Abstract
Khat chewing is on the rise and has emerged as a public health issue. The longtime consumption of khat has been associated with many health issues such as cardiovascular, gastrointestinal, hepatobiliary, genitourinary, nervous system, respiratory, and oral health (OH)-related problems. Among the OH-related problems, tooth decay, periodontal diseases, and oral cancer are the most prevalent and have been linked with khat use. This chapter introduces OH, followed by a description of khat and its epidemiology. Then, a review of the evidence relating khat use to oral diseases is presented. It is seen, based on the available reports, that khat use cannot be considered as a causal factor for oral diseases. However, it is possible that cathinone, a prime extract in khat, may cause xerostomia which can aggravate the infection process in an already infected tooth or supporting tissues. Furthermore, with the available literature, the direct relationship between khat alone and oral cancer is also questionable. In few studies, khat seems to be an anticancer agent, but few other studies point to the chances of carcinogenesis associated with a longtime chewing of khat. In conclusion, the effect of khat on oral tissues is not as direct as in case of many other coadministered stuff like sugar or sugared beverages, alcohol, tobacco smoking, smokeless tobacco, and the presence of pesticides.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Abbreviations
- FDI:
-
Dental Federation Internationale
- GBD:
-
Global Burden of Disease
- OH:
-
Oral health
- WHO:
-
World Health Organization
References
Al Moaleem MM, Porwal A, Al Ahmari NM, Shariff M, Homeida H, Khalid A (2020) Khat chewing induces a floral shift in dental material-associated microbiota: a preliminary study. Med Sci Monit 26:e918219. https://doi.org/10.12659/MSM.918219. https://www.ncbi.nlm.nih.gov/pubmed/31956260
Al-Akwa AA, Shaher M, Al-Akwa S, Aleryani SL (2009) Free radicals are present in human serum of Catha edulis Forsk (khat) abusers. J Ethnopharmacol 125(3):471–473
Al-Alimi A, Taiyeb-Ali T, Jaafar N, Al-hebshi NN (2015) Qat chewing and periodontal pathogens in health and disease: further evidence for a prebiotic-like effect. Biomed Res Int 2015:291305. https://doi.org/10.1155/2015/291305. https://www.ncbi.nlm.nih.gov/pubmed/26351631
Al-Alimi KR, Razak AAA, Saub R (2018) Is khat chewing habit a risk factor for occlusal caries progression? Afr Health Sci 18(4):1036–1045. https://doi.org/10.4314/ahs.v18i4.25. https://www.ncbi.nlm.nih.gov/pubmed/30766570
Albandar JM (2005) Epidemiology and risk factors of periodontal diseases. Dent Clin N Am 49(3):517–532, v–vi. https://doi.org/10.1016/j.cden.2005.03.003. https://www.ncbi.nlm.nih.gov/pubmed/15978239
Albandar JM, Tinoco EM (2002) Global epidemiology of periodontal diseases in children and young persons. Periodontol 2000(29):153–176. https://www.ncbi.nlm.nih.gov/pubmed/12102707
Al-hebshi NN, Al-ak’hali MS (2010) Experimental gingivitis in male khat (Catha edulis) chewers. J Int Acad Periodontol 12(2):56–62. https://www.ncbi.nlm.nih.gov/pubmed/20465033
Al-Hebshi NN, Al-Sharabi AK, Shuga-Aldin HM, Al-Haroni M, Ghandour I (2010) Effect of khat chewing on periodontal pathogens in subgingival biofilm from chronic periodontitis patients. J Ethnopharmacol 132(3):564–569. https://doi.org/10.1016/j.jep.2010.08.051. https://www.ncbi.nlm.nih.gov/pubmed/20816745
Ali AA, Al-Sharabi AK, Aguirre JM, Nahas R (2004) A study of 342 oral keratotic white lesions induced by qat chewing among 2500 Yemeni. J Oral Pathol Med 33(6):368–372
