Smokeless Tobacco causes many health problems but the first impacts of usage of smokeless tobacco appear in mouth of user. Smokeless tobacco affects mouth by causing various dental problems like recession of gums, tooth decay, oral lesions, leukoplakia etc. These conditions in detail are as under:
1. Permanent recession of gums from roots of teeth
2. Increased tooth decay due to presence of sweeteners in smokeless tobacco products.
3. Tooth abrasion as a direct affect of the smokeless tobacco products.
Smokeless tobacco use can result in precancerous, cancer and other oral lesions. Other forms of tobacco and other factors such as viruses and nutrition are only additive. Mount of use (hours per day), recency of use, and brands were independently associated with the presence of oral lesions.
Betel quid chewing stains the buccal mucosa- where it is placed inside the mouth bright red due to the formation of o-quinones from polphenols present in it. These stains disappear after discontinuation of the habit.
Pan chewer’s lesion is seen in highly addicted chewing tobacco users, seen as thick dark colored encrustations on site of placement of quid. These can scraped off with a gauge. It is not associated with cancer.
Leukoplakia is the most common lesion seen in patients addicted to smokeless tobacco. It is raised non scrapable white patch which cannot be diagnosed as any other lesion. Leukoplakia is classified into homogenous, ulcerated and nodular types. Most common are the homogenous variety while nodular has the highest malignant potential. The lesions usually don’t disappear even after discontinuation of the habit and treatment is required.
People who have their first use at age less than 10 years have nearly 70% chances of developing leukoplakia and thus cancer.
Changes in the oral tissues cells have been seen as early as 10mins of placement of smokeless tobacco product in the mouth.
Submucous Fibrosis commonly associated with chewing form of smokeless tobacco is a high risk precancerous condition. It is characterized by presence of palpable fibrous strands in the buccal mucosa, mucosal rigidity, and restricted mouth opening.
Continued use of smokeless tobacco may even lead to lichen planus.
Manipuri Tobacco a form of chewing smokeless tobacco is commonly associated with leukoplakia and oral cancer.
Areca Nut chewing is associated with oral submucous fibrosis.
Tobacco plus Lime user’s lesion is thick pale lesion with loose tags of tissue resembling leukoplakia but is scrapable and has lesser malignant potential.
Smokeless tobacco is associated with four types of epithelial changes such as; hyperparakeratosis, hyperorthokeratosis, basal cell hyperplasia and pale surface staining. These changes are associated with the type of smokeless tobacco used (chewing or snuff).
Worst effect of smokeless tobacco is oral cancer. It includes cancer of mouth, throat or pharynx. These are usually carcinomas which are difficult to treat and invade local tissues. Surgery is usually required for its removal along with the affected tissues, leading to disfigurement of the face. Smokeless tobacco users are at a higher risk (4-5 times) of developing oral cancer than non users.
Oral cancer can be preliminary identified by the symptoms appearing in the mouth. The following symptoms may point to oral cancer. These are:
If you find any of the above in your mouth, contact your dentist right away. The sooner you get the treatment the more is survival rate. And quit the habit at the earliest.
Besides the above discussed serious effects of smokeless tobacco, the following are other negatives effects of using it.
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