The Effect of Chewing Apples (Malus sylvestris mill.) on The Plaque Index Among Elementary School Students

Abstract

Background: Oral health is an essential part of general health that influences quality of life. Dental plaque is a major factor causing caries and periodontal disease. Plaque control can be achieved mechanically, chemically, or naturally. Apples (Malus sylvestris Mill.), with their high water and fiber content, are recognized as natural tooth cleansers and may reduce plaque index. This study aimed to analyze the effect of chewing apples on plaque index among students at SDN 45 Banda Aceh. Methods: An quasi-experimental design with a pre-test and post-test control group was employed. The sample consisted of 40 students divided into treatment (chewing apples) and control (rinsing with aquadest) groups. Plaque index was measured using the PHP-M method before and after intervention. Data analysis was conducted using Paired Sample T-test and Independent Samples T-test. Results: In the treatment group, mean plaque scores decreased from 46,10 to 24,25, with most students shifting to good and very good categories. In contrast, the control group showed only a slight reduction from 44,00 to 42,65, with the majority remaining in poor and very poor categories. Statistical analysis revealed t = -9,367 with p < 0,001, confirming a significant difference between groups. Conclusion: Chewing apples proved to have a significant influence on reducing plaque index compared to rinsing with aquadest. Apples can serve as a simple, safe, and practical natural method of plaque control to support children’s oral health. Further studies are recommended to expand sample size and variables for more representative results. Parents are encouraged to provide apples at home as a natural alternative for maintaining children’s dental hygiene, while teachers can integrate these findings into thematic learning and school health programs (UKS) as applicable oral health education material