Self-perceived oral health status and cytomorphological changes in individuals with addictive oral habits: assessed by WHO oral health questionnaire for adults
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20175053Keywords:
Oral addictive habits, Oral cytology, Smoking, Naswar, Paan, Chewing tobaccoAbstract
Background: Oral diseases related to tobacco use are relatively widespread and common in the Pakistani community but epidemiological data regarding maintenance of oral hygiene and suggested treatment is scarce. Therefore, this study was conducted in an under developed district (Muzaffargarh) of Punjab, Pakistan to evaluate oral health status and to determine frequency of cytomorphological changes in buccal mucosa of habitual tobacco users.
Methods: Oral examination of all the subjects was carried out using mouth mirrors and gauze under good illumination. Cytology samples were taken from buccal mucosa. The smears were later stained with Papanicolaou stain and microscopy was performed. All the cytological data was recorded in the respective proformas. Data was analysed using IBM SPSS software version 20. Descriptive statistical analysis was performed. A p value of ≤0.05 was considered significant.
Results: When cross relations were studied among the demographics, addictive habits and cytological variables, soft drink usage was associated with epithelial atypia (p=0.05), marijuana usage was associated with inflammatory infiltrate on cytology (p=0.047) and snuff/niswar usage was associated with inflammatory atypia (p=0.048). No associations were found among the other studied variables.
Conclusions: The results of cellular changes in the smears from subjects with addictive habits can be utilized as an educational and screening tool in cessation therapy. The results attained in this study proposed that tobacco addictive habits produce cellular modifications in clinically normal mucosa on exfoliation cytology.
References
WHO. Available at: http://www.who.int/govern-ance/eb/who_constitution_en.pdf. Accessed on 16 Nov 2012.
"National Oral Health Survey and Fluoride Mapping," 2002-03
Handa S, Prasad S, Rajashekharappa CB, Garg A, Ryana HK, Khurana C. Oral Health Status of Rural and Urban Population of Gurgaon Block, Gurgaon District Using WHO Assessment Form through Multistage Sampling Technique. J Clin Diagnos Res. 2016;10(5):ZC43-51.
SEARO. 90% of Smokeless Tobacco Users Live in South-East Asia; 2013. Available at: http://www.searo.who.int/mediacentre/releases/2013/pr1563/en/. Accessed on 14 April 2014.
Imam SZ, Nawaz H, Sepah YJ, Pabaney AH, Ilyas M, Ghaffar S. Use of smokeless tobacco among groups of Pakistani medical students-a cross sectional study. BMC Public Health. 2007;7:231.
Bhawna G. Burden of smoked and smokeless tobacco consumption in India-results from the Global adult Tobacco Survey India (GATS-India)- 2009-201. Asian Pac J Cancer Prev. 2013;14:3323-9.
Mehta FS, Hamner JE. Tobacco Related Oral Mucosal Lesions and Conditions in India. New Delhi: Jaypee Brothers Medical Publishers; 1993.
Znaor A, Brennan P, Gajalakshmi V, Mathew A, Shanta V, Varghese C, et al. Independent and combined effects of tobacco smoking, chewing and alcohol drinking on the risk of oral, pharyngeal and esophageal cancers in Indian men. Int J Cancer. 2003;105:681-6.
Sridharan G. Epidemiology, control and prevention of tobacco induced oral mucosal lesions in India. Indian J Cancer. 2014;51:80-5.
Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 2009;45:309-16.
Saraswathi TR, Ranganathan K, Shanmugam S, Sowmya R, Narasimhan PD, Gunaseelan R. Prevalence of oral lesions in relation to habits: Cross-sectional study in South India. Indian J Dent Res. 2006;17:121-5.
Yen AM, Chen SC, Chen TH. Dose-response relationships of oral habits associated with the risk of oral pre-malignant lesions among men who chew betel quid. Oral Oncol. 2007;43:634-8.
Annual cancer registry report. SKMCH&RC, 2013. http://shaukatkhanum.org.pk/wp-content/uploads/
/06/acrr-2013.pdf. Accessed on 10 February 2016.
Cebeci AR, Gülsahi A, Kamburoglu K, Orhan BK, Oztas B. Prevalence and distribution of oral mucosal lesions in an adult Turkish population. Med Oral Patol Oral Cir Bucal. 2009;14:272-7.
