The association of khat (Catha edulis) chewing and orodental health: A systematic review and meta-analysis

Ayalew Astatkie, Meaza Demissie, Yemane Berhane


Background. It has been claimed that chewing khat (Catha edulis), a plant common in parts of eastern and southern Africa and the Arabian Peninsula, is associated with a range of orodental problems.

Objective. To provide a synthesis of the evidence on the association between khat chewing and orodental health.

Method. A systematic review and meta-analysis of studies that reported on the association of khat chewing and outcomes related to orodental health identified through a systematic search using web-based electronic search engines.

Results. Nineteen studies were found suitable for this review. Of these, between two and five (based on the type of outcome measured) were suitable for meta-analysis. The rest were used only for qualitative synthesis. A meta-analysis of the association of khat chewing with mucosal white lesions, gum recession, periodontal pocketing and gum bleeding showed that chewing increased the odds of the respective oral problems. However, qualitative synthesis of the findings on the effect of khat chewing on oral micro-organisms showed no evidence that the practice favours the presence of pathogenic micro-organisms in the oral cavity – instead, it seems to favour the proliferation of micro-organisms compatible with orodental health.

Conclusion. Khat chewing is associated with adverse orodental health outcomes. While literature on the topic is scarce and there is a need for generation of more evidence from different countries, on the basis of the evidence accumulated to date, public health officials and health practitioners should consider khat a threat to orodental health and take appropriate action.

Authors' affiliations

Ayalew Astatkie, School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia

Meaza Demissie, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia

Yemane Berhane, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia

Full Text



Khat chewing; Orodental health; Systematic review; Meta-analysis

Cite this article

South African Medical Journal 2014;104(11):773-779. DOI:10.7196/SAMJ.8070

Article History

Date submitted: 2014-02-14
Date published: 2014-07-03

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