Conclusion

In summary, the present pilot study found almost no statistically significant differences in terms of the average bacterial counts of isolated species or in overall bacterial diversity in participants using Toombak or not. Statistically significant differences were observed only for the taxon _Sch. odontolytic_a and in the percentage-based analysis of all Gram-positive rods and aerobic Gram-positive rods. Despite the exploratory nature and methodological limitations of the present pilot investigation, the findings underscore that the oral microbiological implications of habitual Toombak use warrant further scientific and public health attention. Given the widespread consumption of Toombak in Sudan and neighboring regions, even subtle ecological changes in the oral microbiome may have relevance for long-term oral health, particularly in settings with high baseline levels of tobacco-associated disease burden. Consequently, a presumed influence of Sudanese chewing tobacco on the oral microbiota could not be ruled out.