Tukang gigi palsu purwokerto,purbalingga,ajibarang,cilacap,banyumas & sekitarnya.

 

 

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ALAMAT : JL.KAMANDAKA GANG.BALONG KARANSALAM(PURWOKERTO UTARA),BANYUMAS ,JAWA TENGAH.

Fenomena tukang gigi atau yang plang prakteknya banyak di jalan tertulis “AHLI GIGI”, banyak sekali di Indonesia. Banyak rekan sejawat (termasuk saya sendiri) sudah pernah kedatangan pasien ahli gigi (tukang gigi). Disaat nyeri sudah tak tertahankan, biasanya sang pasien kembali jumpa dengan sang ahli gigi minta diobati, namun sang ahli gigi tak bisa bertanggung jawab. Lalu pasien akan pergi ke jalan terakhir, yaitu dokter gigi.

Contoh kisah yang pernah kami alami

  1. Seorang pasien wanita cantik di usia belia (antara 18-19 tahun) mengeluh sakit gigi tak tertahankan. Pasien menggunakan gigi palsu, buatan tukang gigi / ahli gigi. Gigi palsu dibuat secara instan, dimana sisa akar gigi tersebut tak dicabut. Landasan gigi palsu diperluas dan ditempel dilangit-langit mulut pasien tersebut. Agar retentif (tak mudah lepas), gigi palsu tersebut ditempel pada gigi yang telah berlubang disekitarnya. Hingga 1 tahun pasien tersebut tak bisa lepas dari obat nyeri karena sakit berdenyut yang tak tertahankan akibat infeksi dari sisa akar yang tertutup dan gigi2 yang bertambah hancur dan berlubang. Pasien datang ke dokter umum Puskesmas, dokter Puskesmas menyarankan untuk datang kembali ke tukang gigi meminta pertanggung jawaban. Karena merasa tak memperoleh jawaban pasien pun mencari dokter gigi.
  2. Seorang pasien pria datang ke dokter gigi karena gigi nya sudah sakit dan tak tertahankan. Setelah diperiksa, ditemukan bahwa gigi – gigi pasien yang berlubang tidak dilakukan perawatan namun langsung ditambal dengan bahan self cured acrylic yang merupakan kontra indikasi sebagai bahan tambal. Dapat dilihat bahwa setelah akrilik tersebut dibuang, ditemukan masih adanya bagian gigi yang belum dibersihkan sebelum ditambal (jaringan yang membusuk) dan lubang gigi dalam yang menyebabkan nyeri berdenyut. Berikut gambarnya:

korban tkang gigi

Sumber: drg. R. Padalarang – 2014.

Dalam kehidupan bermasyarakat, tukang gigi menjadi salah satu pilihan dalam membuat gigi palsu, pemasangan behel gigi, penambalan, bahkan tak jarang pasien mencabut gigi ke tukang gigi. Alasan yang paling umum adalah karena harga nya yang murah. Dari segi biologis, seorang tukang gigi/ ahli gigi tidak mendapat pendidikan formal mengenai anatomi, farmasi, fisiologi, dsb. Dari segi mekanis, tukang gigi/ ahli gigi mempelajari pembuatan gigi palsu / pemasangan behel melalui otodidak, komunitas, atau dari petunjuk penggunaan alat & bahan yang sudah tertera dari pabrik. Bukan melalui textbook dan pendidikan formal.

Sebagai seorang pasien / konsumen, saya mengajak anda untuk lebih kritis dalam menentukan operator yang akan merawat anda. Karena dalam menentukan perawatan di bidang kesehatan, seorang operator harus memiliki dasar keilmuan yang lengkap. Sebagai contoh, jika operator (baik dokter gigi ataupun ahli gigi) memasang gigi palsu, beberapa pertimbangan yang harus dipikirkan adalah: seberapa banyak gigi yang hilang, apakah gigi yang tersisa mampu menunjang gigi palsu yang akan dibuat, bagaimana kondisi rongga mulut pasien (kesehatan gusi? Karang gigi? Gigi berlubang? langit-langit mulut? kondisi tulang? anatomi mulut? kelainan lain?), alergi yang dimiliki pasien, penyakit sistemik yang dimiliki pasien, indikasi dan kontra indikasi (setiap individu memiliki indikasi berbeda), dan banyak hal lainnya.

