The present investigation examined whether an association exists between betel quid chewing and signs of periodontal disease and determined the prevalence of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis by polymerase chain reaction. The periodontal status of 34 betel quid chewers and 32 non‐betel quid chewers were compared. A significantly higher prevalence of bleeding on probing was found in betel quid chewers than non‐chewers among the subjects with higher plaque level, greater gingival inflammation, deeper probing depth or greater attachment loss. Also, the results suggested that betel quid chewers may harbor higher levels of infection with A. actinomycetemcomitans and P. gingivalis than non‐betel quid chewers. The association persists after adjusting for severity of the clinical parameters. In conclusion, betel quid chewing was associated with a higher prevalence of bleeding on probing where higher clinical levels of disease existed, and with a likelihood of subgingival infection with A. actinomycetemcomitans and P. gingivalis.

This study was designed to determine the histologic response of regenerated tissue to plaque, using an adult Taiwan monkey model with chronically-inflamed, surgically-created, periodontal defects. Standardized 2-walled periodontal defects were surgically created at the mesial of the mandibular lateral incisor on one side. Sutures, 3-0 braided silk, were placed for 8 weeks and tissues positioned so that denuded root surfaces were exposed to plaque, with the subsequent development of the chronically-inflamed periodontal tissues. At 8 weeks the defects were subjected to guided tissue regeneration procedures using expanded polytetrafluoroethylene membrane and allowed to heal for 6 months. Contralateral clinically healthy sites, without surgical procedures, were used as controls. In both experimental (membrane) and control sites, silk ligatures were placed to allow plaque accumulation for 2 or 10 weeks. Four monkeys were sacrificed at each time point and specimens processed for histologic and histometric study. The results indicated that plaque-induced inflammation was less at sites treated by guided tissue regenerative procedures when compared to originally clinically-healthy sites exposed to plaque for the same duration. However, histologically the newly formed osseous tissue was compromised under these conditions.