CHAPTER I

INTRODUCTION

1.1 Background
Nowadays, the people tend to live going back to nature. It means that the
people want to know about the usage of the medicine plants. One of those is Piper
betel leaves. The usage of medicine plants is used in curing the desease
traditionally. The desease like Stomatitis aphtousa and toothches. Meanwhile, the
boiled water of betel leaves can be as antiseptic which can be the mouth antiseptic
wash, preventing halitosis, and removing the body odor. The Indonesia people
have known betel leaves as a material to chew. They believe that the betel leaves
can strengthen teeth, treat oral lession, remove the body odor, stop gingivitis and
become a mouth wash. The subtance on the betel leaves is much. Some of the
subtances are fenil propana and atsiri oil. All the subtances can make the betel
leaves has many function because it can make human healthy. Usually, the betel
leaves is applied in acne soap product, the medicine of diabetes and the
toothpaste.
The brushing of the teeth with use the toothpaste has been used on some
countries in the world. As the advance of the knowledge and the technology. All
kinds of the toothpaste manufactures make inovation to add another subtances
which have function to make teeth healthy. The addition of another substances on
toothpaste must be safe ad effective, and the usage has been agreed by American
Dental Association. There is a common one which is added namely herbal.
Nowadays, in market there are many the toothpastes with the subtance of the
herbal ingredients, one is the toothpaste contains the betel leaves extract. Then,
the subtance of oil atsiri in betel leaves has the power of the antibacterial. It is
caused by there is phenol and its derivation which can change the character of
protein in bactery cells.
The atsiri oil which contains phenol and kavikol has triple effectivity anti
bacterial activity, compared with fluoride compound because fluoride just has
function in inhibiting the development of the bactery and it doesn’t destroy.
However, phenol and kavikol in the atsiri oil of betel leaves have the character of

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bacterisidal which can remove bactery so that it is more effective in keeping the
health of the teeth and gum, prevent halitosis, the toothpaste has ability as buffer
(bactery buffer) so that it can prevent the damage of the teeth.
The usage of the toothpaste with the different subtance can effect the
degree of saliva’s acidity. Saliva normally is acid slightly, its pH is 6. It can change
with the change of the flow speed and the time effect in a day. The degree of
saliva’s acidity is affected by some factors such as the condition of night and day,
diet, the stimulation of the secretion speed and the age factor: the influence of the
day and night condition can make the acidity degree will be high soon after get up.
It can go down in minutes after eat and also it can be high because of the
mechanism stimulation, but after 30-60 minutes, it will be low. At night, the
acidity degree will increase but by night, it will decrease again. In the diet
condition with high carbohydrat, the bactery will increase the production of the
acid. While on protein metabolism will put out the alcaline subtance such as
ammonia so that pH rises.
The degree of saliva’s acidity can cause the caries. Many parents think that
the decidue teeth aren’t too important to treat because they will be replaced by the
permanent teeth. If the decidue teeth are not treated, they will have caries and they
can cause the infection gum and affect the position of the permanent teeth. The
data shows that 9 of 10 children under 5 years old suffering from the teeth
destruction. Every child, average suffers 7 cavities of its 20 teeth. The teeth
enamel of the decidue teeth is thinner than the permanent teeth. Therefore, the
decidue teeth can be broken easily. The subtance of the betel leaves has good
function in caring the teeth but it has trouble for children in toothpaste with the
subtance of the betel leaves. In the children toothpaste, the subtance of the betel
leaves which is added, can make the toothpaste less flavor, it can make children
will not be interested in the toothpaste which contains the betel leaves. Children
will be intersted to the toothpaste which has many flavor variants but the
destruction of the permanent, the teeth also have the high destruction level. It is
caused by treatment behavior or the kinds of the meal. The mouth treatment will
have many forms such as brushing the teeth with the toothpaste. The selection of
the subtance of the toothpaste also affects the teeth treatment, one is the betel

