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Head Neck Pathol 2021 Apr 26. Epub 2021 Apr 26.

Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02115, USA.

Background: Irritant contact stomatitis (ICS) and contact hypersensitivity stomatitis (CHS) are often caused by alcohol, flavoring agents and additives in dentifrices and foods, and contactants with high or low pH. A well-recognized contactant for ICS is Listerine™ mouthwash, while that for CHS is cinnamic aldehyde. However, many other flavoring agents and even smokeless tobacco are contactants that cause mucosal lesions that are entirely reversible. Read More

Ann Maxillofac Surg 2020 Jul-Dec;10(2):488-490. Epub 2020 Jul 2.

Department of Orthodontics and, University of Alabama Birmingham, Birmingham, AL, USA.

The diagnosis of oral white lesions might be quite challenging. White lesions are only 5% of all oral pathologies. Smokeless tobacco (ST), also known as tobacco chewing, spit tobacco, dip, plug, or chew, is one of the well-documented agents that causes white lesions. Read More

J Ayub Med Coll Abbottabad 2020 Oct-Dec;32(4):527-530

Department of Pathology, Al-Tibri Medical College, Isra University Karachi Campus, Pakistan.

Background: To determine staining expression of CK5\6 in healthy oral mucosa and various grades of oral dysplasia and to find out possible association of CK5\6 expression in dysplastic transformation of clinically normal oral mucosa to various grades of oral dysplasia.

Methods: This cross-sectional descriptive study was done at Al-Tibri Medical College and Hospital and Dow University of Health Sciences, Karachi from March 2018 to November 2018. It included 120 diagnosed paraffin embedded tissue samples of normal oral mucosa and various grades of oral epithelial dysplastic lesions. Read More

J Family Med Prim Care 2020 Sep 30;9(9):5004-5009. Epub 2020 Sep 30.

Director, CHRE-UK, London.

Context: Vulnerable population groups such as migrant workers are identified as emerging high-risk groups for oral cancer owing to the high prevalence of smokeless tobacco consumption. Premature deaths due to oral cancer can be prevented by screening the population with high tobacco consumption practices and detecting early reversible stages of oral mucosal cavity lesions and facilitating linkages for further care.

Aim: To assess prevalence of potentially malignant oral mucosal cavity lesions among tobacco consuming migrant construction workers in sub-urban Chennai, India. Read More

Appl Microbiol Biotechnol 2020 Dec 12;104(24):10613-10629. Epub 2020 Nov 12.

Division of Laboratory Sciences, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS 110-03, Atlanta, GA, 30341-3717, USA.

Smokeless tobacco products (STP) contain bacteria, mold, and fungi due to exposure from surrounding environments and tobacco processing. This has been a cause for concern since the presence of microorganisms has been linked to the formation of highly carcinogenic tobacco-specific nitrosamines. These communities have also been reported to produce toxins and other pro-inflammatory molecules that can cause mouth lesions and elicit inflammatory responses in STP users. Read More

J Cancer Res Ther 2020 Apr-Jun;16(3):463-469

Department of Oral Medicine and Radiology, A. J. Institute of Dental Sciences, Mangalore, Karnataka, India.

Background: Tobacco practice in relation with oral diseases is a foremost cause for the global oral disease burden and is accountable for up to 50% of all periodontitis cases among adults. The present cross-sectional study was undertaken to evaluate the local effects of various types of smokeless tobacco on periodontal health in tobacco pouch keratosis (TPK) patients in Mangalore city in the state of Karnataka.

Materials And Methods: A total of 345 TPK patients were evaluated of which all were smokeless tobacco users. Read More

Asian Pac J Cancer Prev 2020 Jun 1;21(6):1615-1622. Epub 2020 Jun 1.

Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.

Background: The prevalence of tobacco chewing, and related oral mucosal lesions is alarmingly high amongst the Paniya tribes of Wayanad. A deeper understanding of their socio-cultural factors, beliefs, attitudes and behaviours would shed greater insights into the indiscriminate use of smokeless tobacco and related products in this community.

Methods: Ethnography was the theoretical framework adopted with network and convenience sampling. Read More

Cancer Control 2020 Jan-Dec;27(1):1073274820914659

Maulana Azad Medical College and Associated Hospitals, New Delhi, Delhi, India.