 

Pembuatan gigi palsu

Gigi palsu terdiri dari 2 macam, yaitu gigi palsu cekat (fix) dan gigi palsu lepasan (removeable). Berikut berbagai macam contoh gigi palsu cekat:

GP Cekat

Contoh gigi palsu lepasan:

gp lepas

 

Terdapat beberapa jenis bahan yang digunakan dalam membuat gigi palsu lepasan, bahan dengan harga yang terjangkau dan nilai estetik yang cukup baik yaitu acrylic ( akrilik). Dalam praktek kesehariannya, cukup sering tukang gigi / ahli gigi menggunakan bahan acrylic terutama tipe Self cured acrylic. Berikut saya berikan sedikit info mengenai bahan tersebut:

Self-curedacrylic atau Chemically-accelerated room temperature processed acrylic merupakan akrilik yang proses polimerisasi (pengerasan) terjadi secara kimia dalam temperatur ruangan. Terdiri dari dua komponen, yaitu powder (polimer) dan cairan (monomer). Komponen powder terdiri dari Polimetil metakrilat, Peroksida organik sebagai initiator, titanium dioksida sebagai pengontrol translusensi, pigmen anorganik sebagai pewarna, dan serat sintetik. Sedangkan komponen liquid terdiri dari, metil metakrilat, hidroquinon sebagai inhibitor, dimetakrilat sebagai cross linking agent dan organic amine (O’Brien, 1996, Craig, 2007).

Pada proses pengerasannya bahan ini meninggal kan residu kimia yang terhadap beberapa individu dapat menimbulkan reaksi alergi. Pada saat membuat gigi tiruan (manipulasi bahan), operator yang baik akan merendam gigi tiruan pada air hangat (60 derajat celcius) selama 5 menit, agar residu berkurang/ hilang dan pengerasan menjadi sempurna. Namun sering kali aplikasi langsung pada mulut pasien oleh tukang gigi/ ahli gigi justru akan menjadi masalah bagi pasien karena  residu kimia terpapar langsung pada pasien.

Kegunaan self cured acrylic indikasi nya cukup terbatas, misalnya pada kondisi sementara memperbaiki gigi tiruan yang patah, membuat gigi tiruan darurat (immediate denture), dsb. Penggunaan bahan ini memiliki batas jangka waktu yang cukup pendek (sekitar 2 minggu). Karena salah satu sifat dari bahan self cured acrylic ini adalah higroskopis (menyerap molekul air pada lingkungannya). Sehingga penggunan yang berkepanjangan dapat mengakibatkan perlekatan pada gusi & langit-langit rongga mulut dan akan mengakibatakan luka (ulcer) atau bahasa umumnya sariawan. Selain luka pada rongga mulut, penggunaan yang berkepanjangan akan mengakibatkan bau mulut akibat adanya lubang-lubang mikro (porositas) akibat pengerasan (polimerisasi) yang tidak sempurna.

 

Penambalan Gigi

Pada gigi yang berlubang, seorang dokter gigi tiadak akan dengan begitu saja menambal. terdapat beberapa tahap sebelum menambal gigi. yaitu:

1. Diagnosa yang tepat

diagnosa sangat penting untuk menentukan vitalitas gig (apakah masih hidup atau sudah mati). hal ini akan sangat menentukan rencana perawatan (jenis tindakan apa yang akan dilakukan, dan bahan apa yang akan digunakan).

2. Membersihkan gigi yang berlubang

Pembersihan pada gigi yang berlubang serta daerah sekitarnya bertujuan untuk menghilangkan sumber infeksi (bakteri, sisa jaringan gigi yang lapuk, karang gigi disekitar gigi tersebut). pembersihan tersebut menggunakan bor, pasien sering kali mengeluh karena merasa lubang gigi nya semakin besar. Penggunaan bor selain untuk membersihkan jaringan yang terinfeksi, juga untuk membentuk lubang agar tambalan awet dan tak mudah lepas.

cavity balck

3. Penambalan

Tahap akhir dari rangakain perawatan adalah penambalan permanen. Bahan tambal permanen yang saat ini umum digunakan yaitu bahan tambal resin (komposit), logam (amalgam, logam cor), dan semen. Setiap bahan memiliki kekurangan dan kelebihan masing-masing dengan indikasi tertentu. misal, komposit yang diaktivasi dengan sinar biru baik untuk tambalan estetik. Amalgam baik untuk gigi graham karena kekuatannya yang baik namun nilai estetik rendah. Sedangkan semen baik untuk gigi sulung, karena biayanya lebih murah, tidak membutuhkan estetik dan gigi sulung akan tergantikan dengan gigi dewasa.

tambalan komposit-amalgam

 

Kesimpulan:

  1. Kunjungilah dokter gigi sebagai pihak yang berkompeten agar anda mendapatkan perawatan gigi yang tepat.
  2. Tukang gigi / ahli gigi merupakan pekerjaan yang seharusnya bersinergis dengan dokter gigi, dan sesuai dengan kapasitas dan kompetensinya.
  3. Komunikasikan dan diskusikan keperluan perawatan serta anggaran biaya anda kepada dokter gigi anda, karena itu adalah hak anda sebagai pasien.
  4. Manfaatkan berbagai jasa yang disediakan pemerintah agar meringankan biaya pengobatan gigi anda.

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