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leaves. The usage of the subtance of the betel leaves in the toothpaste is expected
to prevent the permanent teeth from the destruction. Commonly, teenagers and
adults don’t care the flavor variant in the toothpaste. The addition of the mint in
betel leaves toothpaste is expected to help reduce slightly the original flavor of
betel itself. That is why the toothpaste which contains betel leaves is especially
used for teenagers or adults.
In this research, the author will use the teenagers as the object with age
about 13-16 years. To see the effect in the toothpaste which containing the betel
leaves. BUGEMM is expected to be useful for everyone who reads and also for
students in SMA Plus Negeri 17 Palembang who are interested in using the herbal
toothpaste which containing the betel leaves.

1.2 Problem Formulation

1. How to measure the degree of saliva’s acidity for the usage toothpaste which
containing the betel leaves?
2. What are the effects of the measurement the degree of saliva’s acidity for the
usage toothpaste which containing the betel leaves?

1.3 Objectives
1. To know the measurement the degree of the saliva’s acidity for the usage
toothpaste which containing the betel leaves.
2. To know the effects of the measurement the degree of saliva’s acidity for the
usage toothpaste which containing the betel leaves.

1.4 Benefits
1. For the writer, to know the measurement the degree of saliva’s acidity for the
usage toothpaste which containing the betel leaves.
2. For the reader, to know the effects of the measurement the degree of saliva’s
acidity for the usage toothpaste which containing the betel leaves.

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 CHAPTER II

LITERATURE REVIEW

2.1 Piper Betel Leaves

Kingdom: Plantae
Subkingdom: Tracheobionta
Super Divisi: Spermatophyta
Divisi: Magnoliophyta
Class: Magnoliopsida
Sub Class: Magnoliidae
Ordo: Piperales
Famili: Piperaceae
Genus: Piper
Spesies: Piper betle L.

Picture 2.1 Piper Betel Leaves

Based on Muthoharoh, Layin (2011: 2) the betel leaves is Indonesia original
plant which grows vine on other stem tree. As a culture, the leaves and fruit can
be eaten by chewing together with gambier, areca nut and lime. Chewing betel
leaves related to the disease of the oral cancer and the form of Squamous cell
carcinocoma which is maglinant. The betel leaves is used as a medicinal plant
(phytopharmaca); it is useful in the life and various ceremonies Malay.
This plant can reach 15 meters in height. The steam of the betel leaves is
greenish brown, round, segmented, and an appearing place of the root. The single
leaves is heart-shaped, pointed end, and grows alternately, stemmed, and has a
good smell. Its length is about 5-8 cm and a width of 2-5 cm. The flowers are
shaped compound grains and bract ± 1 mm elliptical. In the male grain length is
about 1.5 to 3 cm and there are two short stamens. At the female length is about
1.5 to 6 cm in where there are three to five pieces of white and yellowish green
stigma. Its fruits is round shaped and graynish green in color. Its root is tap.

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2.1.1 Types of Betel Leaves
Based on Rosdiana, Anna (2014: 17)
A. Netherlands Betel Leaves

Picture 2.2 Netherlands betel leaves

Netherlands betel leaves has latin name Epipremnum aureum. This plants has
characteristics as follows:
1) Have the leaves yellow or yellowish green
2) Having a large leaves
3) It has a spicy flavor
4) Possess a sharper smell
5) Has the ability movement propagates quickly
Behind the yellow or yellowish green leaves on the netherlands betel leaves.
In fact there is a great use in the plant. It can be one of the antipollutant plants
with great absorbing capacity. It makes netherlands betel leaves has important role
because this time the air is very polluted and it has much carbon dioxide which
comes from vehicles fumes, burning, cigarette smoke so, now the complants about
the lack of the fresh air have bee common issue for the people. To overcome this
trouble, many people use the air foilter which can clean the air from bacterial and
germs.

