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THE UNPLEASANT TRUTH: EXPLORING THE COMPLEXITIES OF HALITOSIS Kartika, Henny; Chuan, How Kim; Halim, Susanna
SCIENCE : Jurnal Inovasi Pendidikan Matematika dan IPA Vol. 5 No. 2 (2025)
Publisher : Pusat Pengembangan Pendidikan dan Penelitian Indonesia (P4I)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51878/science.v5i2.4879

Abstract

Halitosis, or bad breath, is a common condition that can significantly affect an individual’s quality of life and social interactions. It results from a complex interaction of multiple etiological factors, predominantly originating within the oral cavity such as the activity of anaerobic microbes producing volatile sulfur compounds (VSCs), but also greatly influenced by systemic health status, diet, and lifestyle choices. Effective management therefore requires a comprehensive and careful diagnostic approach, not only to identify specific etiological factors such as the level of oral hygiene, periodontal health, and the presence or absence of xerostomia, but also to uncover potential contributions from underlying systemic medical conditions and dietary intake. This paper aims to present a comprehensive review of current concepts in the diagnosis and management of halitosis. Successful halitosis management strategies rely heavily on the pillars of ongoing patient education, the development of a personalized treatment plan based on the underlying cause—including mechanical and chemical interventions—and regular clinical monitoring and follow-up. Furthermore, interdisciplinary collaboration, combining expertise from dentistry, oral microbiology, internal medicine, and psychology, is crucial to advance more accurate diagnostic approaches and more effective therapeutic options. Thus, the importance of implementing a holistic, interdisciplinary, patient-centered approach to improve overall oral health and enhance overall patient well-being is emphasized. ABSTRAKHalitosis, atau bau mulut, adalah kondisi umum yang dapat memengaruhi kualitas hidup dan interaksi sosial seseorang secara signifikan. Hal ini disebabkan oleh interaksi kompleks berbagai faktor etiologi, yang sebagian besar berasal dari rongga mulut seperti aktivitas mikroba anaerobik yang menghasilkan senyawa sulfur volatil (VSC), tetapi juga sangat dipengaruhi oleh status kesehatan sistemik, pola makan, dan pilihan gaya hidup. Oleh karena itu, penanganan yang efektif memerlukan pendekatan diagnostik yang komprehensif dan cermat, tidak hanya untuk mengidentifikasi faktor etiologi tertentu seperti tingkat kebersihan mulut, kesehatan periodontal, dan ada atau tidaknya xerostomia, tetapi juga untuk mengungkap potensi kontribusi dari kondisi medis sistemik yang mendasarinya dan asupan makanan. artikel ini bertujuan untuk menyajikan tinjauan komprehensif tentang konsep terkini dalam diagnosis dan penanganan halitosis. Strategi penanganan halitosis yang berhasil sangat bergantung pada pilar-pilar edukasi pasien yang berkelanjutan, pengembangan rencana perawatan yang dipersonalisasi berdasarkan penyebab yang mendasarinya termasuk intervensi mekanis dan kimia dan pemantauan dan tindak lanjut klinis yang teratur. Lebih jauh lagi, kolaborasi interdisipliner, yang menggabungkan keahlian dari kedokteran gigi, mikrobiologi oral, penyakit dalam, dan psikologi, sangat penting untuk memajukan pendekatan diagnostik yang lebih akurat dan pilihan terapi yang lebih efektif. Dengan demikian, pentingnya menerapkan pendekatan holistik, interdisipliner, dan berpusat pada pasien untuk meningkatkan kesehatan mulut secara keseluruhan dan meningkatkan kesejahteraan pasien secara keseluruhan ditekankan.
THE PATHOPHYSIOLOGY AND MANAGEMENT OF XEROSTOMIA: A COMPREHENSIVE REVIEW Raja, Ricky Ferdian; Chuan, How Kim; Halim, Susanna
SCIENCE : Jurnal Inovasi Pendidikan Matematika dan IPA Vol. 5 No. 2 (2025)
Publisher : Pusat Pengembangan Pendidikan dan Penelitian Indonesia (P4I)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51878/science.v5i2.4880