Javed F, Chotai M, Mehmood A, Almas K. Oral mucosal disorders associated with habitual gutka usage: A review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:857-64.
World Health Organization. Tobacco or health: a global status report. Geneva: WHO, 1997.
Pakistan Medical Research Council. National health survey of Pakistan 1990 - 94. Islamabad: Network Publication Services; 1998.
Jarallah JS, Al-Rubeaan KA, Al-Nuaim ARA, Al-Ruhaily AA, Kalantan KA. Prevalence and determinants of smoking in three regions of Saudi Arabia. Tobacco Control. 1999;8(1):53-6.
Cheng R, Yang H, Shao M, Hu T, Zhou XD. Dental erosion and severe tooth decay related to soft drinks: a case report and literature review. J Zhejiang Univ Sci. 2009;10:395.
Bertoldi C, Lucchi A, Zaffe D. Effects of soft-drinks and remineralising treatment on teeth assessed by morphological and quantitative X-ray investigations. Eur J Paediatr Dent. 2015;16(4):263-71.
Sauro S, Mannocci F, Piemontese M, Mongiorgi R. In situ enamel morphology evaluation after acidic soft drink consumption: protection factor of contemporary toothpaste. Int J Dent Hyg. 2008;6(3):188-92.
Sreebny LM. Sugar availability, sugar consumption and dental caries. Community Dentistry Oral Epidemiol. 1982;10:1–7.
Moynihan P, Petersen PE. Diet, nutrition and the prevention of dental diseases. Public Health Nutrition. 2004;7(1):201–26.
Bangash MFK, Khan J, Hanif A. Oral hygiene practice and awareness among Pakistanis in Riyadh, Saudi Arabia. Pakistan Oral Dental J. 2013;33:2.
Parveen N, Ahmed B, Bari A, Butt AM. Oro dental health: awareness and practice. J Univ Med Dental Coll. 2011;2:2.
Narker JC, Rise J. Distribution of oral health behavior in adults. Community Dent Oral Epidemiol. 2007;49(1):9-13.
Oogarah-Pratap B. Dietary habits in adults. Nutr Food Sci. 2007;37(6):442-51.
Nazir R, Hussain A, Kaleem M. Oral health status and malocclusion in flood affected and internally displaced children in Pakistan. Pak Oral Dent J. 2012;32:110-4.
Attaullah, Khan M, Khan AA. Oral health related knowledge, Attitude and practices among patient –A study. Pak Oral Dent J. 2010;30:186-91.
Devaraj C, Eswar P. Reasons for use and non-use of dental services among people visiting a dental college hospital in India: A descriptive cross-sectional study. Eur J Dentistry. 2012;6(4):422–7.
Cohen LA, Bonito AJ, Eicheldinger C, Manski RJ, Masek MD, Edwards RR, et al. Behavioral and socioeconomic correlates of dental problem experience and patterns of health care-seeking. J Am Dent Assoc. 2011;142:137–49.
Phukan RK, Ali MS, Chetia CK, Mahanta J. Betel nut and tobacco chewing: potential risk factors of cancer of oesophagus in Assam, India. Br J Cancer. 2001;85:661-7.
World Health Organization. World health report 2002: reducing risk, promoting healthy life. Geneva: WHO, 2002.
Pakistan Health Education Survey 1991-92. Islamabad, Ministry of Health, Government of Pakistan,1993.
Asghar M, Jan ZA. Monitoring of harmful constitutenta of cigarette and tobacco in Pakistan. J Pak Med Assoc. 1989;39:66-8.
Zaman M, Irfan U, Irshad E. Prevalence of cigarette smoking among Peshawar University students. Pak J Chest Med. 2002;8:9-18.
Sugerman PB, Savage NW. Exfoliative cytology in clinical oral pathology. Aust Dent J. 1998;41(2):71-4.
Remmerbach TW, Weidenbach H, Muller C, Hemprich A, Pomjanski N, Buckstegge B, et al. Diagnosis value of nuclear organizer regions (Ag NoRS) in brush biopsies of suspicious lesion of the oral cavity. Anal Cell Pathol. 2003;25(3):139-45.
