ORAL MUCOSAL LESIONS – PREVALENCE STUDY AMONG DIFFERENT PATTERNS AND FREQUENCY OF TOBACCO USAGE

Abstract

Oral habits such as chewing,smoking compromises the oral health.Tobacco, alcohol and areca nut [betel quid] use are among leading causes of oral cancer. Various chemical constituents such as nicotine , picoline ,pyridine etc are leached when tobacco is chewed which leads to local irritation and causes alterations in mucosa .Nearly 267 million adults (15 years and above) in India (29% of all adults) are users of tobacco, according to the Global Adult Tobacco Survey India.In Karnataka 35.2% of men, 10.3% of women and 22.8% of all adults either smoke tobacco and/or use smokeless tobacco Oral malignancies account for about 4% in males and 2% in females among all malignant tumors. Tobacco use in the oral cavity can cause potentially malignant disorders such as oral submucous fibrosis (OSMF), leukoplakia and oral squamous cell carcinoma (OSCC). Tobacco is one of the cause for various lesions such as leukoplakia , candidiasis ,erythroplakia ,oral submucosal fibrosis ,oral cancer and many more .If not diagnosed early the oral mucosal lesions which only require conservative management can potentially transform into malignant form. Aim and objectives:  To evaluate the distribution and prevalence of oral mucosal lesions and risk factor associated with tobacco.This study aimed at studying and correlating the oral mucosal changes among the tobacco users with the different forms of tobacco used. Materials and Methods: A total sample size of 5000 people was considered who are visiting M R Ambedkar dental college and hospital for routine dental checkup. Study details were  explained to the patient orally and a written consent form was taken.A detailed case history with good clinical examination was done.Questionnaire was recorded along with the oral examination of the patient. Oral examination was done on dental chairs with proper illumination and using mouth mirrors and explorers .The questionnaire included information such as name ,age ,sex, occupation, address, medical history ,and also about the usage of tobacco like type ( smokeless tobacco or smoking tobacco), duration of use , frequency, placement in oral cavity.Four thousand and five hundred individuals were examined and patients with habits were categorized as Group A: only chewing, Group B: only smoking and Group C: smoking and chewing. A preformed case sheet with a detailed recording of the patient's habits was used for each individual. The suspected oral lesions were examined with care and a biopsy was taken (if needed) with patient consent. The collected data were compiled and statistical analysis was done. Conclusion: OSCC, OSMF and chewer's mucositis were seen more among A and C Group individuals. Smoker's palate was more in Group B. All the lesions showed a strong correlation with increased usage of tobacco. Lesions were more among males compared to females as there were no females with smoking habits in the study. A future study with larger sample size and equal gender distribution in different population among various locations is to be carried out to get accurate details about the lesions associated with tobacco habits and to correlate between the types,