Prevalence of Dental Caries among Smoking and Smokeless Tobacco Users Attending Dental Hospital in Eastern Region of Uttar Pradesh

The association between smoking and smokeless tobacco use with dental caries among Pakistani patients

BACKGROUND

Tobacco use is widely recognised as a significant risk factor for oral cancer and periodontal diseases. However, the relationship between various types of tobacco use and dental caries has been inconsistent. This study aimed to determine the association between smoking and smokeless tobacco and dental caries among patients in a tertiary care hospital in Quetta, Pakistan.

METHODS

This cross-sectional study was conducted from November 2020 to March 2021 among patients in a tertiary care hospital in Quetta, Pakistan. Oral examinations and interviews were performed according to the WHO Oral Health Survey basic methods (5th edition) to determine dental caries status, tobacco use, and oral health behaviours. The odds ratio and binary logistic regression were analysed to assess the association between the types (smoking tobacco, smokeless tobacco, and use of both types), duration, and frequency of tobacco use and high caries level (DMFT ≥ 5).

RESULTS

Four hundred participants aged 18-65 were included, and 67.8% were tobacco users. Use of both smoking and smokeless tobacco (aOR = 14.7, 95%CI = 1.87-115.96, p = 0.011), smokeless tobacco only (aOR = 5.90, 95%CI = 1.89-18.37, p = 0.002), and smoking only (aOR = 2.18, 95%CI = 1.23-3.88, p = 0.008) were associated with significantly increased risk of high caries. Using tobacco for longer periods and more frequently daily also significantly increases the risk of high caries.

CONCLUSION

Smoking and smokeless tobacco are significantly associated with high dental caries after adjusting for other factors. Due to the high severity of dental caries and the high prevalence of tobacco use among Pakistani patients in this study, it is highly recommended to strengthen policies aimed at reducing tobacco usage, including smokeless forms.

Impact of tobacco habits on poor oral health status among bone-factory workers in a low literacy city in India: A cross-sectional study

Oral health is a vital indicator of well-being that is influenced by various habits and lifestyles of individuals. Oral diseases are the bottleneck in the effective control of non-communicable diseases (NCDs) due to chronic in nature and reciprocal relationship as sharing the common risk factors and habits such as sugar, tobacco, and alcohol consumption that increase the risk of developing various inevitable diseases. However, there is a lack of literature highlighting the relationship between risk factors for oral diseases and general health among individuals. This cross-sectional study was carried out among 500 study participants aged 20 to 64 years who gave written informed consent and were recruited by Multistage Stratified Cluster Sampling technique among workers in five bone factories, working for at least one year since January 2001 to March 2022 in Sambhal city, Uttar Pradesh. WHO-Basic Oral Health Survey-1997 was used to record the data regarding sociodemographic and oral health status variables. We used the modified WHO-STEPWISE pre-structured questionnaire to record tobacco consumption habits and oral health-seeking behavior. We scheduled a clinical intra-oral examination to record the Decayed Missing Filled Teeth (DMFT) index and the interview on the premises of five bone factories. Among the 500 bone-factory workers, the total number of males was 342 (68.40%) and 158 (31.60%) were females. The mean age (Standard Deviation) was 33.18 (10), and the mean DMFT score of factory workers was 2.84 (3.12). Production workers had the highest mean DMFT score of 4.60 (3.25). More than half of the factory workers (53.2%) were tobacco users. Tobacco users were 3.52 times more likely to have a severe DMFT index. Most common pre-cancerous lesions were oral submucous fibrosis and leukoplakia. Compared to non-tobacco users, mild tobacco users have 6.80 folds higher odds of oral lesions. Tobacco consumption is not only harmful for oral health but also leads to several non-communicable and systemic diseases. NCDs and dental caries are chronic and preventable conditions with a bidirectional relationship implicated by modifiable major risk factors such as tobacco consumption. Decreasing the consumption of tobacco use may improve oral health and reduce the risk of the development of NCDs. Also, regular dental visits should be scheduled to monitor the oral health status of factory workers. Additionally, tailored intervention for tobacco cessation should be implicated to maintain the general and oral health of industrial workers.

Comparative Analysis of Dentition and Periodontal Status in Patients With Unilateral Smokeless Tobacco Pouch Keratosis

INTRODUCTION

The consumption of smokeless tobacco (SLT) and related products has become an epidemic worldwide, especially among young people, as they come into direct contact with the tissues of the oral cavity. Therefore, the present cross-sectional study was conducted to compare the status of dentition and periodontal health of teeth associated with the unilateral SLT pouch keratosis with the unaffected contralateral side.

