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"ABSTRAKHalitosis atau bau mulut adalah masalah kesehatan gigi dan mulut yang banyak dikeluhkan dan dapat menjadi persoalan kesehatan yang serius. Penyebab halitosis terutama dan terbanyak adalah bakteri yang hidup dalam rongga mulut terutama bakteri anaerob gram negatif yang menghasilkan sulfur. Keseluruhan senyawa sulfur yang dihasilkan disebut Volatile Sulfur Compounds (VSC) dan inilah yang menyebabkan bau pada mulut. Tujuan penelitian adalah untuk mengetahui perbandingan efektifitas oral hygiene menggunakan chlorhexidine dan normal saline terhadap skor halitosis. Metode dalam peneltian ini adalah quasi eksperimen dengan subjek penelitian pasien dengan penyakit kritis sebanyak 28 orang yang dibagi dalam dua kelompok, 14 responden dilakukan oral hygiene dengan menyikat gigi dan lidah dengan chlorhexidine glukonate 0,1% dan 14 responden dilakukan oral hygiene dengan menyikat gigi dan lidah dengan normal saline. Pengukuran skor halitosis dilakukan sebelum dan 15 menit sesudah oral hygiene. Gas VSC diukur menggunakan alat Tanita BreathChecker . Hasil menunjukkan terjadi penurunan skor halitosis sebelum dan sesudah oral hygiene dengan memperlihatkan perbedaan yang signifikan (p<0,05). Jumlah responden dengan nilai 0 pada skor halitosis sebanyak 10 responden (72%) pada kelompok pertama dan pada kelompok kedua sebanyak 4 responden (29%). Kesimpulan penggunaan chlorhexidine glukonate 0,1% lebih efektif terhadap penurunan skor halitosis dibandingkan menggunakan normal saline.

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ABSTRACTHalitosis or bad breath is a dental health problem that mainly complaint and can be a serious health problem. The cause of halitosis mainly and mostly bacterias which live in the oral cavity, especially anaerob negatif gram bacteria that produce sulfur. The whole sulfur component that was produced called Volatile Sulfur Compounds (VSC) and this is the cause of bad breath. The purpose of this study was to know the comparison of effectiveness oral hygiene using chlorhexidine and normal saline on halitosis score. This study used Quasy experiment with subjects consisted of 28 patients with critically ill, divided into two groups, 14 subjects conducted oral hygiene to brush their teeth and tongue with chlorhexidine glukonate 0,1% and 14 subjects conducted oral hygiene to brush their teeth and tongue with normal saline. The measurement of Volatile Sulfur Compounds level used Tanita BreathChecker, conducted before and 15 minutes after oral hygiene. The result showed significant differences in reducing VSC components in both groups (p<0,05). Number of subjects with score halitosis 0 by 10 subjects (72%) in first group and 4 subjects (29%) in second group. In conclusion, chlorhexidine glukonate 0,1% is more effective decreased score halitosis than normal saline on patients with critically ill."

"Pendahuluan: Ventilator Associated Pneumonia (VAP) merupakan infeksi nosokomial yang didapatkan di rumah sakit khususnya di ruang Intensive Care Unit (ICU) pada 48-72 jam paska pemasangan ETT dan Ventilator. Oral care dengan Chlorhexidine merupakan salah satu dari intervensi keperawatan yang bermanfaat dalam menjaga kebersihan mulut dari flora orofaringeal dan kolonisasi mikroorganisme yang berpotensi masuk kedalam saluran nafas karena pemasangan Endotrakheal Tube ( ETT ).Metode: Desain pada penelitian ini menggunakan Randomized Controlled Trial (RCT), untuk menguji efektivitas oral care menggunakan chlorhexidine gel 2% 4 kali sehari dengan cara menggosok gigi dalam menurunkan insiden VAP. Penelitian ini menggunakan teknik random allocation untuk menentuan kelompok kontrol dan kelompok intervensi dan juga menerapkan double blind study. Teknik dalam menentukan sampel pada penelitian ini menggunakan teknik random blok berdasarkan variasi permutasi dibagi menjadi 11 blok kemudian dilakukan random dan  didapatkan total sampel sejumlah 44 yaitu 22 untuk kelompok intervensi dan 22 untuk kelompok kontrol sesuai randome yang didapatkan.Hasil: Pada kelompok kontrol didapatkan hasil sejumlah 9 responden (40,9% ) mengalami VAP, dan sejumlah 13 responden (59,1%) tidak mengalami VAP. Sedangkan untuk kelompok intervensi didapatkan sejumlah 1 responden (4,5%) mengalami VAP, dan sejumlah 21 responden (95,5%) responden tidak mengalami VAP nilai p value  0,012.Kesimpulan: Terdapat perbedaan yang bermakna antara oral care kelompok control dengan kelompok intervensi terhadap insiden VAP.Tindakan keperawatan Oral care dengan chlorhexidine gel 2% 4 kali sehari dengan cara menggosok gigi terbukti efektif dalam menurunkan insiden VAP

