Pan-chewing is very common in India. The lady whose dental photographs appear here has been using Betet-quid (locally known as Paan) for the last forty years. And she has been using a pinch of tobacco with each “treat”.
She has landed up with heavy calculus deposits and the gums are in a state of Chronic inflammation. Her only problem is that she is unable to chew efficiently –otherwise, there is no other complaint like gum bleeding, sensitivity to hot and cold etc.
This photograph is typically a photograph of an Indian Betel-quid chewer who has been indulging in this harmful habit for years. I daily get to see quite a few such cases daily though the severity of effects varies from person-to-person.
It has been a very old tradition in India for the last a few centuries that Betel-quid is offered to a visitor to one’s place. People “enjoy” this habit and consider it as totally harmless. They just think that it just stains the teeth which does not seem to bother them. Here in this picutre also you can see the Paan-stains and heavy calculus deposits on the lower teeth of the same lady (whose dental picture is given above) on the side facing the tongue (lingual surfaces).
But we know that Betet-quid with tobacco has got carcinogenic potential. We have so many cases of cancer of mouth (oral cancer) here in India and it is one of the leading type of Head and Neck cancer in India.
One interesting thing is that people are using betel-quid without tobacco, they consider it absolutely harmless. No, it is not! The areca-nut (vern. Supari) present in a simple betel-quid is known to cause Sub-mucous fibrosis which is debilitating and is definitely a pre-cancerous condition of the oral cavity. In this condition there is progressive decrease in the oral opening because fibrous bands appear at the back of the mouth and with time, patient is unable to eat any solid food. It requires urgent surgical intervention.
In India, it is quite challenging for the dentists to dissuade people from using tobacco in various forms . At times we are successful – in majority of cases, we fail. Old habits die hard !