MATERIALS AND METHODS

In this study, 96 SLT users from north Maharashtra, India, with unilateral SLT pouch keratosis were studied. Demographic data, past and present SLT use history, features of SLT pouch keratosis, modified community periodontal index, dentition status index, and loss of tooth attachment were recorded. Data were collected and subjected to statistical analysis using the unpaired t-test and chi-square test.

RESULTS

The results of the present study showed a significant difference (p≤0.05) in gingival bleeding, pocket depth, and attachment loss in teeth associated with smokeless tobacco keratosis (STK) compared to teeth at the contralateral sides of the arch. The duration of tobacco use had a significant effect on the severity of loss of attachment at SLT pouch keratosis sides. There was a significant difference (p≤0.05) in the mean scores of the sound crown, carious crown, and coronal caries status between the SLT pouch keratosis side and the contralateral side.

CONCLUSION

The results of the study revealed that significant gingival bleeding, gingival recession, and attachment loss in the teeth are associated with SLT pouch keratosis compared with the teeth on the contralateral side without the lesion.

Oral health and nicotine dependence in tobacco users visiting a Dental Institution in North India

Objective

The cross-sectional study was intended to evaluate the oral health and nicotine dependence among tobacco users.

Material & Methods

Fagerstorm Test for Nicotine Dependence estimated nicotine dependence and clinically oral examination was performed in recording the dentition status, oral hygiene, gingivitis and periodontal health. Descriptive statistics was computed using mean, percentage and standard deviation. Association was estimated using Independent T Test. Binary logistic regression and multiple regression analysis was used in inferential statistics.

Results

In general, 55.3% had dental caries, followed by 92.6% having gingivitis and 7.4% had clinical attachment loss. Mean DMF was 2.60 (± 3.88) and the subjects mean oral hygiene score was 3.49 (± 1.11). The mean DMF score of tobacco users worsened with increasing age. Current smokers were 1.07 times more predisposed to get dental caries than former smokers and smokeless tobacco chewers had higher odds of 1.060 times to fall susceptible to dental caries than those smoking tobacco. Dependence on tobacco substantially worsened oral hygiene.

Conclusions

Tobacco cessation practices shall be effectively enforced to minimize the burden of nicotine dependence.

Assessment of Periodontal Health Status among the Male Adult Population with a Dual Habit of Smoking and Gutkha Chewing: A Cross-Sectional Study

Aims and Objective

The aim of this study was to assess the periodontal health status in subjects having dual habits of smoking and gutkha chewing among the male population of Kanpur City, Central Uttar Pradesh (UP).

Materials and Methods

A total number of 500 male subjects were included, divided into three study groups: group I-164 subjects with a dual habit of smoking and gutkha chewing, group II- 170 gutkha chewers, and group III-166 smokers. Case history, clinical examination, and the following clinical parameters were recorded-oral hygiene index (OHI-S), gingival index (GI), bleeding index, clinical attachment loss (CAL), gingival recession, and furcation involvement.

Result

In this study, the proportion of severe CAL was maximum in dual habit (78%) followed by smokers (70.5%) and then gutkha chewers (40.0%). A significant difference was observed in the proportion of CAL status between smokers, gutkha, and dual habit cases (P < 0.001). The result revealed that the dual habit group had more severe periodontal disease than smokers and gutkha chewers.

Conclusion

Overall, it was concluded that periodontal health status was found to be very poor in both smokers and gutkha chewers, but the subjects in the dual habit group were found to have extremely poor periodontal health status.

Dental caries: Impact of tobacco product among tobacco chewers and tobacco smokers

Objective

Tobacco is the most significant social burden and the leading cause of death. Tobacco is derived from "Nicotiana tabacum" which has nicotine as the main component. There are various disadvantages from tobacco on health which are reported in the medical literature. But the risk of caries among these tobacco users, such as chewers and smokers, is still debatable. Hence, the present study aims to determine the prevalence of dental caries among tobacco chewers and smokers.

Materials and methods

In this study, 389 individuals were included. Out of 389 individuals, 304 were men and 85 were women aged between 18 and 60 years. They were classified into two groups. Group A had 207 individuals with habitual tobacco chewing, and Group B had 182 individuals with habitual tobacco smoking and provided a 6 months history. The DMFT index (Decayed, Missing, and filled teeth index-WHO modification 1997) was used to assess caries.

Results

The study revealed a higher prevalence of dental caries among tobacco chewers compared to tobacco smokers. The DMFT scores were higher among gutka chewers compared to other types of tobacco use. The lower posterior tooth region showed higher dental caries in tobacco chewers compared to smokers.

Conclusion

The higher presence of caries in the tobacco chewing group is due to the presence of sweeteners, which act as cariogenic agents. Similarly, smokers have a thiocyanate component that acts as an anticariogenic agent; therefore, the prevalence of caries was lower in tobacco smokers.