Understanding Emergency Dental Health Literacy Among Indonesian Migrants in Singapore: A Cross?Sectional Survey
Abstract
Introduction: Dental health literacy is crucial in managing emergency dental and oral health issues, especially for Indonesian migrant workers in Singapore who have limited access to healthcare services. The Singapore Department of Statistics reported that as of 2023, there were 1.77 million non-residents in Singapore, a 13.1% rise from the year before. This growth was mostly due to foreign employment in domestic and construction-related industries. Language barriers, economic constraints, and differences in healthcare systems contribute to a low understanding of emergency dental actions. This study aims to analyze this group’s emergency dental health literacy level.
Methods: This study employed a descriptive cross-sectional quantitative design using a survey method on 124 Indonesian migrant workers in Singapore. Data was collected through a Likert-scale-based questionnaire to measure participants' understanding, attitudes, and self-efficacy in handling emergency dental situations. Data analysis was conducted using descriptive analysis, reliability testing, Spearman’s correlation, and the Kruskal-Wallis comparative test. The study has received ethical approval from the Ethics Committee of the Faculty of Medicine and Health Sciences at Universitas Muhammadiyah Yogyakarta (FKIK UMY), and participants provided informed consent in order to protect participants' rights.
Results: The Cronbach’s Alpha reliability test produced a value of 0.803, indicating good internal consistency. A total of 76.6% of respondents understood emergency dental management steps, while 92% recognized the importance of seeking medical assistance if a toothache persisted for more than two days. However, only 57.3% were aware of safe over-the-counter medications for dental pain relief. Education played a role in improving dental health literacy, but no significant differences were found based on age.
Conclusion: The majority of Indonesian migrant workers in Singapore have a relatively good understanding of emergency dental health literacy; however, improvements are needed in the selection of appropriate medications. This study highlights the need for more effective awareness programs and policy support to enhance access to dental health information, enabling migrant workers to handle emergency dental issues appropriately. Concrete interventions such as increasing emergency dental literacy can be done with mobile dental health outreach, multilingual training programs, and connecting with networks in the migrant community.
References
Vivek VS, James A, Janakiram C, Kumar VS. Impact of oral health literacy on oral conditions among different population groups( A systematic review and meta-analysis). Journal of Health Literacy [Internet]. 2024 Jun 1 [cited 2025 Apr 29];9(2):88–105. Available from: https://literacy.mums.ac.ir/article_24364.html
Aggarwal VR. The Role of Oral Health in Complex Emergencies and Disaster Rehabilitation Medicine. Disaster Med Public Health Prep [Internet]. 2018 Dec 1 [cited 2025 Apr 29];12(6):772–7. Available from: https://www.cambridge.org/core/journals/disaster-medicine-and-public-health-preparedness/article/abs/role-of-oral-health-in-complex-emergencies-and-disaster-rehabilitation-medicine/5069C43C57CC00C55245A8A69F3F703D
Sohal KS, Jeremiah L, Okechi U, Agbor AM. Self-medication for dental caries-associated toothache among dental outpatients attended at public health facilities in Dar es Salaam, Tanzania: A cross-sectional study. Health Sci Rep [Internet]. 2024 Sep 1 [cited 2025 Apr 29];7(9):e70032. Available from: /doi/pdf/10.1002/hsr2.70032
Grossman A, Kim NY, Stagnell S, Allen Y, Shah S. Assessment of public and professional perceptions of access to unscheduled dental care. Br Dent J [Internet]. 2018 May 25 [cited 2025 Apr 29];224(10):815–20. Available from: https://www.nature.com/articles/sj.bdj.2018.357
Rajaraman N, Yip TW, Kuan BYH, Lim JFY. Exclusion of Migrant Workers from National UHC Systems—Perspectives from HealthServe, a Non-profit Organisation in Singapore. Asian Bioeth Rev [Internet]. 2020 Sep 1 [cited 2025 Apr 29];12(3):363–74. Available from: https://link.springer.com/article/10.1007/s41649-020-00138-y
Oral Health Status of Immigrant and Refugee Children in North America: A Scoping Review | JCDA [Internet]. [cited 2025 Jul 29]. Available from: https://jcda.ca/g3
