The literature on smokeless tobacco (ST) use with either increasing or decreasing dental caries incidence was harder to find than that associating tobacco smoking with dental caries. Evidence linking ST use with increased dental caries prevalence had been reported by few reseachers (22,23). In contrast,to a case reported Zitterbart and his colleague, who did not find any evidence of caries in the area of quid placement (23,24). Some researches assessed the total amount of sugar and fluoride percentage in commercially available form of chewable tobacco. They found that the highest amount of caries promoting factor like sugar and caries inhibiting chemical like fluoride in non smoking of tobacco forms (25). Generally, chewable form of tobacco
