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"Inflammasi neurogenik berperan pada penyebaran infeksi oral. Teori infeksi fokal rongga mulut telah diusulkan sejak awal 1900an, infeksi gigi menyebabkan berbagai penyakit sistemik. Namun, teori ini mulai ditinggalkan setelah banyak gigi telah dicabut tanpa memberikan hasil yang memuaskan. Penelitian terbaru membuktikan bahwa infeksi rongga mulut dapat menyebar secara sistemik. Walaupun demikian, penemuan terdahulu tidak dapat membuktikan bagaimana terapi periodontal “assisted drainage” (ADT), dapat mengurangi gejala migren dan asma dalam hitungan menit. Penelitian terkait interaksi keradangan imunogenik dan neurogenik yaitu mediator proinflamasi calcitonin gene-related peptide (CGRP), TNF-α dan vasoactive intestinal peptide (VIP) masih jarang dilakukan. Tujuan: Melakukan verifikasi penyebaran keradangan neurogenik mulut ke organ yang jauh setelah melakukan ADT melalui ekspresi CGRP, VIP dan TNF-α. Metode: 24 tikus wistar jantan disuntik intragingival dengan lipopolisakarida Porphyromonas gingivalis (PgLPS1435/1450). Setelah empat hari, 12 tikus diberikan ADT, kemudian semua sampel dikorbankan 40 menit setelah ADT. Ekpresi CGRP, VIP dan TNF-α dianalisis dengan imunohistokimia. Analisis statistik menggunakan ANOVA dilakukan untuk menganalisis perbedaan nilai ekspresi CGRP, VIP, dan TNF-α tiap kelompok uji. Hasil: Injeksi PgLPS meningkatkan CGRP, VIP an TNF-α walau tidak selalu bermakna pada kelompok kontrol. Ekspresi CGRP dan TNF-α menurun, tetapi ekspresi VIP meningkat pada kelompok ADT. Simpulan: Peradangan neurogenik terlibat dalam penyebaran keradangan rongga mulut ke seluruh tubuh yang dimungkinkan karena ADT mengurangi peradangan organ lain melalui stimulasi VIP.

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Focal infection theory proposed in early 1900’s stated that dental infection caused systemic disorders. Nevertheless, the theory was abandoned since large number of teeth were extracted with no satisfying result. Recent reports revealed that oral infections were able to spread systemically. However, there is no rationalization available toexplain how assisted drainage therapy (ADT), a periodontal therapy that could relief migraine and asthma within minutes. Oral neurogenic and immunogenic inflammation interaction involving pro-inflammatory markers such as calcitonin gene-related peptide (CGRP), TNF-α; and antiinflammatory vasoactive intestinal peptide (VIP) was still under investigation. Objective: To verify the spread of oral inflammation to distant organ after performing ADT by analysing CGRP, VIP and TNF-α expressions. Methods: Two different concentration of Porphyromonasgingivalis lipopolysaccharide (PgLPS1435/1450) was injected intragingivally into two groups of 12 Wistar rats. After four days, 12 rats were given ADT and all samples were subsequently sacrificed 40 mins after ADT. Immunohistochemistry analysis using CGRP, VIP and TNF-α on the nasal and bronchus tissue was performed. ANOVA was used for statistical analyisis of the difference between CGRP, VIP and TNF-α expression between experimental groups. Results: PgLPS injections slightly increased CGRP, VIP and TNF-α expressions in the control group. Rats undergone ADT had lower CGRP and TNF-α but higher VIP expressions. Conclusion: Neurogenic inflammation involved in systemic spread of oral infection. ADT was able to downregulate inflammation in distant organ posibly by stimulating VIP."

