Saeed Al-Tayar, Badr Abdullah
(2015)
Association between shammah use with periodontal disease and shammah-induced leukoplakia-like lesion among adult males in dawn valley, Yemen.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: The traditional type of smokeless tobacco (SLT) used in the Arabian
Peninsula, especially common in Yemen is called shammah. Shammah and other risk
factors play an important role in development of oral diseases. Objectives: The
present study has been undertaken to determine the prevalence of shammah use and
to determine the association between shammah use with periodontal disease and oral
leukoplakia-like lesions. Other associated factors with periodontal disease as well as
with oral leukoplakia-like lesions were also determined. Materials and Methods: A
cross sectional study was conducted on 346 randomly selected adult males. Multistage
random sampling was used to select the study location. After completing the
structured questionnaire interviews, all the participants underwent clinical
exanimation for periodontal health status and oral leukoplakia-like lesions.
Periodontal status was recorded using the Community Periodontal Index (CPI).
Clinical features of oral leukoplakia- like lesions were characterized based on the
grades of Axéll et al. (1976). Chi-square test was used for assessing significant
differences in shammah status in respect to periodontal disease and oral leukoplakialike
lesions. Univariable logistic regression and multivariable logistic regression
were selected for assessing potential associated factors. Results: Out of 346 male
participants aged 18 years and older, 68 reported being current shammah users. The
prevalence of current shammah use was 19.7% (95% CI: 15.6%, 24.2%). Chi-square
test detected that significant differences exists between the study groups (i.e., never,
former, and current shammah users) in respect to the presence of periodontal disease
(P= 0.001) as well as to the presence of oral leukoplakia-like lesion (P=0.001).
Multivariable logistic regression analysis revealed that age, family income, former
shammah user, current shammah user, and annual duration of shammah use were
statistically associated with the presence of periodontal disease [Adjusted odds ratio
(AOR)= 1.05; 95% CI: 1.03, 1.07; P= 0.001], (AOR= 2.01; 95% CI: 1.16, 3.47; P=
0.012), (AOR= 2.92; 95% CI: 1.20, 7.10; P= 0.018), (AOR= 7.25; 95% CI: 3.84,
13.70; P= 0.001), and (AOR= 2.19; 95% CI: 1.47, 3.24; P= 0.001), respectively. The
multivariable analysis also revealed that age, no formal or primary level of
education, former shammah user, current shammah user, and frequency of shammah
use per day were statistically associated with the presence of oral leukoplakia-like
lesion ( AOR= 1.03; 95% CI: 1.01, 1.06; P= 0.006), (AOR= 8.65; 95% CI: 2.81,
26.57; P= 0.001), (AOR= 3.65; 95% CI: 1.40, 9.50; P= 0.008), (AOR= 12.99; 95%
CI: 6.34, 26.59; P= 0.001), and (AOR= 1.17; 95% CI: 1.02, 1.36; P= 0.026),
respectively.
Conclusion: The results revealed that periodontal disease and oral
leukoplakia-like lesions were significantly associated with shammah use. Therefore,
it is important to develop comprehensive shammah prevention programmes in
Yemen.
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