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All Journal Journal of Dentistry Indonesia ODONTO Dental Journal Odonto dental journal
Indriasti Indah Wardhany
Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430
Dentistry Health Professions Medicine & Pharmacology

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Journal : ODONTO Dental Journal

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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

Abstract

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

Abstract

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.
Co-Authors Agustina, Yohana Alfa Aini, Muhammad Hafiz Ening Krisnuhoni Febrina Rahmayanti Fildzah Nurul Fajrin, Fildzah Nurul Iamaroon, Anak Muhammad Ikhsan Pangeran, David Parlindungan, Faisal Yuniardini Septorini Wimardhani Zahra, Faradina Siti