When one thinks of smoking, one is led to think exclusively of smokers, but the intake of tobacco, whether in the form of combustion from a cigarette or by chewing, involves an alteration of the oral mucosa and other complications in terms of oral health.
The consequences of tobacco use on oral health
One of the main consequences for those who take tobacco is the increase in thickness and keratinization of the oral mucosa.
The alteration of the oral mucosa varies according to the frequency, duration and type of tobacco used. Epithelial cells can undergo dysplastic changes and degenerate into potentially malignant disorders such as oral cancer.
In a clinical study, published in the Journal of Oral Maxillofacial Pathology, the possibility of a correlation between changes in the oral mucosa and tobacco consumption in its consumption patterns was analysed.
4500 subjects were examined, of which patients with smoking habits were identified and classified as:
- Group A: tobacco was only chewed;
- Group B: in which tobacco was only smoked;
- Group C: in which the smoke was smoked and chewed.
For each individual, a preformed questionnaire was used with detailed recording of habits.
Suspected oral lesions were diagnosed and carefully examined, and a biopsy was performed with the patient’s consent.
All the information collected was used to conduct the statistical analysis. Alteration of the oral mucosa in tobacco users
Of the sample analyzed for the study, 1175 individuals were in the habit of smoking and of these 1043 were males and 132 were females, aged between 15 and 85 years.
Groups B and C consisted of male patients only.
Out of 1175 individuals with a tobacco habit, 182 experienced different types of alterations of the oral mucosa:
Patients in Group A showed more lesions than the other two groups. Male patients experienced a higher incidence of lesions than females.
Oral squamous cell carcinoma was found in 6 individuals, 5 males and one female. Lichen planus and oral candidiasis, respectively, were found in one patient.
Among the smokers group it was highlighted: smoker’s palate and smoker’s melanosis were found to be the predominant lesions, followed by leukoplakia and combined lesion of leukoplakia with smoker’s melanosis.
In Group C, individual lesions such as smoker’s melanosis (6), carcinoma (5), tobacco keratosis (1), leukoplakia (4), and lichen planus (1) were identified.
Conditions common to all groups
L’incidenza delle lesioni della mucosa orale è risultata fortemente correlata con l’età dell’individuo, la durata e la frequenza dell’abitudine al tabacco.
Alteration of the oral mucosa and tobacco consumption
From the data emerging from the study there is a strong correlation between alteration of the oral mucosa and tobacco consumption, in particular with regard to the appearance of mucositis and lesions of the oral cavity.
The dentist has the task of informing smoking patients that certain potentially malignant lesions such as oral carcinoma, leukoplakia, mucositis appear more frequently in tobacco-dependent individuals.