Does Tobacco Use Have an Effect on The Orofacial Pain Status? A Systematic Review

Objectives: Objective of the current review is to explore the association between pain related to diseases of the oral cavity and the use of tobacco
Methods: A systematic search of PubMed, Embase, Web of Science and Cochrane databases was carried out on the 1^st of September, 2019. Exposure comprised of any form of tobacco consumed by the participants irrespective of the make, composition, method of consumption and frequency of the habit. The outcome was pain diagnosed or self-reported by the study participants in the orofacial region with no limitation towards the duration of the condition or the site of the orofacial pain. Independent search of databases utilizing a set strategy was performed by two authors and a blind reviewer. A pre-designed form available through Cochrane organization was utilized to extract data from the included studies. Quality of the included studies describing the association of tobacco use with orofacial pain was assessed using the New Castle Ottawa scale for observational studies.

Results: The search resulted in 1986 articles and the final count of studies after applying the PRISMA guidelines was eight. Cumulative sample was 35,668 and the oral diseases assessed among the study population were; temporomandibular disorders (TMD), gum diseases/periodontitis, and tooth pain. The plausible effect of tobacco in increasing the pain among the patients suffering from TMD’s and tooth diseases was not clear. However, consumption of tobacco significantly contributed to pain associated with gum diseases or periodontitis. None of the included studies were of poor quality, while three out of the eight studies demonstrated ‘good’ methodology.

Conclusions: Findings are of clinical importance and may be helpful for the general dentists and specialists in order to comprehensively manage the treatment modality of patient’s addictive to tobacco, especially with periodontal problems. More evidence in future from studies demonstrating temporal relationship is required to substantiate the claim.