Human Immunodeficiency Virus (HIV) disease is characterized by a progressive deterioration in immune function1.

Hipofunctional saliva glands (decreased secretion of saliva objectively) and serostomia (complaint about dry mouth subjectively) is often associated with HIV infection . !hallacombe and "agli# ( $$%) affirming that HIV infection have an effect either directly or indirectly on the oral mucosal immunity on saliva. HIV induce s changes of oral epithelial cells& together with the failure action of !'( lymphocytes and mucosal change of cyto#ine secretion could lead development of secondary infections in the oral mucosal )&(. *istig et al ( $$))& +in et al ( $$))& !oates et al (1,,-)& *weet et al (1,,.)& and /andel et al (1,, )& /ulligan ( $$$) said that the rate of saliva flow in patients HIV positive lower than individual negative.&%&0. *alivary disfunction causing reduction secretion of saliva on patient HIV12I'*. *ecretion of saliva glands and composition of saliva changed as a result of HIV infection . +u ( $$0) mentioned that the HIV replication can affect endothelial cells and caused obtruction of blood capillaries that supplies blood to secretion cells of glandular saliva. 2s a result& secretion of saliva become lower& serostomia& and increasing susceptibility to lesion or oral infection (. "avazesh et al ( $$)) report that there is relationship between progression of HIV infection with alteration of submandibula and sublingual glands function. 3he number of 3 cells !'( 4 $$ cells1mm) has been identified is the ris# factor to a decrease in rate saliva flow-. *alivary fluid is an e5ocrine secretion consisting of appro5imately ,,6 water& containing a variety of electrolytes (sodium& potassium& calcium& chloride& magnesium& bicarbonate& phosphate) and proteins& represented by enzymes& immunoglobulins and other antimicrobial factors& mucosal glycoproteins& traces of albumin and some polypeptides and oligopeptides of importance to oral health. 3here are also glucose and nitrogenous products& such as urea and ammonia.3he components interact and are responsible for the various functions attributed to saliva,. *aliva behaves as a buffer system to protect the mouth& as follows,7 1. It prevents colonization by potentially pathogenic microorganisms by denying them optimization of environmental conditions. . *aliva buffers (neutralizes) and cleans the acids produced by acidogenic microorganisms& thus& preventing enamel demineralization.

"egatively loaded residues on the salivary proteins wor# as buffers. *ialin& a salivary peptide& plays an important role in increasing the biofilm pH after e5posure to fermentable carbohydrates. 8rea is another buffer present in total salivary fluid which is a product of aminoacid and protein catabolism that causes a rapid increase in biofilm pH by releasing ammonia and carbon dio5ide when hydrolyzed by bacterial ureases,. *aliva plays a fundamental role in maintaining the physical9chemical integrity of tooth enamel by modulating remineralization and demineralization. 3he main factors controlling the stability of enamel hydro5yapatite are the active concentrations free of calcium& phosphate& and fluoride in solution and the salivary pH. 'epending on the pH& salivary calcium can be ionized or lin#ed. Ionized calcium is important for establishing e:uilibrium between the calcium phosphates of enamel and its adjacent li:uid. "on9ionized calcium can be lin#ed to inorganic ions (inorganic phosphate& bicarbonate& fluoride)& to small organic ions (citrate)& and to macromolecules (statherin& histidine9rich peptides& and proline9rich proteins). 2 special case of the combination of calcium is its strong lin# with ;9amilase& where it acts as a co9factor necessary for the enzyme function. Inorganic orthophosphate found in saliva consists of phosphoric acid (H )<=() and primary (H <=(9)& secondary (H<=( 9)& and tertiary (<=()9) inorganic phosphate ions. 3he most important biological function of this ion is to maintain the dental structure. 2nother function& discussed previously& is its buffer capacity& relevant only in unstimulated salivary flow. 3he presence of fluoride in saliva& even at physiologically low levels& is decisive for the stability of dental minerals. Its concentration in total saliva is related to its consumption. It is dependent on the fluoride in the environment& especially in drin#ing water. =ther sources are also important& such as entifrices and other products used in caries prevention. 3he presence of fluoride ions in the li:uid phase reduces mineral loss during a drop in biofilm pH& as these ions diminish the solubility of dental ydro5yapatite& ma#ing it more resistant to demineralization. It has also been demonstrated fluoride educes the production of acids in biofilm,. 3he eventual outcome of dental caries is determined by the dynamic balance between pathological factors that lead to demineralization and protective factors that lead to remineralization. <athological factors include acidogenic bacteria& inhibition of salivary function& and fre:uency of ingestion of fermentable carbohydrates. <rotective factors include salivary flow& numerous salivary components& antibacterials (both natural and applied)& fluoride from e5trinsic sources& and selected dietary components1$.

