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Periodontal conditions, gutka-chewing and type 2 diabetes
Fawad Javed DDS, PhD Karolinska Institutet, Institute of Odontology, Research Department, Huddinge, SWEDEN
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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. February 12, 2009
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Artificial sweeteners and fragrances
Composition of gutka Gutka Areca nut Powdered tobacco Slaked lime Artificial sweeteners and fragrances February 12, 2009
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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 February 12, 2009
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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. February 12, 2009
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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) February 12, 2009
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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 February 12, 2009
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Study participants February 12, 2009
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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 February 12, 2009
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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 February 12, 2009
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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. February 12, 2009
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Results February 12, 2009
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Mean age, duration of T2D and random blood glucose levels among
gutka-chewers and non-chewers in subjects with and without T2D February 12, 2009
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Duration of use, placement in the mouth and daily consumption of gutka in subjects with and without T2D February 12, 2009
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Periodontal conditions among gutka-chewers and non-chewers in subjects with and without T2D
No difference February 12, 2009
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Oral symptoms reported by gutka-chewers and non-chewers in subjects with and without T2D
No difference February 12, 2009
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Reasons for gutka use Subjects without T2D Subjects with T2D
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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. February 12, 2009
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Teachers open doors but you must enter by yourself
February 12, 2009
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Thank You ! Fawad Javed Karolinska Institutet, Institute of Odontology, Research Department, Huddinge, SWEDEN
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