PAPER

MKWU BAHASA INGGRIS

GROUP 3:

1. DWI SINTA (NPM : 2110070110026)

2. KHADIJAH PUTRI NOPANI
3. KEVIN RICARDO LUBIS
4. ERTHASYA AURA A
5. MIFTAHUL HAFIZ
6. DEA IGNACIA
7. DINDA OKTAVIANISCA
8. M. HABIB AL FAJAR
9. M SALAHUDDIN AL MAJID
10. MARSHANDA DELON
11. NADHILAH SAFIRAH
(NPM : 2110070110027)
(NPM : 2110070110028)
(NPM : 2110070110030)
(NPM : 2110070110031)
(NPM : 2110070110032)
(NPM : 2110070110033)
(NPM : 2110070110034)
(NPM : 2110070110035)
(NPM : 2110070110036)
(NPM : 2110070110037)

FAKULTAS KEDOKTERAN GIGI

UNIVERSITAS BAITURRAHMAH

TAHUN 2022/2023
 KATA PENGANTAR

Assalamu’alaikum warahmatullahi wabarakatuh.

Segala puji bagi Allah SWT yang telah memberikan kami

kemudahan sehingga kami dapat menyelesaikan makalah ini tepat waktu.
Tanpa pertolongan-Nya tentunya kami tidak akan sanggup untuk
menyelesaikan makalah ini dengan baik. Shalawat serta salam semoga
terlimpah curahkan kepada baginda tercinta kita yaitu Nabi Muhammad
SAW yang kita nanti - nantikan syafaatnya di akhirat nanti.

Penulis mengucapkan syukur kepada Allah SWT atas limpahan

nikmat sehat-Nya, baik sehat fisik maupun akal pikiran, sehingga penulis
mampu untuk menyelesaikan pembuatan makalah MKWU BAHASA
INGGRIS

Penulis mengucapkan terima kasih kepada :

1) Dosen mkwu bahasa inggris

2) Semua pihak yang berkontribusi dalam penulisan makalah ini

Penulis tentu menyadari bahwa makalah ini masih jauh dari kata
sempurna dan masih banyak terdapat kesalahan serta kekurangan di
dalamnya. Untuk itu, penulis mengharapkan kritik dan saran dari pembaca
untuk makalah ini, supaya makalah ini nantinya dapat menjadi makalah
yang lebih baik lagi. Kemudian apabila terdapat banyak kesalahan pada
makalah ini, penulis mohon maaf yang sebesar-besarnya.

Demikian, semoga makalah ini bermanfaat. Terima kasih.

Padang, 5 desember 2022

Group 3
 DAFTAR ISI

KATA PENGANTAR..................................................................................................................... 2
DAFTAR ISI..................................................................................................................................... 3
BAB I PENDAHULUAN.............................................................................................................. 4
1.1 Latar Belakang........................................................................................................... 4
BAB II PEMBAHASAN................................................................................................................ 6
2.1 Klasifikasi Istilah.................................................................................................. 6
2.2 Menetapkan Permasalahan/Define The Problems.................................7
BAB III PENUTUP..................................................................................................................... 25
3.1 KESIMPULAN...........................................................................25
DAFTAR PUSTAKA.................................................................................................................... 26
 BAB I
PENDAHULUAN

1.1 Latar Belakang

Dental traumas are injuries to the teeth, periodontium, and
surrounding soft tissues. They are quite common in dentistry, comprising
5% of all traumatic injuries in people seeking first aid and up to 17% of all
bodily injuries among preschool children.

