Post on 27-Mar-2015
Periodontal conditions, gutka-chewing and type 2 diabetes
Fawad JavedDDS, PhD
Karolinska Institutet, Institute of Odontology, Research Department, Huddinge,
SWEDEN
fawad.javed@ki.se
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What is gutka?
A form of smokeless tobacco.
Commercially available in tins and sachets.
In India, the tobacco industry recorded a growth of up to $ 500 million.
In India, gutka is popular among all socioeconomic groups.
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Composition of gutka
GutkaAreca nut
Slaked lime
Powdered tobacco
Artificial sweeteners and fragrances
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How is gutka chewed?
Placed between maxillary and mandibular teeth
Lightly chewed
Held against buccal mucosa over long period
Continued to be lightly chewed and sucked
Spat or swallowed when desired
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Background
Association between oral cancer and gutka usage has been reported.
Periodontal conditions are severe in subjecs with type 2 diabetes (T2D).
Effect of gutka chewing on periodontal status of individuals with and without T2D are not yet documented.
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Inclusion & Exclusion Criteria:
Inclusion Criteria:
Age 45 to 64 years Medically diagnosed type 2 diabetes (T2D) Self-reported non-diabetic individuals
Exclusion Criteria:
Edentulism Smoking Maxillary and mandibular 3rd molars Self-reported Hepatitis B and Hepatitis C Self-reported infection with Human Immunodeficiency Virus (HIV) Self-reported Acquired Immune Deficiency Syndrome (AIDS)
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Gutka-chewers & Non-chewers
Gutka-chewers:
Chewing at least one sachet of gutka daily for at least 12 months
Non-chewers:
Not using tobacco in any form
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Study participants
Individuals with T2D
29 gutka-chewers 44 non-chewers
14 males
15 females
23 males
21 females
Non-diabetic Individuals
36 gutka-chewers 42 non-chewers
17 males
19 females
22 males
20 females
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Material and methods
In subjects with T2D Duration of T2D
Gutka-chewers in subjects with and without T2D Age Duration of habit Daily consumption Duration of placement in oral cavity Reasons for gutka consumption RBGL
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Material and methods
Clinical periodontal examination PI BOP PD (4mm < 6 mm & ≥ 6 mm)
Self-perceived oral health Gingival bleeding Bad breath, i.e. halitosis Dry mouth
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Statistical Analysis
Performed using a software program.
Dependent variables (PI, BOP and PD [4mm < 6mm and ≥ 6mm) and independent variables were analyzed using ANOVA.
P-values < 0.05 were considered statistically significant.
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Mean age, duration of T2D and random blood glucose levels among gutka-chewers and non-chewers in subjects with and without T2D
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Duration of use, placement in the mouth and daily consumption of gutka in subjects with and without T2D
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Periodontal conditions among gutka-chewers and non-chewers in subjects with and without T2D
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Oral symptoms reported by gutka-chewers and non-chewers in subjects with and without T2D
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Reasons for gutka use
28%
47%
17%
8%
Subjects without T2DSubjects with T2D
17%
52%
7%
24%
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In subjects without T2D:
Gutka-chewers have severe periodontal conditions and oral symptoms compared to non-chewers.
Conclusion
In subjects with T2D:
The severity of these variables is associated with glycemic levels
compared to gutka usage.
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Teachers open doors but you must enter by yourself
Fawad Javed
Karolinska Institutet, Institute of Odontology, Research Department, Huddinge,
SWEDEN
fawad.javed@ki.se
Thank You !