Abstract

ABSTRACT Xerostomia, or more commonly known as dry mouth, is a common clinical condition that significantly affects oral comfort and health, characterized not only by the subjective sensation of dryness in the oral cavity but also by an objective decrease in the measured function of the salivary glands. Its etiology is multifactorial, often related to the side effects of more than hundreds of types of drugs, the consequences of radiotherapy to the head and neck area, manifestations of systemic diseases such as Sjögren's Syndrome and diabetes, and the natural aging process. This decrease in the quantity and quality of saliva directly interferes with the natural defense mechanisms of the mouth, increasing the risk of rampant dental caries, opportunistic infections such as oral candidiasis, and causing significant difficulties in mastication, deglutition and phonation, which ultimately negatively impact the quality of life of the sufferer. Therefore, effective management of xerostomia requires a comprehensive multidisciplinary approach, starting from an accurate diagnosis through anamnesis, clinical examination and sialometry, to the implementation of a treatment strategy tailored to the cause and severity, and ongoing patient education. This comprehensive perspective article aims to provide an in-depth review of the etiology, diagnostic approaches, and current spectrum of xerostomia management, highlighting recent advances in therapeutic modalities including salivary stimulants, artificial saliva, and mucosal protective agents as well as strategies for the prevention of oral complications. Particular attention is paid to the importance of an interdisciplinary perspective, emphasizing the vital role of collaboration between dentists, general practitioners/specialists, and pharmacists in developing a holistic and integrated patient care plan to improve the oral health and quality of life of individuals affected by xerostomia. ABSTRAKXerostomia, atau yang lebih dikenal dengan sebutan mulut kering, merupakan kondisi klinis umum yang secara signifikan memengaruhi kenyamanan dan kesehatan mulut, ditandai tidak hanya oleh sensasi subjektif kekeringan di rongga mulut tetapi juga oleh penurunan objektif fungsi kelenjar ludah yang terukur. Etiologinya multifaktorial, sering kali terkait dengan efek samping dari lebih dari ratusan jenis obat, konsekuensi radioterapi pada area kepala dan leher, manifestasi penyakit sistemik seperti Sindrom Sjögren dan diabetes, serta proses penuaan alami. Penurunan kuantitas dan kualitas air liur ini secara langsung mengganggu mekanisme pertahanan alami mulut, meningkatkan risiko karies gigi yang merajalela, infeksi oportunistik seperti kandidiasis oral, dan menyebabkan kesulitan yang signifikan dalam mengunyah, menelan, dan bersuara, yang pada akhirnya berdampak negatif pada kualitas hidup penderitanya. Oleh karena itu, penanganan xerostomia yang efektif memerlukan pendekatan multidisiplin yang komprehensif, mulai dari diagnosis yang akurat melalui anamnesis, pemeriksaan klinis dan sialometri, hingga penerapan strategi pengobatan yang disesuaikan dengan penyebab dan tingkat keparahan, serta edukasi pasien yang berkelanjutan. Artikel perspektif yang komprehensif ini bertujuan untuk memberikan tinjauan mendalam tentang etiologi, pendekatan diagnostik, dan spektrum penanganan xerostomia saat ini, yang menyoroti kemajuan terkini dalam modalitas terapi termasuk stimulan saliva, saliva buatan, dan agen pelindung mukosa serta strategi untuk pencegahan komplikasi oral. Perhatian khusus diberikan pada pentingnya perspektif interdisipliner, yang menekankan peran penting kolaborasi antara dokter gigi, dokter umum/spesialis, dan apoteker dalam mengembangkan rencana perawatan pasien yang holistik dan terintegrasi untuk meningkatkan kesehatan mulut dan kualitas hidup individu yang terkena xerostomia.  
Oral mucosal lesions associated with fixed orthodontic appliances: A review Kawono, Kawono; Chuan, How Kim; Halim, Susanna
Jurnal Prima Medika Sains Vol. 7 No. 1 (2025): June
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v7i1.6764

Abstract

Orthodontic procedures enhance dental well-being, yet they can lead to painful sores due to irritation from devices. These sores, often found on the inner cheeks and lips, arise from friction caused by brackets, wires, and screws, resulting in discomfort and slow recovery. To prevent these issues, one can use orthodontic wax, materials that are friendly to the body, and make adjustments to the appliances. Innovative treatments like low-level laser therapy and personalized 3D-printed devices are proving to be promising options for relief. Regular check-ups and working together as a team are essential for providing effective care. Addressing issues early can lessen complications, boost comfort, and improve results of orthodontic care, emphasizing the importance of both preventive and treatment methods in practice.
The two way relationship between diabetes mellitus and periodontal disease Ongko, Darius Pranajaya; Chuan, How Kim; Halim, Susanna
Jurnal Prima Medika Sains Vol. 7 No. 1 (2025): June
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v7i1.6765

