Association Between Habitual Khat (Catha edulis) Chewing and Oral Reactive Hyperplastic Lesions: A Cross-Sectional Clinicopathological Study in Yemen.

OBJECTIVE: To investigate the clinicopathological characteristics of oral reactive hyperplastic lesions (RHLs) and evaluate their association with habitual khat (Catha edulis) chewing in a Yemeni dental population. METHODS: This cross-sectional clinicopathological study included 1197 Yemeni patients with 48 histopathologically confirmed RHLs. Demographic characteristics; periodontal status; oral hygiene; and behavioral habits, including khat chewing and smoking, were recorded. Clinical lesion features and histopathological diagnoses were assessed. Associations between khat-chewing status and clinicopathological variables were analyzed by using Pearson's chi-squared or Fisher's exact test, with statistical significance set at P < 0.05. RESULTS: Habitual khat chewing was significantly associated with male gender (P = 0.015), smoking status (P = 0.002), and periodontitis (P = 0.005). Among lesion-related variables, lesion size was significantly associated with khat chewing, with lesions larger than 1 cm occurring more frequently among khat chewers than among nonchewers (P = 0.026). No significant associations were identified between khat chewing and lesion anatomical site (P = 0.604), clinical course (P = 1.000), or histopathological diagnosis (P = 0.762). CONCLUSION: Habitual khat chewing was associated with increased periodontal destruction and large oral RHLs but showed no association with lesion location, clinical behavior, or histopathological subtype. These findings suggest that khat acts as a chronic local irritant that may amplify reactive tissue proliferation without altering the underlying histopathological pattern of RHLs. CLINICAL RELEVANCE: The assessment of khat-chewing habits should be incorporated into routine oral examinations because chronic exposure may contribute to increased lesion burden and periodontal deterioration.