Children and adolescents experience mild or severe dental traumas

from various causes, such as unsafe playing on playgrounds, accidents at
schools, accidents in car crashes, or violence. According to Andersson, 1
the prevalence of traumatic dental injuries (TDIs) in children and
adolescents is approximately 20% and varies little. Petti et al found that
traumatic dental injuries occur in both primary and permanent dentitions,
although the prevalence in primary dentition is higher. Prevalence differs
with age and sex, with a global male-to-female ratio of 1.43, suggesting that
men are more likely to develop TDI than are women. 3

TDI in primary dentition can affect the development of permanent

teeth. Damage and/or disturbances to permanent teeth and germs,
depending on the mouth area affected, 5 can range from mild to severe. TDI
in permanent teeth can cause permanent complications, such as pulp
necrosis and internal and/or external root resorption, 6 and influence
maxillofacial development.
BAB II
PEMBAHASAN

2.1 Dental Trauma

Dental trauma refers to trauma (injury) to the teeth and/or periodontium (gums,
periodontal ligament, alveolar bone), and nearby soft tissues such as the lips,
tongue, etc. The study of dental trauma is called dental traumatology

 Types of dental trauma

Dental injuries
Dental injuries include:

 Enamel infraction
 Enamel fracture
 Enamel-dentine fracture
 Enamel-dentine fracture involving pulp exposure
 Root fracture of tooth

Periodontal injuries

 Concussion (bruising)
 Subluxation of the tooth (tooth knocked loose)
 Luxation of the tooth (displaced)
o Extrusive
o Intrusive
o Lateral
 Avulsion of the tooth[4] (tooth knocked out)

Primary teeth
Trauma to primary teeth occurs most commonly at the age of two to
three years, during the development of motor coordination.[7] When
primary teeth are injured, the resulting treatment prioritises the safety
of the adult tooth,[7] and should avoid any risk of damaging the
permanent successors.[8] This is because the root apex of an injured
primary tooth lies near the tooth germ of the adult tooth.[8]

Therefore, a displaced primary tooth will be removed if it is found to

have encroached upon the developing adult tooth germ.[8] If this
happens, parents should be advised of possible complications such as
 enamel hypoplasia, hypocalcification, crown/root dilaceration, or
disruptions in tooth eruption sequence.[9]

Potential sequelae can involve pulpal necrosis, pulp obliteration and

root resorption.[10] Necrosis is the most common complication and an
assessment is generally made based on the colour supplemented with
radiograph monitoring. A change in colour may mean that the tooth is
still vital but if this persists it is likely to be non-vital.

 Risk factors
o Age, especially young children
- Primary dentition stage (2–3 years old, when children's
motor function is developing and start learning how to
walk/ run)
- Mixed dentition stage (8–10 years old)
- Permanent dentition stage (13–15 years old)
o Male > Female
o Season (Many trauma incidents occur more in summer compared
to winter)
o Sports, especially contact sports such as football, hockey, rugby,
basketball and skating
o Piercing in tongue and lips
o Military training
o Acute changes in the barometric pressure, i.e. dental barotrauma,
which can affect scuba divers and aviators
o Class II malocclusion with increased overjet and Class II skeletal
relationship and incompetent lips are the significant risk factors

 Prevention
Prevention in general is relatively difficult as it is nearly impossible to stop
accidents from happening, especially in children who are quite active.
Regular use of a gum shield during sports and other high-risk activities
(such as military training) is the most effective prevention for dental
trauma.They are mainly being fitted on the upper teeth as it has higher risk
of dental trauma compared to the lower teeth. Gum shields ideally have to
be comfortable for users, retentive, odourless, tasteless and the materials
should not be causing any harm to the body. However, studies in various
high-risk populations for dental injuries have repeatedly reported
low compliance of individuals for the regular using of mouthguard during
activities. Moreover, even with regular use, effectiveness of prevention of
dental injuries is not complete, and injuries can still occur even when
mouthguards are used as users are not always aware of the best makes or
size, which inevitably result in a poor fit.
Types of gum shield

 Stock ready-moulded
o Not recommended as it does not conform the teeth at all
o Poor retention
o Poor fit
o Higher risk of dislodging during contact sports and airway
occlusion which may lead to respiratory distress
 Self-moulded/ Boil and bite
o Limited range of sizes, which may result in poor fitting
o Can be easily remoulded if distorted
o Cheap
 Custom-made
o Made with ethylene vinyl acetate
o The most ideal type of gum shield
o Good retention
o Able to build in multiple layers/laminations
o Expensive
One of the most important measures is to impart knowledge and awareness
about dental injury to those who are involved in sports environments like
boxing and in school children in which they are at high risk of suffering
dental trauma through an extensive educational campaign including
lectures, leaflets, posters which should be presented in an easy
understandable way.