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Introduction: Ventilator Associated Pneumonia (VAP) is a nosocomial infection found in hospitals, especially in the Intensive Care Unit (ICU) room, 48-72 hours after ETT and Ventilator placement. Oral care with Chlorhexidine is one of the nursing interventions that is useful in maintaining oral hygiene from oropharyngeal flora and colonization of microorganisms that have the potential to enter the respiratory tract due to the installation of an Endotracheal Tube (ETT).

Methods: The design of this study used a Randomized Controlled Trial (RCT), to test the effectiveness of oral care using 2% chlorhexidine gel 4 times a day by brushing your teeth in reducing the incidence of VAP. This study uses a random allocation technique to determine the control group and the intervention group and also applies a double blind study. The technique in determining the sample in this study used a random block technique based on permutation variations divided into 11 blocks and then randomized and obtained a total sample of 44, namely 22 for the intervention group and 22 for the control group according to the randome obtained.

Results: In the control group, 9 respondents (40.9%) experienced VAP, and 13 respondents (59.1%) did not experience VAP. As for the intervention group, it was found that 1 respondent (4.5%) experienced VAP, and a number of 21 respondents (95.5%) respondents did not experience VAP with a p value of 0.012.

Conclusion: There is a significant difference between the oral care control group and the intervention group on the incidence of VAP. Oral care with chlorhexidine gel 2% 4 times a day by brushing your teeth is proven effective in reducing the incidence of VAP."

"Halitosis is a general term denoting unpleasant breath arising from mouth, where odorous breath components could be originated from intraoral and/or extraoral. Classification includes genuine halitosis, pseudo-halitosis and halitophobia. Local and systemic factor play role in the process of halitosis. Diagnosis of halitosis can be made by analysing the degree and type of the presence of volatile compounds, as well as the identification of microbial components. Currentlyavailable treatments of halitosis includes local (mechanic and chemical) and systemic (probiotic) approaches. Probiotic is a new therapeutic approach for halitosis. Development of available probiotic-based halitosis treatments is significantly progressing and is overviewed herein."

"Background: Chlorhexidine (CHx) mouthrinse was the first choice for gingivitis. The loss of taste and tooth discolorisation was motivated the clinician to dilute CHx 0.2% to 1:1. Aims: To compare the effectiveness of CHx 0.2% and diluted CHx 1:1 as mouthrinse on gingivitis and evaluate tooth discoloration. Method: Ninety nine students with mild and moderate gingivitis at SMU Labs School jakarta age between 14-15 years had participated. The subjects were randomised selected and double-blind method was applied. The subjects were divided into 3 groups. The first group was instructed to rinse with CHx 0.2%, the second group rinsed with diluted CHx 1:1, and the third group as a control without rinsing. The first and the second groups were rinsing the regimen for one minute, twice a day in 7 days, in the morning and night. Plaque and bleeding were scored using Plaque Index (Loe and Silness), and modified Papilla Bleeding Index (Muhleman) on the first and seventh day of the study. The changes of scores (PII and PBI) before and after rinsing were analyzed using "paired t test". The differences of the effectivity of CHx 0.2%. CHx 1:1 and control groups using "ANOVA test" with 95% probability. Differences of tooth discolouration after rinsing were analyzed by "independen t test". Probabilities of less than 5 percents were taken to be statistically significant. Result: The results showed at day 7, not significant difference between CHx groups for plaque (CHx: 0.74, CHx 1:1: 0.66), and gingival bleeding (CHx: 1.02, CHx 1:1: 0.83). The proportion of tooth discolouration was not significant in the diluted CHx group (4.8%) and in the CHx group (7.3%). Conclusion: Diluted CHx 1:1 effectively on gingivitis. The clinician can be used in the clinic whereas the lost the taste were reduced. No differences significant of tooth discolourisation between rinsing regimens on seventh days."

