Oral Health Consequences of Use of Smokeless Tobacco in North India: A Cross-Sectional Survey

Neha Agrawal,Anshul Aggarwal,Narinder Dev Gupta,Juhi Gupta,Rajendra Kumar Tewari,Amit Kumar Garg

doi:10.1590/pboci.2021.025

Neha Agrawal, Anshul Aggarwal + Show 4 more

Open Access

https://doi.org/10.1590/pboci.2021.025

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Abstract

Objective: To evaluate the effects of commonly used smokeless tobacco forms on oral health at habitual placement sites of smokeless tobacco compared to non-placement sites among the North Indian population. Material and Methods: This cross-sectional study was conducted among 542 individuals using smokeless tobacco recruited from the outpatient wing of the Dental College. Subjects completed a questionnaire and received an oral examination. Periodontal pocket depth, gingival index, plaque index, gingival recession, and oral mucosal changes were assessed. Kendal’s Tau test, paired t-test, and chi-square test were carried out to compare different variables among placement and non-placement sites. Results: Most of the subjects were male, reporting an average of 11.26 years of SLT use. Clinical inflammation of gingiva was significantly greater (p=0.01) at placement-sites (1.64 ± 0.53) of SLT in comparison to non-placement-sites (1.40 ± 0.41). The difference in the GR and PPD at placement and non-placement-sites was also statistically significant with p=0.002 and p=0.001, respectively. Clinically, the majority of subjects had mucosal changes at the placement sites, and a statistically significant association (p=0.034) was observed between the duration of the use of smokeless tobacco and the mucosal changes. Conclusion: Smokeless tobacco use predisposes to increased risk of periodontal diseases and oral mucosal changes at the placement sites in an individual due to the local irritant effect.

Highlights

The global tobacco epidemic has resulted in various adverse health effects and is the leading cause of death worldwide
Objective: To evaluate the effects of commonly used smokeless tobacco forms on oral health at habitual placement sites of smokeless tobacco compared to non-placement sites among the North Indian population
Of the estimated 28.6% tobacco use in India, 21.4% is used in the form of smokeless tobacco (SLT) products such as pan, gutka/pan masala and mishri [2]

Summary

Introduction

The global tobacco epidemic has resulted in various adverse health effects and is the leading cause of death worldwide It is considered the most significant public health threat globally, accounting for more than 7 million deaths annually [1]. SLT use has been reported to be associated with numerous oral manifestations localized at the SLT placement site in the oral cavity, which can be considered the Placementsite. These manifestations include mucosal lesions as leukoplakia, oral cancer, gingival-periodontal effects, gingival recession, gingival inflammation, gingival blood flow changes, and interproximal periodontal attachment loss and dental caries [4,5,6]

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Conclusion