Tobacco menace is responsible for significant mortality and morbidity worldwide. Smokeless tobacco (SLT) is consumed in more than 140 countries, thus is emerging as a global problem. Several adverse health outcomes like oropharyngeal, oesophageal, and pancreatic cancers; oral potentially malignant lesions; diabetes mellitus; cardiovascular diseases; mental illness; osteopenia; low birth weight; preterm births; small for gestation age babies; and stillbirths are attributed to SLT usage. Read More

J Oral Maxillofac Pathol 2019 Sep-Dec;23(3):344-348

Department of Oral and Maxillofacial Pathology, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Tamil Nadu, India.

Background: Elevated salivary alkaline phosphatase (S-ALP) levels have been observed in oral squamous cell carcinoma, but its status in tobacco users and in individuals with oral potentially malignant disorders (OPMDs) is less explored.

Aims And Objectives: The aims and objectives were to estimate and compare the levels of S-ALP among tobacco users, nonusers and in individuals with OPMD.

Materials And Methods: The study population comprised 42 individuals, categorized into four groups with/without tobacco usage habit and with/without lesion. Read More

Ann Maxillofac Surg 2019 Jul-Dec;9(2):247-252

Department of Oral Medicine and Radiology, Rajarajeshwari Dental College and Hospital, Bengaluru, Karnataka, India.

Introduction: Oral submucous fibrosis is a chronic debilitating condition with potential for malignant transformation. Squamous cell carcinoma arising from a background of oral submucous fibrosis presents clinically as a distinct disease due to different etiopathogenesis.

Methodology: This prospective case series describes thirty cases of oral squamous cell carcinoma (OSCC) alongside oral submucous fibrosis (OSF). Read More

Indian J Dent Res 2019 Sep-Oct;30(5):652-655

Department of Public Health Dentistry, Triveni Institute of Dental Sciences, Hospital & Research Centre, Bilaspur, Chhattisgarh, India.

Background: Oral mucous membrane is an integral part of the complex oral cavity which is associated with maintenance of oral as well as general body health. Oral mucosal lesion (OML) is one of the most prevalent diseases in India, which is caused by consumption of smokeless and smoked forms of tobacco.

Aim: To assess the prevalence of OMLs and their association with pattern of tobacco use among patients visiting dental institution in Bhilai. Read More

Harm Reduct J 2019 11 27;16(1):62. Epub 2019 Nov 27.

Imperial Brands Plc, 121 Winterstoke Road, Bristol, BS3 2LL, UK.

Snus is an oral smokeless tobacco product which is usually placed behind the upper lip, either in a loose form or in portioned sachets, and is primarily used in Sweden and Norway. The purpose of this review is to examine the reported effects of snus use in relation to specified health effects, namely lung cancer, cardiovascular disease, pancreatic cancer, diabetes, oral cancer and non-neoplastic oral disease. The review also examines the harm reduction potential of snus as an alternative to cigarettes by comparing the prevalence of snus use and cigarette smoking, and the reported incidence of tobacco-related diseases across European Union countries. Read More

Oral Dis 2019 Oct 19;25(7):1724-1734. Epub 2019 Aug 19.

Department of Preventive Oncology, Tata Memorial Hospital, Mumbai, India.

Objectives: Oral cavity cancers are fourth most common cancers among Indian women. The objectives were to create cancer awareness (CA) and screen tobacco-using women for oral cavity cancers.

Materials And Methods: A community-based CA and screening programme was conducted among women in Mumbai, India. Read More

J Cancer Res Ther 2019 Jul-Sep;15(3):620-624

Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India.

Background And Objectives: Quid-chewing habit is a common and old tradition in India. It causes various potentially malignant disorders. Therefore, a study was undertaken to analyze the association of various quid-chewing habit patterns and different oromucosal lesions. Read More

Cancer Epidemiol 2019 08 23;61:38-49. Epub 2019 May 23.

Division of Molecular Genetics & Biochemistry, Division of Cytopathology, National Institute of Cancer Prevention & Research (ICMR-NICPR), I-7, Sector-39, Noida, India. Electronic address:

Background: Despite being most preventable malignancies associated with smoked and smokeless tobacco products, squamous cell carcinoma of oral cavity is one of the most common malignancy in India. The aim of the present study was to evaluate the role of TLRs in oral pre-cancerous, cancerous cases and their genotypic correlation with HPV/EBV, co-infection & lifestyle habits in Indian population.

