|Year : 2015 | Volume
| Issue : 1 | Page : 12-15
Analysis of smoking habits in patients with varying grades of smoker's palate in South Western region of Maharashtra
Mrunali Dubal1, Ajay Nayak2, Ashwinirani Suragimath2, Abhijeet Sande2, Suresh Kandagal2
1 Department of Dental Sciences, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Satara, Maharashtra, India
2 Department of Oral Medicine and Radiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Satara, Maharashtra, India
|Date of Web Publication||7-Jul-2015|
Department Oral Medicine and Radiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Satara, Maharashtra
Source of Support: None, Conflict of Interest: None
Background: Tobacco is a known carcinogenic substance and a significant risk factor for the development of various oral mucosal lesions.
Objective: To evaluate the smoking habits in patients with varying grades of smoker's palate depending on type of smoking, duration, and its frequency of use.
Material and methods: Total 50 individuals above 20 years of age with smoking habits were included in study. The duration, frequency of smoking habits (cigratte/beedi) and palatal lesions were noted. The lesions were then classified in to different grades of smokers palate. The data was tabulated and statistically analysed.
Results: The present study conducted in South Western region of Maharashtra reveals that in smokers, the type of smoking practiced is mostly cigarette than beedi, the grades increase with increase in duration and frequency too increases with grades.
Conclusion: In our study, cigarette smoking was more commonly practiced than beedi. The grades of smoker's palate progress with longer duration of smoking habit and higher frequency. Early detection and screening of smokers are very important to stop the progression of initial mucosal changes to potentially malignant disorders.
Keywords: Habit, smoker′s palate, tobacco
|How to cite this article:|
Dubal M, Nayak A, Suragimath A, Sande A, Kandagal S. Analysis of smoking habits in patients with varying grades of smoker's palate in South Western region of Maharashtra. J Oral Res Rev 2015;7:12-5
|How to cite this URL:|
Dubal M, Nayak A, Suragimath A, Sande A, Kandagal S. Analysis of smoking habits in patients with varying grades of smoker's palate in South Western region of Maharashtra. J Oral Res Rev [serial online] 2015 [cited 2019 Mar 20];7:12-5. Available from: http://www.jorr.org/text.asp?2015/7/1/12/160171
| Introduction|| |
Tobacco smoking is one of the most common causes of mortality and morbidity in developed and developing countries now.  At present, cigarette and beedi smoking have been found to be positively associated with nearly 40 diseases and causes of death and to be negatively associated with eight or nine.  The habit of tobacco smoking is a specific and peculiar custom in groups with low economical resources with higher frequency in men especially after the third decade of life in South Western region of Maharashtra. Cigarettes contain over 4000 constituents of chemicals and free radicals such as nicotine, ammonia, acrolein, phenols, acetaldehyde, benzopyrene, nitric oxides, carbon monoxide, polonium, radium, and thorium that can cause cellular damage. , Tobacco smoking is one of the most important risk factors for the development of oral mucosal lesions.  Cigarette smoking is associated with oral leukoplakia, smoker's melanosis, nicotinic stomatitis or smoker's palate, black hairy tongue, and squamous cell carcinoma. , Smoking is a significant risk factor for periodontal disease as well. Tobacco contains a huge number of carcinogens, but the most significant of them are the polycyclic aromatic hydrocarbons, aromatic amines, and nitrosamines. 
Smoker's palate or nicotina stomatitis palatini is an asymptomatic lesion associated with heavy pipe and cigar smoking usually appearing as white changes in hard palate, often combined with multiple red dots located centrally in small elevated nodule. These red dots represent the ducts of minor salivary glands that have become inflamed and are painless. This phenomenon is caused by a response of the palatal mucosa to chronic heat. In severe cases, the mucosa may show fissuring and develop a dried lake appearance. The present study was designed to evaluate the different smoking habits in patients with different grades of smoker's palate depending upon age, frequency, and type of smoking with duration.
| Materials and Methods|| |
A descriptive study was conducted over a period of 7 months from February to August 2014 wherein 50 individuals were chosen above 20 years of age who practiced smoking and reported to the out-patient department of our institute. Patients who gave a history of smoking tobacco and manifested smoker's palate were considered for inclusion in the study. Individuals who were suffering from systemic conditions were excluded from consideration. All chosen individuals were informed about the study goals and only those who gave written consent were included in the study. The study design was approved by the ethical committee for the study on human subjects of our university. The study subjects were examined by two experienced clinicians of the department familiar with the diagnosis of oral mucosal lesions. Necessary relevant details such as medical history, type of smoking habit (cigarette or beedi), duration and frequency of the habit, and clinical features of the palatal lesion as per the predetermined proforma were recorded. Patients identified with smoker's palate were classified into three grades: 
The data collected were tabulated, and the descriptive frequencies were determined.
- Mild (Grade I): Consisting of red, dot-like opening on blanched area [Figure 1].
- Moderate (Grade II): Characterized by well-defined elevation with central umbilication [Figure 2].