"Pasien dengan disfagia rentan mengalami komplikasi seperti pneumonia aspirasi hingga kematian. Oleh karena itu diperlukan alat skrining untuk mendiagnosis disfagia secara cepat. GUSS merupakan alat skrining dengan validitas dan reliabilitas yang baik dalam menilai disfagia, namun belum dilakukan uji diagnostik di Indonesia. Subjek penelitian terdiri dari pasien disfagia neurogenik yang kemudian menjalani pemeriksaan GUSS-INA dengan modifikasi bahan uji, dilanjutkan dengan pemeriksaan baku emas FEES. Selanjutnya, dilakukan uji diagnostik untuk melihat sensitivitas dan spesifisitas GUSS-INA sebagai metode skrining disfagia. Rerata pasien disfagia neurogenik di RSCM berusia 56 tahun dengan jumlah proporsi laki – laki lebih besar dengan penyebab tersering adalah stroke, dengan komorbid hipertensi (56.5%), dengan komplikasi pneumonia 21.7%. Sebagian besar mengalami disfagia kronik, seluruh pasien mengalami keluhan subjektif disfagia dengan 3 gejala tersering adalah batuk, tersedak, dan sulit menelan terutama konsistensi padat. Lebih dari separuh pasien membutuhkan selang makan. Rerata status gizi pasien menunjukan indeks masa tubuh 24.92, dengan rerata penurunan BB 2 kg. Berdasarkan pemeriksaan pencitraan pasien stroke, lokasi tersering berada supratentorial, dengan derajat stroke sedang. Rerata nilai GUSS 14 (disfagia sedang) pada seluruh subjek, 28.3% mengalami aspirasi. Hasil Uji diagnostik GUSS-INA sebagai alat skrining deteksi disfagia memiliki nilai Sensitivitas 84%, Spesifisitas 78%, NDP 94%, NDN 54% dan AUC 0.86. Modalitas GUSS-INA dapat dijadikan alat skrining disfagia yang cukup baik.

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Patient with dysphagia has the tendency to undergo serious complications such as aspiration pneumonia that can cause increased mortality. Screening tool to effectively diagnose dysphagia in patient with difficulty swallowing is needed. GUSS is a screening tool with good validity and reliability; however, no diagnostic test has been done in Indonesia. This study samples consisted of neurogenic dysphagia patients which underwent GUSS-INA with test material modification assessment followed by FEES as gold standard examination. Diagnostic test was then done to analyze sensitivity and specificity of GUSS-INA as dysphagia screening tool. The average age of neurologenic dysphagia patients in Cipto Mangunkusumo Hospital was 56 years with higher male proportion, most common etiology was stroke, with most common morbidity being hypertension (56,5%). History of pneumonia was found in 21.7% patients.Majority of patients have chronic dysphagia, all patients had subjective dysphagia complaint with three most common symptoms being cough, choking, and difficulty swallowing especially of solid texture. More than half of the patients needed feeding tube. The average of BMI was 24.93, with average weight loss of 2 kg. Based on radiology results on post-stroke cases, the most common lesion was supratentorial, with moderate stroke score. Average GUSS score is 14 (moderate dysphagia) from all subjects and in 18.3% patients aspiration in found. Diagnostic test result of GUSS-INA as screening tool for neurogenic dysphagia had 84% sensitivity, 78% specificity, 94% PPV, 54% NPV, and AUC of 0.86. GUSS-INA could be used as a screening tool for dysphagia."

"ABSTRAKLatar Belakang: Kesehatan gigi merupakan salah satu hal yang penting dalam menunjang kesehatan umum, dimana penyakit gigi dan mulut dapat menyebabkan penyakit pada bagian tubuh yang lain ataupun dapat meningkatkan keparahan dari penyakit sistemik yang telah ada. Sebaliknya kesehatan sistemik dapat mempengaruhi kesehatan gigi dan mulut. Terdapat beberapa penyakit sistemik yang dapat ermanifestasi pada mulut, seperti Diabetes Melitus dan SLE yang merupakan kelainan sistem imun. Etiologi dari penyakit ini masih belum diketahui. Walaupun demikian terdapat faktor-faktor predisposisi yang sudah diketahui.. Faktor predisposisi yang ditemukan antara lain genetik, infeksi, hormonal, antibodi, kompleks imun, sinar matahari, makanan dan minuman, stress dan kelelahan fisik.