Al-Kholani AI (2010) Influence of khat chewing on periodontal tissues and oral hygiene status among Yemenis. Dent Res J (Isfahan) 7(1):1–6. https://www.ncbi.nlm.nih.gov/pubmed/21448439
Al-Maweri SA, Warnakulasuriya S, Samran A (2018a) Khat (Catha edulis) and its oral health effects: an updated review. J Investig Clin Dent 9(1):e12288. https://doi.org/10.1111/jicd.12288. https://www.ncbi.nlm.nih.gov/pubmed/28834423
Al-Maweri SA, Al-Jamaei A, Saini R, Laronde DM, Sharhan A (2018b) White oral mucosal lesions among the Yemeni population and their relation to local oral habits. J Investig Clin Dent 9(2):e12305
Al-Sharabi AK (2011) Conditions of oral mucosa due to takhzeen al-qat. Yemeni J Med Sci 5:6–6
Bagramian RA, Garcia-Godoy F, Volpe AR (2009) The global increase in dental caries. A pending public health crisis. Am J Dent 22(1):3–8. https://www.ncbi.nlm.nih.gov/pubmed/19281105
Balint EE, Falkay G, Balint GA (2009) Khat – a controversial plant. Wien Klin Wochenschr 121(19–20):604–614. https://doi.org/10.1007/s00508-009-1259-7. https://www.ncbi.nlm.nih.gov/pubmed/19921126
Bogale B, Engida F, Hanlon C, Prince MJ, Gallagher JE (2021) Dental caries experience and associated factors in adults: a cross-sectional community survey within Ethiopia. BMC Public Health 21(1):180. https://doi.org/10.1186/s12889-021-10199-9. https://www.ncbi.nlm.nih.gov/pubmed/33478460
Bray F, Ferlay J, Laversanne M, Brewster DH, Gombe Mbalawa C, Kohler B, Piñeros M, Steliarova-Foucher E, Swaminathan R, Antoni S, Soerjomataram I, Forman D (2015) Cancer incidence in five continents: inclusion criteria, highlights from volume X and the global status of cancer registration. Int J Cancer 137(9):2060–2071. https://doi.org/10.1002/ijc.29670. https://www.ncbi.nlm.nih.gov/pubmed/26135522
Burt BA (2005) Concepts of risk in dental public health. Community Dent Oral Epidemiol 33(4):240–247
Clerehugh V (2008) Periodontal diseases in children and adolescents. Br Dent J 204(8):469–471. https://doi.org/10.1038/sj.bdj.2008.301. https://www.ncbi.nlm.nih.gov/pubmed/18438398
Clerehugh V, Tugnait A (2001) Diagnosis and management of periodontal diseases in children and adolescents. Periodontol 2000(26):146–168. https://www.ncbi.nlm.nih.gov/pubmed/11452903
Collaborators, GBD 2019 Diseases and Injuries (2020) Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396(10258):1204–1222. https://doi.org/10.1016/S0140-6736(20)30925-9. https://www.ncbi.nlm.nih.gov/pubmed/33069326
Collaborators, Global Burden of Disease Study 2013 (2015) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386(9995):743–800. https://doi.org/10.1016/S0140-6736(15)60692-4. https://www.ncbi.nlm.nih.gov/pubmed/26063472
Daba D, Hymete A, Bekhit AA, Mohamed AMI, Bekhit AE-DA (2011) Multi residue analysis of pesticides in wheat and khat collected from different regions of Ethiopia. Bull Environ Contam Toxicol 86(3):336–341
Dhaifullah E, Al-Maweri SA, Al-Motareb F, Halboub E, Elkhatat E, Baroudi K, Tarakji B (2015) Periodontal health condition and associated factors among university students, Yemen. J Clin Diagn Res 9(12):ZC30-3. https://doi.org/10.7860/JCDR/2015/16435.6964. https://www.ncbi.nlm.nih.gov/pubmed/26813290
Dimba E, Gjertsen BT, Francis GW, Johannessen AC, Vintermyr OK (2003) Catha edulis (khat) induces cell death by apoptosis in leukemia cell lines. Ann N Y Acad Sci 1010:384–388
Dimba EAO, Gjertsen BT, Bredholt T, Fossan KO, Costea DE, Francis GW, Johannessen AC, Vintermyr OK (2004) Khat (Catha edulis)-induced apoptosis is inhibited by antagonists of caspase-1 and-8 in human leukaemia cells. Br J Cancer 91(9):1726–1734
