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ABSTRAK
Halitosis 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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ABSTRACT
Halitosis 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.

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ABSTRAK
Latar Belakang: Saat ini pemakaian obat kumur di masyarakat cukup popular. Salah satu kandungan zat aktif obat kumur yang sering digunakan adalah klorheksidin glukonat. Pemakaian obat kumur yang berketerusan disamping menyikat gigi tentunya akan mempengaruhi kondisi dalam rongga mulut, salah satunya protein saliva. Tujuan: Untuk menganalisis pengaruh penggunaan obat kumur yang mengandung klorheksidin glukonat 0,2 % selama 1,2 dan 3 minggu terhadap profil protein saliva. Metode: Pengambilan sampel saliva dari 5 subyek saat sebelum berkumur dan 1, 2, 3 minggu setelah pemakaian obat kumur. Profil pita protein saliva diidentifikasi dengan metode SDS PAGE dengan Recom Blue Wide Range Protein Marker. Hasil: Profil pita protein sebelum berkumur yang teridentifikasi antara 7-80 kDa. Setelah 1,2 dan 3 minggu berkumur teridentifikasi juga pita protein >100 kDa disamping pita protein <50 kDa Kesimpulan: Penggunaan obat kumur yang mengandung klorheksidin glukonat selama 1, 2 dan 3 minggu mengakibatkan perubahan profil protein saliva dengan teridentifikasi pita protein yang sangat bervariasi.

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ABSTRACT
Background: Currently the use of mouthwash is quite popular. One of the active ingredients frequently used is chlorhexidine gluconate. The usage of mouthwash continuously besides brushing the teeth will surely affect conditions in the oral cavity, one of salivary proteins. Objective: To analyze the effect of mouthwash application containing chlorhexidine gluconate 0.2% for 1.2 and 3 weeks to salivary protein profiles. Methods: Sampling saliva of 5 subjects were collected before rinsing and 1, 2, 3 weeks after the use of mouthwash. Salivary protein profile were identified using SDS-PAGE with Recom Blue Wide Range Protein Marker. Results: profile of protein bands before rinsing identified between 7-80 kDa. After using mouthwash 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 chlorhexidine gluconate for 1, 2 and 3 weeks resulted in changes of salivary protein profiles with highly variable.

Abstrak :
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). ......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).

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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.

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ABSTRAK
Latar belakang: Ketahanan ikatan resin komposit-dentin merupakan salah satu penentu keberhasilan restorasi resin komposit. Tujuan penelitian ini adalah menganalisis efek klorheksidin terhadap degradasi kekuatan ikat resin kompositdentin. Metode: Dua puluh empat sampel dentin yang diambil dari mahkota gigi premolar, dibagi menjadi tiga kelompok yang diberikan perlakuan berbeda. Kelompok I diberi perlakuan bahan bonding tanpa klorheksidin, kelompok II diberi perlakuan klorheksidin dan bonding, kelompok III diberi perlakuan bonding mengandung klorheksidin, pada tiap kelompok dibagi menjadi 2 sub-kelompok yaitu kelompok tanpa direndam dan kelompok yang direndam NaOCl 10% selama satu jam, sehingga didapat enam sub-kelompok. Kemudian seluruh kelompok di ukur kekuatan ikat gesernya menggunakan Universal Testing Machine. Satu sampel dari setiap sub-kelompok dilakukan Scanning Electron Microscope (SEM). Data dianalisa statistik dengan uji hipotesis Kruskal Wallis yang dilanjutkan dengan uji Mann-Whitney. Hasil: rerata kekuatan ikat geser sebelum perendaman NaOCl 10% tertinggi kelompok I sedangkan rerata kekuatan ikat geser setelah perendaman NaOCl 10% tertinggi pada kelompok III. Terdapat perbedaan bermakna antara kelompok I terhadap kelompok II dan antara kelompok II terhadap kelompok III. Kesimpulan: Klorheksidin mempunyai efek terhadap pengurangan degradasi kekuatan ikat geser resin komposit-dentin.

