Prevalence of Smokeless Tobacco among medical students

Introduction: the use of smokeless tobacco is highly prevalent in Sudan but there is no data on its adverse effect on periodontal health in Sudanese population.  The  aim  of  this  study was  to investigate  the  prevalence  and  influence  of  argella  and  cigarette smoking  on  the  periodontal  health  of  students  of  the  Medical Campus of University of Khartoum (U of K). Methods: Three hundreds and fifty  students  from  the  Medical  Campus   U of K with an age range of (17-29) years were  randomly  selected  for  the  study.  One hundred and fourteen smokers were using cigarette, argella and a combination (cigarette and argella).  A matched control group of two hundreds and thirty six non-smokers were also included.  The two groups  were  clinically  examined  for  plaque  levels  using the  Plaque Index  (PLI) (Loe and Silness)  and  Community  Periodontal  Index  (CPI)  for  gingival bleeding,  calculus,  pocket  depth  and  loss  of  periodontal  attachment  (LA). Results: Smokers, who showed prevalence of 32%,  had  statistically  insignificant  higher  levels  of  plaque compared  to  non-smokers  (P=0.1). Cigarette smokers (75.6%) showed higher levels of plaque than  argella  and  combination  users. Moreover smokers showed  less gingival  bleeding than non-smokers (22.4%) and  it  was  more  among  cigarette  smokers  than  the  other  two  subgroups (25.2%). Smokers  showed  statistically  significant higher  pocket  depth  (P=0.00),  and LA  (P=0.00)  compared  to  non-smokers.  Argella  users  had  greater  LA  and  deeper periodontal Pockets  than the cigarette  and  combination  subgroups  (59.5% and  13.3%  respectively), while the combination users were greater in shallow pockets than the other two subgroups (31.0%).The relative risk (odd ratio) was found to be of 2.85 for smokers.  Conclusion: All  types  of  tobacco  consumption  increase  periodontal  disease severity  and  argella  smoking  had  a  greater adverse effect  than  cigarette smoking  on the disease  severity.