Efektifitas Bahan Kumur Berbasis Minyak Atsiri Buah Kapulaga (Amomum cardamomum L) Terhadap Penurunan Gas Volatile Sulfur Compound (VSC) Pada Subjek Halitosis
ABSTRAK
Latar belakang: Masalah halitosis atau bau mulut yang tidak sedap, perlu mendapat
perhatian dari kalangan profesi kesehatan, karena dapat mengganggu kehidupan
pribadi penderita maupun orang di sekitarnya. Penanganan halitosis biasanya
menggunakan obat kumur antiseptik yang mengandung alkohol. Indonesia
merupakan negara berpotensial menghasilkan obat kumur herbal non-alkohol yang
mampu membunuh bakteri penyebab halitosis. Kapulaga (Amomum cardamomum L)
merupakan salah satu jenis tanaman herbal yang mengandung minyak atsiri dan
bersifat antibakteri.
Tujuan: Penelitian ini dilakukan untuk menghasilkan obat kumur minyak atsiri buah
kapulaga terstandar dan membuktikan keefektifannya dalam menurunkan kadar gas
metil mercaptan (CH3SH), hidrogen sulfide (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 kapulaga terstandar sesuai dengan persyaratan Materia
Medika Indonesia yaitu dengan memeriksa kadar air, kadar sari yang 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 kapulaga dengan
konsentrasi 0,125%, 0,25%, 0,5%, 1%, 1,5% dan 2% terhadap bakteri
Porphyromonas gingivalis ATTC 33277 dengan metode dilusi dan difusi. Uji
stabilitas sediaan menggunakan pH meter dan viscometer, sedangkan uji hedonik/uji
kesukaan dilakukan oleh 15 orang panelis terhadap warna, rasa dan aroma. Tahap III
merupakan uji klinis untuk membandingkan keefektifan obat kumur minyak atsiri
kapulaga 0,5% dengan Listerine® dan plasebo. Rancangan penelitian adalah
randomized clinical trial dengan cross over design dan double blinded. Sampel
adalah subjek halitosis pada pesantren Raudhatul Hasanah 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
Volatile Sulfur Compound (VSC) dilakukan setiap hari (pagi dan siang hari)
menggunakan alat Oral Chroma dan secara organoleptik. Analisis statistik dilakukan
menggunakan uji Anova Repeated Measure.
Hasil: Penelitian ini menghasilkan sediaan obat kumur minyak atsiri buah kapulaga
terstandar. Hasil uji pre-klinis menunjukkan sediaan obat kumur pada konsentrasi
0,25% sebagai KHM dan 0,5% sebagai KBM. Uji stabilitas sediaan menunjukkan
nilai pH obat kumur minyak atsiri kapulaga berkisar 6,5 – 6,7 dengan nilai viskositas
3. Uji hedonik menunjukkan sediaan 0,5% mendapat skor tertinggi 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
kapulaga dan Listerine®, sebaliknya tidak dijumpai penurunan pada kelompok
perlakuan plasebo. Hasil analisis statistik dengan Anova Repeated Measure
menunjukkan perbedaan yang signifikan antara kelompok perlakuan berkumur
i
Universitas Sumatera Utara
dengan obat kumur minyak atsiri buah kapulaga dan Listerine®, yaitu masing-masing
p=0,001 dan p=0,007 (p0,05). Obat kumur minyak atsiri
buah kapulaga maupun Listerine® terbukti efektif dalam menurunkan kadar gas
VSC, namun kelebihan obat kumur minyak atsiri buah kapulaga tidak mengandung
alkohol yang dapat menyebabkan mulut kering sehingga aman digunakan.
Kesimpulan:. Sediaan obat kumur minyak atsiri buah kapulaga 0,5% efektif
digunakan untuk mengatasi keluhan halitosis, oleh karena itu diharapkan dapat
menjadi sediaan fitofarmaka yang bermanfaat bagi masyarakat.
Kata kunci: Amomum cardamomum, halitosis, Volatile Sulfur Compound, Kadar
Hambat Minimal (KHM), Kadar Bunuh Minimal (KBM),
Porphyromonas gingivalis
ii
Universitas Sumatera Utara
ABSTRACT
Background: Halitosis or bad breath requires serious attention from health
professional because it can disturb private life of patient or surrounding people.
Management of halitosis usually uses antiseptic mouthwash containing alcohol.
Indonesia is a country that potential to produce herbal mouthwash which capable to
reduce halitosis-causing bacteria. Cardamom (Amomumcardamomum L) is a type of
herbal containing essentials oils and has antibacterial effect.
Aim: This study was conducted to produce standardized cardamom essential oil in
mouthwash and demonstrated the effectiveness of the mouthwash in reducing the
level of metil mercaptan (CH3SH), hidrogen sulfide (H2S), dimetil sulfida (CH3)2S
and volatile sulfur compounds (VSC) in halitosis subjects.