"Stelechocarpus Burahol buah asli nusantara penghilang bau mulut dan bau badan diketahui turun temurun di gunakan masyarakat ,sumber bahan alami pembuatan larutan kumur penghilang bau mulut.Tujuan : Mengetahui daya hambat bakteri ekstrak buah kepel, serta efikasi larutan kumur ekstrak buah kepel dibanding larutan komersial dalam mengontrol halitosis fisiologis.Metode : Cross-over 30 subyek penelitian, single blind,dua kelompok. Pengujian organoleptik test serta pengukuran VSCs dengan Oralchroma?.Hasil: uji daya anti bakteri Phyromonas ginggivalis ATCC 33277, Metode dilusi, kepel KBM 75%, KHM (-), larutan komersial KBM 25%, KHM 25%. Metode difusi,kepel;daya hambat konsentrasi 50%:8mm, 75%:8mm, 100%:10mm, larutan komersial;25%:10mm, 50%:11mm, 75%:14mm, 100%:14mm,signifikan larutan komersial ,P-value 0.034,alpha 5%. Analisa crossover;H2S kepel 0.05, komersial 0.25,P-value 0.0349 ,alpha 1%,nilai R-square sebesar 69.1%. Nilai CH3SH kepel 0,24,komersial 0.17 P-value 0.324,alpha 1%. Nilai (CH3)2S kepel 0.246, komersial 0.238, P-value 0.338 alpha 1%. P-value nilai tengah H2S , CH3SH, dan (CH3)2S, diatas alpha 1%.Kesimpulan : Kemampuan daya hambat bakteri larutan kumur komersial lebih baik secara bermakna, namun kemampuan larutan kepel dan komersial dalam menghambat H2S , CH3SH dan (CH3)2S tidak beda bermakna.

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Kepel (Stelechocarpus Burahol) an nusantara's fruit of origin, well known as oral and body anti mallodour for a long time ago specialy in javanish heritage, its become natural promising source for develope natural mouthwash in controling fisiologic halitosis.This research aimed in testing efficacy betwen kepel and commercial mouthwash containing green tea extract as oral anti mallodour in fisiologic halitosis.Method: A randomized, single blind, two-group ,Cross-over design with 30 subject. Using organoleptic test and Oralchroma ?.Result : anti bacterial test against Phyromonas ginggivalis ATCC 33277, diluted methode ; kepel KBM 75%, KHM (-), comercial mouthwash KBM 25%, KHM 25%. Difused methode kepel mouthwash positive in concentration 50%:8mm, 75%:8mm, 100%:10mm, comercial moutwash 25%:10mm, 50%:11mm, 75%:14mm, 100%:14mm, better result in commercial mouthwash ,P-value 0.034 alpha 5%. Crossover analytic H2S kepel 0.05, commercial 0.25,P-value 0.0349 alpha 1%, R-square 69.1%. Result for CH3SH kepel 0,24,commercial 0.17 Pvalue 0.324 alpha 1%. Result (CH3)2 kepel 0.246, commercial 0.238, P-value 0.338 alpha 1%. P-value for H2S , CH3SH and (CH3)2S above alpha 1% .Conclusion : Anti bacterial ability of commercial mouthwash better than kepel's, thougt both kepel and commercial mouthwash had almost same resulted in reducting levels H2S , CH3SH and (CH3)2S."