Downer MC (1994) Caries prevalence in the United Kingdom. Int Dent J 44(4):365–370
Edelstein BL (2006) The dental caries pandemic and disparities problem. BMC Oral Health 6(Suppl 1):S2. https://doi.org/10.1186/1472-6831-6-S1-S2. https://www.ncbi.nlm.nih.gov/pubmed/16934119
Eke PI, Wei L, Thornton-Evans GO, Borrell LN, Borgnakke WS, Dye B, Genco RJ (2016) Risk indicators for periodontitis in US adults: NHANES 2009 to 2012. J Periodontol 87(10):1174–1185. https://doi.org/10.1902/jop.2016.160013. https://www.ncbi.nlm.nih.gov/pubmed/27367420
El-Wajeh YA, Thornhill MH (2009) Qat and its health effects. Br Dent J 206(1):17–21. https://doi.org/10.1038/sj.bdj.2008.1122. https://www.ncbi.nlm.nih.gov/pubmed/19132030
Eriksen HM, Dimitrov V (2003) Ecology of oral health: a complexity perspective. Eur J Oral Sci 111(4):285–290
Erratum: global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries (2020) CA Cancer J Clin 70(4):313. https://doi.org/10.3322/caac.21609. https://www.ncbi.nlm.nih.gov/pubmed/32767693
Fasanmade A, Kwok E, Newman L (2007) Oral squamous cell carcinoma associated with khat chewing. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 104(1):e53–e55
Fejerskov O (2004) Changing paradigms in concepts on dental caries: consequences for oral health care. Caries Res 38(3):182–191
Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T (2017) Global epidemiology of dental caries and severe periodontitis – a comprehensive review. J Clin Periodontol 44(Suppl 18):S94–S105. https://doi.org/10.1111/jcpe.12677. https://www.ncbi.nlm.nih.gov/pubmed/28266116
Gjermo P, Rösing CK, Susin C, Oppermann R (2002) Periodontal diseases in Central and South America. Periodontol 2000(29):70–78. https://www.ncbi.nlm.nih.gov/pubmed/12102703
Glass RL (1982) The first international conference on the declining prevalence of dental caries. J Dent Res 61:1304–1383
Glick M, Williams DM, Kleinman DV, Vujicic M, Watt RG, Weyant RJ (2017) A new definition for oral health developed by the FDI World Dental Federation opens the door to a universal definition of oral health. J Public Health Dent 77(1):3–5. https://doi.org/10.1111/jphd.12213. https://www.ncbi.nlm.nih.gov/pubmed/28276588
Halboub E, Dhaifullah E, Abdulhuq M (2009) Khat chewing and smoking effect on oral mucosa: a clinical study. Acta Med (Hradec Kralove) 52(4):155–158
Hassan NA, Gunaid AA, Murray-Lyon IM (2007) Khat (Catha edulis): health aspects of khat chewing. East Mediterr Health J 13(3):706–718. https://www.ncbi.nlm.nih.gov/pubmed/17687845
Haugejorden O (1994) Changing time trend in caries prevalence in Norwegian children and adolescents. Community Dent Oral Epidemiol 22(4):220–225
Hill CM, Gibson A (1987) The oral and dental effects of q’at chewing. Oral Surg Oral Med Oral Pathol 63(4):433–436. https://doi.org/10.1016/0030-4220(87)90255-6. https://www.ncbi.nlm.nih.gov/pubmed/3472143
Jorgensen E, Kaimenyi JT (1990) The status of periodontal health and oral hygiene of Miraa (Catha edulis) chewers. East Afr Med J 67(8):585–590. https://www.ncbi.nlm.nih.gov/pubmed/1979771
Kalakonda B, Al-Maweri SA, Al-Shamiri HM, Ijaz A, Gamal S, Dhaifullah E (2017) Is khat (Catha edulis) chewing a risk factor for periodontal diseases? A systematic review. J Clin Exp Dent 9(10):e1264–e1270. https://doi.org/10.4317/jced.54163. https://www.ncbi.nlm.nih.gov/pubmed/29167719
Kassie F, Darroudi F, Kundi M, Schulte-Hermann R, Knasmüller S (2001) Khat (Catha edulis) consumption causes genotoxic effects in humans. Int J Cancer 92(3):329–332