Sofiani E, Kurniasih I, Suhartininingtyas D, Sugianto R, Maharani. Oral Health Problems Among Indonesian Moslem in Germany: A Survey and Analysis. BIO Web Conf [Internet]. 2024 Nov 11 [cited 2025 Jul 30];137:02009. Available from: https://www.bio-conferences.org/articles/bioconf/abs/2024/56/bioconf_icbcd2024_02009/bioconf_icbcd2024_02009.html
Xu N, Deng S, Liang Y, Chen A, Zou D, Li L, et al. Impact of migration on oral health outcomes of children in multi-beneficial kindergartens in Nanning, Southern China: a cross-sectional study. BMC Oral Health [Internet]. 2023 Dec 1 [cited 2025 Jul 29];23(1):1–9. Available from: https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03212-7
Lee J, Park S, Jang SN, Reyes KA, Garcia F, Canila C, et al. Differential impacts of health systems and sociocultural environment on vulnerable populations during the COVID-19 pandemic: lessons from four Asia-Pacific countries. BMC Public Health [Internet]. 2024 Dec 1 [cited 2025 Apr 29];24(1):1–13. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-18949-1
Riggs E, Gussy M, Gibbs L, Van Gemert C, Waters E, Kilpatrick N. Hard to reach communities or hard to access services? Migrant mothers’ experiences of dental services. Aust Dent J [Internet]. 2014 Jun 1 [cited 2025 Apr 29];59(2):201–7. Available from: /doi/pdf/10.1111/adj.12171
King S, Thaliph A, Laranjo L, Smith BJ, Eberhard J. Oral health literacy, knowledge and perceptions in a socially and culturally diverse population: a mixed methods study. BMC Public Health [Internet]. 2023 Dec 1 [cited 2025 Apr 29];23(1):1–10. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-16381-5
Salim NA, Maayta WA, Hassona Y, Hammad M. Oral health status and risk determinants in adult Syrian refugees in Jordan. Community Dent Health [Internet]. 2021 Feb 25 [cited 2025 Aug 25];38(1):53–8. Available from: https://europepmc.org/article/MED/33507649?utm_source=chatgpt.com
Pabbla A, Duijster D, Grasveld A, Sekundo C, Agyemang C, van der Heijden G. Oral Health Status, Oral Health Behaviours and Oral Health Care Utilisation Among Migrants Residing in Europe: A Systematic Review. J Immigr Minor Health [Internet]. 2022 Apr 26 [cited 2025 Aug 25];23(2):373–88. Available from: https://evidenceaid.org/resource/oral-health-among-migrants-in-europe/
Singapore Department of Statistics. Web Page. 2023 [cited 2025 Aug 25]. Population in Brief 2023: Key Trends. Available from: https://www.population.gov.sg/media-centre/articles/population-in-brief-2023-key-trends/
Henderson E, Dalawari P, Fitzgerald J, Hinyard L. Association of Oral Health Literacy and Dental Visitation in an Inner-City Emergency Department Population. International Journal of Environmental Research and Public Health 2018, Vol 15, Page 1748 [Internet]. 2018 Aug 15 [cited 2025 Apr 29];15(8):1748. Available from: https://www.mdpi.com/1660-4601/15/8/1748/htm
Bujang MA. A step-by-step process on sample size determination for medical research. Malaysian Journal of Medical Sciences [Internet]. 2021 [cited 2025 Aug 26];28(2):15–27. Available from: https://pubmed.ncbi.nlm.nih.gov/33958957/
Akoglu H. User’s guide to correlation coefficients. Turk J Emerg Med [Internet]. 2018 Sep 1 [cited 2025 Sep 3];18(3):91–3. Available from: https://www.sciencedirect.com/science/article/pii/S2452247318302164
Novrinda H, Han DH. Oral health inequality among Indonesian workers in South Korea: role of health insurance and discrimination factors. BMC Oral Health [Internet]. 2022 Dec 1 [cited 2025 Apr 29];22(1):1–9. Available from: https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-022-02050-3
Lin YC, Lin YC, Chen JH, Lin PL, Chen T, Huang HL. Long-term effects of a lay health advisor intervention on immigrant children’s dental caries and maternal preventive behaviour: A randomized controlled trial. Community Dent Oral Epidemiol [Internet]. 2022 Aug 1 [cited 2025 Apr 29];50(4):280–91. Available from: /doi/pdf/10.1111/cdoe.12670
Chang Q, Gao X, Xu M, Zhang C, Du S, Wang X, et al. Socioeconomic-related inequality in dental care utilization among preschool children in China. Community Dent Oral Epidemiol [Internet]. 2021 Dec 1 [cited 2025 Apr 29];49(6):505–12. Available from: /doi/pdf/10.1111/cdoe.12681
Allen F, Guarnizo-Herreño CC, Fan SY, Tsakos G. Does subsidizing the cost of care impact on dental attendance patterns among older adults? Community Dent Oral Epidemiol. 2024 Jun 1;52(3):328–35.