Abstract

Periodontitis and diabetes mellitus are common chronic diseases with an established bidirectional relationships. Epidemiological studies have clearly identified that diabetes is a major factor for periodontitis, increasing the risk approximately three-fold compared to non-diabetic individuals, particularly if glycemic control is poor. This article discusses the possibility impact of diabetes on the periodontal patient and the ways in which untreated periodontitis may influence the course of diabetes. Diabetes mellitus is considered a risk factor and associated with an increased prevalence and severity of gingivitis and periodontitis. Inflammation plays an obvious role in periodontal diseases, evidence in literature also supports the role of inflammation as a major component in the pathogenesis of diabetes and diabetes complications. There is also evidence that periodontal disease can worsen a patient’s control of diabetes mellitus and proper management of periodontal disease can improve control of diabetes mellitus. The association between diabetes mellitus and periodontal diseases is clear that glycemic control improves periodontal conditions, while the management of periodontal infection improves glycemic control of diabetic patients (HbA1c reduction approximately 0,4%). Periodontal assessment is as important in people with diabetes as it is in people who do not have diabetes and people with diabetes should be made aware of their increased risk for periodontal disease.
MANAGEMENT OF GINGIVAL ENLARGEMENT IN PATIENT WITH NON SURGICAL TREATMENT: A CASE REPORT Watri, Desi; Chuan, How Kim; Halim, Susanna
SCIENCE : Jurnal Inovasi Pendidikan Matematika dan IPA Vol. 5 No. 1 (2025)
Publisher : Pusat Pengembangan Pendidikan dan Penelitian Indonesia (P4I)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51878/science.v5i1.4748

Abstract

Penyakit gingiva merupakan peradangan pada rongga mulut dan pembengkakan gingiva merupakan salah satu hal yang paling sering ditemukan. Pembesaran gingiva merupakan lesi inflamasi kronis yang disebabkan oleh plak bakteri dan kalkulus. Pembesaran gingiva muncul pada tingkat papila interdental dan/atau jaringan marginal gingiva, dapat terlokalisasi atau menyeluruh. Artikel ini mengkaji kasus pasien yang menderita pembesaran gingiva dan lesi gingiva yang disebabkan oleh plak bakteri. Kasus ini ditangani dengan perawatan periodontal nonsurgical. Selama lima hari, dilakukan terapi antibiotik dan terapi manual. Evaluasi ulang satu bulan kemudian menunjukkan resolusi pembesaran, penurunan peradangan, supurasi, persentase poket periodontal dan penurunan pembengkakan gingiva; perawatan periodontal dilakukan pada saat itu. Setelah tiga bulan, terjadi penurunan persentase poket periodontal dan pembengkakan gingiva; pada saat itu dilakukan terapi periodontal pemeliharaan. ABSTRACTGingiva diseases is an inflammation in oral cavity and gingiva enlargement is one of the most common things found. Gingival enlargement is a chronic inflammatory lesion caused by bacterial plaque and calculus. It appears at the level of interdental papilla and/or marginal gingival tissue, it can be localized or generalized. This article studies a case of a patient who suffered from gingival enlargement and gingival lesions caused by bacterial plaque. This case was managed with the use of nonsurgical periodontal treatment. For five days, antibiotic therapy and manual therapy were performed. Re-evaluation one month later showed resolution of the enlargement, decrease in inflammation, suppuration, percentage of periodontal pockets and decrease gingival swelling; periodontal treatment was performed at that time. After three months, a decrease in the percentage of periodontal pockets and gingival swelling was observed; at that time maintenance periodontal therapy was performed.
EPULIS FISSURATUM CAUSED BY CHRONIC IRRITATION FROM THE USE OF COMPLETE DENTURES: A CASE REPORT Nurhayati, Sri; Chuan, How Kim; Angela, Emerentia; Halim, Susanna
SCIENCE : Jurnal Inovasi Pendidikan Matematika dan IPA Vol. 5 No. 2 (2025)
Publisher : Pusat Pengembangan Pendidikan dan Penelitian Indonesia (P4I)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51878/science.v5i2.4884

