On our mission trip to Papua, New Guinea we were introduced to betel nut chewing in a big way. We flew into Port Morsby and from there drove cross country to the mission camp where we did our work. On the way, we would see friendly people along the road smiling, revealing blackened teeth and mouths filled with blood-red saliva. The people would often be spitting the red saliva onto the pavement, leaving an unsightly mess. These people were chewing betel nut and it is a common habit there.

From East Africa, Pakistan and India, and through Southeast Asia, to Papua, New Guinea, and Micronesia, betel nut users number hundred of millions – about 10 percent of the world’s population. Betel nut venders, sometimes with their children, set up their tables in public markets on the streets.

Worldwide, betel nut sales bring in billions of dollars. What, though, is betel nut? Why do so many people chew it? How does the habit affect their health?


What is commonly called betel nut is actually the fleshy fruit of the areca palm (betel palm), which is a tropical plant found in the Pacific and Southeast Asia. It is a common ornamental in tropical regions here in the states. The name betel comes from the unrelated betel-pepper plant. Betel nut chewers wrap a piece of the areca fruit in a betel-pepper leaf, along with a little mineral lime. The lime promotes the release of alkaloid stimulants. Some chewers add spices, tobacco, or sweeteners to enhance the flavor and effect.

This preparation stimulates the production of saliva and colors it blood-red. Hence, chewers spit frequently, much like tobacco chewers.


The areca nut has been used for thousands of years and has assumed major social, cultural, and even religious roles. Users often consider it harmless and report a sense of well-being, euphoria, and a warm sensation of the body. It is, however, far from harmless and we were able to see many of the effects from this. Drug-prevention authorities believe that one of the alkaloids in betel nut can be habit forming. Indeed, some users chew it nearly continuously.

From a dental and general health standpoint, the chemicals cause an irritation on the skin lining of the mouth. They develop a characteristic staining, thickening, and wrinkling of the mucous membrane lining of the mouth. This may develop into a chronic, progressive, scarring of the oral tissues called submucous fibrosis.

Partner With a Well-Traveled Oral Surgeon

Whether you chew betel nut or not (and you shouldn’t!), our professional team is experienced in handling a variety of oral health issues. For a consultation, call Wagner Oral Surgery and Dental Implant Specialists at (262) 634-4646 today! Our professional, experienced oral surgeon will take excellent care of you.

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