bacterial colonies found in early childhood
caries.
DISCUSSION
The study aims to determine the
number of bacterial colony comparisons and
pH saliva differences in infants early
childhood caries and non early childhood
caries after consuming formula milk by
using a bottle (dot). This research is an
experimental research laboratory with a
cross sectional approach to PAUD students
in North Padang sub-district who consume
formula milk using bottles consisting of
men and women With a large sample of 15
toddler saliva early childhood caries and 15
saliva toddlers non early childhood caries.
In the results of the research
obtained the results of counting bacteria,
obtained the number of higher bacterial
colonies in early childhood caries with an
average of 407.2 x 10-4/ml while the balita
non early childhood caries lower with an
average of 125.5 x 10-4/ ML, so it can be
concluded that the number of bacteria in
early childhood caries toddlers more than
the non-early childhood caries. While the
pH measurement results of saliva showed
that in toddlers early childhood caries
acquired 11 people with pH acid (pH < 6.8).
In a toddler group non early Childhood
caries only 3 people with a pH acid (pH <
6.8) so that it can be concluded that there is
a difference in pH saliva in infants early
childhood caries and non early childhood
caries after consuming formula milk with
Using a bottle (dot) significantly where the
pH of saliva in early childhood caries group
toddlers is more acidic than the pH saliva in
toddlers group non early childhood caries.
Each normal child has 6-9 million
total bacterial colonies in the saliva. The
result of counting the number of saliva
colony above indicates that there are 4
million saliva colonies in the children of
ECC. The results of this calculation are very
6
strong in the pH, where the pH and the
saliva buffer affect the existence of caries in
the oral cavity. The lower of the pH saliva,
the caries tend to be higher. According to
research conducted by Soesilo (2005), the
degree of acidity (pH) of optimum saliva to
inhibit bacterial growth between 6.5 – 7.5
and if its pH oral cavity low between 4.5 –
5.5 would facilitate the growth of
acidophilic germs such as Streptococcus
mutans and Lactobacillus. In addition,
decreased pH in the oral cavity can cause
quick demineralization of tooth elements.10
Early childhood caries often occur in infants
or children who are still very young. At first
the affected are 4 upper maxillary teeth,
then extending into the molar teeth of the
upper jaw and the lower jaw then caninus
the eldest. This is due to the habit of
drinking formula milk using bottles until the
child sleeps.11
The results of this study showed that
the increasing number of bacterial colonies
resulted in saliva pH being acidic in early
childhood caries. This is caused by when the
child is sucking his milk bottle during his
sleep, then the front teeth will be flooded so
that it will be faster to experience caries
(perforated teeth). Liquids containing sugar
such as milk, syrup, sweet tea, fruit juices
with additional sugar can provide a good
environment for the development of caries
causing microorganisms. In addition, the
reduction of saliva flow during sleep also
enhances the process of caries.12 Prolonged
use of the dot has a strong correlation to the
onset of caries. Several studies, reported that
there has been a correlation between
prolonged use of the dot (2 years or more)
with the onset of caries. This condition is
exacting when the use of the dot is done
while sleeping (night feeding).13 The use of
milk bottles causes a large hours of milk
around the teeth of infants and children,
then the fluid is in contact with the dental
email and joins the Bacteria such as
Streptococcus mutans.14 Research on 150
children aged 18-36 months by Peressini
(2003), concluded that there was a
significant correlation between the habit of
drinking bottled milk while sleeping with
the onset of caries and tooth decay.13
Dental caries are a process of
damage that starts from enamel to dentin,
caused by certain bacteria such as
Streptococcus streptococcus and
Lactobacillus which can ferment
carbohydrates such as sucrose and glucose,
forming acids, lowering the pH to < 5 and
resulting in demineralization of the
susceptible tooth surface. The saliva colony
can be isolated to early childhood caries and
non-early childhood caries after consuming
fomula milk using bottles (dot) on this
research are Streptococcus sp and Nieserria
sp, Klebsiella sp and Staphylococcus sp.
The bacteria that can be identified
macroscopic and microscopically is
Streptococcus sp-smactic blood, Nieserria
sp shaped slimy and clear colonies, white-
colored Klebsiella sp and yellow, while
Staphylococcus sp is a large colony-shaped,
clear and slimy. While the features of
observation on microscopic bacteria of
Streptococcus sp are round and chained,
Nieserria sp diplokokus like coffee beans,
Klebsiella sp shaped basil like capsules, and
Staphylococcus sp shaped coke or round
seromed like wine.
The bacteria above are normal
bacteria in the oral cavity. The bacteria are
instrumental in the formation of caries,
especially Streptococcus streptococcus
which are carcinogenic germs because they
are capable of forming extracellular
polysacharides of sucrose form. This is what
leads to the attachment of plaques on a
slippery tooth surface, and the
7
Streptococcus mutans in dental plaque are
also able to make the acid from the
carbohydrates that can be made.
Furthermore, the acid produced by the
bacterial activity will progressively destroy
the inorganic part of the tooth so that the
dental caries eventually occur.15
CONCLUSIONS AND SUGGESTIONS
Based on the results of research and
discussion can be concluded that there is a
difference in the number of saliva colony in
early childhood caries and non-early
childhood caries after consuming formula
milk using a bottle (dot) When the number
of infants in early childhood caries was
higher with an average of 407.2 x 10-4/ml,
while the early childhood caries were lower
with an average of 125.5 x 10- 4/ml. While
the pH saliva in infants early childhood
caries are acidic with an average of 6.2 and
pH in infants non early childhood caries
normal with an average of 6.9.
In relation to preventing ECC in
children, parents are expected to pay
attention and further reduce the frequency of
consuming formula milk by using bottles
(dot) because there proved to be a difference
in the number of significant saliva bacteria
in children The ECC and non ECC, so that
they can prevent ECC.
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8