Ramos-Gomez F, Parkinson S, Garcia de Jesus V, Rios JA, Kinsler JJ. Pediatric Oral Health Online Education for Rural and Migrant Head Start Programs in the United States. International Journal of Environmental Research and Public Health 2024, Vol 21, Page 544 [Internet]. 2024 Apr 25 [cited 2025 Apr 29];21(5):544. Available from: https://www.mdpi.com/1660-4601/21/5/544/htm
Talenta Theresia T, Adinda Cikagri A, Erri Astoeti T. Analysis Of The Relationship Between Education And Level Of Oral Health Knowledge In Posyandu Cadres. The Indonesian Journal of Public Health [Internet]. 2024;19(3):549–61. Available from: https://doi.org/10.20473/Ijph.v19i3.2023.549-561
Nourwali IM, Maddhar AK, Alsaati BH, Alhazmi RA, AlAyoubi SM, AlHarbi SS. Emergency management of dental trauma: A survey of public knowledge, awareness, and attitudes in Al-Madinah Al-Munawwarah. Clin Cosmet Investig Dent [Internet]. 2019 [cited 2025 Jul 29];11:279–84. Available from: https://pubmed.ncbi.nlm.nih.gov/31695507/
Sofiani E, Arinawati DY, Putri SS, Martadewi FA. Caries Incidence Rates Examination Through the Indonesian Digital Caries Risk Assessment for Parents of Muhammadiyah Warungboto Elementary School Yogyakarta. E3S Web of Conferences. 2024 Sep 18;570.
Mehra VM, Costanian C, Khanna S, Tamim H. Dental care use by immigrant Canadians in Ontario: A cross-sectional analysis of the 2014 Canadian Community Health Survey (CCHS). BMC Oral Health [Internet]. 2019 May 8 [cited 2025 Apr 29];19(1):1–9. Available from: https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-019-0773-x
Calvasina P, Lawrence HP, Hoffman-Goetz L, Norman CD. Brazilian immigrants’ oral health literacy and participation in oral health care in Canada. BMC Oral Health [Internet]. 2016 Feb 15 [cited 2025 Jul 29];16(1). Available from: https://pubmed.ncbi.nlm.nih.gov/26875752/
Valdez R, Spinler K, Kofahl C, Seedorf U, Heydecke G, Reissmann DR, et al. Oral Health Literacy in Migrant and Ethnic Minority Populations: A Systematic Review. J Immigr Minor Health [Internet]. 2022 Aug 1 [cited 2025 Jul 29];24(4):1061–80. Available from: https://pubmed.ncbi.nlm.nih.gov/34448993/
Badran A, Keraa K, Farghaly MM. The impact of oral health literacy on dental anxiety and utilization of oral health services among dental patients: a cross sectional study. BMC Oral Health [Internet]. 2023 Dec 1 [cited 2025 Jul 29];23(1):1–11. Available from: https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-02840-3
Hultin L, Pöder U, Hedström M, Ekman A, Hjelm K. A qualitative study on diverse experiences of medication safety among foreign-born persons living in Sweden. BMC Public Health [Internet]. 2024 Dec 1 [cited 2025 Apr 29];24(1):1–11. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-18711-7
Shmarina E, Stensson M, Jacobsson B. Oral health literacy among migrant mothers in Sweden. A qualitative study. Acta Odontol Scand [Internet]. 2024 Mar 26 [cited 2025 Jul 29];83:83–91. Available from: https://medicaljournalssweden.se/actaodontologica/article/view/40282/45718
Rodriguez NM, Casanova F, Pages G, Claure L, Pedreira M, Touchton M, et al. Community-based participatory design of a community health worker breast cancer training intervention for South Florida Latinx farmworkers. PLoS One [Internet]. 2020 Oct 1 [cited 2025 Jul 29];15(10):e0240827. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0240827