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B. Black Betel Leaves

Picture 2.3 Black betel leaves

The black betel leaves is conspicious with the ordinary green betel leaves. The
difference is its leaves are more rigid, more black in color. It has the same smell
with the green betel leaves.
The plants can be grown in the heat and inside of the room but, when the rainy
season this plant is not allowed submerged more than 30 hours because it can
cause the stem to rot. The content of the substances on this black betel leaves is
commonly magnesium, copper, zinc, starch, vitamin A, vitamin B complex,
vitamin C, vitamin D, vitamin E.

C. Green Betel Leaves

Picture 2.4 Green betel leaves

The green betel leaves has been being used since long time ago. In small
villages there are many parents who still use traditional green betel leaves or it is
called “nginang”. Nginang is chewing green betel leaves together with gambier,
areca nut and lime. This traditional doesnt’t only use the Java betel leaves, but the
green betel leaves is often used too. The othes use of green betel leaves is to
prevent Stomatitis aphtousa, gingivitis, candidiasis vaginal, dengue fever and
other.

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D. Yellow Betel Leaves

Picture 2.5 Yellow betel leaves

Fresh betel leaf yellow is very difficult to get. It can only be found in the area
of North Sumatera at Lawu Boleng district, Karo regency. It is so liked by the
people, because it has many functions. Not only that, it is often searched by the
people in some traditional market in Medan. The price of the yellow betel leaves
is high relatively, it can be Rp 40.000 until Rp 50.000 per bunch and it consists of
20 leaves.

E. Red Betel Leaves

Picture 2.6 Red betel leaves

Red betel leaves which has the scientific name Crocatum piper is a kind of
plant such as wine with a heart shape and has a red color. Typically, these plants
live in the highlands. It’s quite easy to plant this red betel. The way is just put it in
the media and placed in a humid environment and not exposed to direct sunlight.
The red betel leaves include the betel leaves which have many benefits. In
addition, the betel leaves are also used by Indonesian people, especially Java
people, not only that, the betel leaves are used as ubarampe in traditional
ceremonies, and as the women beauty cosmetic tool. As well as being antiseptic,
red betel can also be used to cure the diabetes desease. Drinking the boiled water

7
of the red betel leaves every day will make lower blood sugar level up to normal
level.
2.1.2 The Content of Betel Leaves
Based on Pannuti, Matos (2014: 27) the betel leaves contains the atsiri oil
where the main components consist of phenol and its compounds, such as kavikol,
cevibetol, carvacrol, eugenol. In addition to the atsiri oil, the betel leaf plants also
contain compounds of carotene, thiamine, riboflavin, nicotinic acid, vitamin C,
tannin, sugar, starch, amino acid.
The substances of the atsiri oil contain natural phenols that have a very strong
antiseptic (bactericidal and fungsid) but not sporosid. The betel leaves have a
distinctive aroma, namely flavor spicy, pungent, and a pungent odor. The
distinctive taste and flavor are caused by kavikol and betehphenol which are
contained in the atsiri oil. However, two compounds contained in the atsiri oil is
not the only factor that determines the aroma and taste of the betel leaves.
There are phytochemical compounds in the betel leaf plants which contain the
substances, namely alkaloids, saponin, tannin, flavonoid, enzymes diastase and
sugar. The young betel leaves contain enzymes diastase, sugar, and the atisiri oil
which is more than the red betel leaves. Flavonoid substance works by blocking
an important phase in the biosynthesis of prostaglandins, which is on trajectory
cyclooxygenase. Flavonid also inhibits fosfodiasterase, aldoreduktase,
monoamine oxidase, a protein kinase, DNA polymerase and lipooksigenase. The
betel leaf plants also contain arecoline across any part of the plant, in addition to,
there are the fat content of unisex styptic (resistantion bleeding), vulnerary (treat
lession skin), stomachic (digestive tract drugs).

