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VOLUME 8 , ISSUE 5 ( July, 2007 ) > List of Articles

RESEARCH ARTICLE

Smokers’ Melanosis in a Nigerian Population: A Preliminary Study

Solomon O. Nwhator, Kofo Winfunke-Savage, Patricia Ayanbadejo, Sunny O. Jeboda

Citation Information : Nwhator SO, Winfunke-Savage K, Ayanbadejo P, Jeboda SO. Smokers’ Melanosis in a Nigerian Population: A Preliminary Study. J Contemp Dent Pract 2007; 8 (5):68-75.

DOI: 10.5005/jcdp-8-5-68

License: CC BY-NC 3.0

Published Online: 01-07-2007

Copyright Statement:  Copyright © 2007; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

Terms relating to pigmentation of the oral mucosa include physiologic (racial) pigmentation, oral pigmented nevi, oral melanotic maculae, melanoma, and smokers’ melanosis. The literature is replete with studies about oral mucosal pigmentation which is thought to result from melanin incontinence. The documented etiological factors are both local and systemic and include hormones, drugs, smoking, and idiopathic causes. This study investigated the prevalence of melanosis among Nigerian smokers and controls who were non-smokers.

Methods and Materials

A total of 1270 sites were examined in 253 subjects consisting of 60 smokers and 193 non-smokers. They were all systemically healthy adults drawn from 12 factories located in different urban and rural settings in the state of Lagos in Nigeria. Five oral mucosal sites were examined per subject. A single examiner performed all examinations and recorded all findings. Pigmentation was scored either as “present” or “absent.” Subjects’ smoking status, degree, and duration of smoking were ascertained and recorded using an examiner-administered questionnaire.

Results

There were five pigmented sites (0.52%) among non-smokers and 18 (6%) among smokers. The buccal mucosa was the most frequently pigmented site found in smokers while the lingual mucosa was the most common site found for non-smokers. The prevalence of pigmented sites increased directly among smokers with the duration of smoking (years); degree of smoking (cigarettes smoked per day); and smoking pack-years (degree of smoking divided by 20 and multiplied by duration of smoking, where 20 is the average number of cigarettes in a pack of cigarettes). SPSS version 11.0 was used for data entry and analysis. Frequency distributions were generated for all categorical variables for descriptive aspects of the analysis. Means were determined for quantitative variables such as age and number of cigarettes smoked. For homogenous variances, the student's t test was used for quantitative variables between smokers and nonsmokers, while for non-homogenous variances the Mann-Whitney test was adopted. Chi-square statistic was used for comparisons between smokers and non-smokers. In tables with low expected frequencies, Fisher's exact test was adopted. Statistical tests yielding p-values =/<0.5 were considered significant.

Conclusions

Smokers in this study had a significantly higher prevalence of pigmented oral mucosal sites (melanosis) than non-smokers. The number of pigmented sites increased with the degree and duration of smoking. The buccal mucosa was the most frequently pigmented site found among the smokers in this study.

Citation

Nwhator SO, Winfunke-Savage K, Ayanbadejo P, Jeboda SO. Smokers’ Melanosis in a Nigerian Population: A Preliminary Study. J Contemp Dent Pract 2007 July;(8)5:068-075.


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  1. Medical Problems in Dentistry. 2nd ed. Bristol: Wright, 1987;pp 528-29.
  2. A structureless recurrent deposit on teeth. J Dent Res 1973;22:479-83.
  3. The microflora of black stain on human primary teeth. J Dent Res 1974;82:484-88.
  4. Pigmented nevi of the oral mucosa: A clinicopathologic study of 36 cases and review of 155 cases from the literature. Oral Surg Oral Med Oral Pathol 1987;63:566-72.
  5. Colour atlas of oral disease. 2nd ed. London: Mosby-Wolfe, 1964.
  6. Oral effects of tobacco use. J Am Dent Inst Cont Edu 1992;43:3-17.
  7. Outline of periodontics. 3rd ed. London: Butterworth-Heinemann. 1999;pp 2-3.
  8. The long term outcome after adrenalectomy and prophylactic pituitary radiotherapy in adrenocorticotropindependent Cushing's syndrome. J Clin Endocrinol Metab 1995;80(1):165-71.
  9. Oral melanotic macules that develop after radiation therapy. Oral Surg Oral Med Oral Pathol 1994;77:431-34.
  10. Disappearance of smoker's melanosis after reducing smoking. Oral Surg Oral Med Oral Pathol 1993;22:228-30.
  11. Oral melanin pigmentation related to smoking in a Turkish population. Comm Dent Oral Epidemiol 2001;29(4):272-77.
  12. Association of melanin pigmentation in the gingiva of children with parents who smoke. Paediatrics 2005;116(2):e186-e190.
  13. The relationship between cigarette smoking smoking and oral lesions. J Babol Uni Med Sci 1999;1(4):1-5. (Sited from Journal's web page.)
  14. Oral melanin pigmentation in smoked and smokeless tobacco users in India. Clinicopathologic study. Indian J Dent Res 2003;14(2):101-6.
  15. Dose-response relationship between tobacco consumption and melanin pigmentation in the attached gingiva. Arch Environ Health 1993;38(6):375-8.
  16. Oral melanin pigmentation in 467 Thai and Malaysian people with special emphasis on smokers’ melanosis. J Oral Pathol Med 1991;20(1):8-12.
  17. Oral mucosa pigment changes in heavy smokers and drinkers. J Nat Med Assoc 1991;83(5):434-38.
  18. Case 47, part II: Oral hyperpigmentation associated with Addison's disease. J Oral Maxillofac Surg 1983;41(10):680-82.
  19. Melanoma of the oral mucosa. A case of infiltrating melanoma originating in Hutchinson's lentigo or precancerous melanosis of of Dubreuilh. Oral Surg Oral Med Oral Pathol 1969;28(1):1-16.
  20. Oral melanoma and other pigmented lesions of the oral cavity. J Am Acad Dermatol 1991;24:527-37.
  21. Pigmented lesions of the oral cavity. Ann Pathol 1985;5(4-5):221-29.
  22. The normal and pathologic pigmentation of oral mucuous membranes. A review. J Contemp Dent Pract 2003;4(3):76-86.
  23. Smoker's melanosis. Report of a case. NY State Dent J 1997;63(8):20-21.
  24. Smoking and complications of endosseous dental implants. J Periodontol 2002;73(2):153-57.
  25. Periodontal disease in smokers: a study of factory workers in Lagos State. National Postgraduate Medical College Dissertation. May 2005.
  26. The oral melanotic macule. Oral Surg Oral Med Oral Pathol 1977;44(2):219-26.
  27. Colour atlas of oral diseases. Thieme Med. Pub. 2nd Ed. Stuggart. 1994;1-372.
  28. Barnes G. Oromucosal pigmentation: an updated literary review. J Periodontol 1971;42(11):726-36.
  29. Melanin pigmentation of the palatal oral mucosa in reverse smokers: a preliminary study. J Oral Pathol Med 1992;21:440-44.
  30. Disappearance of smoker's melanosis after reducing smoking. J Oral Pathol Med 1993;22:228-30.
  31. Epidemiologic study of excessive oral melanin pigmentation with special reference to the influence of tobacco habits. Scand J Dent Res 1982;90(4):434-42.
  32. Treatment of melanotic spots in the gingiva by argon laser. J Oral Maxillofac Surg 1993;51:759-61.
  33. The long-term effect of nicotine on the oral mucosa. Addiction 1999; 94(3):417-23.
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