The Effect of Sudanese Smokeless Tobacco (Toombak) using on Oral Microbiota

BackgroundToombak, saffa and saod are the common local name of Sudanese smokeless tobacco which used by large population in different regions in Sudan. That chemical nature of Toomback includes very high levels of carcinogenic substances, strong alkaline materials and microorganisms. The used of Toombak implying application of the highly addictive product in the mouth many times per day for long times differed from users to other. ObjectivesThe objective of this study was to study the effect of Toombak on the oral microbial flora (Microbiota). Materials and Methods100 buccal swabs were collected in this study, 50 swabs from Toombak users and 50 swabs from non Toombak users as control group. All the participants were non smokers. The swabs were cultured on Chocolate agar, Blood agar and Sabouraud agar and incubated aerobically for up to 7 days. Then colonial morphology, indirect microscopy and biochemical tests were used to identify the isolated organism. ResultsToomback shows inhibitory effect on the viridanas streptococci and the baccual swabs collected from toomback users show significant increase in number of mixed growth (P value 0.000/ likelihood ratio 43.24) and colonization of oral cavity with Bacillus species (P value 0.000/ likelihood ratio 57.41), Aspergillus species (P value 0.003/ likelihood ratio 10.462) and Aspergillus flavus (P value 0.036/ likelihood ratio 4.45). ConclusionToombak using is affecting the quality and quantity of the oral normal flora because it has inhibitory effect on viridians streptococci, leading to rising of new colonizing species such as Bacillus species and Aspergillus specie especially aflatoxins producing Aspergillus flavus. These changes in the microenvironment may affect the immunity and health of the Toombak users and may lead to serious oral and systemic health problems.