2.1.3 The Benefits of Betel Leaves

Based on Rosdiana, Anna (2014: 31) traditionally, the archipelago plants
which also grow and are found in India, Sri Lanka, and Malaysia are used to treat
body odor and halitosis, Stomatitis aphtousa, sinusitis, and treat candidiasis
vaginal. This is because a medicinal plant that has been known since the year 600
SM contains an antiseptic that can kill germs. The content of phenols in the
antiseptic properties is five times more effective than ordinary phenol.

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 In pharmacology in China, the betel leaves are known to have a warm and
spicy character. They commonly use the betel leaves to stop coughing, reduce
inflammation and relieve itching. Whereas in traditional medicine in India, the
betel leaves are known as a warm aromatic substance, they are antiseptic. With the
antiseptic properties contained in the betel leaves. The ancient people often used
them to heal foot wounds, the stypic content of the betel leaves is able to
withstand the bleeding and vulnerary, which makes healing wounds on the skin.
In addition to be used as one of a medicinal ingredients for the Stomatitis
aphtousa, the betel leaves are also classified as gastrointestinal (GIT) drugs, as
ekspectoran, and the group of the dental and the oral medicine. In the group of
the drug utilization as the oral and dental, this is the result of scientific research
which based on the empirical experience of the since a long time ago. Especially,
in the drug utilization as the drug of toothaches, gingivitis, the abscesses of the
oral cavity, prevent halitosis, and treat Stomatitis aphtousa. Thus, in modern time,
many the health experts and the companies commercialize the betel leaf contents
the toothpaste and mouthwash product. The betel leaves have antibacterial effects
against: Streptococcus mutans, Streptococcus sanguis, Streptococcus viridans,
Actinomyces, and staphylococcus aureus.

2.2 Saliva
Based on Stookey (2008: 11) saliva is a combination of various fluids and
components are excreted into the oral cavity. Saliva is produced by three pairs of
major saliva glands (parotid, submandibular and sublingual) as well as a number
of minor saliva glands, and the fluid of gingival exudate.
The saliva function are the saliva begins the digestion of carbohydrates in the
mouth through the saliva amylase work which is an enzyme that breaks down
polysaccharides into disaccharides; saliva facilitates the ingestion process by
wetting the particles of the food that it is united each other and by making the
mukus, mukus is thicka and slippery as a lubricant. The saliva has an antibacterial
effect, firstly by lysozyme enzyme which lyse or destroy the certain bacteria and
secondly by rinsing the materials that may be used by the bacteria as a food
source; serves as a solvent for molecules that stimulate the papil taster; helping

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mastication and speaking because of the oral lubrication. Saliva plays an
important role in helping to maintain the health of the oral mucosa in the presence
of the growth factors to assist in the process of wound healing. The saliva flow
continuously helps rinsing the food residue, releasing epithelial cells, and foreign
objects. the Bicarbonate buffer in saliva to neutralize the acids in foods and the
acid which is produced by bacteria in the mouth, thus helping to prevent dental
caries.

2.2.1 The Composition of Saliva

Based on Stookey (2008: 17) saliva is composed of 94% -99.5% of water,
the organic materials and inorganic. The inorganic components of saliva such as
Na, K, Ca, Mg, Cl, SO, H, PO, and HPO. The inorganic component which has the
highest concentration of Na and K. The main organic component is a protein and
mucin. Beside that there are also lipid, glucose, amino acid, urea ammonia, and
vitamin. The organic components can be found from the exchange of bacteria and
food substances. Protein is quantitatively important is α-amylase, proline-rich
protein, mucin, and immunoglobulins.

2.2.2 The Saliva Flow Rate

Based on Haroen (2002: 29) the Saliva flow rate greatly affected the quantity
of saliva produced. The saliva flow rate is unstimulated and the quality of saliva is
greatly affected by time and it can change throughout the day. There is an increase
in the saliva flow rate when you wake up until it reaches the maximum level
during the day, as well as decreased dramatically when sleeping. Reflex saliva is
stimulated by chewing or there is any food, acid can increase the saliva flow rate
up to 10 times or more. In normal people, the saliva flow rate is unstimulated
around 0.3-0.4 ml/min. The amount of the secretion of saliva per day without
stimulation was 300 ml. Whereas when sleeping for 8 hours, the saliva flow rate is
only about 15 ml. Within 24 hours, an average of saliva will be stimulated at the
meal time for 2 hours. Then saliva are in a resting condition for 14 hours, with a
total production of saliva 700-1500 ml. The rest is saliva in a rest condition.

