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Abdul1, Mahesh Shenoy2, Sahana Shivakumar3, Ganiga C. Shivakumar4, Bhuvan Jyoti5, Shubham Patel6  \n1Department of OMFSand Diagnostic Sciences, Faculty of Oral Pathology, Riyadh Elm University,  \nRiyadh 11681 Kingdom of Saudi Arabia, 2Department of OMFS and Diagnostic Sciences, Faculty of Oral Pathology, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, Kingdom of  \nSaudi Arabia, 3Department of Public Health  \nDentistry, People’s College of Dental Sciences and Research Centre, Peoples University, Bhopal, Madhya Pradesh, India, 4Department of Oral Medicine and Radiology, People’s College of Dental Sciences and Research Centre, Peoples University, Bhopal, Madhya Pradesh, India, 5Dental Surgeon and Consultant‑ Oral Medicine and Radiology, Department of Dental Surgery, Ranchi Institute of Neuro‑Psychiatry and Allied Sciences, Ranchi, Jharkhand, India, 6Department of Oral Pathology and Microbiology, People’s College of Dental Sciences and Research Center, Peoples University, Bhopal, Madhya Pradesh, India  \nAbstract  \nBackground: Adolescent tobacco use, particularly of smokeless forms, has become a growing public health concern in India. Early and chronic exposure to tobacco during this developmental phase leads to pathological changes in the oral mucosa, some of which may progress to malignancy. This study was undertaken to clinically and cytopathologically evaluate oral mucosal changes in adolescent smokeless tobacco chewers and assess early markers of potentially malignant disorders. Methods: A cross‑sectional study was conducted among adolescent tobacco users and age‑matched controls. Clinical examination identified mucosal changes, while exfoliative cytology was used to detect cellular alterations. Cytological findings were graded based on Papanicolaou criteria. Results: Among tobacco users, 76% showed clinical changes like hyperpigmentation and leukoplakia, while 52% exhibited cytological atypia (Grades II–V) . Only 8% of controls had mild inflammation. A strong correlation was observed between tobacco use and epithelial changes. Conclusion: Early oral mucosal changes in adolescents highlight the need for preventive screening and cessation programs.  \nKeywords: Adolescents, exfoliative cytology, oral mucosa, potentially malignant disorders, tobacco chewing   \nSubmitted: 08‑Aug‑2025  \nRevised: 27‑Aug‑2025  \nAccepted: 30‑Aug‑2025  \nPublished: 17‑Dec‑2025  \n\n| Access this article online |  |\n| --- | --- |\n| Quick Response Code:\u003Cbr>| Website: [https://journals.lww.com/jpbs](https://journals.lww.com/jpbs) |\n|  | DOI: 10.4103/jpbs.jpbs_1421_25 |\n\nS3358 © 2025 Journal of Pharmacy and Bioallied Sciences | Published by Wolters Kluwer-Medknow   \nIntroduction  \nToabasccoignifiusecant amonpublgic  \nadolescents has emerged as health issue in India, with  \nincreasing use of smokeless tobacco products such as gutkha, khaini, and betel quid. Adolescents often perceive these habits as socially acceptable and harmless, leading to early initiation and chronic exposure during a critical developmental phase. The oral mucosa, being in direct contact with carcinogenic agents in tobacco, is particularly vulnerable to pathological changes, which may serve as early indicators of potential malignancy.[1]  \nClinical changes in the oral cavity among adolescent tobacco users include mucosal dryness, hyperpigmentation, leukoplakia, and oral submucous fibrosis (OSMF)—many of which are classified as potentially malignant disorders (PMDs) . These conditions, if left undiagnosed, can undergo dysplastic transformation and eventually progress to oral cancer. Considering the long latency period of oral carcinogenesis, early identification and management of such mucosal alterations are imperative.[2]  \nCytopathological assessment through exfoliative cytology offers a non‑invasive, cost‑effective, and practical metho","cbCaijsbxFhuIx0h","https://ap.wps.com/l/cbCaijsbxFhuIx0h","pdf",560614,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction\n## Clinical oral changes\n## Cytopathological rationale\n# Methodology\n# Results","[{\"question\":\"What public health issue does the study focus on?\",\"answer\":\"It focuses on the growing concern of adolescent smokeless tobacco use, particularly in India, and its impact on the oral mucosa during a critical developmental period.\"},{\"question\":\"How were oral mucosal changes evaluated in the study?\",\"answer\":\"Oral mucosal changes were assessed clinically, and exfoliative cytology was used to detect and grade cellular alterations using Papanicolaou criteria.\"},{\"question\":\"What were the key findings among tobacco chewers and controls?\",\"answer\":\"Among tobacco users, most showed clinical changes such as hyperpigmentation and leukoplakia, and a substantial proportion showed cytological atypia. Only a small fraction of controls had mild inflammation, with strong correlation between tobacco use and epithelial changes.\"}]","Evaluation of Oral Mucosal Changes in Adolescent Tobacco Chewers - A Clinical and Cytopathological Study | PDF"]