Abstract
BackgroundBetel quid chewing is associated with the periodontal status; however, results of epidemiological studies are inconsistent. To the best of our knowledge, no study has reported radiographic alveolar bone loss (RABL) associated with betel quid chewing.MethodsThis survey was conducted in an aboriginal community in Taiwan because almost all betel quid chewers were city-dwelling cigarette smokers. In total, 114 subjects, aged 30–60 years, were included. Full-mouth intraoral RABL was retrospectively measured and adjusted for age, gender, and plaque index (PI). Multiple regression analysis was used to assess the relationship between RABL and potential risk factors.ResultsAge-, gender-, and PI-adjusted mean RABL was significantly higher in chewers with or without cigarette smoking than in controls. Multiple regression analysis showed that the RABL for consumption of 100,000 pieces betel quid for the chewer group was 0.40 mm. Full-mouth plotted curves for adjusted mean RABL in the maxilla were similar between the chewer and control groups, suggesting that chemical effects were not the main factors affecting the association between betel quid chewing and the periodontal status.ConclusionBetel quid chewing significantly increases RABL. The main contributory factors are age and oral hygiene; however, the major mechanism underlying this process may not be a chemical mechanism. Regular dental visits, maintenance of good oral hygiene, and reduction in the consumption of betel quid, additives, and cigarettes are highly recommended to improve the periodontal status.
Highlights
Betel quid chewing is associated with the periodontal status; results of epidemiological studies are inconsistent
The adjusted mean radiographic alveolar bone loss (RABL) was significantly higher if there was a daily chewing habit, if >10 pieces were chewed per day, if the chewing habit persisted for >10 years, if >33,000 pieces were chewed till the present date, or if betel fruit, betel leaves, or lime was used with betel quid
The present study showed that after adjustment for age, gender, and plaque index (PI), the mean RABL in the smoker and chewer group as well as the chewer group was significantly higher than that in the control group, showing an upward trend in RABL with older age, cigarette smoking, poor oral hygiene, higher consumption of betel quid, and consumption of extra additives with betel quid
Summary
Betel quid chewing is associated with the periodontal status; results of epidemiological studies are inconsistent. To the best of our knowledge, no study has reported radiographic alveolar bone loss (RABL) associated with betel quid chewing. It is usually added to the flower and/or leaf of Piper betle along with several other chemical additives; the mixture is known as betel quid. Hospital-based studies have reported that betel quid chewing is associated with a high prevalence of bleeding on sulcus probing [17] and that betel quid additives may significantly aggravate periodontitis [18]. Another study reported that betel quid additives have no significant association with chronic periodontitis after adjustment for smoking habits [19].
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