"ABSTRAKLatar Belakang: Saat ini pemakaian obat kumur di masyarakat cukup popular.Salah satu kandungan zat aktif obat kumur yang sering digunakan adalahklorheksidin glukonat. Pemakaian obat kumur yang berketerusan disampingmenyikat gigi tentunya akan mempengaruhi kondisi dalam rongga mulut, salahsatunya protein saliva. Tujuan: Untuk menganalisis pengaruh penggunaan obatkumur yang mengandung klorheksidin glukonat 0,2 % selama 1,2 dan 3 mingguterhadap profil protein saliva. Metode: Pengambilan sampel saliva dari 5 subyek saatsebelum berkumur dan 1, 2, 3 minggu setelah pemakaian obat kumur. Profil pitaprotein saliva diidentifikasi dengan metode SDS PAGE dengan Recom Blue WideRange Protein Marker. Hasil: Profil pita protein sebelum berkumur yangteridentifikasi antara 7-80 kDa. Setelah 1,2 dan 3 minggu berkumur teridentifikasijuga pita protein >100 kDa disamping pita protein <50 kDa Kesimpulan:Penggunaan obat kumur yang mengandung klorheksidin glukonat selama 1, 2 dan 3minggu mengakibatkan perubahan profil protein saliva dengan teridentifikasi pitaprotein yang sangat bervariasi.

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ABSTRACTBackground: Currently the use of mouthwash is quite popular. One of the activeingredients frequently used is chlorhexidine gluconate. The usage of mouthwashcontinuously besides brushing the teeth will surely affect conditions in the oralcavity, one of salivary proteins. Objective: To analyze the effect of mouthwashapplication containing chlorhexidine gluconate 0.2% for 1.2 and 3 weeks to salivaryprotein profiles. Methods: Sampling saliva of 5 subjects were collected beforerinsing and 1, 2, 3 weeks after the use of mouthwash. Salivary protein profile wereidentified using SDS-PAGE with Recom Blue Wide Range Protein Marker. Results:profile of protein bands before rinsing identified between 7-80 kDa. After usingmouthwash for 1,2 and 3 weeks also identified > 100 kDa protein band in addition to<50 kDa protein band. Conclusion: The use of mouthwash containing chlorhexidinegluconate for 1, 2 and 3 weeks resulted in changes of salivary protein profiles withhighly variable."

"Stroke merupakan penyakit neurologi yang dapat menyebabkan berbagai kerusakan neurologis seperti paralisis, afasia, disfagia, gangguan sensorik. Suwita (2012), mengatakan bahwa 30-50% pasien stroke sering mengalami disfagia. Tingginya kejadian disfagia, membuat penderita stroke memiliki resiko tinggi dalam aspirasi dan terjadinya infeksi pernapasan. Sehingga perawatan mulut (Oral Hygiene) sangat diperlukan bagi pasien stroke. Studi kasus ini merupakan penerapan oral hygiene menggunakan Chlorhexidine 0,2 % dalam menjaga kebersihan mulut dan mencegah infeksi. Metode yang dilakukan dalam melakukan studi ini adalah dengan melakukan pengkajian tentang tingkat kebutuhan perwatan pasien. Kemudian dilakukan dengan pengkajian tingkat kebersihan mulut pasien dengan instrument AOG (oral assessment guide ), dan pasien dilakukan perawatan mulut menggunakan sikat gigi anak dan menggunakan Chlorhexidine 0,2%. Perawatan mulut dilakukan selama 3-5 menit dua kali dalam sehari dan dievaluasi setelah 6 hari. Evaluasi dilakukan menggunakan AOG (oral assessment guide). Setelah dilakukan perawatan mulut selama 6 hari didapatkan nilai AOG menurun yang menandakan terjadi perbaikan dalam tingkat kebersihan mulut

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Stroke is a neurological disease that can cause various neurological damage such as paralysis, aphasia, dysphagia, sensory disorders. Suwita (2012), said that 30-50% of stroke patients often experience dysphagia. The high incidence of dysphagia, making stroke patients have a high risk of aspiration and respiratory infections. So that oral care (Oral Hygiene) is very necessary for stroke patients. This case study is the application of oral hygiene using Chlorhexidine 0.2% in maintaining oral hygiene and preventing infection. The method used in conducting this study is to conduct an assessment of the level of patient needs. Then it was carried out by assessing the level of oral hygiene of the patients with the AOG instrument (oral assessment guide), and the patients having oral care using a childs toothbrush and using Chlorhexidine 0.2%. Oral care is carried out for 3-5 minutes twice a day and evaluated after 6 days. Evaluation is done using AOG (oral assessment guide). After 6 days of oral care, the AOG value was decreased which indicated improvement in the level of oral "