- Severe (Grade III): Marked by papules of 5 mm or more with umbilication of 2-3 mm [Figure 3].
| Results|| |
This study consisted of 50 subjects with a diagnosis of smoker's palate who are all males. In our study subjects, with Grade I smoker's palate (n = 13), there were more of cigarette smokers (n = 11) than beedi smokers (n = 2). While in Grade II, of 21 patients, 16 were cigarette users while 5 were beedi users. In Grade III patients (n = 16), 11 practiced cigarette smoking and 5 practiced beedi smoking [Table 1] and [Figure 4].
|Figure 4: Comparison between grades of smoker's palate and type of smoking|
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|Table 1: Comparison between grades of smoker's palate and type of smoking |
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Analysis of the duration of smoking habits revealed, of the 13 Grade I smoker's palate patients, 4 patients practiced smoking for 6-10 years, while 5 individuals practiced smoking for 11-15 years and 4 subjects practiced smoking for more than 15 years. Grade II subjects constituted 21 patients, of which 3 patients practiced smoking for 6-10 years, 11 patients practiced smoking for 11-15 years, and 7 had smoked for over 15 years. In the 16 Grade III subjects, 1 patient practiced smoking for 6-10 years, 5 patients practiced smoking for 11-15 years, and 10 had smoked for over 15 years [Table 2] and [Figure 5].
When the frequency of the smoking habit was analyzed among the study subjects, it was noted that from 13 patients manifesting Grade I smoker's palate, 6 individuals smoked up to 5 times a day, and 7 subjects smoked more than 5 times a day. From 21 Grade II patients, 15 patients practiced smoking up to 5 times a day while 6 patients practiced smoking more than 5 times in a day. In Grade III group, of 16 patients, 6 patients practiced smoking up to 5 times a day, and 10 patients smoked more than 5 times a day [Table 3] and [Figure 6].
| Discussion|| |
The dental clinician encounters a myriad of oral mucosal lesions that proper identification and diagnosis for according appropriate treatment. The oral health of any population can be very easily assessed by the prevalence of oral mucosal lesions. The prevalence data of these lesions are, therefore, vital in planning oral health care services for the population. In the present study, 50 subjects manifesting smoker's palate were assessed.
In a study by Ahmadi-Motamayel et al., the prevalence of oral mucosal lesions in male smokers and nonsmokers was assessed in Iran.  They evaluated oral lesions in 516 males; smokers compared with nonsmokers. They found a large number of oral mucosal lesions that had a strong correlation with smoking.
Alvarez GÓmez et al. studied reverse smoking in Colombia and found that palatal changes were the second most common manifestations.  The average duration of the smoking habits in their observations was 30 years while the average frequency per day of smoking noted as 2.29% with the range of 1-7 times/day. This is in concurrence with our findings of longer duration of smoking habit resulting in palatal changes.
In our study, an analysis of the type of smoking habit revealed cigarette smoking manifested smoker's palate more often than the beedi smokers. The analysis on the basis of the grade of the lesions showed higher proportions of patients manifested severe (II or III) grades of the lesion. When the duration of habit practice was assessed, larger proportion of the subjects was noted with smoker's palate in individuals with longer practice of smoking. The severity of the grade of the lesion also increased as the duration of the smoking progressed. Analysis of the habit frequency revealed those individuals with higher frequency of smoking per day manifested more often and severe grades of smoker's palate.
| Conclusion|| |
Tobacco smoking has many deleterious effects on oral mucosa and organs of the body. It is one of the most important risk factors for oral cancer. Cigarette smoking negatively influences oral cavity. In our study, cigarette smoking was more commonly practiced than beedi. The grades of smoker's palate progress with longer duration of smoking habit and higher frequency. Early detection and screening of smokers are very important to stop the progression of initial mucosal changes to potentially malignant disorders.
Financial support and sponsorship
Conflict of interest
There are no conflicts of interest.
| References|| |
Musk AW, de Klerk NH. History of tobacco and health. Respirology 2003;8:286-90.
Doll R. Uncovering the effects of smoking: Historical perspective. Stat Methods Med Res 1998;7:87-117.
Pasupathi P, Saravanan G, Farook J. Oxidative stress biomarkers and antioxidant status in cigarette smokers compared to nonsmokers. J Pharm Sci Res 2009;1:55-62.
Pryor WA, Hales BJ, Premovic PI, Church DF. The radicals in cigarette tar: Their nature and suggested physiological implications. Science 1983;220:425-7.
Hayes RB, Bravo-Otero E, Kleinman DV, Brown LM, Fraumeni JF Jr, Harty LC, et al.
Tobacco and alcohol use and oral cancer in Puerto Rico. Cancer Causes Control 1999;10:27-33.
Greenburg MS, Glick M, Ship JA. Burket's Oral Medicine. 11 th
edition, BC Decker Inc; 2008. p. 77-106.
Meraw SJ, Mustapha IZ, Rogers RS 3 rd
. Cigarette smoking and oral lesions other than cancer. Clin Dermatol 1998;16:625-31.
Ding YS, Zhang L, Jain RB, Jain N, Wang RY, Ashley DL, et al.
Levels of tobacco-specific nitrosamines and polycyclic aromatic hydrocarbons in mainstream smoke from different tobacco varieties. Cancer Epidemiol Biomarkers Prev 2008;17:3366-71.
Ahmadi-Motamayel F, Falsafi P, Hayati Z, Rezaei F, Poorolajal J. Prevalence of oral mucosal lesions in male smokers and nonsmokers. Chonnam Med J 2013;49:65-8.
Alvarez Gómez GJ, Alvarez Martínez E, Jiménez Gómez R, Mosquera Silva Y, Gaviria Núñez AM, Garcés Agudelo A, et al.
Reverse smokers's and changes in oral mucosa. Department of Sucre, Colombia. Med Oral Patol Oral Cir Bucal 2008;13:E1-8.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
[Table 1], [Table 2], [Table 3]