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Tujuan: untuk mengetahui status kesehatan gigi dan mulut pada Orang Dengan Lupus (Odapus) yang berkunjung di Yayasan Lupus Indonesia(YLI). Dari 30 responden diketahui bahwa 26 orang adalah perempuan dan 4 orang laki-laki. Metodologi yang digunakan dalam penelitian ini adalah dengan menggunakan wawancara dan pemeriksaan klinis kesehatan gigi dan mulut pada Odapus dengan Index OHIS untuk melihat status kebersihan gigi dan mulut, Index DMFT untuk mengukur kesehatan gigi ,dan Index CPITN untuk mengukur kesehatan jaringan periodontal.

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Hasil: Rata-rata Odapus yang diteliti, 21 orang (70 %) memiliki tingkat kebersihan mulut sedang, 13 orang ( 44%) memiliki tingkat kesehatan gigi sedang dan 10 orang (34 %) memiliki kelainan periodontal dengan kedalaman poket antara 4-5 mm.

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Kesimpulan: Hasil penelitian ini menunjukan bahwa status kesehatan gigi dan mulut pada Odapus masih tergolong sedang. Hal ini dapat dipengaruhi dari tingkat pendidikan yang sebenarnya sudah baik, tetapi dari faktor perilaku yang masih kurang dan dari penyakit SLE yang dapat memperburuk kondisi kesehatan gigi dan mulut

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ABSTRACTBackground: Oral health is one of the most important that supports general health. Oral diseases can cause systemic diseases or worsen the existent systemic diseases. On the revearse, systemic diseases can influence oral health. Etiology of this disease is still unknown. Nevertheless, several predisposition factors found, e.g. genetic, infection, hormonal factors, antibody, immune complex, sunburn, food, stress, and exhausted.

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Pruposes: to know oral health status of SLE patient that visited Indonesian Lupus Organization. From 30 respondents, it is found that 26 patients are women and 4 patients are men. This research uses interview and clinical examination methods which the respondents are examined with Index OHIS to see oral hygiene status, Index DMFT to messure teeth health, and Index CPITN to meassure periodontal tissue health.

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Results: The avarage of SLE patients examined, 21 patients (70%) have moderate oral hygiene, 13 patients (44%) have moderate teeth, and 10 patients (34%) have periodontal diseases with pocket depth between 4- 5 mm.

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Conclusion: This research result shows that SLE patients have moderaten oral health status. This condition is influenced by bad behaviour factors, although their education status is good, and also the SLE which worsen their oral health."

"Tujuan: Tujuan dari penelitian ini digunakan untuk menentukkan validitas dan reliabilitas kuesioner C-OIDP pada anak SMP dengan rentang usia 12-15 tahun di Wilayah DKI Jakarta. Metode: Versi Bahasa dari C-OIDP dibentuk sesuai dengan pedoman proses adaptasi cross-cultural. Penelitian dilakukan pada 502 anak usia 12 - 15 tahun dari enam SMP Negeri di Jakarta yang dipilih secara acak. Tes psikometrik mencakup konsistensi internal, reliabilitas test-retest, validitas diskriminan, dan validitas konvergen. Hasil: mean usia subyek penelitian adalah 13.3 tahun (SD ± 0.9) dan 54% subyek penelitian merupakan perempuan. Mean C-OIDP dari peserta adalah 3.49, (SD ±5.61). Konsistensi internal dan reliabilitas test-retest C-OIDP dengan nilai Chronbach’s alpha 0.72 dan intra-class correlation coefficient (ICC) 0.61. anak-anak dengan decay aktif, PUFA positif, rongga mulut tidak bersih, atau gingivitis memiliki skor C-OIDP yang lebih rendah secara signifikan (P ≤ 0.001). Dua per tiga (64.9%) dari sampel memiliki paling sedikit satu dampak oral yang berpengaruh pada performa keseharian. Kesimpulan: C-OIDP versi Bahasa Indonesia berhasil dibuat untuk digunakan sebagai instrumen OHRQoL pada anak-anak usia 12-15 di Indonesia.