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ABSTRACT
Background: Resilience of composite resin-dentin bonding known as one of success composite resin restoration determinants. The purpose of this study was to analyze the effect of chlorhexidine on reducing the degradation of composite resin-dentin shear bond strength. Methods: Twenty-four premolar crowns were divided into three groups then given different treatments. Group I was treated material bonding without chlorhexidine, group II was treated with chlorhexidine and bonding, group III was treated with chlorhexidine-contained bonding. Each group was divided into two sub-groups: the group without immersion of NaOCl 10% and the group with immersion of NaOCl 10% for one hour, then it were obtained six sub-groups. After twenty-four hours, shear bond strengths measured using Universal Testing Machine. A sample of each group was photographed with Scanning Electron Microscope (SEM). Statistical analysis was done by Kruskal Wallis test, then followed by Mann Whitney test to determine significance between groups. Results: The mean value of shear bond strength before immersion of NaOCl 10% was highest on Group I, while the mean value of shear bond strength after immersion of NaOCl 10% was highest on Group III. There are significant differences between Group I with Group II and between Group II with Group III. Conclusion: Chlorhexidine have an effect on reducing the degradation of shear bond strength of resin-dentin bonding

Abstrak :
Papain dan Papacarie® adalah bahan kemomekanik yang dikembangkan dari bahan alami berupa enzim papain. Enzim papain diperoleh dari getah buah pepaya, mengandung α- I antitrypsin yang hanya bekerja pada jaringan terinfeksi. Bahan kemomekanik yang terbaik adalah yang juga memiliki efek antimikroba karena bakteri dapat tetap hidup pada lesi karies yang telah dipreparasi. Tujuan: membandingkan efek antimikroba antara papain dan Papacarie® terhadap Streptococcus mutans. Material dan metode: kelompok uji adalah papain dan Papacarie® dengan kontrol klorheksidin. Uji analisis dilakukan secara in vitro dengan uji dilusi dan uji difusi yang menghasilkan Kadar Hambat Minimal (KHM), Kadar Bunuh Minimal (KBM) dan zona hambatan. Hasil: KHM papain lebih tinggi dari Papacarie®. KBM papain lebih tinggi dari Papacarie® dan Zona hambatan papain lebih rendah dari Papacarie®.. Kesimpulan: papain sebagai bahan kemomekanik memiliki efek antimikroba yang tidak lebih baik dari Papacarie®.

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Papain and Papacarie® are chemomechanical removal caries (CMCR) materials that developed from natural material, papain enzim. Papain enzym derived from papaya latex, containing α- I antitrypsin that only works in infected tissue. The best CMCR is also contain antimicrobial material because the bacteri could alive in the caries lesion. Objective: to compare the antimicrobial effects of papain and Papacarie® with dilution and difussion test. Materials and methods: test groups are papain and Papacarie®; control group is chlorhexidine. Analyses are tests with dilution and diffusion tests by in vitro that found the KHM ,KBM and zona hambatan as antimicrobial effects. Result: The KHM of papain is higher than Papacarie. The KBM of papain is higher than Papacarie®. The Zona hambatan of papain is lower than Papacarie®. Conclusion: papain as chemomechanical caries removal has antimicrobial effect but Papacarie® have antimicrobial effect better than papain.

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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%. ......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.

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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 ......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.

