Uji Efektivitas Sediaan Obat Kumur Berbasis Minyak Atsiri Bunga Kenanga (Cananga Odorata (Lam.) Hook F. &Thomson) terhadap Penurunan Gas Volatile Sulfur Compound (VSC) pada Subjek Halitosis

Abstract

Background: The problem of halitosis or bad breath needs attention from the health community, because it can interfere with the personal life of the sufferer and those around him. Halitosis treatment usually uses an antiseptic mouthwash that contains alcohol. Indonesia is a country with the potential to produce non-alcoholic herbal mouthwash that can kill the bacteria that cause halitosis. Flower ylang (Cananga Odorata (Lam) Hook f & Thomson) is a type of herbal plant that contains essential oils and antibacterial. Purpose: This research was conducted to produce cananga flower essential oil mouthwash and prove its effectiveness in reducing levels of methyl mercaptan (CH3SH), hydrogen sulfide (H2S), dimethyl sulfide (CH3)2S and Volatile Sulfur Compound (VSC) in halitosis subjects. Methods: This research was conducted in three stages, first stage to obtain cananga flower essential oil in accordance with the requirements of the Indonesian Ministry of Health 1995, namely by checking the water content, water-soluble extract, ethanol-soluble extract, total ash content, non-ash content. soluble in acids. Phase II includes pre-clinical trials to determine the Minimal Inhibitory Level (MIC) and Minimal Killing Concentrations (KBM) of cannanga flower essential oil with concentrations of 6.25% ; 12.5% ; 25% ; 50% and 100% against Porphyromonas gingivalis bateria ATTC 33277 by dilution and diffusion methods. The stability test of the preparation used a pH meter and a viscometer, while the hedonic test / preference test was carried out by 20 panelists on color, taste and aroma. Phase III is a clinical trial to compare the effectiveness of 25% cannanga flower essential oil mouthwash with 0.2% chlorhexidine gluconate. The study design was a randomized clinical trial. The sample was the subject of halitosis in the SUBDIT DALMAS POLDA Southeast Sulawesi totaling 20 people, consisting of men and women. Each subject rinsed 2 times a day as much as 10 cc for 5 days. Measurement of gas levels of CH3SH, H2S, (CH3)2S and Volatile Sulfur Compound (VSC) was carried out every day (morning and afternoon) using an Oral Chroma device. Statistical analysis was performed using T test and Anova Repeated Measure. Results: This study produced cannanga flower essential oil mouthwash. The results of pre-clinical trials showed mouthwash at a concentration of 12.5% as MIC and 25% as MBC. The stability test of the preparation showed that the pH value of cannanga flower essential oil mouthwash ranged from 6.5 to 6.7 with a viscosity value of 3.6%. The hedonic test showed that 25% cannanga flower essential oil mouthwash was preferred by panelists in terms of taste, color, and aroma. From clinical trials, it was proven that there was a decrease in H2S, CH3SH, and (CH3)2S gas levels in the treatment group gargling of cannanga flower essential oil and Chlorhexidine gluconate by 0.2%. The results of statistical analysis using Anova Repeated Measure showed a significant difference between the treatment group gargling with cananga flower essential oil mouthwash and 0.2% chlorhexidine gluconate, Sig = 0,000 <0.05 and 0,000 <0.05 (sig <0,05). Cananga flower essential oil mouthwash and chlorhexidine gluconate 0.2% have been proven to be effective in reducing VSC gas levels, but the excess of cananga flower essential oil mouthwash does not contain alcohol which can cause dry mouth so it is safe to use. Conclusion: Cananga flower essential oil mouthwash 25% is effective for reduce VSC is the cause halitosis.