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 When saliva is stimulated, the saliva flow rate increased up to 1.5-2.5 ml /
min. Patients are called xerostomia when they are stimulated, the saliva flow rate
is less than 0.7 ml / min. The Saliva flow rate was stimulated by taste and
mastication, including flavor chewing gum containing xylitol and its chewing.
The increase of eleven of the saliva flow rate will increase the pH because there
are bicarbonate ions so that the ability to maintain the pH of saliva (buffering
capacity) will also increase. Calcium ions and phosphate also increase so that
there will be a balance between demineralization and remineralization.

2.2.3 Saliva Function

Based on Haroen (2002: 31) saliva has a variety of functions which are for
lubrication tissues in the oral cavity, protects tissues in the oral cavity to prevent
abrasion when mastication occur, helps metabolize carbohydrates, antibacterial
activity against pathogenic bacteria of the oral cavity, clean up debris and food
scraps are left in the oral cavity, and saliva also helps maintain the stability of the
buffer system in the oral cavity. Another function is to help digest food, and tools
necessary to optimize the function of taste as mentioned above, saliva has another
important function is to maintain the integrity of the teeth, tongue and oral
mucous membranes and oropharynx.

CHAPTER III

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 METHODOLOGY

3.1 Operational Definition of Terms

The operational definition in this study are:
1. Saliva is a combination of various fluids and components are excreted into the
oral cavity.
2. Betel leaves is a native Indonesia plant that grows vines or leaning on another
tree.

3.2 Research Variables

1. The independent variable is the variable / factor that made free and varied. In
this study, the independent variables are brushing teeth.
2. The dependent variable is the factor that emerged as a result of the independent
variables. In this study, the dependent variable is the degree of acidity.
3. The control variable is another factor that take effect are made equal and
controlled. In this study, the control variable is toothpaste betel leaves.

3.3 Research Methodology

The method used in this study is experimental. Experiments done is to
measure the degree of saliva’s acidity of the use toothpaste containing betel leaf.

3.4 Time and Place Research

This research was conducted in October 2015 in the house writers in Wolter
Mongonsidi street, Casa Felix Residence Block C 10 Patal-Pusri Kalidoni
Palembang.

3.5 Procedure Research

The data obtained through experiments conducted by the authors, the
following are experimental procedures performed.

3.5.1 Tools and Materials

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1. Toothbrush.
2. Toothpaste containing betel leaves.
3. Gloves.
4. Pot container saliva.
5. Indikator universal paper

3.5.2 How To Do
1. The subjects were selected based on criteria of age.
2. Each subject was asked not to eat for an hour before the study began.
3. Standardization carried out on the subject by brushing teeth using toothpaste
that contains betel leaf.
4. Measurement of pH of saliva is done immediately, after brushing using
toothpaste containing betel leaf.
5. Saliva is placed in a container pot saliva is then measured by using a indicator
universal paper.
6. The number of respondents overall were obtained by simple randomize
sampling by 4 people. The criteria of age of all research subjects in this study
were adolescents aged 13-16 years. In the youngest a ge of the subjects in this
study was 10 years old, while the oldest is 16 years of age.

3.6 Data Collection Techniques

Techniques used by researchers to collect data in this study is observation, it
means collect the saliva’s from some subject to measure the degree of saliva’s
acidity by indicator universal paper and take the picture.

3.7 Data Analysis Techniques

This research is quantitative analysis techniques. The data obtained in this
study is to document the process of measuring the degree of saliva’s acidity to the
usage toothpaste of containing the betel leaves and obtain measurement results the
degree of saliva’s acidity to the usage toothpaste of containing the betel leaves.

