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SALIVARY PROFILE AND IDENTIFICATION OF EXISTING CANDIDA sp OF AN INSTITUTIONALIZED ELDERLY POPULATION IN JAKARTA: PROFIL SALIVA DAN IDENTIFIKASI KEBERADAAN CANDIDA sp PADA LANSIA DI PANTI JOMPO DI JAKARTA Febrina Rahmayanti; Yuniardini Septorini Wimardhani; Indriasti Wardhany
Dentika: Dental Journal Vol. 17 No. 4 (2013): Dentika Dental Journal
Publisher : TALENTA

Saliva plays an important role to protect oral and dental health, in maintenance oral microflora balance. In elderly, disease, and medications usually influence the saliva. The purpose of this preliminary study was to investigate salivary profile, oral symptoms of dryness, and existing of Candida sp of an institutionalized elderly in Jakarta, Twenty seven (27) elderly (17 men and 10 women) were examined in a cross sectional study. Unstimulated whole saliva was collected for 5 minutes, according to published protocol, and then salivary flow rate and pH were measured. Candida sp were cultured in CHROM agar. The yeasts were counted and identified. Oral symptom or complaints of oral dryness, and burning or itching were recorded with an interview. Data of systemic conditions and medication the used were obtained from the medical record. Eighteen (66.7%) CHROM agar plates were Candida sp positive cultured, and about 61.1% subjectsâ€™ salivary pH were below normal range. Twenty one (77.8%) subjects had oral symptom and complain about oral dryness, even thought the salivary flow rate were in normal range. In this study, C.albicans is not the most frequently found colonized. About 72% were identified not C.albicans. This study suggests that, in elderly which salivary pH was below normal range have greater opportunistic infected by Candida sp. It can be concluded that, the result did not confirm a significant difference between subjectsâ€™ data and salivary profile concentration. The mycological finding Candida albicans is not the most frequently found colonized in this elderly population. Further study which lagger elderly population and might give deeper insights of salivary profile in this population.

Oral Hairy Leukoplakia: Clinical Indicator of an Immunosuppressive Condition and Challenges in Patient Management Agustina, Yohana Alfa; Wardhany, Indriasti Indah; Wimardhani, Yuniardini Septorini; Krisnuhoni, Ening; Iamaroon, Anak
Journal of Dentistry Indonesia Vol. 23, No. 2
Publisher : UI Scholars Hub

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Oral hairy leukoplakia (OHL) is defined as an asymptomatic white patch with vertical corrugation pattern the lateral borders of the tongue, that is associated with Epstein-Barr Virus (EBV) infection. Generally, it is related to immunosuppressive condition found in HIV-positive patients and patients undergoing immunosuppressive therapy. Sometimes, its clinical appearances could mimic other white lesions. Although most OHL cases are found in HIV seropositive individuals, finding in the immunocompetent individuals has also been reported. Appropriate clinical evaluations and laboratory investigations are important for patient’s comprehensive management. Objective: To report a finding of oral hairy leukoplakia as a clinical indicator of an immunosuppressive condition in otherwise a clinically healthy-looking individual and to discuss the challenges on patient management. Case Report: A 40 yearold man presented with asymptomatic, bilateral homogenous white hyperkeratotic plaques with a hairy appearance located on the dorsal of the tongue, extended to the lateral tongue mucosa. The patient failed to remember the lesion’s first appearance, until three weeks before a visit. Working diagnosis of OHL was made with differential diagnoses including white sponge nevus, leukoplakia and oral lichen planus. Histopathological assessment was consistent with OHL. Challenges on patient management include identifying possible risk factors and assuring patient for HIV testing. Conclusion: This case reported findings of OHL as the first clinical indicator of immunosuppressive condition that might be related to HIV-infection.