Ahmed HG. Assessment of oral cytological changes associated with exposure to chemotherapy and/or radiotherapy. Cyto J. 2009;6:8-10.
Proial K, Paszkiewicz MG, Nasca MAS,Franke GE, Pauly JL. Smoking and Smokeless Tobacco-Associated Human Buccal Cell Mutations and Their Association with Oral Cancer - A Review. Cancer Epidemiology, Biomarkers Prevention 2006:15:1061.
Konopacka M. Effect of smoking and aging on micronucleus frequencies in human exfoliated buccal cells. Neoplasms. 2003;50:380-2.
Gordon AE, Ahmer OR, Chan R, Madani OM, Braun JM, Weir DM, et al. Why is smoking a risk factor for sudden infant death syndrome? Child Care Health Dev. 2002;28:23-5.
Wu PA, Loh CH, Hsieh LL, Liu TY, Chen CJ, Liou SH. Clastogenic effect for cigarette smoking but not areca quid chewing as measured by micronuclei in exfoliated buccal mucosa cells. Mutat Res. 2004;562:27–38.
Konopacka M. Effect of smoking and aging on micronucleus frequencies in human exfoliated buccal cells. Neoplasma. 2003;50:380–2.
Sarto F, Finotto S, Giacomelli L, Mazzotti D, Tomanin R, Levis AG. The micronucleus assay in exfoliated cells of the human buccal mucosa. Mutagenesis 1987;2:11–7.
Celik A, Cavas T, Gozukara SE. Cytogenetic biomonitoring in petrol station attendants: micronucleus test in exfoliated buccal cells. Mutagenesis. 2003;18:417-21.
Einstein TB. Sivapathasundharam B, Cytomorphometric analysis of the buccal mucosa of tobacco users. Indian J Dent Res. 2005;16(2):42-6.
Hosseini Azimi S, Mashhadiabbas F, Kaharazifard MG, Ebrahimifard T, Rafieiann N. Comparison of cytological finding in oral mucosa of smokers and non-smokers. JIDA. 2011;23(1):10-6.
Varvaky P, Santána M, Diniz J, Quadros O, Fatturi L, Capra P. Citología exfoliativa da cavidade bucal. R Fac Odontol Porto Alegre. 1999;40:53-9.
Van Oijen MG, Gilsing MM, Rijksen G, Hordijk GJ, Slootweg PJ. Increasednumber of proliferating cells in oral epithelium from smokers and exsmokers. Oral Oncol. 1998;34:297-303.
Ogden GR, Cowpe JG, Green MW. Quantitative exfoliative cytology of normal buccal mucosa: effect of smoking. J Oral Pathol Med. 1990;19:53-5.
Winn DM. Tobacco use and oral disease. J Dent Educ. 2001;65:306-11.
Banoczy J, Gintner Z, Dombi C. Tobacco use and oral leukoplakia. J Dent Educ. 2001;65:322-7.
Bastiaan RJ, Reade PC. The histopathologic features which follow repeated applications of tobacco tar to rat lip mucosa. Oral Surg. 1980;49:435-40.
Bustoc OAI, Santander EIL, Martiniez FE, Freyre LJN, Pinto OAV. Evaluation of keratinization and AgNORs count in exfoliative cytology of normal oral mucosa from smokers and non-smokers. Med Oral. 2004;9(3):197-203.
Abdelaziz MS, Osman TE. Detection of Cytomorphological Changes in Oral Mucosa among Alcoholics and Cigarette Smokers. Oman Med J. 2011;26(5):349–52.
Ahmed HG, Idris AM, Ibrahim SO. Study of oral epithelial atypia among Sudanese tobacco users by exfoliative cytology. Anticancer Res. 2003;23:1943-9.
Babu S, Bhat RV, Kumar PU. A com-parative clinico-pathological study of oralsubmucos fibrosis in habitual chewers ofpan masala and betel quid. J Toxicol ClinToxicol. 1996;34:317-22.
Idris AM, Nair J, Friesen M, Ohshima H, Brouet I, Faustman EM. Carcinogenic tobacco-specific nitrosamines are present at unusually high levels in the saliva of oral snuff users in Sudan. Carcinogenesis 1992;13:1001-5.