Chewing Tobacco And Importance of Dental Visits

Syeda Bushra Ansari BDS MPH, Dr. Holly Kramer MD MPH

Loyola University Chicago, Parkinson School of Health Sciences and Public

Health

Introduction:

Objectives:

Methods:

Results:

Conclusion:

Chewing/smokeless tobacco (SLT) - most frequently used in the US

1.

Commonly known as spit, chew or dip.

Contains chemicals- 4 folds higher risk of

cancer2.

Precancerous oral lesions – leukoplakia2.

1 can of tobacco can release nicotine as much as 60 cigarettes

2.

60% - 80% of the SLT users present with

premalignant lesions3.

Dental visits– early detection & prevention3.

According to ADA – visit dentist once in 6 months4.

Review & analyze if the SLT users visit the dentist regularly, Assess the distribution of the SLT users across the

different states of the USA.

Cross-sectional observational study using BRFSS

2018 data.

Weighted data.

Primary exposure of interest – SLT use.

Outcome of interest – dental visit in 1 year

Covariates used for analysis - Age, Gender, Race,

Smoking, Education, Health insurance, and State of

residence.

All analyses incorporated sampling weight, strata and

cluster statement.

One psu with only 1 stratum – excluded.

Chi square – categorical variables.

Multivariate logistic regression - relation of SLT use

and dental visits.

SLT users—33% lower odds of visiting the dentist com-

pared to non SLT users (95% CI 28% – 37%).

Females 13% more likely to visit the dentist.

Young people much less likely to visit the dentist com-

pared to older individuals.

Blacks are at 33% less likely to visit the dentist com-

pared to Whites (95% CI 0.64 – 0.70).

Cigarette smokers are more likely to use SLT compared

to non-smokers.

Individuals without health insurance are 59% less likely

to visit the dentist.

Results (Contd.):

Figure 1: Graph (a) showing the distribution of participants across the BRFSS data. Graph (b)

showing the number of SLT users who visited the dentist.

High % of SLT Users: Wyoming, Mississippi, & West

Virginia.

Low % of SLT users: California, Maryland & Vermont.

High % of SLT users Not Visited dentist: Louisiana,

Mississippi & Tennessee.

Low % of SLT users Not Visited dentist: Connecticut, New

Hampshire, & Vermont.

SLT users are less likely to visit the dentist.

SLT users with college education visited the dentist more

often.

Need of spreading awareness of ill effects in SLT use

Encouraging people to visit dentist regularly.

Changing health insurance & advertisement policies.

Awareness about early diagnosis of oral cancer is

paramount.

References:

1.Tam, J., Day, H. R., Rostron, B. L., & Apelberg, B. J. (2015). A systematic review of transitions between cigarette and smokeless tobacco product use in the United

States. BMC Public Health, 15(1). doi: 10.1186/s12889-015-1594-8

2.Dentalhealthorg. (n.d.). Smokeless tobacco. Retrieved from https://www.dentalhealth.org/smokeless-tobacco

3.It may be smokeless, but it's still tobacco. (n.d.). Retrieved from https://www.deltadentalins.com/oral_health/smokelesstobacco.html

4.(n.d.). Retrieved from https://www.ada.org/en/press-room/news-releases/2013-archive/june/american-dental-association-statement-on-regular-dental-visits