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A 3-year epidemiological surveillance open cohort study of 22009 patients found that 36.6% had dental caries with smoking as a risk indicator for dental caries with an odds ratio of 1.84 (95% CI:1.642.07)

However, these disciplinary actions have been criticized as potentially ineffective, unjust, and even harmful, as they may lead to further exclusion rather than constructive support for students, many of whom may be experiencing nicotine addiction [11, 21]

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Leukoplakia can be benign but sometimes indicates more serious conditions like oral cancer