Pendekatan Psikologis pada Penatalaksanaan Burning Mouth Syndrome Akibat Konsumsi Pil Kontrasepsi

Burning Mouth Syndrome (BMS) merupakan suatu kumpulan gejala dengan karakteristik rasa panas dan sakit pada satu atau beberapa struktur mulut dengan mukosa normal tanpa adanya gejala klinis yang ditemukan. Faktor penyebab BMS ini diketahui ada tiga yaitu faktor lokal, sistemik, dan psikogenik, ketiga faktor ini dapat digali melalui anamnesis. Seorang wanita, 54 tahun, dikonsulkan dari RS.Swasta, dengan keluhan rasa panas dan perih pada lidah dan mulut. Berdasarkan anamnesis diketahui pasien merasa takut terjadi kanker mulut dan takut hamil sehingga menggunakan pil kontrasepsi  tanpa konsultasi dengan dokter. Pemeriksaan ekstra oral terdapat  bibir kering dan pemeriksaan intra oral ditemukan depapilasi lidah pada 1/3 anterior dorsum lidah,eritema, dan sakit. Berdasarkan anamnesa dan pemeriksaan klinis pasien didiagnosa dengan BMS diduga akibat penggunaan pil kontrasepsi. Terapi dari Ilmu Penyakit Mulut (IPM) diberikan obat kumur Sodium Chlorite, Vitamin B12, dan Asam Folat,  edukasi tentang penggunaan obat, dan dikonsulkan ke Bagian Obsetri dan Ginekologi dan diinstruksikan untuk menghentikan pil kontrasepsi. Setelah dilakukan terapi di IPM selama 6 minggu pasien merasakan perbaikan pada rongga mulutnya. Insidensi BMS sering terjadi pada wanita dengan populasi usia premenopause dan menopause. Depresi dan kecemasan merupakan permasalahan yang sering timbul pada pasien BMS yang mengalami menopause, pada kondisi pasien dengan kecemasan tinggi penting bagi dokter gigi untuk memberikan informasi dan edukasi serta dukungan terhadap pasien. Konsultasi yang baik dapat menimbulkan pengertian yang lebih dalam  sehingga pasien dapat mengeliminasi rasa cemasnya. Keberhasilan pendekatan psikologis dan medis akan membantu dalam penatalaksanaan yang tepat pada pasien BMS

HAEM, DIEM atau OEM?

Diagnosis erythema multiforme (EM) diklasifikasikan menjadi tipe mayor dan minor. EM dapat dipicu oleh obat (drug-induced erythema multiforme/ DIEM) atau infeksi virus herpes simplex (herpes associated erythema multiforme/ HAEM), dengan dua gambaran utama: lesi target tipikal atau atipikal pada kulit dan nekrosis sel satelit atau epitelium yang luas. Oral erythema multiforme (OEM) dimasukkan dalam klasifikasi diagnosis EM kategori ketiga selain tipe mayor dan minor dengan gambaran klinis berupa ulserasi pada bibir dan mukosa intra oral khas EM, tanpa disertai lesi target di kulit. Seorang wanita, 14 tahun, datang ke Poli Ilmu Penyakit Mulut SMF Gimul RSHS setelah sebelumnya dirujuk dari bagian Bedah Mulut RSHS dengan diagnosa suspek EM. Pada pemeriksaan ekstra oral terlihat lesi krusta berwarna coklat kehitaman pada bibir atas dan bawah, yang diakui pasien muncul setelah mengkonsumsi obat untuk penyakit kulit yang dideritanya dan mengganggu aktivitas bicara serta makan. Pasien diterapi menggunakan salep steroid racikan selama 1 minggu disertai instruksi untuk menghentikan pemakaian obat untuk penyakit kulitnya. Pasien meperlihatkan perbaikan yang signifikan pada kunjungan kontrol 1 minggu. Diagnosis suspek DIEM dan suspek Lesi oral terkait hipersensitivitas ditegakkan pada pasien ini. berdasarkan pertimbangan adanya pengaruh medikasi untuk pengobatan kelainan kulit yang dideritanya. Hasil pemeriksaan IgE negatif dan IgG anti HSV-1 yang reaktif serta hasil observasi pada kunjungan kontrol lebih lanjut, juga mengarahkan penegakkan diagnosis HAEM dan OEM. Penting mendiagnosa EM dengan baik, agar mampu melakukan tatalaksana dini yang tepat, untuk mendapatkan prognosis yang baik

Oral Manifestation Related to Drug Abuse : A Systematic Review: Manifetasi oral terkait penggunaan obat-obatan terlarang : Sebuah tinjauan sistematis

