Salivary Oxidative Stress and Antioxidant Capacity in Smokeless Tobacco (Naswar) Users

Figures & data

Table 1 Characteristics and Oral Health Habits of Participants Who Were Enrolled in the Case Control Study to Compare Naswar Users to Non-users, Pakistan

Participant Characteristics	Total	Naswar User	Non-User	P value
	N=84 (%)	N (%)	N (%)
Demographic characteristics
Age group
18–25 years	34 (41)	16 (38)	18 (43)	0.205
26–34 years	25 (30)	11 (26)	14 (33)
35–44 years	13 (15)	10 (24)	3 (7)
45–54 years	12 (14)	5 (12)	7 (17)
Education
Primary and below	10 (12)	7 (17)	3 (7)	0.129
High school and college	44 (52)	24 (57)	20 (48)
University level	30 (36)	11 (26)	19 (45)
Occupation
Employed (govt., private, or business owners)	41 (49)	19 (45)	22 (52)	<0.0001
Daily-wage worker	22 (26)	19 (45)	3 (7)
Student	21 (25)	4 (10)	17 (41)
Dwelling
Own house	64 (76)	33 (79)	31 (74)	0.608
Rented building or other	20 (24)	9 (21)	11 (26)
No. of household members
<10	32 (38)	13 (31)	19 (45)	0.178
10–15	52 (62)	29 (69)	23 (55)
Oral health habits
Daily teeth brushing frequency
Once	34 (40)	18 (43)	16 (38)	0.656
Twice or more	50 (60)	24 (57)	26 (62)
When teeth are brushed
Morning only	34 (40)	16 (38)	18 (43)	0.656
Morning and bedtime	50 (60)	26 (61)	24 (57)
What is used to clean teeth
Toothbrush and toothpaste	47 (56)	15 (36)	32 (76)	0.0002
Miswak/other, eg Dandasa	37 (54)	27 (64)	10 (24)
Gums bleed during brushing
No	59 (70)	30 (71)	29 (69)	0.811
Yes	25 (30)	12 (29)	13 (31)
History of teeth mobility
No	68 (81)	33 (79)	35 (83)	0.578
Yes	16 (19)	9 (21)	7 (17)
Frequency of dental visits
Regularly (every six months)	1 (1.2)	0 (0)	1 (2.4)	0.790
As needed	65 (77.4)	32 (76.2)	33 (78.6)
Never visited a dentist	18 (21)	10 (24)	8 (19)

Figure 1 (A-E)Laboratory and clinical oral health status of the participants. (A) Salivary pH; (B) Sa livary flow rate; (C) Decayed, Missing and Filled teeth (DMFT) score; (D) Salivary total oxidant status (TOS); (E) Salivary total antioxidant capacity (TAC). Independent sample t-test was used. ****p<0.0001, ***p<0.001.

Abbreviation: ns, non-significant.

Table 2 Characteristics of Naswar Use by Cases, Pakistan

Characteristics	N=42 (%)
Type of Naswar commonly used
Green moist	26 (62)
Black dry	12 (29)
Green dry	3 (7)
Black moist	1 (2)
Brand of Naswar commonly used
Bara brand	21 (50)
Wazir bagh	6 (14)
Banuse	5 (12)
Sarhad	2 (5)
Other	8 (19)*
Quadrant of the mouth Naswar is usually placed?
Lower right	14 (33)
Lower left	11 (26)
Upper left	10 (24)
Upper right	7 (17)
Mean number of daily units normally dipped (SD)	17.24 (10.81)
Daily number of dips
1–10	19 (45)
11–20	14 (33)
>20	9 (21)
Duration of dips in minutes
1–5	21 (50)
6–10	11 (26)
>10	10 (24)
What user does with saliva coming into his/her mouth
Spits	39 (93)
Swallows	3 (7)

Note: *Each brand was consumed by one participant.

Table 3 Association Between Oral Health Scores and Characteristics of Naswar Use for Cases, Pakistan

Characteristics of Naswar Use	Oral Health Scores
	DMFT SCORE		Salivary pH		Salivary Flow Rate (mL/min)		Total Oxidant Status (µmol/L)		Total Antioxidant Capacity (mmol/L)
	Mean (SD)	P-value	Mean (SD)	P-value	Mean (SD)	P-value	Mean (SD)	P-value	Mean (SD)	P-value
Type of Naswar used*
Green moist	3.19±1.06^a	0.005	7.71±0.25	0.735	0.70±0.26	0.539	64.26±46.37	0.099	0.61±0.20	0.267
Green dry	2±1^a,b		7.70±0.17		0.70±0.00		27.75±17.37		0.53±0.12
Black dry	2.25±0.45^b		7.68±0.25		0.73±0.15		32.62±25.24		0.48±0.18
Number of units used per day
1–10 per day	2.26±0.65^a	0.005	7.73±0.26	0.545	0.70±0.18	0.491	36.01±30.83	0.089	0.54±0.21	0.403
11–20 per day	3.07±1.14^b		7.64±0.19		0.76±0.23		60.48±45.14		0.55±0.20
>20 per day	3.44±1.13^b		7.72±0.28		0.66±0.29		70.87±49.62		0.63±0.16
Duration of Naswar use
1–5 min	2.57±0.93	0.207	7.76±0.24	0.141	0.73±0.20	0.240	45.62±42.19	0.365	0.56±0.21	0.496
6–10 min	2.91±0.83		7.57±0.16		0.64±0.26		69.84±50.04		0.61±0.22
>10 min	3.10±1.45		7.70±0.29		0.74±0.23		44.26±27.43		0.52±0.13
What user does with saliva coming into his/her mouth
Spit	2.72±1.05	0.080	7.71±0.24	0.454	0.72±0.22	0.577	51.26±41.77	0.927	0.56±0.19	1.000
Swallow	3.67±0.58		7.57±0.25		0.63±0.21		56.51±54.73		0.57±0.26

Notes: *Black moist excluded from this analysis. ^aKruskal–Wallis test. ^bGrouping variable.