 Management
The management depends on the type of injury involved and whether it is a
baby or an adult tooth. If teeth are completely knocked out baby front teeth
should not be replaced. The area should be cleaned gently and the child
brought to see a dentist. Adult front teeth (which usually erupt at around
six years of age) can be replaced immediately if clean. See below and the
Dental Trauma Guide website for more details. If a tooth is avulsed, make
sure it is a permanent tooth (primary teeth should not be replanted, and
instead the injury site should be cleaned to allow the adult tooth to begin to
erupt).

 Reassure the patient and keep them calm.

 If the tooth can be found, pick it up by the crown (the white part).
Avoid touching the root part.
 If the tooth is dirty, wash it briefly (ten seconds) under cold running
water but do not scrub the tooth.
 Place the tooth back in the socket where it was lost from, taking care
to place it the correct way (matching the other tooth)
 Encourage the patient to bite on a handkerchief to hold the tooth in
position.
 If it is not possible to replace the tooth immediately, ideally, the tooth
should be placed in Hank's balanced salt solution,[31] if not available, in
a glass of milk or a container with the patient's saliva or in the patient's
cheek (keeping it between the teeth and the inside of the cheek – note
this is not suitable for young children who may swallow the tooth).
Transporting the tooth in water is not recommended, as this will
damage the delicate cells that make up the tooth's interior.
 Seek emergency dental treatment immediately.
When the injured teeth are painful while functioning due to damage to
the periodontal ligaments (e.g., dental subluxation), a
temporary splinting of the injured teeth may relieve the pain and enhance
eating ability.[32] Splinting should only be used in certain situations.
Splinting in lateral and extrusive luxation had a poorer prognosis than in
root fractures.[33] An avulsed permanent tooth should be gently rinsed under
tap water and immediately re-planted in its original socket within
the alveolar bone and later temporarily splinted by a dentist.[4] Failure to re-
plant the avulsed tooth within the first 40 minutes after the injury may
result in very poor prognosis for the tooth. [4] Management of
injured primary teeth differs from management of permanent teeth; an
avulsed primary tooth should not be re-planted (to avoid damage to the
permanent dental crypt).[8] This is due to the close proximity of the apex of
a primary tooth to the permanent tooth underneath. The permanent
dentition can suffer from tooth malformation, impacted teeth and eruption
disturbances due to trauma to primary teeth. The priority should always be
reducing potential damage to the underlying permanent dentition. [34]
For other injuries, it is important to keep the area clean by using a soft
toothbrush and antiseptic mouthwash such as chlorhexidine gluconate. Soft
foods and avoidance of contact sports is also recommended in the short
term. Dental care should be sought as quickly as possible.

 Complications

Not all sequelae of trauma are immediate and many of them can
occur months or years after the initial incident thus required
prolonged follow-up. Common complications are pulpal necrosis,
pulpal obliteration, root resorption and damage to the successors
teeth in primary teeth dental trauma. The most common
complication was pulp necrosis (34.2%). 50% of the tooth that have
trauma related to avulsion experienced ankylotic root resorption
after a median TIC (time elapsed between the traumatic event and
the diagnosis of complications) of 1.18 years. Teeth that have
multiple traumatic events also showed to have higher chance of pulp
 necrosis (61.9%) compared to teeth that experienced a single
traumatic injury (25.3%) in the studies (1)[39]

Pulpal necrosis[edit]

Pulp necrosis usually occurs either as ischaemic necrosis (infarction)

caused by disruption to the blood supply at the apical foramen or as
an infection-related liquefactive necrosis following dental trauma
(2). Signs of pulpal necrosis include[40]

 Persistent grey colour to tooth that does not fade

 Radiographic signs of periapical inflammation
 Clinical signs of infection: tenderness, sinus, suppuration, swelling

Treatment options will be extraction for the primary tooth. For the
permanent tooth, endodontic treatment can be considered.

