Study of benign oral lesions and serum vitamin levels in tobacco consumers

Reshma P. Chavan, Shivraj M. Ingole, Shubhangi M. Dalvi


Background: Oral mucosal lesions are seen commonly in tobacco consumers and some of them are precancerous. Study of various benign oral mucosal lesions has done in tobacco consumers. Comparison of serum Vitamin levels was done in patients with benign oral lesions in tobacco consumers and non- tobacco consumers.

Methods: Retrospective study of 100 patients with benign oral lesion with tobacco addiction was done. Control group includes tobacco non-addicts. Detail history regarding tobacco consumption was noted. Tobacco consumption pattern was studied in patients with benign oral lesion. Ear, nose, throat examination was done in detail. Oral lesion was noted. Comparison between serum levels of vitamin A, C and vitamin E in benign oral lesion of patients with tobacco addiction and tobacco non-addicts were included in the study. The results were analysed statistically by student t-test.  

Results: Patient with tobacco consumption with lime application was more prone to develop benign oral lesions. Gingivitis was most common lesion seen in study population followed by leukoplakia. Serum vitamin A, C and E were significantly decreased in tobacco consumers with benign oral lesions as compared to tobacco non-consumers. Decreased in serum vitamin levels were seen in all benign oral lesions irrespective of its malignant potential.

Conclusions: Gingivitis was most common lesion seen in study population followed by leukoplakia. Serum level of non-enzymatic antioxidant vitamin such as vitamin A, C and E gets decreased significantly in all benign oral lesions irrespective of its malignant potential. Serum levels of the antioxidant vitamins indicate need of increased oral intake of these vitamins to protect from damage in all benign oral lesions.


Tobacco, Addiction, Benign, Vitamin

Full Text:



Porter SR, Scully C, Pedersen A. Recurrent aphthous stomatitis. Crit Rev Oral Biol Med. 1998;9:306–21.

Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis:A consensus approach. J Am Dent Assoc. 2003;134:200–7.

Trivedy CR, Craig G, Warnakulasuriya S. The oral health consequences of chewing areca nut. Addict Biol. 2002;7:115-25.

Machuca G, Rosales I, Lacalle JR, Machuca C, Bullon P. Effect of cigarette smoking on periodontal status of healthy young adults. J Periodontol. 2000;71:73-8.

Baker H, Frank O. Determination of serum ɑtocopherol. In: Gowenlock, McMurry. Varley’s Practical Clinical Biochem; London. 6th ed; 1968: 902-903.

Ayeqaw. A simple colorimetric method for ascorbic acid determination. Clinica Chem Acta. 1978;86:153-7.

Kline K, Yu W, Sanders B. Vitamin E and Breast Cancer. J Nutr. 2004;134:3458S–62S.

Neville B, Damm D, Allen C, Bouquot J. Oral and Maxillofacial Pathology. 3rd edition. St. Louis, Mo, USA: Saunders/Elsevier; 2009.

Agrawal R, Chauhan A, Kumar P. Spectrum of Oral Lesions in A Tertiary Care Hospital. J Clin Diagno Res. 2015;9(6):EC11-3.

Mathew AL, Pai KM, Sholapurkar AA, Vengal M. The prevalence of oral mucosal lesions in patients visiting a dental school in Southern India. Indian J Dent Res. 2008;19(2):99–103.

Allon I, Kaplan I, Gal G, Chaushu G, Allon DM. The clinical characteristics of benign oral mucosal tumors. Med Oral Patol Oral Cir Bucal. 2014;19(5):e438-43.

Sujatha D, Hebbar PB, Pai A. Prevalence and correlation of oral lesion among tobacco smokers, tobacco chewers, areca nut and alcohol users. Asian Pac J Cancer of Prev. 2012;13:1633-7.

Aljabab MA, Aljbab AA, Patil SR. Evaluation of Oral Changes Among Tobacco Users of Aljouf Province, Saudi Arabia. J Clin Diagnos Res. 2015;9(5):ZC58-61.

Napier SS, Speight PM. Natural history of potentially malignant oral lesions and conditions: an overview of the literature. J Oral Pathol Med. 2008;37(1):1–10.

Suarez P, Batsakis JG, El-Naggar AK. Leukoplakia: still a gallimaufry or is progress being made?—a review. Adv Anatomic Pathol. 1998;5(3):137–55.

Chandra P, Govindraju P. Prevalence of oral mucosal lesions among tobacco users. Oral health Prev Dent. 2012;10:149-53.

Baig S, Lucky MH, Qamar A, Ahamad F, Khan S, Ahmed W, et al. Human papilloma virus and oral lesions in gutka eating subject in Karachi. J Coll Physicians Surg Pak. 2012;22:135-8.

Wang Y, Huang DS, Eskelson CD, Watson RR. Long term dietary vitamin E retards development of retro virus-induced disregulation in cytokine production. Clini Immunol Immunopathol. 1994;72:70-5.

Omach EH, Kidao S, Sanders BG, Kline K. Effects of RRR-α-tocopherol suucinate on IL-1 and PGE2 production macrophages. Nutr Cancer. 1993;20:205-14.

Krajcovicova KM, Paukova V, Bacekova M, Dusinka M. Lipid peroxidation in relation to vitamin C and vitamin E levels. Cent Eur. J Publ Health. 2004;12(1):46-8.

Nidarsh H, Sucheta K, Amita H, Prasanna C, Neeriksha R. Lipid peroxidation and vitamin C levels in saliva of oral precancerous patients an invitro study. RJPBCS. 2011;2(2):13-8.

el Attar TM, Lin HS. Effect of vitamin C and vitamin E on prostaglandin synthesis by fibroblasts and squamous carcinoma cells. Prostaglandins Leukot Essent Fatty Acids. 1992;47(4):253-7.