Pakistan Dental Guide 3 min read
Paan, Gutka, Naswar and Chalia: What They Do to Your Teeth and Mouth
Chewed areca nut and smokeless tobacco stain teeth, damage gums and raise the risk of mouth cancer. Here are the signs to watch and how to get help stopping.
This guide relates to our gum treatment treatment.
What are paan, gutka, naswar and chalia?
Paan, gutka, naswar and chalia are chewed products that usually contain areca nut, tobacco, or both. They are common in Pakistan and the wider region. Commercially packaged products such as gutka and pan masala can contain a high concentration of areca nut in every chew.
Whatever the name, the mouth is in contact with the products for a long time, and the damage builds up over years. This is why these habits matter for your gum health even when you feel well.
What do they do to your teeth and gums?
They stain teeth brown or black, cause bad breath, and wear the enamel. They also irritate the gums, which can lead to gum disease and tooth loss over time. Users often notice the staining first, and the gum damage later.
Chewing these products regularly is also linked to a condition called oral submucous fibrosis, in which the tissue inside the mouth becomes stiff and it becomes harder to open the mouth fully. A review of betel quid chewing found the risk rises with how much and how long people chew.
| Effect | What it looks or feels like |
|---|---|
| Staining | Brown or black teeth that do not brush off |
| Gum damage | Bleeding, swollen or receding gums |
| Oral submucous fibrosis | Stiff tissue in the mouth and difficulty opening it fully |
| Mouth cancer risk | Sores or patches that do not heal, which need checking |
How big is the mouth cancer risk?
The International Agency for Research on Cancer (IARC), part of the World Health Organization, reported in 2024 that smokeless tobacco and areca nut together accounted for an estimated 30.8% of the world's oral cancer cases in 2022. The study found a higher risk from areca nut, with or without tobacco, than from smokeless tobacco alone.
Most of these cases were in low- and middle-income countries, which is why prevention and quitting support matter in Pakistan. The risk is linked to how often the products are used, so quitting at any point helps.
What warning signs should you check for?
See a dentist if you have a white or red patch in the mouth, a sore or ulcer that does not heal, pain when opening the mouth, or a lump in the cheek or neck. These signs need checking even if they do not hurt.
We check the inside of the mouth at each visit, and we will refer you for a further check if we see anything that needs it.
How can you stop, and where do you get help?
Stopping is hard, and it is easier with support. Tell your doctor or dentist that you want to stop, and ask for help. Quitting lowers the risk for your mouth over time, and it removes the irritation that these products cause to the gums.
Ask us how to care for your gums while you cut down. Brush twice a day with fluoride toothpaste and clean between your teeth, because plaque and staining build faster when these products are used.
When to see a dentist in Multan
Book a check-up if you use these products and notice bleeding, swelling, a sore that does not heal, or stains that keep returning. We are open Sunday to Thursday and on Saturday, from 5:30 pm to 10:30 pm, and we are closed on Fridays. Message us on WhatsApp about gum health and we will advise on the next step.
This article is general information. Please see a dentist for advice about your own teeth.
Frequently asked questions
Is paan without tobacco safe?
No. Areca nut itself is a risk factor for oral cancer and oral submucous fibrosis, according to the IARC and a review of betel quid chewing.
Can the damage be reversed?
Gum irritation can ease once the habit stops. Stiffness from oral submucous fibrosis can persist after stopping, so the earlier you quit, the better.
Should I see a dentist if I have a white patch?
Yes. A white or red patch, or a sore that does not heal, should be checked by a dentist or doctor even if it does not hurt.
Does a dentist clean the stains?
Yes. Scaling and polishing removes the stain and tartar, but the stain returns if the habit continues.
Sources
Have a question about your own teeth?
Book on WhatsApp, and our team will reply with the next steps.