{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T03:06:22Z","timestamp":1790564782954,"version":"4.1.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Naswar is a moist, non-chewable, and smokeless tobacco product ensconced in the buccal vestibule or floor of the mouth. Consumption of naswar is very popular in South Asia, especially Pakistan. This cross-sectional study compared the periodontal clinical parameters amongst mild, moderate, and severe naswar users.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>318 naswar users, categorized into three equal groups (n = 106) severe naswar users, moderate naswar users, and mild naswar users were drawn for this study. Bleeding on probing, pocking depth, gingival recession, and attachment loss were assessed using the UNC-15 probe and compared among the three groups of naswar users. Data analysis was done with the help of SPSS. Statistical significance was deliberated at <jats:italic>p<\/jats:italic> value \u22640.05.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>28.9 \u00b1 7.6 years was the mean age presentation. The mean % of bleeding on probing score was 61.95% in severe naswar users, 56.62% in moderate naswar users, and 51.23% in mild naswar users with a p-value of 0.001*. In severe, moderate, and mild naswar users the probing pocket depth (4-6mm) were 35.14%, 30.95%, and 23.21% respectively. 26.78% severe naswar users were having mean percentage for probing pocket depth (&gt;6m) followed by moderate naswar users (17.26%) and mild naswar users (17.26%) with a significant p-value (0.001*). Clinical attachment loss (CAL) was 2.50 percent in light naswar users, 3.0 percent in moderate naswar users, and 4.25 percent in severe naswar users. Clinical attachment loss (CAL) was 2.50 percent in light naswar users, 3.0 percent in moderate naswar users, and 4.25 percent in severe naswar users. Severe naswar users had a high mean percentage of gingival recession (23.21%), whereas light 13.67 percent and moderate 14.88 percent naswar users had a smaller difference.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Clinical periodontal parameters were more worsen in heavy naswar users compared to moderate and light naswar users.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0273288","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T17:36:25Z","timestamp":1663349785000},"page":"e0273288","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of severity of periodontal clinical parameters among naswar\/snuff users: Cross sectional study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9119-6632","authenticated-orcid":true,"given":"Abid","family":"Rahim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kawish","family":"Syed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babar","family":"Ahad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afaq","family":"Farooq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zain","family":"Ayub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Midhat","family":"Batool","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,16]]},"reference":[{"key":"pone.0273288.ref001","unstructured":"World Health Organization. Tobacco- Leading cause of death, illness and impoverishment [Internet]. Web Report. 2020 [cited 2021 Jan 28]. [about 2 screens]. https:\/\/www.who.int\/news-room\/factsheets\/detail\/tobacco#:~:text=The%20tobacco%20epidemic%20is%20one,level%20of%20exposure%20to%20tobacco."},{"key":"pone.0273288.ref002","unstructured":"Pakistan Bureau of Statistics, Ministry of National Health Sevices, Regulations and Coordination, World Health Organization. Fact Sheet\u2014Global Adult Tobacco Survey, Pakstan 2014. [Internet] Web Report 2019 [cited 2021 Jan 28]. https:\/\/extranet.who.int\/ncdsmicrodata\/index.php\/catalog\/257."},{"issue":"1","key":"pone.0273288.ref003","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1177\/0022034519872480","article-title":"Oral Health Effects of Combusted and Smokeless Tobacco Products","volume":"30","author":"SL Tomar","year":"2019","journal-title":"Adv Dent Res"},{"issue":"2","key":"pone.0273288.ref004","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1080\/00016357.2017.1394489","article-title":"Comparison of periodontal inflammatory parameters among habitual gutka-chewers and naswar-dippers: a split-mouth retrospective clinical study","volume":"76","author":"Z Akram","year":"2018","journal-title":"Acta Odontol Scand"},{"issue":"4","key":"pone.0273288.ref005","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1111\/odi.12295","article-title":"Comparison of periodontal inflammatory conditions among habitual gutka chewers and betel quid 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Khan","year":"2017","journal-title":"PLoS One"},{"issue":"3\u20134","key":"pone.0273288.ref009","first-page":"207","article-title":"Oral cancer and cultural practices in relation to betel quid and tobacco chewing and smoking","volume":"9","author":"K Jayant","year":"1986","journal-title":"Cancer Detect Prev"},{"issue":"1","key":"pone.0273288.ref010","first-page":"12","article-title":"Tobacco and Oral Diseases-Report of EU Working Group, 1999","volume":"46","author":"EU-Working Group on Tobacco and Oral Health","year":"2000","journal-title":"J Ir Dent Assoc"},{"issue":"6","key":"pone.0273288.ref011","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1902\/jop.2010.090310","article-title":"Smokeless tobacco use and periodontal health in a rural male population","volume":"81","author":"YH Chu","year":"2010","journal-title":"J 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