Histopathologic changes in oral mucosa of Yemenis addicted to water-pipe and cigarette smoking in addition to takhzeen al-qat.

BACKGROUND: Because the clinicopathologic effects of takhzeen al-qat are similar to those induced by smoking, the aim of this paper was to study the oral effect of 3 bad oral habits: takhzeen al-qat and cigarette and water-pipe smoking. STUDY DESIGN: This study was done on 33 Yemeni chronic qat users grouped as heavy cigarette smokers (GI), nonsmokers (GII) and water-pipe smokers (GIII). In all cases (n = 33) 2 biopsies were taken (n = 66), one from the buccal mucosa at the chewing side and the other from a similar mucosa at the contralateral (nonexposed) side. Biopsies were prepared for routine H&E staining. RESULTS: Acanthosis appeared in 88% and 0%, abnormal rete ridges in 70% and 3%, hyperparakeratosis in 67% and 0%, and epithelial dysplasia in 30% and 0% of the chewing and nonchewing sides, respectively, in the 3 groups. Epithelial dysplasia appeared in 41% of GI and GIII (smokers) but in only 9% of GII (nonsmokers). CONCLUSIONS: Takhzeen al-qat causes distinct histopathologic changes in the oral mucosa at the side of chewing, such as acanthosis, abnormal rete ridges, and hyperparakeratosis. The association between takhzeen al-qat and cigarette or water-pipe smoking may increase the risk of epithelial dysplasia.