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Professor and Hon Consultant in Dental Public Health, Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Heath Park, Cardiff CF14 4XY, UK
Waterpipes are used to smoke tobacco by more than 100 million people worldwide. Use is not restricted to any single racial, ethnic, or cultural group, and dentists are almost certain to encounter waterpipe users amongst their patients. This article describes what the practice involves and seeks to inform members of the dental team of the significantly detrimental impacts of waterpipe smoking on both general and oral health and how ‘hubble-bubble really can lead to trouble’. Advising patients on ceasing waterpipe use is also discussed.
Clinical Relevance: This paper explains what smoking a waterpipe involves, the associated misconceptions of safety amongst users and the dangers to health.
Article
Waterpipe smoking is a centuries old practice, with its origins in the Eastern Mediterranean Region, the Middle and Far East.1,2 Uncommon in most of the world until the late twentieth century, in recent decades this practice has spread across the globe and is increasingly common in areas with no previous tradition of use.3,4,5
Waterpipes are known by a variety of names, including argileh, narjeela, goza, shisha, boory, hookah, hubble bubble, narghile, nargile, nargila, mada'a and orarghile.3,6 For the purpose of this review, we shall refer to them as waterpipes.
Although there are various types of waterpipes, differing in size, shape and colour, the typical layout is shown in Figure 1. The tobacco bowl is positioned within the body and is the site where tumbac (moistened raw tobacco) is covered with burning charcoal and placed on an ashtray on top of the pipe. This, in turn, is connected to a glass or steel decanter-shaped base containing liquids, usually water but sometimes water mixed with other liquids such as wine. The use of tobacco flavoured with molasses creates a mixture referred to as tobamel (tobacco plus ‘mel’ for ‘honey’ in Latin) or mu'essel (‘honeyed’, in Arabic). The tobacco bowl may be covered with a conical cap to allow use for a longer period of time in an open space.
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