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 CHAPTER IV

RESEARCH FINDINGS AND DISCUSSION

4.1 The Results

4.1.1 Procedure research

Picture 4.1 The selection of the research subjects based on age criteria.

Picture 4.2 The subjects did not consume the food for one hour before to the research.

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 Picture 4.3 Collecting saliva before brushing teeth.

Picture 4.4 Brushing teeth using toothpaste that contains betel leaves.

15
Picture 4.5 The toothpaste containing betel leaves.

Picture 4.6 Collecting the saliva after brushing.

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Picture 4.7 Indicator universal paper.

Picture 4.8 Measure the degree of saliva’s acidity

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4.1.2 The results of the measurement the degree of saliva's acidity.
Table 1.1 Observations the color of the indicator universal paper of the saliva,
before and after brushing teeth.

Research Color of indicator universal paper

No Subjects Before brushing teeth After brushing teeth
1 Subjects
1

2 Subjects
2

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 3 Subjects
3

4 Subjects
4

Tabel 1.2 The degree of saliva’s acidity result measurement.

The degree of saliva’s acidity

No Research Subjects Before brushing teeth After brushing teeth
1 Subjects 1 7 8
2 Subjects 2 7 7
3 Subjects 3 8 8
4 Subjects 4 6 6

4.2 Discussion
From the research which was conducted on 4 subjects with age range 13-
16 years, obtained the results of the degree of saliva's acidity measurement after
the usage of the toothpaste containing betel leaves. To change the pH of the
saliva, there are no significant changes after the usage of the toothpaste containing

19
betel leaves. The significant changes only occurred in one subject. This can be
caused by salivary pH is strongly influenced by the bicarbonate system.
Bicarbonate system is very effective in neutralizing the acid and is proportional to
the speed of the salivary secretion. This indicates that there is no significant
change in the pH of saliva after the usage of toothpaste containing betel leaves.
Therefore the betel leaves substance in the toothpaste does not affect the
increment the saliva’s acidity. This is shown because there is no chemical
components in a betel leaves.

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 CHAPTER V

CONCLUSION AND SUGGESTION

5.1 Conclusion
Based on the results of the study concluded that:
1. This research measurement is done by collecting saliva before and after
brushing with the toothpaste containing betel leaves, the collected data is the
primary data of saliva's acidity measurement results.
2. The usage of the toothpaste containing betel leaf does not affect the saliva's
acidity changes. Seen in the test results of statistical data on the effect of the
use of toothpaste containing betel leaves against saliva's acidity, significant
changes only occurred in one subject, while the other subjects are not
significant changes.

5.2 Suggestion
Things to authors suggest that after doing this research, these are:
1. It is recommended if the research will be continued, the research could
better control of confounding variables that could affect the research results.
2. It is recommended to the reader to be able to switch use the particular herbal
toothpaste containing betel leaf extract to improve dental and mouth health.
3. It is recommended to further research that the chemical components in the betel
leaves can be used as material for a mixture of toothpaste and oral antiseptic
products, and also can be considered about addition of flavor so that the product
more attractive but still in accordance with the standards for pharmacy.

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 REFERENCES

Haroen. 2009. Influence of Mastication and Taste Stimuli to The Flow Velocity
and The Degree of Saliva Acidity. Jakarta: Journal of Dentistry UI.

Muthoharoh, Layin. 2011. Pharmacies Life Around Us. Jakarta: Transmedia

Pustaka.

Pannuti, Matos. 2014. Clinical Effect of A Herbal Dentrifice in The Control of

Plaque and Gingivitis. Brazilia : Pesqui Odontal Bras.

Rosdiana, Anna. 2014. Efficacy of Magical Betel Leaves Cure Various Diseases.
Jakarta: Padi Pustaka.

Stookey. 2008. The effect of saliva on dental karies. Indiana: University School of
Dentistry Press.

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