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Obejctives: The aim of this study is to assess validity and reliability an Indonesian Version of C-OIDP in among 12-15 years old high-school-children in Jakarta.

Method: The Indonesian version of C-OIDP was developed according to the guidelines for the cross-cultural adaptation process. The Indonesian version was tested for reliability and validity on random sample of 502, 12–15 years old school children in Jakarta. Psychometric analysis of the Indonesian Child-OIDP involved construct validity tests as well as internal and test-retest reliability.

Result: Mean age of the participants was 13.3, (SD± 0.9) and 46% of the student are males, 54% are females. Crohnbach’s alpha value was 0.72. In terms of test-retest reliability, the intraclass correlation coefficient (ICC) was 0.61. Two-third (64.9%) of the sample had oral impact affecting one or more performances in the past 3 months. The mean of C-OIDP score was 3.49 (SD±5.61). The construct validity was confirmed by C-OIDP scores being significantly associated with oral health condition.The Spearman’s correlation coefficients significant (all p<0.001).

Conclusion: This study indicates that the Indonesian Child-OIDP index is a valid and reliable measure to be used as an OHRQoL index among 12–15 years old children in Indonesia."

"Latar Belakang: Self-perceived halitosis ditandai dengan bau tidak sedap yang timbul dari rongga mulut dan ditemukan penyebab utamanya berasal dari intraoral. Sehingga sangat penting bagi setiap individu untuk memelihara kesehatan mulutnya. Selain itu, walaupun etiologi utama dari faktor intraoral tersebut adalah tongue coating, namun prevalensi masyarakat yang membersihkan lidah setiap hari masih rendah. Oleh karena itu, pada penelitan ini akan lebih dikhususkan untuk membahas mengenai kebiasaan membersihkan lidah. Tujuan: Penelitian ini bertujuan untuk mengidentifikasi hubungan antara kesehatan oral subjektif dengan self-perceived halitosis. Metode: Penelitian cross-sectional pada 298 remaja yang berusia 12-21 tahun yang berdomisili di DKI Jakarta dan merasa memiliki halitosis melalui kuisioner yang pengisiannya dilakukan secara daring menggunakan google form. Hasil : Penilaian subjektif penyakit dan kondisi rongga mulut yang terdiri dari gingivitis, mulut kering, dan tongue coating memiliki hubungan dengan self-perceived halitosis (p<0.05). Semakin besar responden yang merasa memiliki gingivitis, mulut kering, dan tongue coating di dalam rongga mulutnya, semakin tinggi nilai self-perceived halitosis. Faktor kesehatan oral subjektif lainnya yaitu penilaian subjektif karies dan kebiasaan menjaga kesehatan gigi dan mulut yang terdiri dari menyikat gigi, flossing, menggunakan obat kumur, dan membersihkan lidah tidak memiliki hubungan dengan self-perceived halitosis (p>0.05). Kesimpulan: Terdapat hubungan antara faktor penilaian subjektif penyakit dan kondisi rongga mulut yang terdiri dari gingivitis, mulut kering, dan tongue coating terhadap self-perceived halitosis pada remaja di DKI Jakarta.

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Background: Self-perceived halitosis is characterized by an unpleasant odor arising from the oral cavity. It was found that the main cause of halitosis was from intraoral origin, so it is very important for each individual to maintain their oral health. In addition, although the main etiology of the intraoral factor is tongue coating, the prevalence of people cleaning their tongue every day is still low. Therefore, this research will be more devoted to discussing the habit of cleaning the tongue.

Objective: This study aims to identify the relationship between subjective oral health and self-perceived halitosis.

Methods: A-cross sectional study of 298 adolescents who live in DKI Jakarta and have a subjective halitosis through a questionnaire with a google form.

Results: Subjective assessment of oral diseases and conditions consisting of gingivitis, dry mouth, and tongue coating were associated with self-perceived halitosis (p <0.05). The greater the respondents who feel they have gingivitis, dry mouth, and tongue coating in their oral cavity, the higher the self-perceived halitosis value. Other subjective oral health factors, namely the subjective assessment of caries and oral hygiene habits which consisted of brushing, flossing, using mouthwash, and cleaning the tongue had no relationship with self-perceived halitosis (p> 0.05).