Latar belakang: Masalah halitosis atau bau mulut yang tidak sedap perlu mendapat perhatian dari kalangan kesehatan karena dapat menurunkan kualitas hidup orang yang menderitanya. Penanganan halitosis biasanya menggunakan obat kumur antiseptik yang mengandung alkohol. Indonesia merupakan negara berpotensi menghasilkan obat kumur herbal non-alkohol yang mampu membunuh bakteri penyebab halitosis. Bunga kenanga (Cananga Odorata (Lam) Hook f & Thomson) merupakan bunga khas Sumatera Utara yang telah ditetapkan oleh Gubernur Kepala Daerah Tingkat I Sumatera Utara melalui surat keputusan No. 522.5/1611/K/Tahun 1991. Bunga kenanga merupakan satu jenis tanaman herbal yang mengandung minyak atsiri dan bersifat antibakteri. Tujuan: Penelitian ini dilakukan untuk menghasilkan sediaan obat kumur minyak atsiri bunga kenanga dan membuktikan keefektifannya dalam menurunkan kadar gas metil merkaptan (CH3SH), hidrogen sulfida (H2S), dimetil sulfida (CH3)2S dan Volatile Sulfur Compound (VSC) pada subjek halitosis. Metode Penelitian: Penelitian ini dilakukan dalam tiga tahap, tahap I untuk mendapatkan minyak atsiri bunga kenanga sesuai dengan persyaratan Depkes RI 1995 yaitu dengan memeriksa kadar air, kadar sari larut dalam air, kadar sari yang larut dalam etanol, kadar abu total, kadar abu yang tidak larut dalam asam. Tahap II meliputi uji pre-klinis untuk menentukan Kadar Hambat Minimal (KHM) dan Kadar Bunuh Minimal (KBM) minyak atsiri bunga kenanga yang diuji dengan beberapa konsentrasi, 6,25% ; 12,5% ; 25% ; 50%, dan 100% terhadap bakteri Porphyromonas gingivalis ATTC 33277 dengan metode dilusi dan difusi. Uji stabilitas sediaan menggunakan pH meter dan viskometer, sedangkan uji hedonik/uji kesukaan dilakukan oleh 20 orang panelis terhadap warna, rasa dan aroma. Tahap III merupakan uji klinis untuk membandingkan keefektifan sediaan obat kumur minyak atsiri bunga kenanga 25% dengan klorheksidin glukonat 0,2%. Rancangan penelitian adalah randomized clinical trial. Sampel adalah subjek halitosis pada SUBDIT DALMAS POLDA Sulawesi Tenggara berjumlah 20 orang, yang terdiri atas laki-laki dan perempuan. Masing-masing subjek berkumur 2 kali sehari sebanyak 10 cc selama 5 hari. Pengukuran kadar gas CH3SH, H2S, (CH3)2S dan VSC dilakukan setiap hari (pagi dan siang hari) menggunakan alat Oral Chroma. Analisis statistik dilakukan menggunakan uji T dan Anova Repeated Measure. Hasil: Hasil uji pre-klinis konsentrasi 12,5% sebagai KHM dan 25% sebagai KBM. Uji stabilitas sediaan menunjukkan nilai pH sediaan obat kumur minyak atsiri bunga kenanga 25% berkisar 6,5 – 6,7 dengan nilai viskositas 3,6%. Uji hedonik menunjukkan sediaan obat kumur minyak atsiri bunga kenanga 25% disukai panelis dari segi rasa, warna, dan aroma. Dari uji klinis terbukti adanya penurunan kadar gas H2S, CH3SH, dan (CH3)2S pada kelompok perlakuan berkumur minyak atsiri bunga kenanga dan klorheksidin glukonat 0,2%. Hasil analisis statistik dengan Anova Repeated Measure menunjukkan perbedaan yang signifikan antara kelompok perlakuan berkumur dengan sediaan obat kumur minyak atsiri bunga kenanga dan klorheksidin glukonat 0,2% yaitu masing-masing Sig= 0,000 < 0,05 dan 0,000 < 0,05 (sig < 0,05). Sediaan obat kumur minyak atsiri bunga kenanga 25% maupun klorheksidin glukonat 0,2% terbukti efektif dalam menurunkan kadar gas VSC, namun kelebihan sediaan obat kumur minyak atsiri bunga kenanga 25% tidak mengandung alkohol yang dapat menyebabkan mulut kering sehingga aman digunakan. Kesimpulan: Sediaan obat kumur minyak atsiri bunga kenanga 25% efektif menurunkan kadar gas VSC yang merupakan penyebab halitosis.