Abstract

Epulis fissuratum is a reactive fibrous hyperplasia commonly caused by chronic mechanical irritation from ill-fitting complete dentures. It often presents as mucosal folds in the vestibular area of the oral cavity. Aim: This case report aims to describe the clinical features, etiological factors, management strategies, and the role of patient education in preventing recurrence. A 65-year-old female patient presented with a soft tissue enlargement in the mandibular vestibule, associated with prolonged use of unadjusted complete dentures. Clinical examination and patient history confirmed the diagnosis of epulis fissuratum. Conservative surgical excision was performed under local anesthesia, followed by prosthetic rehabilitation and oral hygiene education. Postoperative healing was uneventful, with complete tissue recovery observed within two weeks. A new denture was fabricated to accommodate the anatomical changes and prevent further trauma. Monthly follow-ups for three months showed no signs of recurrence, and the patient reported improved comfort and satisfaction. Chronic irritation from ill-fitting dentures remains a major contributor to soft tissue lesions such as epulis fissuratum. Early detection, surgical intervention when needed, and appropriate prosthetic management—combined with effective patient education—are key to successful outcomes. Denture users should be advised of the importance of routine evaluations to ensure long-term oral health and prevent recurrence of such lesions. ABSTRAKEpulis fissuratum adalah hiperplasia fibrosa reaktif yang umumnya disebabkan oleh iritasi mekanis kronis akibat gigi tiruan lengkap yang tidak pas. Kondisi ini sering muncul sebagai lipatan mukosa di area vestibulum rongga mulut. Tujuan: Laporan kasus ini bertujuan untuk menjelaskan gambaran klinis, faktor etiologi, strategi penatalaksanaan, dan peran edukasi pasien dalam mencegah kekambuhan. Seorang pasien perempuan berusia 65 tahun datang dengan keluhan pembesaran jaringan lunak di vestibulum mandibula, yang berhubungan dengan penggunaan gigi tiruan lengkap yang tidak disesuaikan dalam jangka waktu lama. Pemeriksaan klinis dan riwayat pasien memastikan diagnosis epulis fissuratum. Eksisi bedah konservatif dilakukan dengan anestesi lokal, diikuti dengan rehabilitasi prostetik dan edukasi kebersihan mulut. Penyembuhan pascaoperasi berjalan lancar, dengan pemulihan jaringan lengkap yang diamati dalam dua minggu. Gigi tiruan baru dibuat untuk mengakomodasi perubahan anatomi dan mencegah trauma lebih lanjut. Tindak lanjut bulanan selama tiga bulan tidak menunjukkan tanda-tanda kekambuhan, dan pasien melaporkan peningkatan kenyamanan dan kepuasan. Iritasi kronis akibat gigi palsu yang tidak pas tetap menjadi penyebab utama lesi jaringan lunak seperti epulis fissuratum. Deteksi dini, intervensi bedah bila diperlukan, dan manajemen prostetik yang tepat—dikombinasikan dengan edukasi pasien yang efektif—merupakan kunci keberhasilan. Pengguna gigi palsu harus diberi tahu tentang pentingnya evaluasi rutin untuk memastikan kesehatan mulut jangka panjang dan mencegah kekambuhan lesi tersebut.
ARTICLE REVIEW “A CASE REPORT OF BLACK HAIRY TONGUE (MELANOTRICHIA LINGUAE OR LINGUA PILOSA NIGRA)” Yap, Ivana; Chuan, How Kim; Halim, Susanna
KNOWLEDGE: Jurnal Inovasi Hasil Penelitian dan Pengembangan Vol. 5 No. 2 (2025)
Publisher : Pusat Pengembangan Pendidikan dan Penelitian Indonesia (P4I)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51878/knowledge.v5i2.4786

Abstract

Black hairy tongue (BHT) is a benign but alarming oral condition characterized by hypertrophy and elongation of the filiform papillae, resulting in a black or brown discoloration of the tongue. This case report presents a 64-year-old male who developed BHT after a 10-day course of ceftriaxone and pantoprazole therapy. The patient had no history of smoking, poor oral hygiene, or systemic disease. Clinical observation revealed black discoloration on the dorsal tongue surface. The temporal association between drug administration and lesion onset, along with improvement after medication discontinuation and oral hygiene reinforcement, suggests a drug-induced etiology. The patient's condition improved following the cessation of pantoprazole and substitution of ceftriaxone with trimethoprim-sulfamethoxazole. Literature review indicates that antibiotics, especially beta-lactams, and proton pump inhibitors may play a role in the pathogenesis of BHT by altering oral microbial flora and inhibiting keratin desquamation. This case highlights the importance of clinician awareness regarding rare adverse drug reactions such as BHT. Prompt identification and management, including discontinuation of offending agents and improvement of oral hygiene, are essential for resolution and prevention of unnecessary diagnostic procedures.
Case Report of Drug-Induced Gingival Overgrowth (DIGO) in Amlodipine User at Bhayangkara Brimob Hospital Rayanti, Rike; Yasmine, Sylvia Angela; Chuan, How Kim; Halim, Susanna
Jurnal Penelitian Pendidikan IPA Vol 11 No 5 (2025): May
Publisher : Postgraduate, University of Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jppipa.v11i5.10994

