{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T14:10:40Z","timestamp":1778767840434,"version":"3.51.4"},"reference-count":34,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"unspecified","delay-in-days":43,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,4,29]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Diet affects oral health locally through interactions with teeth, saliva and plaque as well as systemically through impacts on oral tissues and bone. The indigenous communities of Bangladesh may have more oral health issues as a result of their dietary practices and tobacco use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was performed in the outpatient department of Bandarban Sadar Hospital in Bangladesh. A total of 245 indigenous adults aged 18 years and above were recruited using convenience sampling. Data were gathered via a standardised, interviewer-administered questionnaire and clinical oral examination. Oral health outcomes included dental caries, gingivitis, dental plaque, tooth stains, tooth mobility and self-reported oral symptoms. Data were collected using a structured interviewer-administered questionnaire and clinical oral examination. Associations were assessed using \u03c7\u00b2 tests and ORs with 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The average age was 38.25 years (SD 8.83). Gingivitis (p=0.001) and tooth stains (p&lt;0.001) were substantially correlated with smokeless tobacco usage. Users were 2.8 times more likely to have gingivitis (95%\u2009CI 1.52 to 5.18)\u2009and 3.85 times more likely to have tooth stains (95%\u2009CI 1.76 to 8.42). Only tooth stains (p&lt;0.001) and dental caries (p&lt;0.001) were strongly correlated with tobacco use. Dental caries was prevented by eating eggs (OR: 0.45; 95%\u2009CI 0.24 to 0.81). Other dietary components, including milk and citrus fruits, showed no significant relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among indigenous people, tobacco use, especially smokeless tobacco, is closely linked to poor dental outcomes. There were conflicting associations between dietary variables and dental caries; however, egg consumption was protective. For Bangladesh\u2019s indigenous inhabitants, culturally appropriate tobacco cessation and oral health education programmes are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004820","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T13:20:50Z","timestamp":1778764850000},"page":"e004820","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association between dietary pattern, tobacco use and dental health status among indigenous adults in Bandarban, Bangladesh: a cross-sectional study"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6735-817X","authenticated-orcid":false,"given":"Razia","family":"Shultana","sequence":"first","affiliation":[{"name":"Ophthalmology, Bangladesh Eye Hospital & Institute, Dhaka, Bangladesh"},{"name":"Department of Health Promotion and Health Education, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hafiza","family":"Sultana","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Health Education, National Institute of Preventive and Social Medicine Department of Health Education, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Foyzur","family":"Rahman\u00b9","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, National Institute of Preventive and Social Medicine Department of Community Medicine, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7471-6042","authenticated-orcid":false,"given":"Mohammad Meshbahur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, National Institute of Preventive and Social Medicine Department of Biostatistics, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1823-3649","authenticated-orcid":false,"given":"Mohibbul","family":"Haque","sequence":"additional","affiliation":[{"name":"Preventive and Social Medicine, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasrin","family":"Sultana","sequence":"additional","affiliation":[{"name":"Department of Health Education, National Institute of Preventive and Social Medicine Department of Health Education, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md. Akib Bin","family":"Aziz","sequence":"additional","affiliation":[{"name":"Public Health, German University Bangladesh, Gazipur, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umma","family":"Southa Mourin","sequence":"additional","affiliation":[{"name":"HS&UHC, BRAC University James P Grant School of Public Health, Dhaka, Bangladesh"},{"name":"Health, Friendship NGO, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2957-2518","authenticated-orcid":false,"given":"Sabrin","family":"Shohid","sequence":"additional","affiliation":[{"name":"Department of Public Health and Hospital Administration, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arna","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of Nutrition, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alif N","family":"Disha","sequence":"additional","affiliation":[{"name":"Department of Health Education, National Institute of Preventive and Social Medicine Department of Health Education, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahazaman","family":"Shazu","sequence":"additional","affiliation":[{"name":"Department of Health Education, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad R","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, National Institute of Preventive and Social Medicine Department of Community Medicine, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"2026051406202253000_4.2.e004820.1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.job.2021.01.007","article-title":"The role of sugar-rich diet and salivary proteins in dental plaque formation and oral health","volume":"63","author":"Gasmi Benahmed","year":"2021","journal-title":"J Oral Biosci"},{"key":"2026051406202253000_4.2.e004820.2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/78.4.881S"},{"key":"2026051406202253000_4.2.e004820.3","doi-asserted-by":"crossref","unstructured":"Ing ME . 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