1. Periodontal conditions, gutka-chewing and type 2 diabetes
Fawad Javed
DDS, PhD
Karolinska Institutet, Institute of Odontology, Research Department, Huddinge,
SWEDEN

2. 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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3.
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4. Artificial sweeteners and fragrances
Composition of gutka
Gutka
Areca nut
Powdered tobacco
Slaked lime
Artificial sweeteners and fragrances
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5. 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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6. 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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7.
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8. 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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9. Gutka-chewers & Non-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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10. Study participants
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11. Material and methods 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
In subjects with T2D
Duration of T2D
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12. 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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13. 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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14. Results
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15. 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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16. Duration of use, placement in the mouth and daily consumption of gutka in subjects with and without T2D
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17. Periodontal conditions among gutka-chewers and non-chewers in subjects with and without T2D
No difference
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18. Oral symptoms reported by gutka-chewers and non-chewers in subjects with and without T2D
No difference
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19. Reasons for gutka use Subjects without T2D Subjects with T2D
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20. Conclusion In subjects without T2D:
Gutka-chewers have severe periodontal conditions and oral symptoms compared to non-chewers.
In subjects with T2D:
The severity of these variables is associated with glycemic levels
compared to gutka usage.
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21. Teachers open doors but you must enter by yourself
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22. Thank You !
Fawad Javed
Karolinska Institutet, Institute of Odontology, Research Department, Huddinge,
SWEDEN