Association of Tobacco Use with Gingival Health Statusamong Patients in Rehabilitation Centers in Peshawar

Abstract

Background: There is a strong association between severe oral health deterioration and substance use disorders (SUD) and long-term tobacco smoking. People undergoing addiction treatment often have complex oral health needs, exacerbated by less-than-ideal oral hygiene and infrequent dental visits. These characteristics need to be assessed within recovery frameworks to create comprehensive and integrated health solutions. Aims and Objectives: To find out the tobacco use profile and oral hygiene practices and their associated gingival health status of patients living in drug rehabilitation centers of Peshawar, Pakistan. Material and Methods: The cross-sectional study was conducted in which the sample of N = 121 male participants aged 18 to 60 years of particular rehabilitation centres in Peshawar were assessed. Dental care patterns, tobacco use and demographic data were obtained using a standardized questionnaire. Objective clinical assessment of Individual Oral Hygiene Index (OHI) scores and Gingival Index (GI) status was done. Descriptive statistics were used to analyze the data. Result: The mean age was 35 \standard deviation 10.2 years. The majority of the respondents had secondary education (45.5%), and the sample was 100% male. Tobacco use profile was 100%: 30.6% had smoked for >6 years; and 47.9% smoked 1-5 times per day. The high rate of illegal drug use was also observed at the same time, with polydrug use (2 or more drugs) at 38.0% followed by the use of methamphetamine alone (24.0%) and THC/cannabis use (23.1%). 65,3% of people used a toothbrush, 24,8% infrequently brushed and an alarming 54,5% had never been to a dentist, according to oral hygiene practices. Consequently, there was poor baseline health with 45.5% of the participants in the "Severe" gingival inflammation (GI score) and 57.9% of the subjects in the "Poor" OHI group. Conclusion: The prevalence of poor oral hygiene and advanced gingival inflammation among the rehabilitation patients of Peshawar is alarming and smoking, polydrug abuse and neglectful dental care are very potent factors in exacerbating this situation. These findings demonstrate the need for implementing necessary dental care treatments in traditional substance recovery programs as a diagnostic and/or preventive service.