DENTIST’S ROLE IN COLLABORATIVE MANAGEMENT OF TETANUS PATIENT Amaliah, Nurfitri; Indah Wardhany, Indriasti
Journal of Health and Dental Sciences Vol. 3 No. 3 (2024): Journal of Health and Dental Sciences
Publisher : Fakultas Kedokteran Gigi Unjani

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Tetanus was a life-threatening infection causing muscle contractions. The need for qualified collaborative management was crucial due to the potential for poor prognosis and complications. Dentists can contribute significantly to the treatment, as the mouth can be one of the entry points for tetanus-causing bacteria. A 45-year-old male tetanus inpatient was referred from the Intensive Care Unit to the Oral Medicine Unit at Universitas Indonesia Hospital to evaluate the possible source of oral focus infection. A boil was on his back, suspected to be the main port of entry for tetanus bacteria. The definitive diagnosis was Tetanus of moderate to severe severity (Philips score 24, Dakar score 1, Ablett score 2). Extra oral examination shows lip inflammation. An intra-oral examination cannot be done optimally despite his trismus. The oral foci of infection found were chronic gingivitis and pulp necrosis on 47 48, in addition to the diagnosis of cheilitis simplex. Since the comprehensive management of the foci of infection could only be done in an outpatient setting, the nurse was instructed to clean the intra-oral using sterile gauze moistened with NaCl 0.9% solution to improve the patient's oral hygiene (OH). Comprehensive management includes periodically visiting to maintain OH, administering muscle relaxants, antibiotics, and analgesics, and administering Tetanus toxoid vaccination. The patient was recovered. Management of tetanus cases needs a multidisciplinary approach. Dentists are pivotal in identifying oral infection sources and ensuring its management. A dentist's role in the collaborative management of tetanus patients might significantly contribute to the patient's prognosis. DOI : 10.54052/jhds.v3n3.p303-316

The Importance Of Oral Health Care Optimization In Bedridden Medicocompromised Patients: A Case Series Zahra, Faradina Siti; Parlindungan, Faisal; Aini, Muhammad Hafiz; Wardhany, Indriasti Indah
Odonto : Dental Journal Vol 12, No 3 (2025): December 2025
Publisher : Faculty of Dentistry, Universitas Islam Sultan Agung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30659/odj.12.3.346-353

Background: Bedridden patients were highly susceptible to oral complications due to prolonged immobilization, impaired oromotor function, and limited capacity for self-care. The accumulation of debris and reduced salivary flow can become pathological, leading to infection in the oral cavity. This case report aims to describe two cases of medico-compromised bedridden inpatient highlighting the importance of optimizing oral health care. Case Report: Two bedridden inpatients were reffered to Oral Medicine Division, Universitas Indonesia hospital from internist. First case, was a 59-year-old female inpatient with stage IV breast carcinoma and bone metastasis. The second case, was a 68-year-old male inpatient with acute encephalopathy and multiple comorbidities. Both patients shows decreased consciousness, severe oral dryness with high Clinical Oral Dryness Scores (CODS), poor oral hygiene with a abundant plaque and debris, inflamed periodontal tissue and lip lesion. Oral health care maintenance by cleaning and wipping teeth and oral mucosa using sterile gauze moistened in 0.9% NaCl was done and demonstrated to caregiver to be done daily. Petroleum Jelly was perscribe for the lips lesions. Both patients showed improved mucosal hydration, debris reduction, and greater comfort. Discussion: Oral cavity infection is one of the factors that plays an important role in accomplishing the successful overall treatment while bedridden patients had increased risks of oral infection due to limited abilities. Cleaning and wipping with 0,9% NaCl was a safe choice for patient with high risk of aspiration, had a mild antiseptic properties and maintain mucosal hydration. Conclusion: Optimization of oral care in bedridden patients begin with the selection of oral health care maintenance methods by considering the patient's systemic condition.

Challenges in Managing Oral Manifestations of Anticonvulsant-Induced Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome Fajrin, Fildzah Nurul; Wardhany, Indriasti Indah; Rahmayanti, Febrina; Ikhsan, Muhammad; Pangeran, David
Odonto : Dental Journal Vol 12, No 3 (2025): December 2025
Publisher : Faculty of Dentistry, Universitas Islam Sultan Agung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30659/odj.12.3.332-345

