Betel nut or Supari also known as Areca nut, is one of the most commonly consumed psychoactive substances in South and Southeast Asia.

✪Traditionally chewed
alone or wrapped in a betel leaf (often with slaked lime and sometimes tobacco), it holds cultural, social, and religious significance in many communities.

✪However, from a dental and medical standpoint, betel nut chewing has serious consequences for oral and overall health.
[4:43 pm, 19/9/2025] Me: ✪Effects on Oral Health and Its Treatments✪

1) Staining/ Discoloration of Teeth

Chewing betel nut causes reddish-brown stains on teeth and gums that are difficult to remove with regular brushing. Over time, this leads to poor aesthetics and a neglected oral appearance.

✪ Treatment ✪
1) Professional Dental Cleaning
2) Tooth Whitening
3) Restorative /Cosmetic options for severe tooth discoloration
4) Prevention and Care

2) Loose gum/ Pyorrhea

Betel nut acts as an irritant to oral tissues. Regular use is strongly associated with gum inflammation, pocket formation, periodontal disease. The fibrous texture of the nut also causes mechanical trauma, leading to gum recession.

✪ Treatment ✪
1) Cleaning the Teeth
2) Medicines
3) Gum Surgery
4) Maintain proper Hygiene

3) Progressive wearing away of tooth enamel / Tooth Attrition

✪Sensitivity✪
●The hard, fibrous nature of the nut accelerates tooth wear, causing attrition and sensitivity.
● Treatments :
1) Toothpaste for Desensitizing
2) Fluoride Treatment : Thicken the Enamel of tooth to resist severe sensitivity.
3) Dental Sealents & Bonding : To Protect exposed Dentin and mend Enamel damage.
4) Sensitive Gum : Gum grafting, Scaling & Root planning
5) Severe Tooth Sensitivity : Endodontic treatments( RCT, Crown,Inlays/Onlays)
6) Oral Hygiene : Brush twice a day, Floss everyday, Dental Checkup

✪ The loss of vertical tooth height results in Ageing of face and wrinkles.
This demands restoration of lost tooth structure with a systematic treatment planning and execution of Full Mouth Rehabilitation

4) Reduce Mouth Opening
One of the most serious conditions linked to betel nut is oral submucous fibrosis, a precancerous condition where the oral tissues become stiff and inelastic. Patients experience burning sensation while eating spicy foods and difficulty opening the mouth.

✪ Treatment ✪
1) Mouth opening Exercises : Using fingers, wooden spatulas, tongue depressors, or mouth opening devices- Heister Mouth Gag).
Heat therapy and ultrasound physiotherapy to relax muscles.
2) Nutrition Suppliments
3) Surgical Management
4) Steroid gels or hyaluronidase injections in fibrotic conditions.

5) Oral Cancer

Betel nut chewing is classified as a Group 1 carcinogen (cancer-causing substance) by the International Agency for Research on Cancer (IARC).
●Leukoplakia is a white patch in the mouth that is considered a precancerous lesion because it carries a risk of developing into oral cancer.
●Erythroplakia bright red patches seen as higher risk of malignant transformation. Long-term use significantly increases the risk of oral squamous cell carcinoma, especially when combined with tobacco.

✪ Treatment✪
Diagnosis & Planning by Biopsy and Scans CT, MRI, PET-CT
1) Surgery as Main Treatment
●Radiotherapy
●Chemotherapy ●Reconstruction Flap Surgery
2) Supportive & Rehabilitation Care
●Speech therapy & physiotherapy
●Dental prosthesis or Implants
●Nutritional support & Habit counselling
3) Follow up for Lifelong monitoring advised.