Research methods: The present study was conducted in three stages, 1st stage to
produce standardized cardamom essential oil according to Materia Medika Indonesia
which is based on determination of water content, solubility in water and ethanol,
total ash and acid insoluble ash. The 2nd stage included preclinical tests to establish
the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal
Concentration (MBC) with concentration 0,125%, 0,25%, 0,5%, 1%, 1,5%, and 2%
using dilution and diffusion methods against Porphyromonas gingivalis ATTC 33277.
In addition, the stability testing using pH meter and viscometer, and hedonic testing
for human sense (color, smell, and taste) among 15 panels. In the clinical trial of 3rd
stage, a randomized, double blind pre and post test cross over experimental design
was performed among 20 healthy male and female subjects at Religion based School
of Raudhatul Hasanah to compare cardamom essential oil 0,5% in mouthwash with
Listerine® as positive control and placebo. Subjects were instructed to rinse with the
10cc experimental mouthwash, twice per day (on morning and afternoon) for 5 days.
At baseline and after 5 days, the concentration of hydrogen sulfide (H2S), methyl
mercaptan (CH3SH) and dimethyl sulfide [(CH3)2S] were assessed by using oral
chroma and organoleptic assessment. Statistical analysis were performed using
Anova Repeated Measure.
Results:The standardized cardamom essential oil in mouthwash was produced. In
preclinical trial, 0.25% cardamom essential oil in mouthwash was obtained as MIC
and 0.5% as MBC. Hedonic test showed 0.5% cardamom essential oil in mouthwash
the highest preferred score from the panels in terms of color, taste and aroma.
Stability test showed the pH value of cardamom essential oil in mouthwash was 6.5 –
6.7 with viscosity 3. It was demonstrated from clinical trial that level of CH3SH,
H2S, (CH3)2S was reduced in 0.5% cardamom essential oil and Listerine®
treatment group, on the other hand, there were no reduction in placebo group. It also
appeared that 0.5% cardamom mouthwash could more effectively reduce VSC level
when compared to placebo. ANOVA repeated measures analysis showed significant
differences of cardamom essential oil in mouthwash and Listerine® groups (p=0,001
and p=0,007, respectively; p0,05). Both cardamom and Listerine® mouthwash are
effective to reduce the level of VSC moreover cardamom essential oil mouthwash
does not contain alcohol which can cause dry mouth and therefore it is safe.
Conclusion: It can be concluded that cardamom essential oil in concentration 0,5%
mouthwash can be used to overcome halitosis, therefore these cardamom mouthwash
possible to become phytopharmaca drug that is useful for the community.
Keywords: Amomum cardamomum L, halitosis, Volatile Sulfur Compound,
Minimal Inhibitory Concentration (MIC), Minimal Bactericidal
Concentration (MBC), Phorphyromonas gingivalis
iv
Universitas Sumatera Utara
Latar belakang: Masalah halitosis atau bau mulut yang tidak sedap, perlu mendapat
perhatian dari kalangan profesi kesehatan, karena dapat mengganggu kehidupan
pribadi penderita maupun orang di sekitarnya. Penanganan halitosis biasanya
menggunakan obat kumur antiseptik yang mengandung alkohol. Indonesia
merupakan negara berpotensial menghasilkan obat kumur herbal non-alkohol yang
mampu membunuh bakteri penyebab halitosis. Kapulaga (Amomum cardamomum L)
merupakan salah satu jenis tanaman herbal yang mengandung minyak atsiri dan
bersifat antibakteri.
Tujuan: Penelitian ini dilakukan untuk menghasilkan obat kumur minyak atsiri buah
kapulaga terstandar dan membuktikan keefektifannya dalam menurunkan kadar gas
metil mercaptan (CH3SH), hidrogen sulfide (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 kapulaga terstandar sesuai dengan persyaratan Materia
Medika Indonesia yaitu dengan memeriksa kadar air, kadar sari yang 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 kapulaga dengan
konsentrasi 0,125%, 0,25%, 0,5%, 1%, 1,5% dan 2% terhadap bakteri
Porphyromonas gingivalis ATTC 33277 dengan metode dilusi dan difusi. Uji
stabilitas sediaan menggunakan pH meter dan viscometer, sedangkan uji hedonik/uji
kesukaan dilakukan oleh 15 orang panelis terhadap warna, rasa dan aroma. Tahap III
merupakan uji klinis untuk membandingkan keefektifan obat kumur minyak atsiri
kapulaga 0,5% dengan Listerine® dan plasebo. Rancangan penelitian adalah
randomized clinical trial dengan cross over design dan double blinded. Sampel
adalah subjek halitosis pada pesantren Raudhatul Hasanah 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
Volatile Sulfur Compound (VSC) dilakukan setiap hari (pagi dan siang hari)
menggunakan alat Oral Chroma dan secara organoleptik. Analisis statistik dilakukan
menggunakan uji Anova Repeated Measure.
