title: Severity of periodontal disease in individuals chewing betel quid with and without tobacco.
abstract: BACKGROUND
  The deleterious effects of chewing betel quid (BQ) with or without tobacco on periodontal health are poorly addressed. The aim of this study was to investigate the severity and extent of periodontal disease among individuals chewing BQ with and without tobacco.
  
  
  METHODS
  One hundred twenty individuals (70 BQ chewers: 35 with tobacco and 35 without tobacco) and 50 control individuals (non-chewers) were included in this study. Sociodemographic data and information regarding BQ chewing habit were collected using a questionnaire. Plaque index, bleeding on probing and probing pocket depth were measured. Numbers of missing teeth were recorded and marginal bone loss was measured on panoramic radiographs. Statistical analyses were performed using 1-way analysis of variance and Bonferroni post hoc test.
  
  
  RESULTS
  The socioeconomic status of subjects in the control group was significantly higher as compared with those chewing BQ either with or without tobacco. Plaque index, bleeding on probing and probing pocket depth were greater in subjects chewing BQ with tobacco than in those chewing BQ without tobacco and the controls. Subjects chewing BQ with tobacco had fewer teeth than those chewing BQ without tobacco and the controls. Marginal bone loss was higher in subjects chewing BQ with tobacco than in those chewing BQ without tobacco and the controls.
  
  
  CONCLUSIONS
  The severity of periodontal disease is enhanced in subjects chewing BQ with tobacco as compared with those chewing BQ without tobacco. Subjects with a low socioeconomic status and poor education are significantly more likely than others to develop periodontal disease.
authors.affiliation: Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences (FJ, KA-H) and Department of Periodontics and Community Dentistry (FJ, KA-H), King Saud University, Riyadh, Saudi Arabia; Department of Periodontology (HCT) and Department of Preventive Dentistry (GN-F), Faculty of Dentistry, University of Toronto, Ontario, Canada; Section of Dentistry (FQ), Aga Khan University Hospital, Aga Khan University, Karachi, Pakistan; Department of Semiology and Clinic (FOBC), School of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, Brazil; Oral Biosciences (LPS), Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, Hong Kong, China.
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: Faisal
authors.initials: F
authors.lastname: Qayyum
authors.forename: Fernanda O Bello
authors.initials: FO
authors.lastname: Correa
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Hezaimi
authors.forename: Lakshman P
authors.initials: LP
authors.lastname: Samaranayake
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000139:chemically induced / Q000453:epidemiology; D001114:Areca / Q000633:toxicity*; D017610:Calcium Compounds / Q000633:toxicity*; D004245:DMF Index; D003774:Dental Plaque Index; D005260:Female; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000139:chemically induced / Q000453:epidemiology; D008409:Mastication; D008439:Maxillary Diseases / Q000139:chemically induced / Q000453:epidemiology; D008875:Middle Aged; D009754:Nuts / Q000009:adverse effects / Q000633:toxicity; D010087:Oxides / Q000633:toxicity*; D010154:Pakistan / Q000453:epidemiology; D010510:Periodontal Diseases / Q000139:chemically induced* / Q000453:epidemiology; D031701:Piper / Q000633:toxicity*; D010936:Plant Extracts / Q000633:toxicity*; D012189:Retrospective Studies; D014030:Tobacco, Smokeless / Q000633:toxicity*
chemical_list: D017610:Calcium Compounds; D010087:Oxides; D010936:Plant Extracts; C495400:lime-piper betel quid