Conclusion: There is a relationship between the subjective assessment of oral diseases and conditions consisting of gingivitis, dry mouth, and tongue coating with self-perceived halitosis of adolescents who live in DKI Jakarta."

"Tujuan: Reliabilitas dan validitas kuesioner COHIP-SF 19 versi Bahasa Indonesia. Metode: Dibuat berdasarkan pedoman proses adaptasi cross-cultural. Penelitian dilakukan pada 548 anak usia 12 - 15 tahun dari enam SMP Negeri di Jakarta yang dipilih secara acak. Tes psikometrik mencakup konsistensi internal, reliabilitas test-retest, validitas diskriminan, dan validitas konvergen. Hasil: Mean usia subjek penelitian adalah 13,3 tahun (SD 0,9) dan 54% subjek penelitian merupakan perempuan. Mean COHIP-SF 19 adalah 57,8 (SD 8,8) dan mediannya adalah 58 (rentang 27 - 75). Konsistensi internal dan reliabilitas test-retest COHIP-SF 19 sangat baik dengan nilai Chronbach’s alpha 0,83 dan intra-class correlation coefficient (ICC) 0,81. Anak-anak dengan decay aktif, PUFA positif, rongga mulut tidak bersih, atau gingivitis memiliki skor COHIP-SF 19 yang lebih rendah secara signifikan (P ≤ 0,030). Korelasi antara skor COHIP-SF 19 dan masing-masing domain, dengan tingkat keparahan klinis dan penilaian diri terhadap kesehatan umum atau kesehatan rongga mulut setelah disesuaikan dengan usia, jenis kelamin, dan sekolah sangat rendah hingga rendah (│rs│ = 0,04 – 0,27, P ≤ 0,028). Kesimpulan: COHIP-SF 19 versi Bahasa Indonesia berhasil dibuat untuk digunakan sebagai instrumen OHRQoL pada anak-anak usia sekolah di Indonesia. Konsistensi internal, reliabilitas test-retest, validitas diskriminan, dan validitas konvergen COHIP-SF 19 versi Bahasa Indonesia sudah dibuktikan.

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Objectives: Assessing reliability and validity of COHIP-SF 19 Indonesian version.

Methods: Developed according to the guidelines for the cross-cultural adaptation process. The instrument was tested among 548 children age 12 – 15 years old, from randomly selected six junior high school in Jakarta. The psychometric test include internal consistency, test-retest reliability, discriminant validity, and convergent validity.

Results: Mean age of the participants was 13,3 years (SD 0,9) and 54% of the participants were girls. The mean score was 57,8 (SD 8,8) and the median was 58 (range 27-75). The internal consistency and test-retest reliability was excellent with Chronbach’s alpha 0,83 and intra-class correlation coefficient (ICC) 0,81. Children with active decay, positive PUFA, not clean oral cavity, or gingivitis had significantly lower scores (P ≤ 0,030). Correlation between COHIP-SF 19 score, subscale scores and clinical severity as well as self-rated general or oral health were very low to low (│rs│ = 0,04 - 0,27, P ≤ 0,028), after adjustment for children’s age, gender, and school.

Conclusion: The Indonesian version of COHIP-SF 19 was successfully developed to be used as an OHRQoL instrument for Indonesian school-age children. The internal consistency, test-retest reliability, discriminant validity, and convergent validity of COHIP-SF 19 Indonesian version were confirmed."

