Effect of a Novel Betel Leaf Dentifrice on Commonly Seen Oral Hygiene Parameters—A Randomized Clinical Crossover Study

Ali, Maha Ziad; Elbaz, Wafaa Fathy Ahmed; Adouri, Saja; Desai, Vijay; Fanas, Salem Abu; Thomas, Biju; Varma, Sudhir

doi:10.3390/dj10090166

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…Multiple physiological pathways might explain the direct effects of betel quid use and anemia suggested by our findings. Betel quid use might cause irritation or blood loss in the mouth or gastrointestinal tract, which could lead to anemia [ 47 , 48 ]. Using betel quid might also have direct physiological effects on hemoglobin production, erythropoiesis, or erythrocyte longevity, or adversely affect these via oxidative stress [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Betel quid use is associated with anemia among both men and women in Matlab, Bangladesh

Sznajder

Shenk

Alam

et al. 2023

PLOS Glob Public Health

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Anemia accounts for 8.8% of total disability burden worldwide. Betel quid use among pregnant women has been found to increase anemia risk. Betel quid is prepared by wrapping the betel (or areca) nut, with spices and other additions, in betel or tobacco leaf and it is chewed or placed in the mouth. We explored the association between betel quid use and anemia among men and non-pregnant women. We collected data from a random sample of women and their husbands in Matlab, Bangladesh. Participants reported their current betel quid use and individual characteristics. We assessed hemoglobin (a biomarker of anemia) with a hemoglobinometer and soluble transferrin receptor (a biomarker of iron deficiency) and C-reactive protein (a biomarker of inflammation) in dried blood spots via enzyme immunoassay. We estimated logistic regression models to evaluate the association between betel quid use and anemia and structural equation models (SEM) to evaluate mediating roles of iron deficiency and elevated inflammation. A total of 1133 participants (390 men and 743 non-pregnant women) were included. After controlling for important confounders, any betel quid use was positively associated with anemia among men (OR: 1.80; 95% CI: 1.12, 2.89). Among women, betel quid use was associated with anemia only among the most frequent users (OR: 1.62; 95% CI: 1.03, 2.53). SEM did not reveal indirect paths through inflammation or iron deficiency. Betel quid use may contribute to the burden of anemia among adults in Bangladesh. Our findings suggest the burden of disease attributed to betel quid use has been underestimated.

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Section: Discussionmentioning

confidence: 99%

Betel quid use is associated with anemia among both men and women in Matlab, Bangladesh

Sznajder

Shenk

Alam

et al. 2023

PLOS Glob Public Health

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“…The latter preparation of BQ without added areca nut or SLT poses negligible hazard to oral or general health and the literature provides no data on any ill effects of consuming betel leaf. On the contrary, plenty of literature is available on its medical benefits (Rai et al, 2011, Ali et al, 2022, Aara et al, 2020. On the other hand, the preparation constituting areca nut and/or SLT has been categorised as a class I carcinogen by WHO.…”

Section: Dear Editormentioning

confidence: 99%

TikTok Content Analysis on Smokeless Tobacco and Betel Quid: Perception Versus Reality

Sarode

Sengupta

Sarode

2023

Asian Pac J Cancer Prev

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Periodontitis presenting among betel quid users: A case series

Park,

Pitchumani,

Tatakis

2024

Clin Adv Periodontics

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BackgroundBetel leaf chewing habit has been studied extensively, as it has been an ancient practice in many Asian countries. Although betel leaf has been reported to have potential beneficial properties, it has also been shown to have a strong association with oral diseases, including periodontitis. This case series addresses the presentation of periodontitis among betel quid users, to help clinicians identify and manage such patients when they are encountered in settings outside the countries and territories where betel quid use is common.MethodsFour patients of Asian ethnicity were referred to The Ohio State University College of Dentistry Graduate Periodontology clinic for periodontal treatment. Targeted questioning resulted in all four patients reporting a past and current betel leaf chewing habit, established at a young age, typically in a family setting, and long before their immigration from their native country.ResultsAll four patients exhibited similar reddish‐brown staining on the teeth and generalized radiographic bone loss. Notably, the patients disclosed the betel chewing habit only after different vernacular names for betel quid were used during questioning, which complicated history taking. Severe periodontitis (stage III/IV, grade C) was diagnosed in all four patients, who were given appropriate periodontal treatment plans.ConclusionBetel leaf chewing, prevalent in many Asian countries, is associated with periodontitis and may present with extensive tooth staining. Oral healthcare providers should consider this cultural habit and pursue thorough assessment and history taking for their patients originating from countries where the habit is common practice.Key Points Clinicians should be aware of the clinical presentation and oral findings in betel quid users. Given the increasing diversity of the patient pool that clinicians are encountering, knowledge of vernacular names for betel quid usage can prove valuable in history taking. A protocol for betel quid cessation should be incorporated into the management strategy for these patients in clinical practice. Plain Language SummaryBetel quid (paan) chewing is a widespread cultural habit, especially in Asia. The chewing of betel quid, whether alone or with tobacco, has been strongly associated with periodontitis and other oral conditions, such as leukoplakia, oral cancer, and oral submucous fibrosis. This report illustrates the typical presentation of periodontitis patients who habitually chew betel quid, highlights the associated clinical features, such as reddish‐brown tooth staining and severe bone loss, and underlines the challenge of obtaining a complete history because of the very many vernacular names used for betel quid in different countries and the fact that for many of the patients, this is considered a routine cultural tradition. It is unusual to encounter patients chewing betel quid in this country because the practice is not common. However, immigrants from countries where betel quid chewing is commonplace may continue the habit after they move to the United States. Oral healthcare providers should be aware of this possibility and elicit the relevant information from the patients. This will help practitioners to properly address this underlying factor and to provide appropriate care to these patients, including cessation advice and support, and establishment of routine oral screenings and regular periodontal maintenance.

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Effect of a Novel Betel Leaf Dentifrice on Commonly Seen Oral Hygiene Parameters—A Randomized Clinical Crossover Study

Cited by 4 publications

References 28 publications

Betel quid use is associated with anemia among both men and women in Matlab, Bangladesh

Betel quid use is associated with anemia among both men and women in Matlab, Bangladesh

TikTok Content Analysis on Smokeless Tobacco and Betel Quid: Perception Versus Reality

Periodontitis presenting among betel quid users: A case series

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