Saharla A. Jama, DMD
Northwest Journal of Dentisry
Vol. 84 No.3
Khat and Its Oral Manifestations
Catha edulis, commonly known as khat or Qat, is a shrub-like plant that is actively chewed and collected in the mouth over an extended period of time, thus remaining in contact with the mucosa. It mainly contains Cathinone, a psychoactive constituent similar to amphetamine. Like amphetamine, Cathonine produces euphoria, irritability, and hallucination among many of its psychoactive manifestations.
As such, khat was first noted in the literature for its use in depressive states. This substance is highly abusive and, according to the World Health Organization (WHO), it falls in the Schedule I category of psychotropic substances.
Originally indigenous to Yemen, khat has traveled with the gradual spread of Islam to the ancient city of Harar in Northern Ethiopia and neighboring regions in East Africa.
The khat habit has a major social and cultural role in communities throughout the Middle East and East Africa. Following the migration of these communities to North America, especially the Somalis who have come to Minnesota, not only does the habit continue to be prevalent among this population, but many dentists remain unaware of this prevalence and its implications for oral health.
It is of great importance for dental practitioners to recognize the role of this substance in the development of oral pre-cancerous lesions and cancer. Other oral manifestations include:
• dry mouth,
• burning mouth syndrome,
• TMJ dysfunctions,
• stomatitis, and
• periodontitis.
Although the toxic effects of khat have been studied for more than 20 years, there are few systematic studies on the incidence of head and neck cancers in countries in which khat is widely consumed. However, existing studies all show a consistent trend for oral cancer in chronic khat users.
Additional limitations exist in establishing khat as an independent risk factor due to the fact that most khat consumers are cigarette smokers and almost always smoke and chew khat simultaneously.
Also of notable importance to dental practitioners is khat's drug interaction with penicillin derivates. It has been shown that bioavailability of PCN and its derivatives to be markedly reduced in khat users if administered within two hours of khat consumption. Therefore it is highly recommended to use alternative antibiotics for patients with a history of khat use.
References
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