Oral Clues of Chronic Smoking and Cannabis

Abstract

Objective: To study oral manifestations among chronic smokers and assess the impact of occasional cannabis co-use on oral hygiene status, periodontal health, xerostomia, dental caries, and mucosal pathology.

Materials and Methods: The study was a cross-sectional observational study which was conducted over a period of six months in a tertiary care de-addiction centre that had an outpatient dermatology linkage. It was enrolled with 50 adult participants (aged 18 years and above) who had a history of chronic tobacco smoking. Six participants noted some co-use of cannabis. Standard oral cavity examinations done under sufficient lighting, recording mucosal pigmentation, leukoplakia, keratosis, ulcers, erosions, periodontal indices, xerostomia and dental caries. Statistical analysis was done by a chi-square and Fisher exact test, with p<0.05 being regarded as statistically significant.

Results: Out of the 50 participants, 44 (88%), were exclusive tobacco smokers and 6 (12%), reported occasional co-use of cannabis. The age was between 18 to 40 years. Among the findings in smokers, melanosis (78%), dental staining (92%), and periodontal disease (64%) were predominant. The co-users of cannabis had overlapping manifestations without statistically independent features (p=0.412). Oral examination has a diagnostic accuracy of 89% sensitivity and 84% specificity to diagnose chronic smoking status. All comparative tables showed p<0.05 of the key parameters.

Conclusion: Tobacco smoking leads to significant and recognizable oral mucosal and dental alterations. Dermatologists should routinely examine the oral cavity, counsel on cessation, and refer suspected oral potentially malignant disorders (OPMDs) early to reduce morbidity and malignancy risk.