Prevalence of smokeless tobacco use and its impact on periodontal health among adults in Rajnandgaon, Chhattisgarh, India: a cross-sectional study.

Background: While the detrimental effects of smoking on periodontal health are well-established, the impact of smokeless tobacco (SLT) remains understudied, particularly in rural populations where SLT use is prevalent. The objective of the study is to (1) determine the prevalence of SLT consumption, and (2) evaluate its impact on periodontal health indicators among the adults in Rajnandgaon, Chhattisgarh, India.

Methods: In this cross-sectional study, 1,404 adults from Chhattisgarh, India, were screened, of whom 806 identified as SLT users were further assessed. Demographic data, oral hygiene practices, and SLT consumption patterns were recorded via structured questionnaires. Clinical periodontal parameters, including plaque index (PI), gingival index (GI), clinical attachment loss (CAL), probing pocket depth (PPD), and gingival recession (GR), were assessed. Multivariate regression and structural equation modeling (SEM) were employed to analyze associations between SLT use and periodontal outcomes, adjusting for confounders.

Results: SLT users exhibited significantly worse periodontal health than NTB users, with higher mean CAL (8.7 ± 2.18 mm vs. 3.2 ± 1.45 mm, p < 0.001), GR (2.99 ± 1.35 mm vs. 1.05 ± 0.82 mm, p < 0.001), and PPD (5.72 ± 1.69 mm vs. 2.91 ± 1.12 mm, p < 0.001). Gutkha and Tobacco + Lime demonstrated the strongest associations with periodontal destruction (β = 1.82, p < 0.01 and β = 1.64, p < 0.01, respectively). Prolonged SLT use (>10 years), higher frequency (>5 times/day), and lower buccal placement were significant predictors of deterioration (p < 0.05). SEM confirmed that SLT type, duration, and poor oral hygiene synergistically exacerbated periodontal damage (CFI = 0.92, RMSEA = 0.04).

Conclusion: The prevalence of smokeless tobacco consumption in Rajnandgaon, Chhattisgarh, was found to be 58.26%, with a higher proportion of users among males (60%) compared to females (40%). SLT, particularly Gutkha, is a significant risk factor for periodontal disease, with usage patterns significantly influencing disease severity. These findings underscore the urgent need for region-specific public health interventions that target smoking cessation and improved oral hygiene practices. Future longitudinal studies should investigate causal mechanisms and the efficacy of interventions.