Background : Antiepileptic drugs were common causative agents for DRESS syndrome, which was a severe, idiosyncratic drug hypersensitivity reaction characterized by a prolonged latency period, fever, rash, and marked eosinophilia. The oral manifestations present a diagnostic challenge due its similarity to other hypersensitivity reactions as well as its comprehensive management. Objective: This case report aims to describe the challenges in comprehensive management of DRESS syndrome severe oral manifestations, highlighting the challenges from diagnosis to management for patient with complex comorbidities. Case: A 19-year-old female inpatient was referred to Oral Medicine division, Dental and Oro-maxillofacial unit of Universitas Indonesia Hospital (RSUI) for severe oral sores after treated with phenytoin and lamotrigine for her temporal lobe epilepsy and bipolar affective disorder. Patient shows general weakness and clinical examination revealed multiple intra oral erosions, lips erosions with exfoliation and haemorrhagic crust, generalized maculopapular rash, facial oedema, tender lymphadenopathy, and. Laboratory findings confirmed a severe hyper-eosinophilia (32%) and lymphopenia (13.5%), while liver function was normal. A diagnosis of DRESS syndrome was finally established. Case management were immediate withdrawal of phenytoin and lamotrigine, followed by multidisciplinary care including intra vena and topical corticosteroids. The patient's condition significantly improved after collaborative comprehensive treatment. Conclusion: Definitive diagnosis decisions requires careful consideration on the correlation of clinical findings, medication history, and hallmark laboratory results, especially in patients with complex comorbidities and intraoral clinical features with characteristics similar to other hypersensitivity reactions. Comprehensive collaborative management, including patient’s and other healthcare professionals collaboration, is crucial for successful treatment.

The Importance Of Oral Health Care Optimization In Bedridden Medicocompromised Patients: A Case Series Zahra, Faradina Siti; Parlindungan, Faisal; Aini, Muhammad Hafiz; Wardhany, Indriasti Indah
Odonto : Dental Journal Vol 12, No 3 (2025): December 2025
Publisher : Faculty of Dentistry, Universitas Islam Sultan Agung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30659/odj.12.3.346-353

Background: Bedridden patients were highly susceptible to oral complications due to prolonged immobilization, impaired oromotor function, and limited capacity for self-care. The accumulation of debris and reduced salivary flow can become pathological, leading to infection in the oral cavity. This case report aims to describe two cases of medico-compromised bedridden inpatient highlighting the importance of optimizing oral health care. Case Report: Two bedridden inpatients were reffered to Oral Medicine Division, Universitas Indonesia hospital from internist. First case, was a 59-year-old female inpatient with stage IV breast carcinoma and bone metastasis. The second case, was a 68-year-old male inpatient with acute encephalopathy and multiple comorbidities. Both patients shows decreased consciousness, severe oral dryness with high Clinical Oral Dryness Scores (CODS), poor oral hygiene with a abundant plaque and debris, inflamed periodontal tissue and lip lesion. Oral health care maintenance by cleaning and wipping teeth and oral mucosa using sterile gauze moistened in 0.9% NaCl was done and demonstrated to caregiver to be done daily. Petroleum Jelly was perscribe for the lips lesions. Both patients showed improved mucosal hydration, debris reduction, and greater comfort. Discussion: Oral cavity infection is one of the factors that plays an important role in accomplishing the successful overall treatment while bedridden patients had increased risks of oral infection due to limited abilities. Cleaning and wipping with 0,9% NaCl was a safe choice for patient with high risk of aspiration, had a mild antiseptic properties and maintain mucosal hydration. Conclusion: Optimization of oral care in bedridden patients begin with the selection of oral health care maintenance methods by considering the patient's systemic condition.

Challenges in Managing Oral Manifestations of Anticonvulsant-Induced Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome Fajrin, Fildzah Nurul; Wardhany, Indriasti Indah; Rahmayanti, Febrina; Ikhsan, Muhammad; Pangeran, David
Odonto : Dental Journal Vol 12, No 3 (2025): December 2025
Publisher : Faculty of Dentistry, Universitas Islam Sultan Agung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30659/odj.12.3.332-345