"Tujuan: mengetahui jumlah pelepasan Bispheno-A (BPA), yakni substansi yang memiliki efek sitotoksis pada Resin Adhesif Ortodonti, setelah perendaman larutan obat kumur Klorheksidin Glukonat dan saliva buatan. Metode Penelitian: 66 lempeng silindris Resin Adhesif Ortodontik direndam dalam dua larutan berbeda yaitu , (1) Klorheksidin Glukonat dan (2) Saliva buatan. Perendaman dilakukan pada beberapa waktu berbeda yaitu, 1 jam, 7 hari, dan 30 hari. Dihitung pelepasan BPA pada kedua kelompok menggunakan metode Liquid Chromathography-Mass Spectrometry (LC-MS/MS). Hasil: Diperoleh pelepasan BPA dari Resin Adhesif Ortodonti pada larutan obat kumur Klorheksidin Glukonat 1 jam: 0,21 ng/ml, 7 hari: 0,32 ng/ml, 30 hari: 0,78 ng/ml, sedangkan pada saliva buatan 1 jam: 0,19 ng/ml, 7 hari: 0,53 ng/ml, 30 hari: 1,41 ng/ml. Kesimpulan: Jumlah BPA yang terlepas dari Resin Adhesif Ortodonti pada perendaman larutan obat kumur Klorheksidin Glukonat dan saliva buatan selama 1 jam, 7 hari dan 30 hari, berada di bawah dosis toleransi harian BPA (< 1.52 ng/mL).

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Objective: to determine the amount of BPA, cytotoxic substance found in orthodontic adhesive resin, after immersion in a solution of chlorhexidine gluconate mouthwash and artificial saliva. Research Methods: 66 Orthodontic adhesive resin cylindrical plates were immersed in two different solutions: (1) Chlorhexidine Gluconate, (2) artificial saliva, for 1 hour, 7 days, 30 days. In each experimental group, the BPA release in the solution was calculated using LC- MS/MS. The release of BPA in both groups was calculated using the Liquid Chromathography-Mass Spectrometry (LC-MS/MS). Results: The release of BPA from Orthodontic Adhesive Resin was obtained in the Chlorhexidine Gluconate mouthwash solution, 1 hour: 0.21 ng/ml, 7 days: 0.32 ng/ml, 30 days: 0.78 ng/ml, while in artificial saliva, 1 hour: 0.19 ng/ml, 7 days: 0.53 ng/ml, 30 days: 1.41 ng/ml. Conclusion: The amount of BPA released from the Orthodontic Adhesive Resin by immersion in a solution of Chlorhexidine Gluconate mouthwash and artificial saliva for 1 hour, 7 days and 30 days, was below the daily tolerated dose of BPA (< 1.52 ng/mL)."

"Latar Belakang : Enterococcus faecalis merupakan bakteri yang mampu membentuk biofilm dan banyak ditemukan pada kasus kegagalan perawatan saluran akar. Tujuan : Melihat daya antibakteri kitosan dan klorheksidin terhadap E. faecalis dalam biofilm. Metode : Deteksi dan kuantifikasi E. faecalis dalam biofilm yang hidup pasca pemaparan bahan uji, dengan real time PCR. Hasil : Terdapat perbedaan jumlah bakteri yang signifikan antara kedua kelompok bahan uji terhadap kontrol (p ≤ 0,05), tetapi tidak terdapat perbedaan bermakna antara kelompok kitosan dan klorheksidin. Kesimpulan : Daya antibakteri kitosan 2% terhadap biofilm E. faecalis sebanding dengan klorheksidin 2%.

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Background : Enterococcus faecalis has an ability to form biofilms and become a predominant bacteria that plays a major role in the etiology of persistent lesions after root canal treatment.

Aim : To analyze the efficacy of chitosan and chlorhexidine against E. faecalis in biofilms.

