A review of the effect of smokeless tobacco on oral health

Background: The harmful effects of using smokeless tobacco are not as well known as the effectscaused by smoking. Smoking and oral smokeless tobacco use is one of the most importantenvironmental risk factors for periodontal diseases by affecting the physiology, immunology andmicrobiology of the oral environment. In one study of people who had taken SLT for more than۴۰ years, it was found that more than ۴۰% had leukoplakia, erythroplakia, or both. How smokelesstobacco contributes to non-neoplastic oral diseases is unclear. But it certainly increases the risk oforal mucosal lesions. The habit of using SLT is common among all populations, but the strongassociation between oral diseases and SLT is seen in Asian populations due to the presence ofimpurities.Method: In this study, relevant articles up to December ۲۰۲۲ were searched in various databasesincluding PubMed, Scopus, Web of Science and Google Scholar using keywords Oral disease,smokeless, tobacco. Data were evaluated separately for oral mucosal lesions, periodontal andgingival diseases, dental caries and tooth loss, and oral pain.Results: SLT contains more than ۴۰۰۰ toxic substances, including benzo-alpha-pyrene,nitrosamine, pesticides, heavy metals such as lead and cadmium, which can cause damage totissue. Studies have shown the relationship between gingival analysis and SLT, but thisrelationship has not been proven. A study on patterns of tooth loss among tobacco users in centralIndia found that mandibular tooth loss was higher among oral SLT users, suggesting that theadverse effects of SLT use were greater in maxillary teeth. The bottom is revealed. Studies haveshown that cancer from smokeless tobacco use is definite but slow. In addition, oral candidiasis,tooth and implant decay, smoker's palate and changes in smell and taste are also evident inconsumers.Conclusion: Considering the difference in the purity of SLT in different regions, it is difficult todraw conclusions about its effects on oral health. To better understand the relationship betweenoral SLT habits and periodontal diseases, more studies should be conducted in high-riskpopulations. The health risks in smokeless tobacco users are probably lower than in smokers, buthigher than that of non-smokers.

Keywords:

Tobacco , Oral Disease , Smokeless