"Latar Belakang :Pesantren merupakan institusi pendidikan di Indonesia yang menjalankan sistem tempat tinggal asrama. Kondisi status kesehatan gigi mulut di beberapa pesantren masih menunjukkan hasil sedang hingga rendah, padahal terdapat lebih dari empat juta remaja yang menempuh pendidikan di pesantren. Upaya meningkatkan kesehatan gigi mulut adalah melaksanakan program promosi kesehatan mulut berbasis sekolah, dan program ini dapat disusun dengan sebelumnya melakukan identifikasi perilaku kebersihan gigi mulut.Tujuan : Menganalisis hubungan antara perilaku kebersihan gigi mulut dengan indeks plak, laju alir saliva, dan kuantifikasi bakteri Veillonella Parvula dalam saliva di komunitas pesantren populasi anak usia 12 – 14 tahun. Metode: Penelitian dilakukan pada 101 siswa Ibnu Hajar Boarding School. Pengisian kuesioner indeks OHB untuk menilai perilaku kebersihan gigi mulut. Pengambilan sampel saliva tanpa stimulasi dan diukur lajur alir, dilanjutkan pemeriksaan indeks plak. Sampel saliva dibawa ke laboratorium untuk mengetahui kuantifikasi bakteri Veillonella parvula melalui metode RT-PCR. Hasil: Koefisien korelasi antara OHB dengan Indeks plak adalah r = 0.127 p-value = 0.204. Koefisien korelasi antara OHB dengan laju alir saliva adalah r = -0.211, p-value = 0.034. Koefisien korelasi antara OHB dengan Ct Veillonella parvula adalah r = -0.156 , p-value = 0.119. Kesimpulan: Terdapat hubungan berbanding terbalik dan bermakna antara perilaku kebersihan gigi mulut dengan laju alir saliva, dan hubungan tidak bermakna antara perilaku kebersihan gigi mulut dengan indeks plak dan kuantifikasi bakteri Veillonella parvula.

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Background: Boarding schools in Indonesia operate as residential educational institutions. The oral health status in some boarding schools still indicates moderate to low results, despite more than four million adolescents pursuing education in these institutions. Efforts to improve oral health include implementing a school-based oral health promotion program, which can be designed after identifying oral hygiene behaviors. To date, there has been no study examining the relationship between oral hygiene behaviors and plaque index, saliva flow rate, and quantification of Veillonella Parvula. Objective: To analyze the relationship between oral hygiene behaviors and plaque index, saliva flow rate, and quantification of Veillonella Parvula in a population of 12- to 14-year-old students in a boarding school. Method: The OHB index questionnaire was used to assess oral hygiene behaviors. Unstimulated saliva samples were collected and saliva flow rate measured, followed by plaque index examination. Saliva samples were taken to the laboratory to determine the quantification of Veillonella Parvula bacteria using RT-PCR. Results: The correlation coefficient between OHB and the plaque index was r = 0.127, p-value = 0.204. The correlation coefficient between OHB and saliva flow rate was r = -0.211, p-value = 0.034. The correlation coefficient between OHB and Ct Veillonella Parvula was r = -0.156, p-value = 0.119. Conclusion: There was an inverse and significant relationship between oral hygiene behavior and salivary rate, and a non-significant relationship between oral hygiene behavior and plaque index and quantification of Veillonella parvula bacteria."

"Objective: To assess the oral health status and oral hygiene habits of the dependent elderly in Muang Phitsanulok,Thailand. Methods: 70 dependent elderly with an activity of daily living score of 0 - 4 were selected for this studyusing a convenience sampling technique. Both participants and their caregivers were interviewed and an oralexamination was carried out on all subjects. Information regarding demographics, oral health care habits, and oralhealth status including dental caries, remaining dentition, and occluding pairs of teeth was collected. The data wasanalysed using descriptive statistics. Results: Results showed that 82.1% of the participants had at least one cariouslesion. 62.9% of subjects possessed their natural dentition, however 52% of those did not have any occluding teeth.The majority of the edentulous group were categorised as a low socioeconomic status. Interestingly, none of thedentate group reported ever flossing their teeth, 31.9% brushed their teeth twice daily, and 14.3% reported that theydid not employ any oral hygiene methods. Additionally, it was found that the caregivers played a major role in theoral health care of the dependent elderly. Conclusion: The oral health of the dependent elderly is generally poor,especially amongst the low socioeconomic community. The subject’s declining dexterity and increase of general health risks limits their ability to maintain acceptable oral health."