*aliva plays a role as a buffer so that the up and down of the degree of acidity (pH) can be retained. *alivary buffer capacity is determined by the bicarbonate concentration of -.6& 1(6 is determined by the concentration of phosphate and 16 by salivary proteins. >icarbonate is the main component of saliva to neutralize the acid thus inhibiting the caries process11. Pain due to caries caused by stimulation received by the structure of teeth, email, then forwarded to dentine, get to the relation of pulpa-dentin, which contains receptors pain and finally to pulpa. The stimuli will be converted into impulses and transmitted to the nerve center. The stimulus can be a chemical, electrical, mechanical or thermal stimulation.

referensi7 1. (/ehta *& ?iovannucci @& /ugusi A/& *piegelman '& 2boud *& et al. ( $1$) Vitamin ' *tatus of HIV9Infected Bomen and Its 2ssociation with HIV 'isease<rogression& 2nemia& and /ortality. <+o* ="@ .(1)7 e-00$.). . +in 2+& Cohnson '2& *tephan D3& Eeh !D. 2lteration in salivary function in early HIV infection. C 'ent Fes $$)G- (,)701,90 (. ). !hallacombe *C& *weet *<. =ral mucosal immunity and HIV infection7current status. =ral 'isease $$ G-7... (. !hallacombe *C& "agli# CF. 3he @ffects of HIV Infection on =ral /ucosal Immunity. 2dv 'ent Fes $$%G1,7 ,9).. .. /andel I'& Dhurana H*. 3he Felation of Human *alivary Ig2 and 2lbumin to Alow Fate. 2rchs =ral >iol 1,%,G1(71())91().. %. *weet *<& Fahman '& !hallacombe *C. Ig2 subclasses in HIV disease7dichotomy between raised levels in serum and decreased secretion rates in saliva. Immunology 1,,.G-%7..%9..,. 0. !oates @2& Bilson '@& +ogan F/. 3he effects of HIV infection on the :uality and flow of saliva. Int !onf 2I'*. 1,,-G 1 7 1$1.9% (abstract no. %$$-(). -. "avazesh et al. 2 (9year longitudinal evaluation of 5erostomia and salivary gland hypofunction in the womenHs interagency HIV study participants.=ral *urg =ral /ed =ral <athol oral Fadiol @ndod $$)G,.7%,)9-. ,. ( de 2lmeida <'V& ?rIgio 2/3& /achado /J"& de +ima 22*& 2zevedo +F. *aliva !omposition and Aunctions7 2 !omprehensive Feview. C !ontemp 'ent <ract $$/archG (,))7$0 9$-$.) 1$. Aeatherstone& C.'.>. $$(. 3he !ontinuum of 'ental !ariesK@vidence for a 'ynamic 'isease <rocess. Cournal of 'ental Fesearch. vol. -)(1). !),9!( 11. *uryadinata, Arief. 2012. D2'2F >ID2F>="23 *2+IV2 <@"'@FI32 D2FI@* '2" >@>2* D2FI@*. *2I"*3I*. V=+8/@ 1(1). 1 . Balton& Fichard @ dan /ahmoud 3orabinejad. <rinsip dan <ra#ti# Ilmu @ndodonsia& @disi ). Ca#arta7@?!.