Effects of smokeless tobacco on gingival and periodontal status in adults: A case control study

Abstract

Background: The practice of placing a small amount of smokeless tobacco or chewing tobacco in the oral cavity and leaving it in place for extended periods of time appears to be finding its way onto middle school, high school, and college campuses as a socially acceptable and popular habit. Numerous reports in the literature have described the oral changes that appear to be associated with the use of smokeless tobacco in adults. Such information is unavailable for the lower age groups. The study was carried to evaluate and compare the effects of smokeless tobacco on oral hygiene status, gingival health, and periodontal status. Settings and Design: This comparative study was conducted at the Department of Periodontics, Yenepoya Dental College, Mangalore. Materials and Methods: A total of 140 individuals from in and around Mangalore were selected for the study, of whom there were 70 smokeless tobacco users and 70 nonusers. A detailed questionnaire was used which included questions regarding the history of smokeless tobacco usage and oral hygiene practices. Oral health assessment was made by clinical examination by using various indices which included (1) Simplified Oral Hygiene Index (OHI-S), (2) Plaque Index (PI), (3) Gingival Index (GI), (4) Periodontal Pocket Depth (PPD), (5) Gingival Recession, and 6) Clinical Attachment Level (CAL). Collected data were analyzed by unpaired t -test and chi-square test using SPSS version 15.0 software program. Results: No statistical significance was observed in the OHI-S, GI, PI, and CAL scores, although 33.9% of the patients showed localized gingival recession. A statistically significant difference was seen in PPD measurements in the control group. Conclusion: The present study demonstrates that the usage of smokeless tobacco may negatively influence oral hygiene status, gingival health, and periodontal status.