Burden and determinants of betel quid use and oral health status among tribal adults in Wayanad, Kerala.

BACKGROUND

Betel quid chewing, a culturally embedded habit among tribal populations, poses significant oral health risks due to its addictive and carcinogenic potential. However, data on dependence patterns and their impact on oral health among Kerala's tribal communities remain scarce. Hence this study aimed to estimate the prevalence of betel quid chewing, assess dependence levels and associated factors, and examine their relationship with oral health status among tribal adults in Wayanad, Kerala.

METHODS

A community-based cross-sectional study was conducted among 283 tribal adults aged ≥ 18 years from selected habitations in Wayanad by convenient sampling. Data were collected through face-to-face interviews covering sociodemographic details, chewing habits, and the 16-item Betel Quid Dependence Scale (BQDS). Oral health was assessed using the DMFT (Decayed, Missing, and Filled Teeth) index, and participants were also screened for features suggestive of oral submucous fibrosis and visible mucosal lesions. Data were analysed using SPSS version 22 and Jamovi software. 2.6.2.

RESULTS

The prevalence of betel quid chewing among tribal adults in Wayanad was 67.5% (95% CI: 62.0-72.9). Among current users (n = 191), 56.5% (95% CI: 49.5-63.6) exhibited high dependence. In multivariable analysis, separated/widowed individuals had significantly higher odds of high dependence (AOR = 3.93; 95% CI: 1.13-13.62; p = 0.031). The mean DMFT score was 6.43 ± 8.51, indicating a substantial burden of dental caries. In multivariable linear regression analysis, occupation and high betel quid dependence was independently associated with higher DMFT scores, (β = 2.546; 95% C.I = 0.532 - 4.560; p = 0.014).

CONCLUSION

Betel quid use and dependence are highly prevalent among tribal adults in Wayanad and are linked to poorer oral health. Targeted community-based interventions integrating cessation support and routine oral screening are essential.