title: Periodontal conditions and oral symptoms in gutka-chewers with and without type 2 diabetes.
abstract: OBJECTIVE
  The aim of the study was to investigate the periodontal conditions and oral symptoms among gutka-chewers in subjects with and without type 2 diabetes (T2D).
  
  
  METHODS
  Subjects aged between 45 and 64 years were included. "Gutka-chewers" were defined as subjects who had been chewing at least one sachet of gutka daily for at least 12 months. Subjects who reported never to have used tobacco in any form were categorized as "non-chewers". Periodontal conditions (plaque index [PI], bleeding on probing [BOP], and probing depth [PD] [4 mm<6 mm and > or =6 mm]), number of missing teeth, oral symptoms, reasons for gutka use, and random blood glucose levels were recorded. Exclusion criteria were smoking and use of antibiotics, non-steroidal anti-inflammatory drugs, and steroids.
  
  
  RESULTS
  Mean durations of gutka use in subjects with and without T2D were 10.5 (range 8.0-15.5 years) and 8.4 (range 6.0-20.2 years) years correspondingly. In subjects with T2D, gutka-chewers (n=29) and non-chewers (n=44) showed no difference in periodontal conditions, missing teeth, and gingival bleeding. In subjects without T2D, gutka-chewers (n=36) had increased PI (p<0.01), BOP (p<0.001), PD (4 mm<6 mm) (p<0.01), number of missing teeth, and gingival bleeding (p<0.01) compared to non-chewers (n=42). Non-chewers in subjects with T2D had poorer periodontal conditions and increased oral symptoms compared to gutka-chewers and non-chewers in subjects without T2D.
  
  
  CONCLUSIONS
  In subjects without T2D, gutka-chewers have severe periodontal conditions and oral symptoms compared to non-chewers. In subjects with T2D, the severity of these variables is related to glycemic levels rather than gutka consumption.
authors.affiliation: Karolinska Institutet, Institute of Odontology, Department of Periodontology, Huddinge, Sweden. fawad.javed@ki.se
authors.forename: Fawad
authors.initials: F
authors.lastname: Javed
authors.forename: Mohammad
authors.initials: M
authors.lastname: Altamash
authors.forename: Björn
authors.initials: B
authors.lastname: Klinge
authors.forename: Per-Erik
authors.initials: PE
authors.lastname: Engström
mesh_terms: D001114:Areca / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006209:Halitosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D010510:Periodontal Diseases / Q000209:etiology*; D010512:Periodontal Index; D011795:Surveys and Questionnaires; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D014987:Xerostomia / Q000209:etiology