ORIGINAL RESEARCH Journal of Dentomaxillofacial Science (J Dentomaxillofac Sci ) April 2020, Volume 5, Number 1: 22-27 P-ISSN.2503-0817, E-ISSN.2503-0825 22 © 2020 JDMFS. Published by Faculty of Dentistry, Hasanuddin University. All rights reserved. http://jdmfs.org CrossMark Abstract Objective: To measure the efectiveness of the appreciative inquiry (AI) approach for the formation of tooth brushing automaticity of children in school for 2 months. Material and Methods: Randomized-Community Trial with a school-based supervised tooth brushing program for two months. Automaticity was measured with self-report behavior automaticity index (SRBAI) and intraoral examination was done with patient hygiene performance modifed index (PHP-M)at the baseline, after 1 month and after 2 months. Results: automaticity proportion was signifcantly higher in the AI group (63.8%) compared to conventional group (22.1%) (P = 0.000; OR= 11.9, 95% CI = 4.794-29.497). Conclusion: appreciative inquiry was more efective than conventional health education approach for tooth brushing behavior change. Keywords: Appreciative inquiry, Automaticity, Behavioral change, Habit, Tooth brushing Cite this Article: Prihastari L, Matram ZKA, Rahardjo A. 2020. The formation of tooth brushing automaticity of 7-8 year-old children using appreciative inquiry (Ai) approach. Journal of Dentomaxillofacial Science 5(1): 22-27. DOI: 10.15562/jdmfs.v5i1.968 The formation of tooth brushing automaticity of 7-8 year-old children using appreciative inquiry (Ai) approach Lisa Prihastari, * Zaura KA. Matram, Anton Rahardjo Introduction Brushing teeth properly is the easiest preventive action to reduce the number of dental caries. Based on the 2013 RISKESDAS data, the number of Indonesian people who have the ability to brush their teeth properly is still very low, only 2.3%. 1 Te school based tooth brushing program that has been implemented by the government through the UKGS in community health centers (Puskesmas) and private institutions supported by dental educa- tion institutions is still not efective enough to build the proper tooth brushing behavior. One reason is because forming tooth brushing behavior requires long processes and stages, and it is infuenced by many factors. Early childhood caries prevention, in this case the oral self-care education, should be initiated primarily for children of elementary school age (4-12 years) because of three fundamental things, namely the formation of habits, development of skill and vulnerable age (susceptibility). 2 Te formation of the habit of brushing teeth becomes more dif- cult to be infuenced in adolescence period. 3 Te formation of habit of brushing teeth in elementary school age should be done from the age of 7-8 years. It is a vulnerable age for permanent dental caries related to the time of eruption of incisive teeth and frst molar. In addition, at this age, children’s motor development in brushing teeth has begun to form, mainly in terms of how to hold the brush and how to move the brush. 4 Habit formation in children according to several studies in the feld of psychology is characterized by the formation of automaticity or a person›s automatic response to a trigger that arises due to repetition and consequences. 5,6 Te results of a recent study conducted by PhillipaLally et al in 2009 to 96 participants who made behavioral change eforts showed that the average time needed to adopt behaviors automatically (automaticity) ranged from 18 to 254 days. 6 Tis indicates that the time needed to form a new habit is varied depend- ing on the level of complexity or level of difculty. Furthermore, the average minimum time needed for habit formation is characterized by the presence of automaticity ranging from 66 days to approxi- mately two months. Repetition of the new behavior must be done consistently, especially in the early days because it will help to speed up the process of the new habit installation. 5,7 Gardner et al. 5 validated the four-item scale for automaticity measurement using the SRBAI (Self- Report Behavioral Automaticity Index) question- naire. SRBAI is proven to be reliable and highly correlated with the Self-Report Habit Index (SRHI) developed is a standard questionnaire to measure someone’s habit formation, and it is sensitive to changes. 5 Appreciative inquiry is an approach that devel- ops the concept of positive change that can change the sick paradigm to the healthy paradigm and can Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of YARSI, Central Jakarta, Indonesia * Correspondence to: Lisa Prihastari, Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of YARSI, Central Jakarta, Indonesia lisa.prihastari@yarsi.ac.id Received: 22 August 2019 Revised: 5 January 2020 Accepted: 19 March 2020 Available Online: 1 April 2020