INTRODUCTION:
betel quid chewing is widely prevalent in India and is a major risk factor for head and neck cancer. tribal populations represent a marginalized group with a disproportionately high burden of betel quid use. previous studies among tribes in Wayanad district, Kerala, have reported a high prevalence of this habit. oral leukoplakia (OL) and oral submucous fibrosis (OSF) are common oral potentially malignant disorders with high malignant transformation rates. the present study aimed to evaluate the risk imposed by betel quid habits on the development of oral precancerous lesions among the tribal population of Wayanad.

METHODS:
a cross-sectional descriptive study was conducted among 918 tribal subjects in Wayanad district. the study population consisted of 518 subjects with betel quid chewing habits and 400 subjects without such habits. data regarding betel quid use were collected using a structured questionnaire. a clinical oral examination was performed to identify oral mucosal lesions. the collected data were subjected to statistical analysis to assess the association between betel quid habits and oral precancerous lesions.

RESULTS:
oral mucosal lesions were observed in 322 subjects (22.8 percent) with betel quid habits compared to 16 subjects (1.8 percent) without these habits. OSF (12.2 percent) and OL (9.1 percent) were the most prevalent oral mucosal lesions among betel quid chewers. other oral lesions including oral candidiasis, recurrent aphthous ulcer, frictional keratosis and oral lichen planus (1.1 percent) were more frequently reported among subjects without betel quid habits. the odds of developing oral mucosal lesions among betel quid chewers were 10.12 times higher than abstainers (OR = 10.12, 95 percent CI = 11.02–14.91).

CONCLUSIONS:
High prevalence of oral precancerous lesions among the Wayanad tribal population is strongly linked to betel quid use and poor awareness. Regular screening and culturally appropriate health education are recommended to reduce disease burden.