Siddiqui Lubna Tabassum, Yadadi Sunaina Shetty, Acharya Anirudh B, Mohammed Marwan Mansoor, Shehadat Saaid Al, Vinay Vineet, Desai Vijay, Shetty Raghavendra M
Department of Periodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, India.
Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Front Oral Health. 2025 Sep 5;6:1659319. doi: 10.3389/froh.2025.1659319. eCollection 2025.
While the detrimental effects of smoking on periodontal health are well-established, the impact of smokeless tobacco (SLT) remains understudied, particularly in rural populations where SLT use is prevalent. The objective of the study is to (1) determine the prevalence of SLT consumption, and (2) evaluate its impact on periodontal health indicators among the adults in Rajnandgaon, Chhattisgarh, India.
In this cross-sectional study, 1,404 adults from Chhattisgarh, India, were screened, of whom 806 identified as SLT users were further assessed. Demographic data, oral hygiene practices, and SLT consumption patterns were recorded via structured questionnaires. Clinical periodontal parameters, including plaque index (PI), gingival index (GI), clinical attachment loss (CAL), probing pocket depth (PPD), and gingival recession (GR), were assessed. Multivariate regression and structural equation modeling (SEM) were employed to analyze associations between SLT use and periodontal outcomes, adjusting for confounders.
SLT users exhibited significantly worse periodontal health than NTB users, with higher mean CAL (8.7 ± 2.18 mm vs. 3.2 ± 1.45 mm, < 0.001), GR (2.99 ± 1.35 mm vs. 1.05 ± 0.82 mm, < 0.001), and PPD (5.72 ± 1.69 mm vs. 2.91 ± 1.12 mm, < 0.001). Gutkha and Tobacco + Lime demonstrated the strongest associations with periodontal destruction ( = 1.82, < 0.01 and = 1.64, < 0.01, respectively). Prolonged SLT use (>10 years), higher frequency (>5 times/day), and lower buccal placement were significant predictors of deterioration ( < 0.05). SEM confirmed that SLT type, duration, and poor oral hygiene synergistically exacerbated periodontal damage (CFI = 0.92, RMSEA = 0.04).
The prevalence of smokeless tobacco consumption in Rajnandgaon, Chhattisgarh, was found to be 58.26%, with a higher proportion of users among males (60%) compared to females (40%). SLT, particularly Gutkha, is a significant risk factor for periodontal disease, with usage patterns significantly influencing disease severity. These findings underscore the urgent need for region-specific public health interventions that target smoking cessation and improved oral hygiene practices. Future longitudinal studies should investigate causal mechanisms and the efficacy of interventions.
虽然吸烟对牙周健康的有害影响已得到充分证实，但无烟烟草（SLT）的影响仍研究不足，特别是在SLT使用普遍的农村人口中。本研究的目的是：（1）确定SLT消费的流行率；（2）评估其对印度恰蒂斯加尔邦赖金德冈成年人牙周健康指标的影响。
在这项横断面研究中，对来自印度恰蒂斯加尔邦的1404名成年人进行了筛查，其中806名被确定为SLT使用者并进一步评估。通过结构化问卷记录人口统计学数据、口腔卫生习惯和SLT消费模式。评估临床牙周参数，包括菌斑指数（PI）、牙龈指数（GI）、临床附着丧失（CAL）、探诊深度（PPD）和牙龈退缩（GR）。采用多变量回归和结构方程模型（SEM）分析SLT使用与牙周结局之间的关联，并对混杂因素进行调整。
SLT使用者的牙周健康状况明显比非SLT使用者差，平均CAL更高（8.7±2.18mm对3.2±1.45mm，P<0.001），GR更高（2.99±1.35mm对1.05±0.82mm，P<0.001），PPD更高（5.72±1.69mm对2.91±1.12mm，P<0.001）。古特卡和烟草+石灰与牙周破坏的关联最强（分别为β=1.82，P<0.01和β=1.64，P<0.01）。长期使用SLT（>10年）、更高频率（>5次/天）和较低的颊侧放置是病情恶化的显著预测因素（P<0.05）。SEM证实，SLT类型、使用时间和不良口腔卫生协同加剧了牙周损害（CFI=0.92，RMSEA=0.04）。
在印度恰蒂斯加尔邦赖金德冈，无烟烟草消费的流行率为58.26%，男性使用者比例（60%）高于女性（40%）。SLT，尤其是古特卡，是牙周疾病的重要危险因素，其使用模式对疾病严重程度有显著影响。这些发现强调了针对戒烟和改善口腔卫生习惯的特定区域公共卫生干预措施的迫切需求。未来的纵向研究应调查因果机制和干预措施的效果。
