title: Influence of betel nut chewing, dental care habits and attitudes on perceived oral health among adult Pakistanis.
abstract: OBJECTIVE
  To survey an adult population in a deprived district of Karachi, with reference to factors influencing perceived oral health.
  
  
  METHODS
  Of 1000 questionnaires distributed to households, 994 were returned. The respondents were aged between 30 and 50 years old. Women comprised 49% of the sample.
  
  
  RESULTS
  Pan and betel nut chewing had a strong influence on the perceived oral health of the respondents. Pan chewers, 32% of the respondents, had a greater risk of oral problems, odds ratio 3.63. In contrast to other oral problems, dental caries was significantly less frequent among pan chewers (odds ratio 0.63). Betel nut chewing (28%) was less deleterious to oral health: the only significant effects were a higher risk for dental caries, odds ratio 4.51, and more gingival bleeding. While most of the respondents used a toothbrush for oral hygiene, a substantial proportion (27%) used their fingers. The oral hygiene method had no influence on the perceived oral health, nor did consumption of sweets and tea with sugar. Over 80% of the participants seldom or never visited a dentist. Cleaning frequency was significantly associated with oral health: those who cleaned their teeth at least daily had fewer oral problems. Almost all participants considered that eating sweets, smoking, and chewing pan and betel nuts endangered oral health.
  
  
  CONCLUSIONS
  In this population, typical of deprived urban areas of Pakistan, betel nut habits and frequency of oral hygiene have a strong influence on perceived oral health, while cleaning method and sugar intake do not.
authors.affiliation: Department of Odontology, Karolinska Institutet, Stockholm, Sweden. farzeen_tanwir@yahoo.com
authors.forename: Farzeen
authors.initials: F
authors.lastname: Tanwir
authors.forename: Mohammad
authors.initials: M
authors.lastname: Altamash
authors.forename: Anders
authors.initials: A
authors.lastname: Gustafsson
mesh_terms: D000328:Adult; D000367:Age Factors; D001114:Areca / Q000009:adverse effects; D001294:Attitude to Health; D003729:Dental Care; D003731:Dental Caries / Q000209:etiology; D019422:Dietary Sucrose / Q000008:administration & dosage; D004522:Educational Status; D005260:Female; D005884:Gingival Hemorrhage / Q000209:etiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000209:etiology; D009909:Oral Health; D009910:Oral Hygiene; D010154:Pakistan; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013662:Tea; D014099:Toothbrushing / Q000295:instrumentation; D014504:Urban Health
chemical_list: D019422:Dietary Sucrose; D013662:Tea