Clinical and Histological Manifestations of Chronic Coca Leaf Chewing in a Peruvian Population: A Cross-sectional Study.

Aims: This study aimed to determine the possible clinical and histological periodontal effects of long-term coca leaf chewing habit in habitants of the highland region of Peru.

Materials and methods: A total of 100 residents, were recruited for the study. Fifty individuals were habitual coca leaf chewers and 50 were non-users. Eligibility criteria were: 60-80 years old, ≥20 teeth present (excluding third molars), systemically healthy (controlled systemic disease), not using medication affecting the gingiva. Chronic tobacco smokers were excluded. All participants completed questionnaires, received clinical periodontal examination, and had gingival biopsies harvested for histopathological assessment.

Results: Most coca leaf chewers reported several oral changes resulting from the habit, such as bitterness, numbness and mouth dryness, while none of the non-chewers reported experiencing such changes. Within the clinical periodontal parameters, it was found that there was a significant difference in terms of clinical attachment level loss, with a p value of 0.014 in those who chewed coca leaves, who appeared to have less clinical attachment loss.

Conclusions: Chewing coca leaf produce bitterness, numbness and mouth dryness, and clinical attachment loss. Histologically higher number of inflammatory cells in the stratum spinosum, with more acanthosis, clear cell, and higher number of blood vessels.