Root resorption

Root resorption following traumatic dental injuries, whether located

along the root surface or within the root canal appears to be a sequel
to wound healing events, where a significant amount of the PDL or
pulp has been lost due to the effect of acute trauma.[41]

Pulpal obliteration

4-24% of traumatized teeth will have some degrees of pulpal

obliteration that is characterized by the loss of pulpal space
radiographically and yellow discolouration of the clinical crown. No
treatment is needed if it is asymptomatic. Treatment options will be
extraction for symptomatic primary tooth. For symptomatic
permanent tooth, root canal treatment is often challenging due to
pulp chamber is filled with calcified material and the ‘drop off’
sensation of entering a pulp chamber will not occur.[42]

Damage to the successor teeth

Dental trauma to the primary teeth might cause damage to the

permanent teeth. Damage to the permanent teeth especially during
development stage might have following consequences:[43]

 Crown dilaceration
 Odontoma-like malformation
 Sequestration of permanent tooth germs
  Root dilaceration
 Arrest of root formation

2.2 Xerostomia
Xerostomia is the subjective sensation of dry mouth, which is often (but not
always) associated with hypofunction of the salivary glands. The term is
derived from the Greek words ξηρός (xeros) meaning "dry" and στόμα (stoma)
meaning "mouth".A drug or substance that increases the rate of salivary flow is
termed a sialogogue.

Hyposalivation is a clinical diagnosis that is made based on the history and

examination,but reduced salivary flow rates have been given objective
definitions. Salivary gland hypofunction has been defined as any objectively
demonstrable reduction in whole and/or individual gland flow rates. An
unstimulated whole saliva flow rate in a normal person is 0.3–0.4 ml per
minute, and below 0.1 ml per minute is significantly abnormal. A stimulated
saliva flow rate less than 0.5 ml per gland in 5 minutes or less than 1 ml per
gland in 10 minutes is decreased. The term subjective xerostomia is sometimes
used to describe the symptom in the absence of any clinical evidence of
dryness., Xerostomia may also result from a change in composition of saliva
(from serous to mucous). Salivary gland dysfunction is an umbrella term for
the presence of xerostomia, salivary gland hyposalivation, and hypersalivation

 Signs and symptoms

Hyposalivation may give the following signs and symptoms:

 Dental caries (xerostomia related caries) – Without the buffering effects of

saliva, tooth decay becomes a common feature and may progress much
more aggressively than it would otherwise ("rampant caries"). It may
affect tooth surfaces that are normally spared, e.g., cervical caries and root
surface caries. This is often seen in patients who have had radiotherapy
involving the major salivary glands, termed radiation-induced caries.
[9]
 Therefore, it is important that any products used in managing dry mouth
symptoms are sugar-free, as the presence of sugars in the mouth support
the growth of oral bacteria, resulting in acid production and development
of dental caries.[8]
 Acid erosion. Saliva acts as a buffer and helps to prevent demineralization
of teeth.[10]
 Oral candidiasis – A loss of the antimicrobial actions of saliva may also
lead to opportunistic infection with Candida species.[9]
 Ascending (suppurative) sialadenitis – an infection of the major salivary
glands (usually the parotid gland) that may be recurrent. [3] It is associated
with hyposalivation, as bacteria are able to enter the ductal system against
the diminished flow of saliva. [7] There may be swollen salivary glands
even without acute infection, possibly caused
by autoimmune involvement.[3]
 Dysgeusia – altered taste sensation (e.g., a metallic taste) [1] and dysosmia,
altered sense of smell.[3]
 Intraoral halitosis[1] – possibly due to increased activity of halitogenic
biofilm on the posterior dorsal tongue (although dysgeusia may cause a
complaint of nongenuine halitosis in the absence of hyposalivation).
 Burning mouth syndrome – a burning or tingling sensation in the mouth.[1]
[3]