Methods: The present study was conducted on 300 subjects (100 OSCC, 50 pre-cancer & 150 controls). Read More

Indian J Cancer 2019 Jan-Mar;56(1):15-18

Department of Oral Medicine and Radiology, School of Dental Sciences, KIMSDU, Karad, Maharashtra, India.

Objectives: This study was conducted to determine the number and types of oromucosal lesions (OMLs) in relation to tobacco habits in patients who attended the outpatient department.

Methodology: A total of 1730 patients visiting the Department of Oral Medicine and Radiology were interviewed and screened for tobacco habits (smoking and smokeless). Clinical oral examination was conducted with diagnostic instruments using the Color Atlas of Common Oral Diseases as a guide for diagnosis. Read More

Indian J Otolaryngol Head Neck Surg 2019 Mar 2;71(1):109-114. Epub 2018 Feb 2.

Genomic Research Centre, Maharaja Sayajirao University, Sayajigunj, Aurobindo Ghosh Road, Nr Faculty of Science, Vadodara, 390002 Gujarat India.

To assess and compare cytogenic damage in the form of micronuclei in various oral lesions according to duration and frequency of tobacco use. The present cross sectional study was carried out from October 2015 to October 2016. We included total 420 cases with 60 cases in each of the following subgroups, no tobacco habit with no obvious oral lesion (control) and tobacco habit with no obvious oral lesion, oral sub mucous fibrosis, leukoplakia, melanoplakia, erythroplakia, oral squamous cell carcinoma. Read More

Regul Toxicol Pharmacol 2019 Jun 4;104:21-28. Epub 2019 Mar 4.

Vinča Institute of Nuclear Sciences, Department of Physical Chemistry, University of Belgrade, POB 522, 11000, Belgrade, Serbia. Electronic address:

Long term exposure to oral smokeless tobacco may induce lesions in the oral cavity characterized by a hyperplastic epithelium. The possible role of nicotine and the physical properties of oral tobacco for developing these lesions, as well as of dysplasia and neoplasia is unclear. Low nitrosamine Swedish snus as well as non-genotoxic butylated hydroxyanisole induces increased cellular proliferation in the rat forestomach epithelia. Read More

Indian J Cancer 2018 Oct-Dec;55(4):404-409

Department of Oral Pathology and Microbiology, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India.

Background: Tobacco use is one of the most prevalent forms of habit and associated with development of potential malignant disorders. The aim of the present study was to investigate the prevalence and distribution of oral mucosal lesions (OMLs) among smokeless tobacco users.

Materials And Methods: This is a hospital-based cross-sectional study. Read More

Int J STD AIDS 2019 05 27;30(6):586-595. Epub 2019 Feb 27.

1 Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA.

Cervical cancer is a leading cause of death among women in low- and middle-income countries, and women living with HIV are at high risk for cervical cancer. The objective of this study was to estimate the prevalence and correlates of cervical cancer and pre-cancer lesions and to examine cervical cancer knowledge among women living with HIV receiving antiretroviral therapy in rural Andhra Pradesh, India. We conducted cytology-based screening and administered a standardized questionnaire among 598 HIV-infected women. Read More

Asian Pac J Cancer Prev 2019 Feb 26;20(2):411-415. Epub 2019 Feb 26.

Department of Oral Medicine and Radiology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal. Email:

Background: Oral potentially malignant disorders (OPMDs) and oral cancer (OC) are preventable oral mucosal diseases prevalent in Asian region. This epidemiological study aims to identify oral potentially malignant disorders (OPMDs) and oral cancer (OC), confirm histopathologically, and treat or refer these cases among the population of Eastern Development Region (EDR) of Nepal. It also attempts to assess the risk factors associated in order to compare dose–response measurements of oral habits in these patients. Read More

Indian J Med Res 2018 Dec;148(6):681-686

Section of Evidence Synthesis and Classification, International Agency for Research on Cancer, Lyon, France.

A Working Group of the Monographs programme of the International Agency for Research on Cancer has classified smokeless tobacco as carcinogenic to humans (Group 1). This review article summarizes the data that support the evaluations of sufficient evidence in humans and in experimental animals for the carcinogenicity of smokeless tobacco whether used alone or with betel quid. It also identifies compounds of smokeless tobacco relevant to carcinogenicity (prominently tobacco-specific nitrosamines) and addiction (nicotine). Read More

Head Neck Pathol 2019 Mar 22;13(1):16-24. Epub 2019 Jan 22.

