Khat Chewing and Smoking Effect on Oral Mucosa: A Clinical Study

Abstract

Khat chewing is a deep-rooted habit in Yemen. It was exclusively adult males' habit (17), but it begins to spread among females (4, 15) and children (4). World Health Organization estimated that 70 % to 90 % of men, 30 % to 50 % of women and 25 % of children in Yemen chew khat daily (23). In two separated studies Ali A estimated the prevalence of khat chewing habit in Yemen to be 60.5 % and 61.12 % respectively (2, 3).According to individual authors' observations, khat chewing causes stomatitis that might be secondarily infected (9,17,20). It also causes periodontitis, teeth discoloration and xerostomia (9, 17).There are wide differences in the published epidemiological studies about the effect of khat chewing on oral cavity. Concerning it's dental effect, Hill CM and Gibson A (1987) claimed reduced dental caries among khat chewers (13). Others concluded increased dental carie, especially the cervical ones, teeth staining and attrition in addition to their mobility (5,22). Regarding it's effect on periodontium, it causes gingivitis, periodontitis, periodontal pocket formation and gingival recession (2,5,22). On contrary, other authors proved positive effects of khat chewing, namely less loss of clinical attachment and less pocket depth on the chewing side compared to non-chewing side (13,21) and less plaque and calculus indices among khat chewers compared to non-chewers (14).The aim of this study is to investigate, clinically, the effect of chronic khat chewing on oral mucosae (other than gingiva) and to see if cigarette smoking has additive effect. Material and methodThe study sample consists of 79 Yemeni subjects divided into two main groups, chronic khat chewers (n=54) and control (n=25). The chronocity of khat chewing was defined to be not less than 5 years since starting the habit, not less than 5 days per week and not less than 4 hours per day. The selection criteria of the subjects are male (due to traditional difficulties in finding female sample), systemic diseases-free, no chronic drugs or alcohol users, no shamma (smokeless tobacco) users, do not complain oral mucosal symptoms or use removal dental appliance, For khat chewers, they should chew khat on one side only.The khat chewers group was subdivided according to chewing duration and smoking into six subgroups, Khat chewers for 5-15 years and non-smokers (n=16, mean age=27.1), Khat chewers for 5-15 years and smokers (n=15, mean age=28.5), Khat chewers for more than 15 years and non-smokers (n=10, mean age=37.6), Khat chewers for more than 15 years and smokers (n=13, mean age=36.8). ORIGINAL ARTICLE KHAT CHEWING AND SMOKING EFFECT ON ORAL MUCOSA:A CLINICAL STUDY Summary: Khat (Catha Edulis Forskal) is widely cultivated in Yemen and East of Africa. The habit of chewing tender leaves and twigs of khat is deep-rooted in Yemen. Our study investigates the chronic khat chewing and smoking effect on oral mucosa. The sample (n=79) consists of two main groups, khat chewers (n=54) and control groups (n=25). Khat chewers group is divided into 4 subgroups accord...

Qat Chewing and Risk of Potentially Malignant and Malignant Oral Disorders: A Systematic Review

“…55 The types of the clinical findings on the chewing sides varied according to the duration of Qat chewing habit with more lesions sy ste m at i c re v i e w www.theijoem.com Vol 6, Num 3; July, 2015 among those with longer duration of chewing Qat. There was no statistical difference when comparing the clinical findings between the right and left side of the nonchewers, smokers and non-smokers, while the difference was statistically significant between chewing and non-chewing sides of the Qat chewers.…”

Khat use and related addiction, mental health an physical disorders: the need to address a growing risk

“…However, the major shortcoming of this literature is that other explanations for the physical disorders have not been systematically ruled out, for example tobacco smoking which is frequently combined with khat use (15,21) and the agrochemical content in the leaves (44,45). The negative physical consequences associated with khat use include mucosal problems (46), oral lesions (47), gastric cancers and duodenal ulcers (42), hypertension (48), cardiovascular complications (49), stroke (50), sexual dysfunction (51), hepatoxicity (52) and reduced birth weight of infants born to khat-chewing mothers (53), to mention just a few.…”

The association of khat (Catha edulis) chewing and orodental health: A systematic review and meta-analysis

“…Of these, 30 were eligible for full article reading. Eleven [13,[22][23][24][25][26][27][28][29][30][31] of the 30 articles were excluded because they did not meet the inclusion criteria. Nineteen studies were therefore found appropriate for this systematic review and meta-analysis (only eight of the 19 studies were suitable for metaanalysis) (Fig.…”

“…Comparison was impossible • In 1 study, [26] the outcome measured and the presentation of results were ambiguous • 1 study [27] investigated the e ect of khat extract on in vitro-reconstructed oral mucosa • 1 study [29] involved volunteers • For 1 study, [30] a full report could not be found • 1 study [31] was a duplicate of another [45] …”