Background : Antiepileptic drugs were common causative agents for DRESS syndrome, which was a severe, idiosyncratic drug hypersensitivity reaction characterized by a prolonged latency period, fever, rash, and marked eosinophilia. The oral manifestations present a diagnostic challenge due its similarity to other hypersensitivity reactions as well as its comprehensive management. Objective: This case report aims to describe the challenges in comprehensive management of DRESS syndrome severe oral manifestations, highlighting the challenges from diagnosis to management for patient with complex comorbidities. Case: A 19-year-old female inpatient was referred to Oral Medicine division, Dental and Oro-maxillofacial unit of Universitas Indonesia Hospital (RSUI) for severe oral sores after treated with phenytoin and lamotrigine for her temporal lobe epilepsy and bipolar affective disorder. Patient shows general weakness and clinical examination revealed multiple intra oral erosions, lips erosions with exfoliation and haemorrhagic crust, generalized maculopapular rash, facial oedema, tender lymphadenopathy, and. Laboratory findings confirmed a severe hyper-eosinophilia (32%) and lymphopenia (13.5%), while liver function was normal. A diagnosis of DRESS syndrome was finally established. Case management were immediate withdrawal of phenytoin and lamotrigine, followed by multidisciplinary care including intra vena and topical corticosteroids. The patient's condition significantly improved after collaborative comprehensive treatment. Conclusion: Definitive diagnosis decisions requires careful consideration on the correlation of clinical findings, medication history, and hallmark laboratory results, especially in patients with complex comorbidities and intraoral clinical features with characteristics similar to other hypersensitivity reactions. Comprehensive collaborative management, including patient’s and other healthcare professionals collaboration, is crucial for successful treatment.

Management of oral manifestation of toxic epidermal necrolysis due to antituberculosis drugs Dwi Handayani; Anandina Irmagita Soegyanto; Indriasti Indah Wardhany
Majalah Kedokteran Gigi Indonesia Vol 12, No 1 (2026): April
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.97512

Toxic epidermal necrolysis (TEN) is severe and potentially fatal hypersensitivity reactions, frequently triggered by drugs, characterized by extensive epidermal detachment on mucocutaneous. Drugs that have adverse effects on TEN are antibiotics, anticonvulsants, antiviral, antitubercular, uric acid lowering and nonsteroidal anti-inflammatory drugs (NSAID). This case report discusses the management of TEN oral manifestations caused by anti-tuberculosis drugs (ATD). A 56-year-old male inpatient at Universitas Indonesia Hospital (RSUI) was referred to Oral Medicine Unit due to dry and bleeding lips. He was diagnosed with TEN due to ATD. Extra oral examination showed brown crust on upper and lower circumoral area and blackish red crusts on the upper and lower lips with minor bleeding. Intra oral examination revealed multiple erosions, ulcers, and poor oral hygiene. The established working diagnosis was oral manifestation of TEN, which was managed with NaCl 0.9% solution, clobetasol propionate 0.05% and Vaseline® album concoction, antibiotic cream, chlorhexidine gluconate 0.2% mouthwash, and educating the patient to maintain oral hygiene. The therapy improved the patient’s condition. In the comprehensive management of TEN, dentists play an important role in treating oral manifestations and improving patient’s oral health through adequate food intake and nutritional balance for better quality of life and prognosis.

Diagnostic challenge and biopsychosocial approach in burning mouth syndrome management Ni Putu Yessy Karmila Putri; Anandina Irmagita Soegyanto; Indriasti Indah Wardhany; Ambar Kusuma Astuti; Ratna Kumala Indrastiti
Majalah Kedokteran Gigi Indonesia Vol 12, No 1 (2026): April
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.98771

Burning mouth syndrome (BMS) is a chronic pain disease marked by a prolonged burning sensation in clinically healthy oral mucosa, commonly occurs in fifth to seventh decade women with hormonal changes or psychological problems. Establishing a diagnosis that excludes any apparent organic cause for BMS complaints can be challenging. This case study aimed to determine how the diagnosis and biopsychosocial approach were made in the management of BMS patients. A 53-year-old female patient presented to the Oral Medicine Clinic, Dental Hospital, Faculty of Dentistry, Universitas Indonesia, with a two-month history of burning sensation throughout the oral mucosa and radiating pain affecting the tongue and gums. Last menstrual cycle was three years ago. She admitted to feeling stress and anxiety over her mouth condition and family problems. Extraoral examination revealed dry lips, and intraoral examination showed normal oral mucosa and multiple missing teeth. The Depression Anxiety Stress Scale (DASS-21) showed moderate anxiety and stress levels. The patient was diagnosed with burning mouth syndrome. Reassurance was given on the first visit to help reduce anxiety caused by chronic pain, along with the use of prescribed combination of neurotropic vitamins containing analgesic and stress management. After six weeks, the pain and burning sensation subsided. In order to effectively manage BMS in patients with psychological conditions, a thorough evaluation and comprehensive therapy are important. A successful combination of psychological and medical strategies will be greatly beneficial in the treatment of BMS patients.

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