Tobacco use and its impact on oral health among female adolescents in Riyadh, Saudi Arabia

Tobacco use poses significant public health challenges globally, with profound implications for oral health among adolescents. This study assessed the prevalence of tobacco use and its association with oral health perceptions, practices, and clinically assessed oral conditions among female adolescents in Riyadh, Saudi Arabia. A cross-sectional study was conducted among 1197 female adolescents aged 12-15 years from Fethipublic and private schools in Riyadh, Saudi Arabia. Data were collected using adapted questionnaires from the National Youth Tobacco Survey and WHO Oral Health Questionnaire. Clinical oral examinations were performed on 964 participants. Statistical analyses included chi-square tests and logistic regression. Tobacco use prevalence was 6.9%, with electronic cigarettes being most common (72.0%), followed by waterpipe smoking (59.8%) and traditional cigarettes (57.3%). Curiosity was the primary driver for initiation (74.5%). Significant associations were found between tobacco use and poor self-perceived gingival health ( p < 0.001), school absenteeism due to toothache ( p = 0.009), and avoiding smiling due to dental appearance ( p = 0.021). Among examined participants, 76.6% had active carious lesions, 46.8% had gingivitis, and mean DMFT score was 5.72 ± 4.73. Despite relatively low prevalence, tobacco use was significantly associated with adverse oral health and psychosocial outcomes. These findings highlight the need for gender-sensitive preventive strategies, improved healthcare-based tobacco screening, and stricter regulation of adolescent access to tobacco products.