Kassim S, Rogers N, Leach K (2014) The likelihood of khat chewing serving as a neglected and reverse ‘gateway’ to tobacco use among UK adult male khat chewers: a cross sectional study. BMC Public Health 14(1):1–11
Kidd EAM, Mejare I, Nyvad B (2003) Clinical and radiographic diagnosis. In: Fejerskov O, Kidd EAM (eds) Dental caries – the disease and its clinical management. Blackwell Munksgaard, Oxford, pp 111–128
Kilian M, Chapple IL, Hannig M, Marsh PD, Meuric V, Pedersen AM, Tonetti MS, Wade WG, Zaura E (2016) The oral microbiome - an update for oral healthcare professionals. Br Dent J 221(10):657–666. https://doi.org/10.1038/sj.bdj.2016.865. https://www.ncbi.nlm.nih.gov/pubmed/27857087
Lin GH, Boynton JR (2015) Periodontal considerations for the child and adolescent. A literature review. J Mich Dent Assoc 97(1):36–40, 42, 74. https://www.ncbi.nlm.nih.gov/pubmed/26285502
Maharani DA, Adiatman M, Rahardjo A, Burnside G, Pine C (2017) An assessment of the impacts of child oral health in Indonesia and associations with self-esteem, school performance and perceived employability. BMC Oral Health 17(1):65. https://doi.org/10.1186/s12903-017-0358-5. https://www.ncbi.nlm.nih.gov/pubmed/28327110
Marthaler TM (2004) Changes in dental caries 1953–2003. Caries Res 38(3):173–181
Mengel R, Eigenbrodt M, Schünemann T, Florès-de-Jacoby L (1996) Periodontal status of a subject sample of Yemen. J Clin Periodontol 23(5):437–443. https://doi.org/10.1111/j.1600-051x.1996.tb00571.x. https://www.ncbi.nlm.nih.gov/pubmed/8783048
Needleman I, Garcia R, Gkranias N, Kirkwood KL, Kocher T, Iorio AD, Moreno F, Petrie A (2018) Mean annual attachment, bone level, and tooth loss: a systematic review. J Periodontol 89(Suppl 1):S120–S139. https://doi.org/10.1002/JPER.17-0062. https://www.ncbi.nlm.nih.gov/pubmed/29926956
Nunn JH (2006) The burden of oral ill health for children. Arch Dis Child 91(3):251–253. https://doi.org/10.1136/adc.2005.077016. https://www.ncbi.nlm.nih.gov/pubmed/16492889
Nurelhuda NM, Trovik TA, Ahmed Ali RW, Ahmed MF (2009) Oral health status of 12-year-old school children in Khartoum state, the Sudan; a school-based survey. BMC-Oral Health 9:15
Nurelhuda NM, Ahmed MF, Trovik TA, Astrom AN (2010) Evaluation of oral health-related quality of life among Sudanese schoolchildren using child-OIDP inventory. Health Qual Life Outcomes 8. https://doi.org/10.1186/1477-7525-8-152
Ogden GR (2005) Alcohol and oral cancer. Alcohol 35(3):169–173
Oh TJ, Eber R, Wang HL (2002) Periodontal diseases in the child and adolescent. J Clin Periodontol 29(5):400–410. https://www.ncbi.nlm.nih.gov/pubmed/12060422
Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, Listl S, Celeste RK, Guarnizo-Herreño CC, Kearns C, Benzian H, Allison P, Watt RG (2019) Oral diseases: a global public health challenge. Lancet 394(10194):249–260. https://doi.org/10.1016/S0140-6736(19)31146-8. https://www.ncbi.nlm.nih.gov/pubmed/31327369
Peres MA, Antunes JLF, Watt R (2021) Oral epidemiology: a textbook on oral health conditions, research topics and methods. Springer Nature
Petersen PE (2003) The World Oral Health Report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 31(Suppl 1):3–23. https://www.ncbi.nlm.nih.gov/pubmed/15015736
Petersen PE (2005) Socio-behavioural risk factors in dental caries – international perspectives. Community Dent Oral Epidemiol 33(4):274–279
Petersen PE, Ogawa H (2005) Strengthening the prevention of periodontal disease: the WHO approach. J Periodontol 12:2187–2193
Petersen PE, Razanmihaja N (1996) Oral health status of children and adults in Madagascar. Int Dent J 46:41–47
