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      Effect of Frequency and Duration of Tobacco Use on Oral Mucosal Lesions – A Cross-Sectional Study among Tobacco Users in Hyderabad, India

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          Abstract

          Purpose:

          Tobacco use is one of the most important risk factors for the development of oral mucosal lesions including oral pre-cancer and cancer. The type and location of the lesion varies with the type of tobacco used, the way it is used, and the frequency and duration of use. Hence, the present study aimed to determine the effect of frequency and duration of tobacco use on oral mucosal lesions among tobacco users in Hyderabad city.

          Materials and Methods:

          A cross-sectional study was carried out among 280 tobacco users who were categorized into smokers, chewers and mixed groups according to the habit. One forty subjects diagnosed with Oral Mucosal Lesions, designated as cases and One forty lesion free controls, frequency matched for age, gender, habit and family income were assessed. The study protocol included a visual oral soft tissue examination and a questionnaire-based interview. Statistical analysis was done using Chi square test and t- test. Multiple logistic regression analysis was done to assess the association of the variables with lesions.

          Results:

          Oral submucous fibrosis (18%) was the most common oral mucosal lesion followed by Leukoplakia (14%) and Smoker’s palate (12%). Dose-response relationships were observed for both duration and frequency of habits on the risk of oral mucosal lesions. However, it was significant only for frequency of the habit. A significant positive correlation was observed between occurrence of lesion and those with no education (p=0.005).

          Conclusion:

          The study revealed that frequency and duration of tobacco use was associated with the risk of oral mucosal lesions.

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          Most cited references25

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          Guide to epidemiology and diagnosis of oral mucosal diseases and conditions. World Health Organization.

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            Risk factors for oral soft tissue lesions in an adult Spanish population.

            The aims of this study were (i) to determine the prevalence of oral lesions in adults over 30 years old in the city of Oviedo (Spain), and (ii) to analyze the relationship between the prevalence of oral lesions, toxic habits (tobacco and alcohol) and denture wearers in these patients. A representative sample of the adult population in Oviedo (Spain) was obtained through randomized sampling (n = 753); a total of 308 (41%) subjects were finally included in the study. The observed oral pathology was classified according to the WHO criteria and earlier epidemiological studies. A little over half of all patients (51.1%) had oral lesions. The most frequent lesions were frictional lesion (7.5%), traumatic ulcer (7.1%), denture stomatitis and pseudomembranous candidosis (6.5%), followed by melanin pigmentation (5.8%) and denture-induced hyperplasia (5.2%), plicated tongue (3.9%), lichen planus and hemangioma (3.2%), angular cheilitis and cheek biting (2.9%), fibrous hyperplasia and coated tongue (2.6%), recurrent aphthae (1.9%) and oral leukoplakia (1.6%). In relation to leukoplakia, the odds ratio (OR) of heavy drinkers was 15.98 and the OR of heavy smokers was 12.37. The OR of heavy smokers or heavy drinkers diagnosed of frictional lesion was four times greater than that of nonsmokers or nondrinkers. The OR of heavy smokers with melanic pigmentations was 4.08. The OR of complete denture wearers with candidosis was 11.38. The OR of partial removable denture wearers with hemangioma was 5.01. This study shows the relation of heavy tobacco and heavy alcohol to traumatic keratosis and leukoplakia, and of complete dentures to pseudomembranous candidosis, fibrous hyperplasia and stomatitis. Programs designed to eradicate toxic factors (alcohol and tobacco) should, therefore, be implemented with adequate maintenance of dentures.
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              Prevalence of oral lesions in relation to habits: Cross-sectional study in South India.

              Smoking, drinking and chewing tobacco product, common habits in India have been positively associated with oral lesions. No study has been conducted in this part of Tamilnadu regarding the prevalence of oral lesions in relation to habits. A hospital based cross-sectional study was carried out at Ragas Dental College, Chennai. Already existing data of two thousand and seventeen consecutive patients from sub-urban areas of Chennai, who attended the outpatient department, at Ragas Dental College, for dental complaints during a period of three months in 2004, who underwent oral examination and interviewer based questionnaire was used. Oral soft tissue lesions were found in 4.1% of the study subjects. The prevalence of leukoplakia, OSF and oral lichen planus was 0.59%, 0.55%, and 0.15% respectively. The prevalence of smoking, drinking alcoholic beverages and chewing was 15.02%, 8.78% and 6.99% respectively. Smoking and chewing were significant predictors of leukoplakia in this population. The prevalence of leukoplakia, OSF and oral lichen planus in our study population is similar to those found in other populations. The prevalence of consumption of alcoholic beverages in our study population was higher when compared to the Indian National Sample Survey study. However the prevalence of smoking and chewing was found to be lower. Smokers were more likely to develop smoker's melanosis compared to other lesions. Among those who consumed alcoholic beverages alone, the prevalence of leukoplakia was higher compared to other lesions. OSF was the most prevalent lesion among those who chewed panmasala or gutkha or betel quid with or without tobacco.
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                Author and article information

                Journal
                Asian Pac J Cancer Prev
                Asian Pac. J. Cancer Prev
                Asian Pacific Journal of Cancer Prevention : APJCP
                West Asia Organization for Cancer Prevention (Iran )
                1513-7368
                2476-762X
                2017
                : 18
                : 8
                : 2233-2238
                Affiliations
                [1] Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, India
                Author notes
                [* ] For Correspondence: aishwaryam75@ 123456gmail.com
                Article
                APJCP-18-2233
                10.22034/APJCP.2017.18.8.2233
                5697486
                28843261
                75a12bc1-f1de-41b5-96db-4145c00f87ee
                Copyright: © Asian Pacific Journal of Cancer Prevention

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

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                Categories
                Research Article

                tobacco,dose-response relationship,habits,oral mucosal lesions

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