Background: Plaques undergoing remineralization and becoming rigid can cause periodontal disease. The hardened plaque is called calculus. The occurrence of calculus formation can increase along with the amount of calcium and other minerals in saliva. Minerals in saliva contain calcium, phosphor, and fluoride. Fluoride is a mineral coming from natural sources, which is mostly obtained from drinking water. Indonesia, as a maritime country with a large coastal community, has a population that majority uses well water as drinking water. Well water can contain fluoride and calcium.
Purpose: To analyze the relationship between fluoride and calcium levels in drinking water on periodontal responses in children.
Methods: This study was an analytic observational study with a cross-sectional approach. Total sampling was carried out in Bangkalan District with a total of 140 parents and children as respondents. Informed consent and questionnaires were given to parents for data collection. Furthermore, the clinical examination on students was done by using a disclosing agent, then measured by OHI-S assessment. The results were analyzed using the Kolmogorov-Smirnov test and the Spearman test.
Results: The results showed there was a relationship between regions with OHI-S scores, OHI-S scores with fluoride levels, and OHI-S scores with calcium levels.
Conclusion: The calcium levels in drinking water can affect salivary levels and increase plaques and calculus formation. Plaque accumulation is a major factor in the occurrence of periodontal disease.

• Artawa IMB, Swastini IP (2011). Differences in the Occurrence of Tooth Tartar in the Community that consumes Well Water and Non Well Water. J SKALA HUSADA.;167.
• Astuti, T. P. (2018). Analisis Faktor-Faktor Yang Mempengaruhi Pola Konsumsi Mahasiswa (Studi Kasus: Mahasiswa Pendidikan IPS FITK UIN Jakarta) (Bachelor's thesis, Jakarta: FITK UIN Syarif Hidayatullah Jakarta).
• Bazzi, K. (2015). Expanded of Informal Jobs in Iranian Border Cities, Case: Zabol-Iran. International Journal of Geography and Geology, 4(3), 47-56.
• Chattopadhyay, A., Podder, S., Agarwal, S., & Bhattacharya, S. (2011). Fluoride-induced histopathology and synthesis of stress protein in liver and kidney of mice. Archives of toxicology, 85(4), 327-335.
• Ganta, S., Yousuf, A., Nagaraj, A., Pareek, S., Sidiq, M., Singh, K., & Vishnani, P. (2015). Evaluation of fluoride retention due to most commonly consumed estuarine fishes among fish consuming population of Andhra Pradesh as a contributing factor to dental fluorosis: A cross-sectional study. Journal of clinical and diagnostic research: JCDR, 9(6), ZC11.
• Isrofah NEM (2010). Effects of Dental Health Education on Knowledge and Attitudes of School Age Children at SD Boto Kembang Kulonprogo Yogyakarta. Pena Med J Kesehat.;1(1).
• Manson, J.D, Eley, B.M. (2004) Periodontics, Edinburgh London New York etc: Wright. An Impr Elsevier Ltd.;55–81.
• Newman, M. G., Takei, H. H., & Klokkevold, P. R. (2006). Carranza’s clinical periodontology 10th ed. St. Louis: Saunders Elsevier, 1075.
• Newman, M. G., Takei, H., Klokkevold, P. R., & Carranza, F. A. (2011). Carranza's clinical periodontology. Elsevier health sciences.
• Nisa, T.D, Primartha, R. (2013). The diagnosis of periodontal dental disease uses a fuzzy expert system. J Generic.;8(1).
• Pertiwi ASP. (2009). Correlation of Mouth Health Status between Mother and Children in Sukapura Elementary School, Sukaraja sub-district, Tasikmalaya district. Maj Ilmu Kedokt Gigi. 2009;11.
• Sehkarin, R.K. (2017). Effect of Calcium Saliva Levels on the Formation of Calculus for Gingivitis Patients Who Smoke in the Periodontia Installation of RSGM FKG USU.
• Shaji, E., Viju, J., & Thambi, D. S. (2007). High fluoride in groundwater of Palghat District, Kerala. Current Science, 240-245.
• Sukanti, E. (2018). Corelation Behavior of Maintaining Oral and Dental Health With OHI-S Index in SDN 06 Gadut Agam District. Jurnal Kesehatan Masyarakat Andalas, 12(1), 39-43.
• Tin, M. H., Mohamed Ali, S., Ardini, Y. D., & Taib, M. N. A. (2015). Periodontal health status of Malaysian diabetic children and adolescent: a hospital based case-control study in Kuala Lumpur and Kuantan. Malaysian Family Physician, 10(2), 24-25.
• Wulandari, D., & Suharjono, S. H. THE CONCEPTION OF PLAQUE SCORE ON 7TH GRADE STUDENTS OF SMP MUHAMMADIYAH 1 GODEAN SLEMAN.
• Wungkana, W.S, Kepe,l B.J, Wicaksono, D.A(2014). Overview of Calculus in Coastal Communities that Use Dug Well Water in Gangga II Village. e-GiGi.;2(2).

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