Abstract

Drug-induced gingival overgrowth (DIGO) is a condition where the gingiva is abnormally enlarged caused by anticonvulsant, calcium channel blocker, and immunosuppressant drugs. Amlodipine, a calcium channel blocker, is used to treat hypertension and is reported to be the first drug to cause gingival overgrowth. The prevalence of gingival overgrowth induced by calcium channel blockers including amlodipine is 6%-83%. This case report was written with the aim of presenting information on the management of DIGO treatment in hypertensive patients without drug replacement also underlines the importance of integrating science-based health education in dental care to support treatment adherence and patient literacy. The 60-year-old female patient came to the Dental Clinic of Bhayangkara Brimob Hospital with the main complaint of enlarged gums since one year ago almost throughout her mouth. Gum enlargement is slow and painless, but sometimes bleeds when brushing teeth. The patient had a history of high blood pressure and was prescribed amlodipine 10 mg once a day and routinely consumed since the last 5 years. Cleaning of supra and sub-gingival tartar, prescribing chlorhexidine gluconate 0.2% mouthwash to be swished before bedtime, and motivating the patient to continue to maintain oral hygiene. Conclusion: Amlodipine is one of the drugs that cause DIGO (Drug Induced Gingival Overgrowth). Good dental hygiene and patient education have a major role in improving the condition of gingival enlargement.
Dentin Hypersensitivity: A Literature Review Wibowo, Gustantyo Wahyu; Chuan, How Kim; Halim, Susanna
Jurnal Penelitian Pendidikan IPA Vol 11 No 5 (2025): May
Publisher : Postgraduate, University of Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jppipa.v11i5.10995

Abstract

Dentin hypersensitivity is characterized by brief, intense pain triggered by external stimuli that affect exposed dentin with open tubules. The condition is primarily caused by two factors: the exposure and loss of dentin and the opening of dentin tubules, which allows sensory signals from the pulp to be transmitted in response to stimulation of the dentin surface. A precise diagnosis is crucial before initiating treatment and begins with a thorough patient medical history and clinical examination. Various treatment options have been developed to manage sensitivity, focusing primarily on nerve desensitization and the closure of open dentinal tubules. Developing a better understanding of the causes and mechanisms of dentin hypersensitivity is essential for effective prevention and treatment strategies for patients suffering from this condition. This review aims to provide dental professionals with comprehensive knowledge about dentin hypersensitivity, including its causes, diagnostic procedures, clinical management techniques, and innovative methods for reducing sensitivity.
Management of Traumatic Ulcers in a Patient with Angle Class I Malocclusion: A Case Review Soehardy, Juanna; Angela, Thalia; Angela, Emerentia; Chuan, How Kim; Halim, Susanna
Jurnal Penelitian Pendidikan IPA Vol 11 No 5 (2025): May
Publisher : Postgraduate, University of Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jppipa.v11i5.11029

Abstract

Malocclusion is an inappropriate relationship of opposing teeth when the jaws are in contact. This malocclusion condition can cause oral cavity problems, one of which is traumatic ulcers. Traumatic ulcers are one of the most common lesions on the oral mucosa, where there is a loss of the epithelial layer beyond the basement membrane and affects the lamina propria which is generally caused by trauma. Traumatic ulcers can occur on the oral mucosa, including: on the tongue, lips, buccal mucosa folds, gingiva, palate, labial mucosa, buccal mucosa and floor of the mouth. The clinical picture of traumatic ulcers is not specific depending on the etiology, has a smooth surface, a yellowish lesion base and red margins and no induration. Ulcers usually heal without leaving a trace in 10-14 days, spontaneously or after eliminating the cause. Traumatic ulcers can occur at any age, both in men and women. The prevalence of traumatic ulcers is quite high. Several studies show variations in the range of 3 - 24% of the population. Management of traumatic ulcers is in the form of correcting predisposing factors. Local symptomatic treatment is the standard treatment for simple traumatic ulcers. Therapy in this case is to provide Oral Hygiene Instructions on the importance of maintaining dental and oral health. In addition, the patient was prescribed topical hyaluronic acid (Aloclair gel 8 ml) to reduce pain, povidone iodine antiseptic mouthwash and vitamin B12 to accelerate healing and the patient was asked to check 1 week after treatment. Summary of the results of traumatic ulcer therapy due to class I malocclusion with topical hyaluronic acid Aloclair gel 8 ml, antiseptic povidone iodine mouthwash, and vitamin B12 showed significant improvement in symptoms. Aloclair gel helps reduce pain and accelerate healing, while antiseptic mouthwash helps prevent infection. Vitamin B12 plays a role in accelerating the wound healing process.