Atlanta Oral Pathology, Emory Decatur Hospital, Emory University School of Medicine, 2701 N. Decatur Road, Decatur, GA, 30033, USA.

White lesions of the oral cavity are quite common and can have a variety of etiologies, both benign and malignant. Although the vast majority of publications focus on leukoplakia and other potentially malignant lesions, most oral lesions that appear white are benign. This review will focus exclusively on reactive white oral lesions. Read More

J Oral Maxillofac Pathol 2018 Sep-Dec;22(3):413-414

Department of Oral and Maxillofacial Pathology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India.

Oral cancer burden poses a major challenge in India. Oral cancer in the majority of instances arises from preexisting oral potentially malignant disorders (OPMDs). Early detection of OPMD and elimination of primary risk factors such as smokeless and smoking tobacco help in reduction of oral cancer. Read More

Int J Environ Res Public Health 2019 01 9;16(2). Epub 2019 Jan 9.

Beijing Key Laboratory of Environmental & Viral Oncology, College of Life Science and Bioengineering, Beijing University of Technology, Beijing 100124, China.

N'-nitrosonornicotine (NNN) is one of the tobacco-specific nitrosamines (TSNAs) that exists widely in smoke and smokeless tobacco products. NNN can induce tumors in various laboratory animal models and has been identified by International Agency for Research on Cancer (IARC) as a human carcinogen. Metabolic activation of NNN is primarily initiated by cytochrome P450 enzymes (CYP450s) via 2'-hydroxylation or 5'-hydroxylation. Read More

Minerva Stomatol 2019 Feb 7;68(1):25-30. Epub 2019 Jan 7.

Department of Oral and Maxillofacial Pathology and Microbiology, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad, India.

Background: Free radicals (FRs) are active chemical substances having unpaired electron(s) which participate in the causation of precancerous lesions or cancer in tobacco habituates. Alterations in the antioxidant levels are reflected throughout the antioxidant enzyme activities in blood, wherein erythrocytes are considered highly sensitive to those enzymes. Our study was therefore aimed to assess the effects of tobacco consumption on erythrocyte antioxidant enzyme- Superoxide dismutase (E-SOD) and evaluate its defensive action. Read More

Indian J Med Res 2018 Jul;148(1):35-40

WHO Collaborating Centre for Oral Cancer; King's College London, London, UK.

Smokeless tobacco (SLT) use has many oral effects including oral cancer, leukoplakia and erythroplakia, oral submucous fibrosis (if mixed with areca nut), loss of periodontal support (recession) and staining of teeth and composite restorations. This review was aimed to provide information to identify oral lesions that occur due to the use of smokeless tobacco so that effective interventions can be undertaken to reduce morbidity and mortality from the use of SLT. Read More

Asian Pac J Cancer Prev 2018 Aug 24;19(8):2165-2170. Epub 2018 Aug 24.

Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India. Email:

Objective: Globally oral cancer is one of the ten most common cancers with prevalence being high in Central and South East Asian countries. This survey was conducted to estimate the prevalence of oral pre-malignant lesions (OPML) and to identify their risk factors. Methods: A community based cross-sectional study was carried out among 2033 individuals aged ≥18 years. Read More

J Int Soc Prev Community Dent 2018 Jul-Aug;8(4):339-342. Epub 2018 Jul 18.

Department of Periodontology, Himachal Dental College and Hospital, Sundar-Nagar, Himachal Pradesh, India.

Aims And Objectives: Nicotine absorption through the mucous membrane is directly proportional to pH, so the snuff is buffered to pH of 8-9 by adding sodium carbonate. The objective of the present study is to assess the impact of various forms of sodium carbonate in snuff on mucosal conditions.

Materials And Methods: The present cross-sectional study was conducted on 284 participants. Read More

J Coll Physicians Surg Pak 2018 May;28(5):381-385

Department of Biochemistry, Ziauddin University, Clifton, Karachi.

In Pakistan, extensive use of several precarious chewable tobacco formulations has made oral cancer the second leading malignancy. Selection of literature was done by a survey of studies published from 1990 to 2017 mainly, from PUBMED and few from other search engines, on naswar, gutka, areca nut and betel quid, which included published reviews, original articles and other data sources on chewable tobacco, its epidemiology, pathological implications, and psychological effects. These studies have revealed that the chemicals in these formulations bind and mutate DNA of oral mucosa through down regulating cellular repair pathways and upregulating genetic networks associated with pathogenesis. Read More