Hasil: Penelitian ini menghasilkan sediaan obat kumur minyak atsiri buah kapulaga
terstandar. Hasil uji pre-klinis menunjukkan sediaan obat kumur pada konsentrasi
0,25% sebagai KHM dan 0,5% sebagai KBM. Uji stabilitas sediaan menunjukkan
nilai pH obat kumur minyak atsiri kapulaga berkisar 6,5 – 6,7 dengan nilai viskositas
3. Uji hedonik menunjukkan sediaan 0,5% mendapat skor tertinggi 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
kapulaga dan Listerine®, sebaliknya tidak dijumpai penurunan pada kelompok
perlakuan plasebo. Hasil analisis statistik dengan Anova Repeated Measure
menunjukkan perbedaan yang signifikan antara kelompok perlakuan berkumur
i
Universitas Sumatera Utara
dengan obat kumur minyak atsiri buah kapulaga dan Listerine®, yaitu masing-masing
p=0,001 dan p=0,007 (p0,05). Obat kumur minyak atsiri
buah kapulaga maupun Listerine® terbukti efektif dalam menurunkan kadar gas
VSC, namun kelebihan obat kumur minyak atsiri buah kapulaga tidak mengandung
alkohol yang dapat menyebabkan mulut kering sehingga aman digunakan.
Kesimpulan:. Sediaan obat kumur minyak atsiri buah kapulaga 0,5% efektif
digunakan untuk mengatasi keluhan halitosis, oleh karena itu diharapkan dapat
menjadi sediaan fitofarmaka yang bermanfaat bagi masyarakat.
Kata kunci: Amomum cardamomum, halitosis, Volatile Sulfur Compound, Kadar
Hambat Minimal (KHM), Kadar Bunuh Minimal (KBM),
Porphyromonas gingivalis
ii
Universitas Sumatera Utara
ABSTRACT
Background: Halitosis or bad breath requires serious attention from health
professional because it can disturb private life of patient or surrounding people.
Management of halitosis usually uses antiseptic mouthwash containing alcohol.
Indonesia is a country that potential to produce herbal mouthwash which capable to
reduce halitosis-causing bacteria. Cardamom (Amomumcardamomum L) is a type of
herbal containing essentials oils and has antibacterial effect.
Aim: This study was conducted to produce standardized cardamom essential oil in
mouthwash and demonstrated the effectiveness of the mouthwash in reducing the
level of metil mercaptan (CH3SH), hidrogen sulfide (H2S), dimetil sulfida (CH3)2S
and volatile sulfur compounds (VSC) in halitosis subjects.
Research methods: The present study was conducted in three stages, 1st stage to
produce standardized cardamom essential oil according to Materia Medika Indonesia
which is based on determination of water content, solubility in water and ethanol,
total ash and acid insoluble ash. The 2nd stage included preclinical tests to establish
the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal
Concentration (MBC) with concentration 0,125%, 0,25%, 0,5%, 1%, 1,5%, and 2%
using dilution and diffusion methods against Porphyromonas gingivalis ATTC 33277.
In addition, the stability testing using pH meter and viscometer, and hedonic testing
for human sense (color, smell, and taste) among 15 panels. In the clinical trial of 3rd
stage, a randomized, double blind pre and post test cross over experimental design
was performed among 20 healthy male and female subjects at Religion based School
of Raudhatul Hasanah to compare cardamom essential oil 0,5% in mouthwash with
Listerine® as positive control and placebo. Subjects were instructed to rinse with the
10cc experimental mouthwash, twice per day (on morning and afternoon) for 5 days.
At baseline and after 5 days, the concentration of hydrogen sulfide (H2S), methyl
mercaptan (CH3SH) and dimethyl sulfide [(CH3)2S] were assessed by using oral
chroma and organoleptic assessment. Statistical analysis were performed using
Anova Repeated Measure.
Results:The standardized cardamom essential oil in mouthwash was produced. In
preclinical trial, 0.25% cardamom essential oil in mouthwash was obtained as MIC
and 0.5% as MBC. Hedonic test showed 0.5% cardamom essential oil in mouthwash
the highest preferred score from the panels in terms of color, taste and aroma.
Stability test showed the pH value of cardamom essential oil in mouthwash was 6.5 –
6.7 with viscosity 3. It was demonstrated from clinical trial that level of CH3SH,
H2S, (CH3)2S was reduced in 0.5% cardamom essential oil and Listerine®
treatment group, on the other hand, there were no reduction in placebo group. It also
appeared that 0.5% cardamom mouthwash could more effectively reduce VSC level
when compared to placebo. ANOVA repeated measures analysis showed significant
differences of cardamom essential oil in mouthwash and Listerine® groups (p=0,001
and p=0,007, respectively; p0,05). Both cardamom and Listerine® mouthwash are
effective to reduce the level of VSC moreover cardamom essential oil mouthwash
does not contain alcohol which can cause dry mouth and therefore it is safe.
Conclusion: It can be concluded that cardamom essential oil in concentration 0,5%
mouthwash can be used to overcome halitosis, therefore these cardamom mouthwash
possible to become phytopharmaca drug that is useful for the community.
Keywords: Amomum cardamomum L, halitosis, Volatile Sulfur Compound,
Minimal Inhibitory Concentration (MIC), Minimal Bactericidal
Concentration (MBC), Phorphyromonas gingivalis
iv
Universitas Sumatera Utara