Abstract

Objectives:To compare self-perceived oral symptoms and clinical (plaque index [PI], bleeding on probing [BOP], clinical attachment loss [CAL]) and radiographic (marginal bone loss [MBL]) periodontal parameters among naswar (NW) and non-naswar dippers (NNW).Methods:One hundred and forty-two individuals (72 patients consuming naswar and 70 controls) were included. All participants completed a baseline questionnaire that included information regarding demographic characteristics and self-perceived oral symptoms. Clinical periodontal parameters (PI, BOP, PD and CAL) were recorded. MBL was measured on digital panoramic radiographs.Results:Pain in teeth, pain on chewing, bleeding gums and burning sensation in the mouth was significantly worse among NW than NNW (p<0.01). Clinical periodontal parameters and MBL were significantly high in NW than NNW (p<0.001). There was statistically significant influence of daily use and mean duration of naswar consumption on the severity of PI, BOP, PD (4 to 6 and >6 mm) and MBL among NW group.Conclusions:Self-perceived oral symptoms and periodontal parameters were worse among naswar dippers. It is highly recommended that naswar dipping should be considered a potential threat that could have major effects on periodontal tissues.

Highlights

  • Naswar is a type of dipping smokeless tobacco product (STP), made from fresh tobacco leaves, calcium oxide, wood ash and indigo widely consumed in Afghanistan, Iran, Pakistan, India and South Africa.[1,2,3] Naswar is commercially available in transparent non-labeled pouches which are dispensed without a health threatening sign regarding its risk on oral and general health

  • Tooth brushing twice a day was reported by 21.1% of naswar dippers (NW) and 72% of non-naswar dippers (NNW) (Table-I)

  • The present findings clearly demonstrated that clinical and radiographic periodontal parameters were significantly high in

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Summary

Introduction

Naswar ( known as Nass or Niswar) is a type of dipping smokeless tobacco product (STP), made from fresh tobacco leaves, calcium oxide (slaked lime), wood ash and indigo widely consumed in Afghanistan, Iran, Pakistan, India and South Africa.[1,2,3] Naswar is commercially available in transparent non-labeled pouches which are dispensed without a health threatening sign regarding its risk on oral and general health. Naswar is either used by ‘sniffing’ (nasally) or ‘dipping’ by placing in the buccal vestibule either in the upper or lower anterior or posterior area for 10–15 minutes.[1,2] The contents are sucked intermittently and not chewed because of the bad taste. The contents are spat out subsequently and never swallowed. Previous studies have showed worse periodontal conditions such as plaque index (PI), bleeding

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