 Saliva that appears thick or ropey.[9]

 Mucosa that appears dry.
 A lack of saliva pooling in the floor of the mouth during examination. [1]
 Dysphagia – difficulty swallowing and chewing, especially when eating
dry foods. Food may stick to the tissues during eating.
 The tongue may stick to the palate, causing a clicking noise during speech,
or the lips may stick together.
 Gloves or a dental mirror may stick to the tissues.
 Fissured tongue with atrophy of the filiform papillae and a
lobulated, erythematous appearance of the tongue.
 Saliva cannot be "milked" (expressed) from the parotid duct.
 Difficulty wearing dentures, e.g., when swallowing or speaking. There may
be generalized mucosal soreness and ulceration of the areas covered by the
denture.
 Mouth soreness and oral mucositis.
 Lipstick or food may stick to the teeth.
 A need to sip drinks frequently while talking or eating.
 Dry, sore, and cracked lips and angles of mouth.
 Thirst.
However, sometimes the clinical findings do not correlate with the symptoms
experienced. For example, a person with signs of hyposalivation may not
complain of xerostomia. Conversely a person who reports experiencing
xerostomia may not show signs of reduced salivary secretions (subjective
xerostomia). In the latter scenario, there are often other oral symptoms
suggestive of oral dysesthesia ("burning mouth syndrome").  Some symptoms
outside the mouth may occur together with xerostomia.
These include:

 Xerophthalmia (dry eyes).
 Inability to cry.
 Blurred vision.
 Photophobia (light intolerance).
 Dryness of other mucosae, e.g., nasal, laryngeal, and/or genital.
 Burning sensation.
 Itching or grittiness.
 Dysphonia (voice changes).
There may also be other systemic signs and symptoms if there is an underlying
cause such as Sjögren's syndrome,[1] for example, joint pain due to
associated rheumatoid arthritis.

 Cause
Dry mouth is caused when the salivary glands in the mouth don't make
enough saliva to keep your mouth wet. These glands may not work
properly as the result of:

 Medications. Hundreds of medications, including many over-

the-counter drugs, produce dry mouth as a side effect. Among
the more likely types to cause problems are some of the drugs
used to treat depression, high blood pressure and anxiety, as well
as some antihistamines, decongestants, muscle relaxants and
pain medications.

 Aging. Many older people experience dry mouth as they age.

Contributing factors include the use of certain medications,
changes in the body's ability to process medication, inadequate
nutrition, and having long-term health problems.

 Cancer therapy. Chemotherapy drugs can change the nature of

saliva and the amount produced. This may be temporary, with
normal salivary flow returning after treatment is completed.
Radiation treatments to your head and neck can damage salivary
glands, causing a marked decrease in saliva production. This
may be temporary or permanent, depending on the radiation dose
and area treated.

 Nerve damage. An injury or surgery that causes nerve damage

to your head and neck area can result in dry mouth.

 Other health conditions. Dry mouth can be due to certain

health conditions, such as diabetes, stroke, yeast infection
(thrush) in your mouth or Alzheimer's disease, or due to
autoimmune diseases, such as Sjogren's syndrome or HIV/AIDS.
Snoring and breathing with your mouth open also can contribute
to dry mouth.
  Tobacco and alcohol use. Drinking alcohol and smoking or
chewing tobacco can increase dry mouth symptoms.

 Recreational drug use. Methamphetamine use can cause severe

dry mouth and damage to teeth, a condition also known as "meth
mouth." Marijuana also can cause dry mouth.

 Treatment

Your treatment depends on the cause of your dry mouth. Your doctor
or dentist may:

 Change medications that cause dry mouth. If your doctor

believes medication to be the cause, he or she may adjust your
dosage or switch you to another medication that doesn't cause a
dry mouth.

 Recommend products to moisturize your mouth. These can

include prescription or over-the-counter mouth rinses, artificial
saliva or moisturizers to lubricate your mouth. Mouthwashes
designed for dry mouth, especially ones with xylitol, can be
effective, such as Biotene Dry Mouth Oral Rinse or Act Dry
Mouth Mouthwash, which also offer protection against tooth
decay.

