Betel quid chewing is a common practice among people in many Asian countries including Thailand. Objectives: This study aimed to evaluate the role of betel quid chewing and periodontitis as risk indicators of tooth loss among rural Thai female adults. Methods: The study population consisted of 796 females, aged 30-85 years, resident in five districts of Khon Kaen province, Thailand during 1990-91. Data were obtained through an oral examination and a questionnaire interview. Analyses of the study employed descriptive, bivariable, and multivariable Poisson regression. Results: The findings from final multivariable Poisson regression revealed that betel quid chewing and periodontitis were significant predictors of tooth loss. The relative risks of losing teeth were highest among heavy betel quid chewers (chewing betel quid for more than 20 years), who also had shallow periodontal pockets (RR=3.3) compared to chewing betel quid alone (RR=1.6) and having shallow periodontal pockets alone (RR=1.2). Likewise, the relative risks found among heavy betel quid chewers who also had deep periodontal pockets, heavy betel quid chewers only, and people with deep periodontal pockets only, were 4.7, 1.6, and 1.4, respectively. Other variables that were adjusted for in the model included age, oral hygiene, tooth brushing frequency, dental caries, calculus, periodontal pockets and interactions between betel quid chewing and dental caries. Conclusions: betel quid chewing is a risk indicator of tooth loss among the study population, and the risk increases with simultaneous presence of periodontitis. Therefore preventive programs aiming at educating Thai people to quit chewing betel quid should be established.

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