You do not smoke it. You do not swallow it. All you do is slosh it around your mouth and spit out the brown juices every few seconds. OK, so it actually is pretty disgusting. But so what? After all, it’s called smokeless or chewing tobacco. That means you chew and spit it, not smoke it, so it cannot be as bad as inhaling tobacco smoke into your lungs, right?

Wrong . . . unfortunately, smokeless does not mean harmless. The fact is, chewing tobacco is every bit as dangerous as smoking it. As the use of tobacco based “Gutkha’ is increasing, the problem of mouth diseases is also increasing. The young generation is under attack of this harmful and lethal habit!

Though smokeless tobacco is considered less harmful than cigarettes, it is still a harmful alternative to cigarettes. Prolonged use can cause nicotine addiction, oral cancer, pharyngeal cancer, esophageal cancer, progressive receding of gums leading to fallout of teeth and precancerous lesions in the mouth (leukoplakia).

Tobacco and Healthy Teeth do not Mix

Tobacco which is botanically termed as Nicotiana tabacum is an agricultural product processed from the leaves of plants in the genus Nicotiana. It is known as tamakhu, dhumapatra in sanskrit and in ayurveda perspective it is tikta rasa, ushna virya and tikshna guna. It is pittala (increases pitta) and has medicinal values such as it is used in scorpion stings, it is antihelmintic etc. But even though it has medicinal values its atiyoga (excess usage) and mithya yoga (improper usage) leads to several ill effects especially on the oral cavity.

Smokeless tobacco also known as chewing tobacco comes as loose tobacco leaves, brick form (plug tobacco) or in twist form. This contains 2000 chemicals, majority of which are considered cancer causing.

Effect of Smokeless Tobacco on Mouth and Teeth
Abrasion of Teeth: It is found that sand and grit contained in the gutkha or chewing tobacco products gradually wears away the tooth enamel. Premature loss of enamel can increase the sensitivity of teeth.

Recession of Gums: Placing of a small wad of chewing tobacco can cause constant gum irritation, thereby causing permanent damage to periodontal tissue. This can damage the root canal and the bony structure of the tooth, thereby resulting in loosened teeth or permanent teeth loss.

Progressive Decay of Tooth: During the curing and processing stage, sugar is added in smokeless tobacco products for added flavour. Reaction of sugar with bacteria (found in the oral cavity) leads to acid reaction, thereby causing tooth decay.

Discoloration of Tooth: Long-term use of smokeless tobacco leads to absorption of nicotine into the teeth. This slowly develops brown stains on the tooth.

Halitosis: Bad breath occurs because of the periodontitis or abcess which occurs due to smoking and chewing of tobacco.

Oral Cancer: Prolonged use of tobacco due to nicotine and other cancer-causing agents can lead to formation of whitish lesions inside the mouth (leukoplakia). These precancerous lesions or leukoplakia could become cancerous when triggered by further tobacco exposure.

Besides these, smokeless tobacco exposure can cause restricted tongue and jaw movements, difficulty in swallowing, difficulty in chewing, oral sore that refuses to heal, lumpy feeling inside the throat, etc.

AYURVEDIC MANAGEMENT

Ayurveda emphasizes on the fact that NIDANA PARIVARJANA (avoiding the cause) is the foremost in the treatment of a disease, so the first and foremost in the treatment is the avoidance of the usage of tobacco; thereafter the effects that have occurred already due to tobacco usage must be treated.

In Periodontitis: When there is inflammation of the gums and recurrent swelling of the gums (upakusha,) are present, the following treatments are done:

Pratisarana (gum massage with medicines)

• Choorna of pippali (Piper longum or long pepper), saindhava (rock salt), and cumin seeds (zeera) should be rubbed over the gums. Trikatu choorna can also be used.
• Triphala choorna
• Dasana samskara choorna

Kavala graha (gargling) or gandusha (holding of medicinal liquid in mouth)

• Triphala kwatha ( acts as cleansing and pacifying)
• Yastimadhu kwatha (ropana- healing effect)
• Arimedadi taila
• Gargling with warm decoction of ginger and parpataka after blood letting is useful.

In Gingival Recession: When sensitivity of the teeth (danta harsha) is present the following measures should be adopted:

Kavala graha:

• With milk boiled with sesamum seeds and madhuyasti (licorice) done twice daily.
• Dashamoola kashaya

In danta sarkara (tartar)

• Regular brushing of the teeth with grihadhoomadhi choorna, kalaka choorna will be beneficial.
• Powder of kshara and honey are applied to remove tartar.

In Halitosis (Bad Breath)    

Avoiding cigarettes and tobacco chewing itself will relieve the problem of bad breath. If it still persists then the following measures can be taken:

• Chewing tulasi leaves and regular gargling with tulasi swarasa (juice) mixed with water.
• Chewing cloves and cinnamon or gargling with water boiled with cloves and cinnamon.

In oral cancer (Arbuda)

The mucosal lesions which are small and benign are removed by excision or by use of kshara and then the site is rubbed with the paste of svargika and nagara mixed with honey. Thereafter gandusha with guduchi and nimba mixed with honey is done.

For effective Ayurvedic and Integrative Dental treatment, visit IAIM Healthcare, Bangalore. Call 080-28567000 to book your appointment