Arefi P, Cardoso E, Azarpazhooh A. Reexamining dental outreach programs: A model for local empowerment and sustainable development. The Journal of the American Dental Association [Internet]. 2020 May 1 [cited 2025 Aug 27];151(5):340–8. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0002817720300404?utm_source=chatgpt.com
Lee JY, Divaris K, Baker AD, Rozier RG, Vann WF. Does an oral health education program increase oral health literacy and access to dental care in a refugee population. Am J Public Health [Internet]. 2016 Jan 1 [cited 2025 Aug 27];102(5):923–9. Available from: https://www.academia.edu/96259001/Does_an_oral_health_education_program_increase_oral_health_literacy_and_access_to_dental_care_in_a_refugee_population
Muller R, Bilich L, Jones M. Impact of an Oral Health Education Program on the Oral Health Literacy of Refugees. J Immigr Minor Health [Internet]. 2024 Aug 1 [cited 2025 Aug 27];26(4):699–710. Available from: https://link.springer.com/article/10.1007/s10903-024-01594-6
Glick M, Williams DM. FDI Vision 2030: Delivering Optimal Oral Health for All. Int Dent J. 2021 Feb 1;71(1):3–4.
Universal Health Coverage. Web Page. 2024 [cited 2025 Aug 27]. 2024–2027 Strategic Framework - UHC2030. Available from: https://www.uhc2030.org/about-us/2024-2027-strategic-framework/
Veladas FMV, De la Torre Canales G, de Souza Nobre BB, Escoval A, Pedro AR, de Almeida AM, et al. Do sociodemographic factors influence the levels of health and oral literacy? A cross-sectional study. BMC Public Health [Internet]. 2023 Dec 1 [cited 2025 Apr 29];23(1):1–7. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-17489-4
Abu-Awwad M, AL-Omoush S, Shqaidef A, Hilal N, Hassona Y. Oral health-related quality of life among Syrian refugees in Jordan: a cross-sectional study. Int Dent J [Internet]. 2020 Feb 1 [cited 2025 Jul 28];70(1):45–52. Available from: https://www.sciencedirect.com/science/article/pii/S0020653920313459?getft_integrator=scite&pes=vor&utm_source=scite
Muller R, Bilich L, Jones M. Impact of an Oral Health Education Program on the Oral Health Literacy of Refugees. J Immigr Minor Health [Internet]. 2024 Aug 1 [cited 2025 Jul 29];26(4):699–710. Available from: https://link.springer.com/article/10.1007/s10903-024-01594-6
Copyright (c) 2025 Media Publikasi Promosi Kesehatan Indonesia (MPPKI)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with Media Publikasi Promosi Kesehatan Indonesia retain the copyright of their work. The journal applies a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0), which grants the following rights:
-
Copyright Retention: Authors retain the copyright of their work, maintaining full control over their intellectual property without restrictions.
-
Right of First Publication: Authors grant the journal the right of first publication of their work. This ensures that the work is initially published and credited in Media Publikasi Promosi Kesehatan Indonesia.
-
License to Share and Reuse: The work is licensed under CC BY-SA 4.0, allowing others to copy, distribute, remix, and build upon the work for any purpose, even commercially, as long as proper credit is given to the authors, and any new creations are licensed under the same terms.