Oral Lesions and Dental Status in Individuals Using Oral Tobacco‐Free Nicotine Pouches
Masoumeh Daneshian, Lars Fredriksson, Pia Skott, Karin Garming LegertABSTRACT
Objectives
Users of Swedish nicotine pouches and traditional oral tobacco‐derived pouches were compared to non‐users for clinical tissue responses and oral health status. In addition, the habits associated with snus use were also evaluated.
Material and Methods
In this cross‐sectional study, participants aged 18–30 were recruited from nine dental clinics: 126 nicotine pouch users, 63 oral tobacco‐derived pouch users, and 83 non‐users. Clinical examinations assessed mucosal changes and dental status, including erythema, ulceration, oedema, hyperkeratosis, etching, bone defects, and gingival recession. Participants completed a questionnaire on snus use, oral hygiene, and education. Tissue responses were graded and intergroup differences analysed. The study followed the STROBE checklist.
Results
Oral lesions were identified in 79% of nicotine pouch users and 89% of oral tobacco‐derived pouch users. Nicotine pouch users more frequently exhibited erythema and reported more oral symptoms, while hyperkeratosis predominated among oral tobacco‐derived pouch users. A non‐significant trend suggested mint‐flavoured nicotine pouches may be associated with more pronounced lesions. No increased risk of caries or periodontal disease was observed for ≤ 6 years of use.
Conclusions
Nicotine pouches appear to induce broader mucosal responses than tobacco‐containing snus. Further research is needed to clarify local and systemic effects.