Clinical characteristics of the oral mucosa in patients with coca chewing habit: comparative cross-sectional study

The aim of this study is to analyze the association between coca chewing and oral mucosal alterations. Oral squamous cell carcinoma (OSCC) of the buccal mucosa is highly prevalent in northern Argentina, where coca chewing is widespread. Despite being a potential risk factor, few studies have addressed its impact on oral mucosa.

An observational study was conducted with 90 adult patients (45 coca chewers and 45 nonchewers), matched by age and sex, recruited at Hospital Señor del Milagro in 2023-2025. Variables included coca chewing characteristics (frequency, duration, additives) and oral lesions (early alterations, keratotic lesions, OSCC). Multivariate logistic regression estimated odds ratios (ORs) with 95% confidence intervals (CIs), adjusting for tobacco and alcohol use (p < 0.05).

Oral lesions were more frequent in coca chewers (73.3%) than nonchewers (17.7%) (OR = 12.7; 95% CI: 4.7-34.1). Daily chewing increased risk (OR = 10.1; 95% CI: 2.1-47.9). OSCC occurred in the gingivobuccal complex, corresponding to the site of coca quid placement. A significant association was observed between coca chewing and oral lesions, particularly among daily and long-term users.

Coca chewing is significantly associated with oral mucosal lesions, especially in daily and long-term users. These findings highlight the need for further studies to clarify its role in oral carcinogenesis.