Comparison of severity of periodontal clinical parameters among naswar/snuff users: Cross sectional study

Rahim, Abid; Syed, Kawish; Ahad, Babar; Farooq, Afaq; Ayub, Zain; Batool, Syed Midhat

doi:10.1371/journal.pone.0273288

Cited by 4 publications

(1 citation statement)

References 28 publications

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“… 15 , 26 , 27 Tobacco products are also known to have an impact on dental health. 28 Naswar use thus may have an impact on DFMT scores only at an advanced age; this impact could be related to duration of Naswar use since onset and is related to the quantity of Naswar use 29 and type of Naswar use. However, in this study the Naswar users were young adults aged 18–34 years (64%).…”

Section: Discussionmentioning

confidence: 99%

Salivary Oxidative Stress and Antioxidant Capacity in Smokeless Tobacco (Naswar) Users

Ahmad¹,

Binmadi²,

Afridi³

et al. 2023

CCIDE

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Background: Naswar, a smokeless tobacco product, commonly consumed in Pakistan, is associated with a 10-fold increase in the risk of oral cancer. However, little is known about Naswar's underlying toxicity mechanisms. Objective: The current study aimed to investigate the effects of Naswar use on oral health and salivary parameters. Methods: A case-control study was conducted among Naswar users (n=42) and age-matched healthy controls (n=42) in Pakistan in 2019. Participant data were collected using questionnaires. Decayed, missing, and filled teeth (DMFT) scores were computed during clinical examinations. Unstimulated whole saliva was collected to assess salivary flow rate, pH, and salivary total oxidative stress (TOS)/total antioxidant capacity (TAC) using commercially available kits. Participants' oral health parameters were compared between cases and controls using ANOVA. Results: No significant differences were observed between the two groups in terms of age, oral health, and hygiene practices and mean DMFT score. Mean salivary pH and the salivary flow rate was significantly (p<0.001) higher in Naswar users (7.7 and 0.71 mL/ minute, respectively) than in non-users (6.95 and 0.52 mL/minute, respectively). Although TOS and TAC were not significantly different between the groups, Naswar users generally had a higher TOS (51.6±42 µmol/L) and lower TAC (0.55±0.18 mmol/L) than non-users (TOS 45.5±38.2 µmol/L and TAC 0.57±0.17 mmol/L). Correlational analysis also revealed a significant positive correlation between DMFT score and Naswar use duration (r=0.796, p<0.001) and the number of dips/units consumed each day (r=0.515; p<0.001). Conclusion: Habitual Naswar use is associated with increased salivary flow rate, pH, and TOS, and reduced TAC levels in Pakistani adults compared to non-users. The pro-oxidant changes may contribute toward deleterious effects of Naswar use including oral cancer.

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Section: Discussionmentioning

confidence: 99%

Salivary Oxidative Stress and Antioxidant Capacity in Smokeless Tobacco (Naswar) Users

Ahmad¹,

Binmadi²,

Afridi³

et al. 2023

CCIDE

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Smokeless tobacco and periodontitis: A systematic review with meta‐analysis

Quadri,

Kamel,

Nayeem

et al. 2024

J of Periodontal Research

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AimThe present systematic review with meta‐analysis aimed to investigate the global association between smokeless tobacco (SLT) use and periodontitis, considering significant effect size variation based on the income levels of countries.MethodsWe searched seven databases to identify studies that assessed the prevalence of periodontitis in adult SLT users compared to non‐users. The quality of studies was evaluated using the 10‐item risk‐of‐bias tool, and publication bias was addressed through the trim‐and‐fill method. Sensitivity analysis utilized the leave‐one‐out approach. Meta‐analysis and meta‐regression, stratified by country income, SLT type, and smoking status, employed robust variance estimation.ResultsFrom an initial pool of 484 studies, 29 studies met the selection criteria and were subjected to qualitative synthesis. Subsequently, data from 19 studies were included in the meta‐analysis. SLT users exhibited a nearly threefold greater likelihood of periodontitis compared to non‐users (OR = 2.99; 95% CI: 2.10, 4.27; p < .01). The pooled estimate did not vary significantly based on the type of SLT used or concurrent smoking. However, the odds of periodontitis varied according to the economic level of the country; the pooled estimate was higher in high‐income countries (OR = 1.69; 95% CI: 1.20, 2.37; p < .01) and even higher in lower‐middle‐income and lower‐income countries (OR = 3.91; 95% CI: 2.66, 5.77; p < .01).ConclusionsSmokeless tobacco users have a higher likelihood of developing periodontitis. This study underscores global disparities in the SLT–periodontitis relationship, highlighting the need for targeted interventions, particularly in economically challenged areas where SLT use is largely unregulated.

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Cytomorphological changes of oral mucosal cells among smokeless tobacco users in low and middle-income country settings: new findings from Pakistan

Hassan,

Sifat,

Munib

et al. 2024

BMC Oral Health

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Background Chronic tobacco use, in any form, induces significant cellular alterations in the oral mucosa. This study investigates four distinct cytomorphological changes in oral mucosal cells among smokeless tobacco users, examining their association across different genders and age groups. Materials and methods This cross-sectional study involved collecting mucosal samples from smokeless tobacco (naswar/snuff) users through consecutive sampling. The prepared smears were examined for dysplastic changes. Data analysis was performed using SPSS, with Chi-square tests and logistic regression employed to evaluate proportions and associations. Results Among 100 Naswar/snuff users, the labial sulcus mucosa was the most common site affected (47%). The most frequent cytomorphological change was micronuclei (46%), followed by nuclear budding (25%), perinuclear halo (18%), and binucleated cells (14%). In the 51–60 age group, micronuclei (78.9%), nuclear budding (55.3%), binucleation (31.6%), and perinuclear halo (36.8%) were more prevalent (P < 0.005). Gender analysis revealed that micronuclei were more common in females (54.2%) compared to males (43.4%), while nuclear budding was more prevalent in males (27.6%) than females (P < 0.28). Logistic regression indicated that individuals aged 51–60 were more likely to exhibit micronuclei (OR = 1.15, 95% CI: 0.22 to 5.83, P = 0.863) and nuclear budding (OR = 15.34, 95% CI: 9.23 to 30.75, P < 0.05). Conclusion The dysplastic changes observed included micronuclei, nuclear budding, binucleated cells, and perinuclear halo, with micronuclei being the most prevalent. These findings could facilitate the early diagnosis of oral lesions and their timely management in habitual smokeless tobacco users.

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Comparison of severity of periodontal clinical parameters among naswar/snuff users: Cross sectional study

Cited by 4 publications

References 28 publications

Salivary Oxidative Stress and Antioxidant Capacity in Smokeless Tobacco (Naswar) Users

Salivary Oxidative Stress and Antioxidant Capacity in Smokeless Tobacco (Naswar) Users

Smokeless tobacco and periodontitis: A systematic review with meta‐analysis

Cytomorphological changes of oral mucosal cells among smokeless tobacco users in low and middle-income country settings: new findings from Pakistan

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