Epidemiological investigation of chewing fresh or dried betel nut and oral mucosal disease

OBJECTIVE This study was conducted to investigate the effect of chewing fresh or dried betel nut on the inci-dence and canceration of oral mucosa disease in Haikou City in Hainan Province. METHODS Through a survey questionnaire, clinical examination, and regular follow-up, we collected clinical data from 1 722 cases and divided them into two groups, among which 704 of the afflicted people chew dried betel nut, whereas the other 1 018 chew fresh betel nut. The data were 
statistically analyzed using different variables which included age, number, time of onset of the disease, and the cancerous condition associated with common oral mucosa disease, including oral submucous fibrosis (OSF), oral leukoplakia (OLK), and oral Lichen planus (OLP). RESULTS 1) The study found no significant difference in the prevalence of oral mucosa diseases between the dried betel nut group (n=704) and fresh betel nut group (n=1 018) among the 1 722 cases (P>0.05), but the peak age of oral mucosal disease was more advanced in the dried betel nut group (P<0.01). 2) The incidence within 5 years of OSF, OLK, OLP, and oral mucosa diseases in the dried betel nut group was significantly higher than that in the fresh betel nut group (P<0.01). 3) The incidence of cancer for oral mucosa disease in patients included in the dried betel nut group was significantly higher than that in the fresh betel nut group (P<0.01). CONCLUSIONS Chewing dried betel nut is more pathogenic and carcinogenic than chewing fresh betel nut. The extremely harmful components of the dried betel nut synergistically play a vital role in the occurrence and carcinogenesis of oral mucosal diseases.