Prevalence and association of smokeless tobacco use with the development of periodontal pocket among adult males in Dawan Valley, Yemen: a cross-sectional study

Abstract

BackgroundThe traditional type of smokeless tobacco used in the Arabian Peninsula, particularly common in Yemen, is called shammah. This study aims to determine the prevalence of shammah use and its association with the development of periodontal pockets. Other associated factors with the development of periodontal pocket were also determined.MethodsThis cross-sectional study included 346 adult males aged 18 years old to 68 years old. Socio-demographic characteristics, oral hygiene practices, and shammah use history were surveyed by using a structured interview questionnaire. The clinical assessment for the presence or absence of periodontal pockets was assessed on the basis of community periodontal index. The chi-square test was used to assess significant differences in study groups in terms of the presence of periodontal pockets. Multivariable logistic regression was selected to assess potential associated factors with the development of periodontal pockets.ResultsAmong the 346 adult males, 248 (71.7 %), 30 (8.6 %), and 68 (19.7 %) males never used shammah, were former shammah users, and were current shammah users, respectively. The significant associated factors with the development of periodontal pocket were age group (30 years old and above) (Adjusted Odds Ratio (AOR) = 2.03, 95 % CI: 1.13, 3.65; P = 0.018), low family income category (AOR = 2.35, 95 % CI: 1.39, 3.99; P = 0.001), former shammah user (AOR = 2.66, 95 %: CI: 1.15, 6.15; P = 0.022), and current shammah user (AOR = 6.62, 95 %: CI: 3.59, 12.21; P = 0.001).ConclusionsThe results revealed that periodontal pockets were significantly associated with age group (30 years old and above), low family income category, former shammah use, and current shammah use. The findings of the current study highlighted the need to develop comprehensive shammah prevention programs and reduce periodontal disease and other shammah-associated diseases.

Betel and tobacco chewing habit and its relation to risk factors for periodontal disease

“…In this regard, our results agree with the reports from different studies that have been performed in Taiwan (Jeng, Lan, Hahn, Hsieh, & Kuo, ), Sri Lanka (Amarasena, Ekanayaka, Herath, & Miyazaki, ; Amarasena et al., ), Thailand (Chatrchaiwiwatana, ), Bangladesh (Akhter, Hassan, Aida, Takinami, & Morita, ), India (Choudhury, Choudhury, Alam, Markus, & Tanaka, ; Mehta, Sanjana, & Barretto, ) and other regions in which betel quid with or without tobacco is consumed. Compared with reports for tobacco chewers, our results agree with studies from the United States (Robertson et al., ), Yemen (Al‐Tayar, Tin‐Oo, Sinor, & Alakhali, ) and India (Anand, Kamath, Shekar, & Anil, ; Parmar, Sangwan, Vashi, Kulkarni, & Kumar, ), among others.…”

Effectiveness of scaling and root planing with and without adjunct probiotic therapy in the treatment of chronic periodontitis amongshammausers and non‐users: A randomized controlled trial

“…[14][15][16] It is sold in pouches and is frequently consumed in Middle-Eastern countries including Yemen and Saudi Arabia. 14,[17][18][19] Shamma is generally placed as a quid in the buccal cavity; however, some users may place it in the lower labial vestibule. 14 There is no data regarding the prevalence of shamma chewing among males and females; however, based upon the currently available evidence, the habit seems to be dominant among males than females.…”

Salivary parameters among Arabian snuff (Shammah) users

“…Apart from being wet-prepared by mixing tobacco with a solution of sodium carbonate, black shammah is mostly similar to the white, which is prepared as powder. 2 , 5 This means that the aqueous nature of the black shammah might reduce the tobacco effects. Overall, it can be implied that white shammah is more dangerous than the black form.…”

“… 2 There is overwhelming evidence on the negative effects of SLT use on systemic health as a whole (which includes serious conditions such as esophageal and pancreatic cancers) and on the oral cavity including dental caries, gingivitis, and periodontitis not to mention oral cancer. 5 - 10 So far, very few studies have assessed the effects of any of the SLTs, other than shammah, on the quality and quantity of a user’s saliva. 11 , 12 …”