Drug abuse influences the pathological of oral diseases. There are scarce evidence-based data on the oral manifestations related to drug abuse. This systematic review aim to assess the oral manifestations related to drug abuse. Electronic databases were searched using keywords include oral manifestations and drug abuse. Observational studies published until September 2018 with the outcome of oral manifestations related to drug abuse were included. Data were extracted as percentage include drug type, route of administration, and oral manifestations. Study quality was assessed using the quartile score of Scopus index. The systematic review of 17 studies revealed that methamphetamine (53%), heroin (41%), cannabis (35%), and cocaine (35%) were the most frequent abused drugs from 10139 samples. The routes of administration include smoking (58%),inhalation (35%), injection (35%), and oral route (17%), with duration of use ranged from one year to forty years. The most significant of oral manifestations reported were periodontal diseases (76%), dental caries (76%), and xerostomia (41%). Adverse drug reaction in oral cavity may cause, directly or indirectly, immunosuppression, susceptibility to infections, and oral pathologies due to chemical composition and mechanism of action specifically to drug type related with duration of use and route of administration

Herpes associated erythema multiforme, drug-induced erythema multiforme atau oral erythema multiforme?

Diagnosis erythema multiforme (EM) diklasifikasikan menjadi tipe mayor dan minor. Erythema multiforme dapat dipicu oleh obat (drug-induced erythema multiforme/DIEM) atau infeksi virus herpes simplex (herpes associated erythema multiforme/HAEM), dengan dua gambaran utama: lesi target tipikal atau atipikal pada kulit dan nekrosis sel satelit atau epitelium yang luas. Oral erythema multiforme (OEM) dimasukkan dalam klasifikasi diagnosis EM kategori ketiga selain tipe mayor dan minor dengan gambaran klinis berupa ulserasi pada bibir dan mukosa intraoral khas EM, tanpa disertai lesi target di kulit. Studi kasus ini bertujuan membahas kemungkinan HAEM, DIEM dan OEM sebagai diagnosa terhadap lesi bibir khas EM. Seorang wanita, 14 tahun, datang ke Poli Ilmu Penyakit Mulut Rumah Sakit Umum Pusat Nasional (RSUPN) Dr. Hasan Sadikin Bandung setelah sebelumnya dirujuk dari bagian Bedah Mulut dengan diagnosa suspek EM. Pada pemeriksaan ekstraoral terlihat lesi krusta berwarna coklat kehitaman pada bibir atas dan bawah, yang diakui pasien muncul setelah mengkonsumsi obat untuk penyakit kulit yang dideritanya dan mengganggu aktivitas bicara serta makan. Pasien diterapi menggunakan salep steroid racikan selama 1 minggu disertai instruksi untuk menghentikan pemakaian obat untuk penyakit kulitnya. Pasien memperlihatkan perbaikan yang signifikan pada kunjungan kontrol 1 minggu. Diagnosis suspek DIEM dan suspek lesi oral terkait hipersensitivitas ditegakkan pada pasien ini berdasarkan pertimbangan adanya pengaruh medikasi untuk pengobatan kelainan kulit yang dideritanya. Hasil pemeriksaan IgE negatif dan IgG anti HSV-1 yang reaktif serta hasil observasi pada kunjungan kontrol lebih lanjut, juga mengarahkan penegakkan diagnosis HAEM dan OEM. Penting mendiagnosa EM dengan baik, agar mampu melakukan tatalaksana dini yang tepat, untuk mendapatkan prognosis yang baik

PHARMACOLOGICAL MANAGEMENT OF ORAL LESIONS IN ADENOID CYSTIC CARCINOMA PATIENTS UNDERGOING RADIOTHERAPY

Objective: This case report aimed to describe the pharmacological management of oral lesions in adenoid cystic submental carcinoma patients undergoing radiotherapy. Methods: A 48 y old female undergoing radiotherapy complained of difficulty eating, swallowing, and speaking due to severe pain in her oral cavity for three weeks. Intra-oral examination revealed painful yellowish-white plaques that could not be scrapped on the tongue, maxillary and mandibular anterior gingiva, left and right buccal mucosa, and palate, diagnosed with oral candidiasis. We also found multiple shallow ulcers on the left buccal mucosa and upper labial mucosa that can be seen as oral mucositis. Results: The patient was given nystatin oral suspension for oral candidiasis, benzydamine hydrochloride for the complaint of pain when swallowing, and saline for promoting wound healing and keeping the oral mucosa moist. These lesions healed in a week and she could eat solid food without pain. Conclusion: Appropriate pharmacological management of oral lesions in a patient undergoing radiotherapy provides significant healing to better quality of life