If you have severe dry mouth, your doctor or dentist may:

 Prescribe medication that stimulates saliva. Your doctor may

prescribe pilocarpine (Salagen) or cevimeline (Evoxac) to
stimulate saliva production.

 Protect your teeth. To prevent cavities, your dentist might fit you
for fluoride trays, which you fill with fluoride and wear over your
teeth at night. Your dentist may also recommend weekly use of a
chlorhexidine rinse to control cavities.

.
 BAB III
PENUTUP

3.1 KESIMPULAN

Dental trauma is not a disease but rather an unfortunate impact injury to the teeth
and mouth that can arise from any activity of daily living. Its prevalence remains
high and studies have indicated that its impact may exceed caries and periodontal
disease in certain populations. Although there is a need to standardize reporting
and research, epidemiological studies have indicated that approximately one-third
of toddlers and one-quarter of adolescents and adults have experienced dental
trauma. Most of these injuries involve the upper central incisors from falls at home
or sustained while playing sport. Predicting the prognosis of teeth is difficult due to
methodological, behavioural, cultural and environmental factors. This further
suggests the need to establish a reliable evidence base. This is where standardized
classification and adjunct methods for recording data may assist.

It's normal to occasionally have a dry mouth if you’re dehydrated or feeling

nervous, but a persistently dry mouth can be a sign of an underlying problem.

You should see your dentist or GP if you have an unusually dry mouth (known as
xerostomia) so they can try to determine the cause.A dry mouth can occur when the
salivary glands in your mouth don't produce enough saliva.

This is often the result of dehydration, which means you don’t have enough fluid in
your body to produce the saliva you need. It's also common for your mouth to
become dry if you're feeling anxious or nervous.
 DAFTAR PUSTAKA

1.  Versteeg, PA; Slot, DE; van der Velden, U; van der Weijden, GA (Nov 2008).
"Effect of cannabis usage on the oral environment: a review". International
Journal of Dental Hygiene. 6 (4): 315–20. doi:10.1111/j.1601-
5037.2008.00301.x. PMID 19138182. S2CID 9123404.
2. ^ Fazzi, M; Vescovi, P; Savi, A; Manfredi, M; Peracchia, M (October 1999).
"[The effects of drugs on the oral cavity]". Minerva Stomatologica. 48 (10):
485–92. PMID 10726452.
3. ^ "DrugFacts: Heroin on National Institute of Drug Abuse". National Institutes
of Health. Retrieved 9 February 2013.
4. ^ "10 Reasons Why Your Mouth Is Dry". Take Home Smile. 22 June 2022.
5. ^ Tsuchiya, H. (2021). "Characterization and Pathogenic Speculation of
Xerostomia Associated with COVID-19: A Narrative Review". Dent. J. 9 (11):
130. doi:10.3390/dj9110130. PMC 8625834. PMID 34821594.
6. ^ "Dry mouth, xerostomia, and the Challacombe Scale". DentistryIQ.
Retrieved 11 June 2019.
7. ^ Banerjee, Avijit; Watson, Timothy F. (2015). Pickard's Guide to Minimally
Invasive Operative Dentistry. Oxford University Press. ISBN 9780198712091.
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trauma in an Australian rural centre. Dent Traumatol 2008;24:663–670. 2.
Bastone E, Freer T, McNamara J. Epidemiology of dental trauma: a
review of literature. Aust Dent J 2000;45:2–9. 3. Glendor U, Andersson L,
Andreasen JO. Economic Aspects of Traumatic Dental Injuries. In:
Andreasen JO, Andreasen FM, Andersson L, eds. Textbook and Atlas of
Traumatic Injuries to the Teeth. 4th edn. Wiley-Blackwell, 2007:217–223.
4. Andersson L. Epidemiology of traumatic dental injuries. J Endod
2013;39:2–5.