Khat use and khat induced oral white lesions among khat and tobacco users at two sites in Kenya

Abstract

Background: Long term chewing of khat is associated with white lesions on the oral mucosa some of which depict histopathological changes. However, due to the limited number of studies in this area, the clinical nature of these white lesions has not been clearly defined, especially when khat is used alongside tobacco. Objective: The purpose of this study was to describe user characteristics and clinical features of lesions induced by chronic chewing of khat on the oral mucosa. Material and Methods: This was a descriptive cross sectional study carried out among 54 volunteers in Eldoret and Meru towns of Kenya. These consisted of 14 chronic khat chewers, 30 chronic khat chewers who also smoked tobacco and 10 nonchewers. Their oral mucosa was examined for clinical changes and comparisons were made between the three groups in terms of user characteristics and clinical appearance of the lesions. Results: Fifty seven percent of all khat chewers preferred to chew on the left side compared to 9% who preferred the right side. Whereas all khat chewers presented with lesions on the buccal mucosa, nonchewers did not present with any pathological changes. The lesions extended to involve the tongue in 36% and the gingiva in 25% of the chewers. Most khat chewers (86%) presented with mixed white and brown discoloration with only a few presenting with purely white or brown lesions. Sixty three percent of the chewers presented with smooth and plaque-like lesions and the rest presented with mild wrinkling. Smoking tobacco had limited effect on khat induced oral mucosa lesions. Conclusions: Results show that chronic khat use is associated with changes on the oral mucosa that manifest mainly as white, brown or mixed white and brown discoloration.