Oral Opportunistic Infections in Patient with HIV Wasting Syndrome

Background: Human immunodeficiency virus (HIV) wasting syndrome is a condition in which weight loss, fever, and chronic diarrhea occur for more than 30 days without any causes other than HIV infection. HIV causes an immunocompromised condition resulting in susceptibility to infection. The opportunistic infections are oral candidiasis, herpes simplex virus (HSV), and tuberculosis. This study aims to explain oral opportunistic infections in a patient with wasting syndrome. Case Report: A 20-year-old female, who was 165 cm in height and 33.75 kg in weight, with wasting syndrome, pulmonary tuberculosis, oral candidiasis, and angular cheilitis was referred from an internist in Hasan Sadikin Hospital. Extraoral examination showed a yellowish brownish crust on the lips. Intraoral examination showed multiple ulcers covered by a yellowish membrane on the labial mucosa. The white plaques were scrapable, and an erythematous was found on the dorsum of the tongue, buccal mucosa, and palate. Laboratory results revealed a decrease in hemoglobin, hematocrit, leucocyte, erythrocyte, basophil, neutrophil, lymphocyte, albumin, reactive anti-HSV IgG, CD4 16 cell/µl, mycology culture test, chest x-ray, and sputum. On the basis of anamnesis, clinical features, and laboratory examination, the patient was diagnosed with stomatitis herpetica and oral candidiasis. Chlorhexidine gluconate 0.2%, nystatin oral suspension, vitamin B12, folic acid, and vaseline album were administered on the lips. Clinical recovery of oral candidiasis was accomplished after five weeks of therapy. Conclusion: Opportunistic infections in patient with wasting syndrome are oral candidiasis, herpetic stomatitis, and tuberculosis

A CONVENIENT HIV SCREENING: ORAL RAPID TEST REVIEW OF LITERATURE

Background: HIV testing is crucial in identifying and initiating the treatment of HIV/AIDS. In recent years, the Oral Rapid Tests (ORT) has become one of the most popular tests based on saliva. This paper aims to present the response from research subjects who took the ORT using OraQuick®. Discussion: A total of 2657 studies was obtained. Finally, 21 articles matched to our review. The 21 included studies showed the advantages of ORT such as comfortable 91%, easy to use 76%, quick results 54%, preferred choice 67%, maintains confidentiality 54% and other reasons. Our reviewed studies demonstrated the consistent high acceptability of the oral rapid test in HIV. Conclusion: The comforts stem from ORT with OraQuick® are being contributed by its easy to use characteristic and non-blood-withdrawn comfortable metho

The correlation of zinc serum levels and zinc intake with taste disorders in elderly patients at Babatan Public Health Center Bandung

Taste disorders, which can be caused by various factors, including deficiency of zinc levels in the body and lack of zinc, generally occur in the elderly. The aim of the study was to analyze the correlation between zinc serum levels and zinc intake, as well as the correlation between salivary volume, hypertension, and smoking with taste disorders in the elderly. This was analytical observational research with a cross-sectional method, which was conducted on 100 elderly patients, at Babatan Health Community Center, Bandung, Indonesia. The sampling was conducted through the following: interview about systemic disease history, drugs taken, and smoking habits; examination of oral cavity conditions; nutrition intake interviews; taste tests tests; and zinc serum measurement using the atomic absorption spectrometry. The data were obtained statistically. Among these one hundred elderly patients, 79 had low zinc serum levels and 94 had inadequate zinc intake. The average zinc serum in the elderly patients with taste disorders was 40.1 μg/dl, whereas those without taste disorders was 72.4 μg/dl, with a p value of <0.001. The average zinc intake in the elderly patients with taste disorders was 3.4, whereas in those without taste disorders was 6.0, with a p value of <0.027. Smoking correlated with taste disorders, while salivary volume and hypertension had no a correlation with taste disorders. There was correlation between zinc serum levels and zinc intake on taste disorders in the elderly patients. Smoking had a relationship with taste disorders in the elderly patients, whereas salivary volume and hypertension had no correlation with taste disorders in the elderly patients

THE USE OF HERBAL MOUTHWASH THERAPY IN ORAL LICHEN PLANUS: A SYSTEMATIC REVIEW

This study aid to describe the advantages of herbal mouthwash therapy in Oral Lichen Planus (OLP). This systematic review was carried out using PRISMA methods. The selected articles were published in the last five years from PubMed and Google Scholar with the keywords mouthwash, mouth rinse, and Oral Lichen Planus was conducted in June 2022. The assessment of the risk of bias uses the Oxford Scoring System. A total of 2225 journals were found, and seven articles were obtained through screening. After the risk of bias assessment, six articles of high-range quality and one article of low-range quality were obtained. The six journals are randomized clinical trials of herbal mouthwashes and synthetic mouthwashes. Three articles on herbal mouthwash, two articles on synthetic mouthwash, and one article comparing herbal and synthetic mouthwashes. These articles show differences in the time, size, and pain of using herbal and synthetic mouthwashes; they also found side effects when using synthetic mouthwashes compared to herbal mouthwashes. Herbal mouthwash has fewer side effects than synthetic mouthwash, although clinically, synthetic mouthwash is more effective than herbal mouthwash