Methods : Detection and quantification of E. faecalis DNA that survive and live after immersing the biofilm in antibacterial solution, with real time PCR.

Result : Statistically there is significant difference of living E. faecalis between chitosan and control and between 2% chlorhexidine and control (p ≤0,05). But there is no significant different between chitosan and chlorhexidine (p>0,05).

Conclusion : Antibacterial effectivity of chitosan is equal to chlorhexidine against E. faecalis in biofilm."

"Latar Belakang: Karies merupakan penyakit kronis infeksius yang telah tersebar luas secara global. Streptococcus mutans dianggap sebagai patogen utama yang bertanggung jawab atas perkembangannya. Karena itu, bakteri Streptococcus mutans umumnya menjadi target utama dalam pencegahan karies. Reduksi jumlah S. mutans dengan berbagai tindakan pencegahan seperti kemoprofilaksis dapat menyebabkan penurunan signifikan dari terjadinya karies gigi. Obat kumur merupakan salah satu kemoprofilaksis dengan sarana penghantaran antibakteri yang aman dan efektif. Chlorhexidine telah terbukti menjadi agen kemoprofilaktik yang efektif terhadap S. mutans. Namun, chlorhexidine juga telah dilaporkan menunjukkan banyak kekurangan dan keterbatasan dalam penggunaannya sehingga diperlukan antibakteri alternatif yang lebih aman dan efektif, salah satunya berupa obat kumur herbal. Penggunaan antibakteri berbahan alami mungkin juga dapat membantu mengontrol spesies yang resisten terhadap antibakteri sintetik. Tujuan: Systematic review ini bertujuan untuk mengevaluasi literatur ilmiah yang relevan untuk menganalisis perbandingan efek antibakteri obat kumur herbal dan chlorhexidine terhadap Streptococcus mutans. Metode: Penelusuran literatur dilakukan secara online hingga bulan Desember 2020 melalui tiga electronic database, yaitu PubMed, ScienceDirect, dan Scopus menggunakan pedoman PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) sebagai panduan penulisan. Hasil: Penelusuran literatur mengidentifikasi sebanyak tiga studi yang diterbitkan pada tahun 2013-2017. Dari ketiganya, dua studi menunjukkan obat kumur herbal memberikan efek antibakteri yang serupa dengan chlorhexidine, dan satu studi menunjukkan obat kumur herbal memberikan efek antibakteri terhadap Streptococcus mutans yang lebih efektif daripada chlorhexidine. Kesimpulan: Obat kumur herbal dapat menunjukkan efek antibakteri terhadap Streptococcus mutans yang serupa atau lebih unggul dibandingkan dengan chlorhexidine.

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Background: Dental caries is a chronic infectious disease that still remains a major oral health problem worldwide. Streptococcus mutans is considered to be a major causative agent of dental caries. Thus, prevention of dental caries generally targets Streptococcus mutans. Reduction of Streptococcus mutans by various preventive measures such as chemoprophylaxis have shown a significant reduction in dental caries. Among the various antibacterial delivery systems, mouthwashes are one of the safest and effective vehicles. Chlorhexidine mouthwash has been shown to be an effective chemoprophylactic agent against Streptococcus mutans. However, it has also been reported to possess certain drawbacks and limitations in its use. This indicates a safer and more effective alternative antibacterial agent is needed, one of which is herbal mouthwash. The use of natural antibacterials may also help control species that are resistant to synthetic antibacterials. Objective: This systematic review mainly aimed to evaluate relevant scientific literature in the interest of analyzing the antibacterial effect of herbal mouthwash against Streptococcus mutans compared to chlorhexidine mouthwash. Methods: Online literature searching was carried out until December 2020 through three electronic databases, namely PubMed, ScienceDirect, and Scopus using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes) guidelines as a guide. Results: Three eligible studies published in 2013-2017 were identified. Among the three studies, two showed that herbal mouthwash provides an antibacterial effect against Streptococcus mutans similar to chlorhexidine while the other one showed herbal mouthwash provides a more effective antibacterial effect against Streptococcus mutans in comparison to chlorhexidine. Conclusion: Herbal mouthwash may exhibit similar or superior antibacterial effects against Streptococcus mutans compared to chlorhexidine"