In society, tobacco products, such as e-cigarettes, and smokeless tobacco products, such as snus and nicotine pouches, are becoming more attractive. There is still a lack of information regarding the effects of these products on the oral mucosa and oral saliva biomarkers. The aim of this study is to evaluate oral mucosa and the presence of inflammatory biomarkers IL-6, IL-1, IL-8, TNF alpha and LRG-1 in saliva. Respondents were divided in four groups based on their tobacco product usage. Oral examination was carried out, saliva samples were taken, and the detection of IL-6, IL-8, IL-1, TNF alpha and LRG-1 levels in saliva was carried out. Out of the tobacco users, 30.8% were snus users, 48.7% were cigarette users and 20.5% were e-cigarette users. The control group was composed of respondents who did not use any tobacco products. E-cigarettes were used more by women, but snus was used more by men. Mucosal changes were seen in the group of snus users, and mucosal changes were only seen in men who had used 5–10 tobacco units per day for 5–10 years. Increased IL-6 levels in saliva were detected in respondents who also experienced mucosal changes. Mucosal changes were white, leathery and localized at the site where snus sachets were placed. Saliva, as an easily available biofluid, could be used as a first tool to detect potentially precancerous signs, but the LRG1 marker cannot be used as a prognostic marker.
Regarding oral biofilm aspects, there has been strong evidence for a microbiotic component in the aetiology of halitosis. Many oral microbiota have protheolytic and putative activity, but there have been no studies investigating the association of microbiota in oral biofilms with halitosis. The objective of this study was to determine species of oral microbiota in the periodontal area and dorsal part of tongue biofilm, and how their quantitative amounts differ in halitosis patients. The clinical bacterial material from halitosis patients (altogether 98 persons, volatile sulphur compounds (VSC) on average 380 ppb) was taken from periodontal pockets and the dorsal part of the tongue for microbiological diagnostics of anaerobic bacteria, using polymerase chain reaction (PCR) tests for the comparison of bacterial quantity. The study showed the primary aetiology factors of halitosis in Latvia, and offers possible versions of microbiological diagnostics of halitosis. Even though the examination of halitosis patients and determination of VSC using a halimeter is technically simpler and cheaper, the determination of aetiological factors and their combinations using microbiological examination of clinical material with PCR tests are more precise. A characteristic ecological niche of anaerobic bacteria is not only the anaerobic environment of periodontal pockets, but also the microbiota of the dorsal part of the tongue. Additionally, some anaerobic bacteria species (Porohyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia) in larger amounts are found on the microbiome of the tongue. Therefore, it is advisable to begin microbiological diagnostics in halitosis patients with quantitative diagnostics of Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Treponema denticola on the biofilm of the tongue coating.
Background New tobacco products, such as smokeless tobacco, are becoming more popular every year. In talking with our patients, we determined several reasons for that trend. The sale of these products is prohibited in many countries; hence, people obtain the product illegally. This is important, since when these products are stored under inappropriate conditions and temperatures, the quality and properties of the product change, including their carcinogenic properties. Sometimes people use a lot of this product or more than one tobacco product daily. It is challenging for dental practitioners to question their patients about tobacco consumption and more challenging to visually detect oral mucosal changes, because patients usually do not have concerns or they do not pay attention. Methods In the two cases presented here, the patients did not have any pain, nor did they notice when the lesions appeared. These patients used conventional cigarettes for some time and then switched to smokeless tobacco due to relocation to Latvia. Soft tissue excision was performed and sent for histopathological examination. Results The findings were proliferation of oral epithelial cells from buccal region, their overgrowth, an excessive amount of fibroblasts, cell destruction and necrosis, and a large amount of inflammatory cells, eosinophil leukocytes, and plasma cells. Conclusions We can conclude that these intraoral findings are important risk factors for possibly developing precancerous lesions. Such mucosal changes can occur with different forms of tobacco, including Swedish snus and betel leaves. Dental practitioners should always question patients about tobacco use and regularly check for mucosal changes for early detection.
Objective: The link between snus, periodontal diseases and oral malignancy is still in question in different literature. This study aims to explore the impact of snus on mucosal lesions and oral malignancy along with evaluation of strategies for snus cessation and approaches to communication with patients. Methods: A questionnaire about tobacco consumption habits was made. A heavy snus group, a light snus group and a control group were made. Oral biopsy samples were tested for protein gene product 9.5, tissue inhibitor of matrix metalloproteinase 2, chromogranin A and B, matrix metalloproteinase 2, interleukin-1, interleukin-10 using immunohistochemical techniques. Periodontal pocket biofilms were tested with combined polymerase chain reaction and were subsequently analyzed in order to determine the presence of pathogenic periodontal bacteria, such as Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Prevotella intermedia. Results: Biopsy results showed cellular disorganization, apoptosis, hyperkeratosis and prevalence of keratotic seborrhea in the area of snus sachets. Microbiological examination revealed the presence of periodontal pathogens in the snus users group. High concentration of pathogenic periodontal bacteria Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia was found in groups of both heavy and light snus users, yet they were absent in the samples of the control group. High concentration of Tannerella forsythia and Treponema denticola was also found in the groups of heavy and light snus users, whereas they were present in samples of only two patients of the control group. Conclusions: Snus changes cell function, it can lead to oral malignancy and promote periodontal disease regardless of the frequency and amount of snus used.
Snus is a tobacco product containing nicotine and is widely used in Sweden. Now it is becoming more and more popular among young athletes and teenagers in Latvia, even though it is forbidden for sale in the European Union. The use of snus is considered to induce various oral illnesses, especially periodontal diseases, diabetes, heart and cardiovascular diseases as well as cancer. Comparison of the microbiome of saliva and tooth biofilm in snus tobacco users with that in people who never use snus showed that, the number and diversity of periodontal pathogenic microorganisms was much higher in samples taken from snus users. The observed features of the oral microbiome, such as the presence of periodontal pathogens and their high concentration, may have adverse effect on periodontal tissues of snus users and their general health in the future.
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