Abstrak :
Ketahanan ikatan resin komposit-dentin merupakan salah satu penentu keberhasilan restorasi resin komposit. Tujuan penelitian ini adalah menganalisis efek klorheksidin terhadap degradasi kekuatan ikat resin kompositdentin. Metode: Dua puluh empat sampel dentin yang diambil dari mahkota gigi premolar, dibagi menjadi tiga kelompok yang diberikan perlakuan berbeda. Kelompok I diberi perlakuan bahan bonding tanpa klorheksidin, kelompok II diberi perlakuan klorheksidin dan bonding, kelompok III diberi perlakuan bonding mengandung klorheksidin, pada tiap kelompok dibagi menjadi 2 sub-kelompok yaitu kelompok tanpa direndam dan kelompok yang direndam NaOCl 10% selama satu jam, sehingga didapat enam sub-kelompok. Kemudian seluruh kelompok di ukur kekuatan ikat gesernya menggunakan Universal Testing Machine. Satu sampel dari setiap sub-kelompok dilakukan Scanning Electron Microscope (SEM). Data dianalisa statistik dengan uji hipotesis Kruskal Wallis yang dilanjutkan dengan uji Mann-Whitney. Hasil: rerata kekuatan ikat geser sebelum perendaman NaOCl 10% tertinggi kelompok I sedangkan rerata kekuatan ikat geser setelah perendaman NaOCl 10% tertinggi pada kelompok III. Terdapat perbedaan bermakna antara kelompok I terhadap kelompok II dan antara kelompok II terhadap kelompok III. Kesimpulan: Klorheksidin mempunyai efek terhadap pengurangan degradasi kekuatan ikat geser resin komposit-dentin. ......Resilience of composite resin-dentin bonding known as one of success composite resin restoration determinants. The purpose of this study was to analyze the effect of chlorhexidine on reducing the degradation of composite resin-dentin shear bond strength. Methods: Twenty-four premolar crowns were divided into three groups then given different treatments. Group I was treated material bonding without chlorhexidine, group II was treated with chlorhexidine and bonding, group III was treated with chlorhexidine-contained bonding. Each group was divided into two sub-groups: the group without immersion of NaOCl 10% and the group with immersion of NaOCl 10% for one hour, then it were obtained six sub-groups. After twenty-four hours, shear bond strengths measured using Universal Testing Machine. A sample of each group was photographed with Scanning Electron Microscope (SEM). Statistical analysis was done by Kruskal Wallis test, then followed by Mann Whitney test to determine significance between groups. Results: The mean value of shear bond strength before immersion of NaOCl 10% was highest on Group I, while the mean value of shear bond strength after immersion of NaOCl 10% was highest on Group III. There are significant differences between Group I with Group II and between Group II with Group III. Conclusion: Chlorhexidine have an effect on reducing the degradation of shear bond strength of resin-dentin bonding.

Abstrak :
ABSTRAK
Pneumonia aspirasi sering terjadi pasien stroke yang mengalami penurunan kesadaran. Salah satu pencegahannya adalah dengan perawatan mulut. Pemilihan bahan perawatan mulut perlu mempertimbangkan efektifitas bahan dan keamanan. Penelitian kuantitatif ini menggunakan metode kuasi eksperimen dengan desain Pre dan Post test control group design. Penelitian ini bertujuan untuk membandingkan efektifitas perawatan mulut dengan madu dan dengan Clorhexidine 0,2 terhadap risiko pneumonia aspirasi pada pasien stroke yang mengalami penurunan kesadaran. Pada desain ini 46 responden dibagi menjadi 23 responden kelompok yang mendapatkan perawatan mulut dengan madu dan 23 responden menjadi kelompok yang mendapatkan perawatan mulut dengan chlorhexidine 0,2 . Perawatan mulut dilakukan dua kali sehari pada pagi dan sore hari selama 30 menit dalam waktu 3 hari. Hasil : Risiko pneumonia aspirasi lebih rendah sebesar 2,522 dengan perawatan mulut menggunakan madu dibandingkan menggunakan Clorhexidine 0,2 . Simpulan: Perawatan mulut menggunakan madu efektif mencegah peningkatan risiko pneumonia aspirasi pada pasien stroke yang mengalami penurunan kesadaran. Saran: Perawatan mulut dengan madu dapat dijadikan bahan untuk perawatan mulut.

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ABSTRACT
Aspiration pneumonia can occur in unconciousness stroke patients. One way prevention aspiration pneumonia is oral care. Selection of materials for oral care need to consider the effectiveness of materials and security. This quantitative study using a quasi experimental design with pre and post test control group design. This research aims comparation between effectiveness of oral care using honey and clorhexidine 0,2 to the risk of aspiration pneumonia in unconsciousness stroke patients. In this design 46 respondents 23 respondents were divided into intervention group with oral treatments using honey and 23 respondents to a group who received oral treatment with chlorhexidine 0.2 . Oral care performed twice daily in the morning and afternoon for 30 minutes within 3 days. Result The risk of aspiration pneumonia was lower by 2,522 with oral treatments using honey instead of using Clorhexidine 0.2 . Conclusion Oral care using honey to effectively prevent the increased risk of aspiration pneumonia in stroke patients. Suggestion Oral care with honey can be used as material for oral care