title: Periodontal inflammatory conditions among gutka chewers and non-chewers with and without prediabetes.
abstract: BACKGROUND
  It is known that gutka chewing jeopardizes periodontal health; however, severity of periodontal inflammation in gutka chewers with and without prediabetes remains unknown. The aim of this study is to investigate the association of periodontal inflammatory conditions with gutka chewing and prediabetes.
  
  
  METHODS
  In this cross-sectional study, the effect of gutka use on periodontal health is investigated among 44 individuals with prediabetes and 44 without prediabetes. Demographic information regarding age, sex, duration of prediabetes, and gutka-chewing habits was collected using a questionnaire. Periodontal inflammatory conditions (plaque index [PI], bleeding on probing [BOP], probing depth [PD], marginal bone loss [MBL]) and fasting blood glucose levels (FBGLs) were recorded. Group differences in periodontal inflammatory parameters were tested using univariate and multivariable analyses (α ≤5%).
  
  
  RESULTS
  Periodontal inflammatory parameters (PI, BOP, and PD) were significantly higher in individuals with prediabetes irrespective of gutka-chewing habit (P <0.05). Odds of periodontal inflammation in individuals with prediabetes were nine times higher than in healthy controls (95% confidence interval [CI] = 3.4 to 23.6). Gutka chewing alone, chewing among individuals with prediabetes, and chewing among healthy controls did not significantly increase the odds of periodontal inflammatory conditions. Individuals with prediabetes were significantly more likely to have periodontal inflammation than individuals without prediabetes even after controlling for sex and gutka chewing (odds ratio = 13.2; 95% CI = 4.3 to 40.7).
  
  
  CONCLUSIONS
  In medically healthy individuals, periodontal inflammatory conditions are worse in gutka chewers compared to non-chewers; in patients with prediabetes, the severity of periodontal inflammation is governed by hyperglycemia when compared to habitual gutka usage.
authors.affiliation: 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia. fawjav@gmail.com
authors.forename: Fawad
authors.initials: F
authors.lastname: Javed
authors.forename: Howard C
authors.initials: HC
authors.lastname: Tenenbaum
authors.forename: Getulio
authors.initials: G
authors.lastname: Nogueira-Filho
authors.forename: Nasser
authors.initials: N
authors.lastname: Nooh
authors.forename: Fernanda
authors.initials: F
authors.lastname: O'Bello Correa
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasuriya
authors.forename: Ananda P
authors.initials: AP
authors.lastname: Dasanayake
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Hezaimi
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000145:classification / Q000150:complications; D001114:Areca; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003774:Dental Plaque Index; D005215:Fasting; D005260:Female; D006801:Humans; D008297:Male; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification / Q000150:complications; D010518:Periodontitis / Q000145:classification / Q000150:complications*; D011236:Prediabetic State / Q000097:blood / Q000150:complications*; D011862:Radiography, Panoramic; D013997:Time Factors; D014030:Tobacco, Smokeless
chemical_list: D001786:Blood Glucose