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C (2005a) The global burden of oral diseases and risks to oral health. Bull World Health Organ 83(9):661–669. https://doi.org//S0042-96862005000900011. https://www.ncbi.nlm.nih.gov/pubmed/16211157
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C (2005b) The global burden of oral diseases and risks to oral health. Bull World Health Organ 83(9):661–669
Pihlstrom BL, Michalowicz BS, Johnson NW (2005) Periodontal diseases. Lancet 366(9499):1809–1820
Reidy J, McHugh E, Stassen LFA (2011) A review of the relationship between alcohol and oral cancer. Surgeon 9(5):278–283
Rosenzweig KA, Smith P (1966) Periodontal health in various ethnic groups in Israel. J Periodontal Res 1(4):250–259. https://doi.org/10.1111/j.1600-0765.1966.tb01869.x. https://www.ncbi.nlm.nih.gov/pubmed/4226588
Satcher DS (2000) Surgeon General’s report on oral health. Public Health Rep 115(5):489–490. https://www.ncbi.nlm.nih.gov/pubmed/11236021
Schmidt-Westhausen AM, Al Sanabani J, Al-Sharabi AK (2014) Prevalence of oral white lesions due to qat chewing among women in Yemen. Oral Dis 20(7):675–681
Selwitz RH, Ismail AI, Pitts NB (2007) Dental caries. Lancet 369(9555):51–59. https://doi.org/10.1016/S0140-6736(07)60031-2. https://www.ncbi.nlm.nih.gov/pubmed/17208642
Soufi HE, Kameswaran M, Malatani T (1991) Khat and oral cancer. J Laryngol Otol 105(8):643–645
Sung, Hyuna, Jacques Ferlay, Rebecca L Siegel, Mathieu Laversanne, Isabelle Soerjomataram, Ahmedin Jemal, Freddie Bray. (2021) Global Cancer Statistics 2020: Globocan Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a cancer journal for clinicians 71(3):209–249
Watt R, Sheiham A (1999) Inequalities in oral health: a review of the evidence and recommendations for action. Br Dent J 187(1):6–12
WHO, World Health Organization (2016) Oral Health Fact sheet: 318. http://www.who.int/mediacentre/factsheets/fs318/en/
**ao J, Fiscella KA, Gill SR (2020) Oral microbiome: possible harbinger for children’s health. Int J Oral Sci 12(1):12. https://doi.org/10.1038/s41368-020-0082-x. https://www.ncbi.nlm.nih.gov/pubmed/32350240
Yang H, **ao L, Zhang L, Deepal S, Ye G, Zhang X (2017) Epidemic trend of periodontal disease in elderly Chinese population, 1987–2015: a systematic review and meta-analysis. Sci Rep 7:45000. https://doi.org/10.1038/srep45000. https://www.ncbi.nlm.nih.gov/pubmed/28358004
Yarom N, Epstein J, Levi H, Porat D, Kaufman E, Gorsky M (2010) Oral manifestations of habitual khat chewing: a case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 109(6):e60–e66
Zero DT, Fontana M, MartÃnez-Mier EA, Ferreira-Zandoná A, Ando M, González-Cabezas C, Bayne S (2009) The biology, prevention, diagnosis and treatment of dental caries: scientific advances in the United States. J Am Dent Assoc 140(Suppl 1):25S–34S. https://doi.org/10.14219/jada.archive.2009.0355. https://www.ncbi.nlm.nih.gov/pubmed/19723928
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this entry
Cite this entry
Ali Quadri, M.F., Mohan, S. (2022). Khat (Catha edulis) and Oral Health. In: Patel, V.B., Preedy, V.R. (eds) Handbook of Substance Misuse and Addictions. Springer, Cham. https://doi.org/10.1007/978-3-030-92392-1_90
Download citation
DOI: https://doi.org/10.1007/978-3-030-92392-1_90
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-92391-4
Online ISBN: 978-3-030-92392-1
eBook Packages: Social SciencesReference Module Humanities and Social SciencesReference Module Business, Economics and Social Sciences