Nicotine Pouches and Oral Health
Course Number: 693
Course Contents
Conclusion
Oral nicotine pouches may appear less harmful than comparable nicotine containing products. However, they are still relatively new with limited research on their long-term effects that is not collected from industry-founded studies. Social media, advertising and marketing trends that promote ONPs as a safer alternative, misleading younger adults to develop dual nicotine dependency, in conjunction with e-cigarettes. Updated health history and surgical consent forms should be implemented, to allow a gateway for dental and medical professionals to navigate proper treatment plans, clinical procedures and patient education. Awareness of the potential concerns and risk factors with oral health needs to be addressed, as these trends are currently so prevalent. Parental or guardian involvement, along with the oral healthcare providers, working together as team, have a better chance of our young adults being receptive to the possibilities of future harm, contributing to oral health and disease from usage from oral nicotine pouches. Supplemental pamphlets and resources to help and guide patients should be available and given to the patient regarding nicotine dependence and oral health. Oral health professionals can collaborate with public health workers, pediatricians, educators, and smoking cessation specialists to create educational programs aimed at preventing the use of nicotine pouches and other products among adolescents. Oral health professionals have an ethical obligation to inform patients on current trends that greatly impact the overall oral health of young adults.34
Table 2. Oral Nicotine Pouches Advantages and Disadvantages
| (ONP) Oral Nicotine Pouch | Advantages | Disadvantages |
|---|---|---|
| Nicotine Replacement Therapy | • Comparable to lozenges with nicotine delivery • Higher nicotine delivery than nicotine gum • Less risk for caries • Less risk of cancer • Oral lesions heal faster | • Used for longer periods of time, ultimately leading to other tobacco dependency • Additional studies are needed in all areas before recommended this to patients, still new |
| Dental Caries | • Artificial Sweeteners halt in S. Mutan development and production- further research and evidence is ongoing to review this claim. | • If used in conjunction with E-cigarettes, the risk of caries increases. • Patient caries risk assessment is different in all patients • Need additional research |
| Oral Mucosa | • Lesions can heal quicker • Not as serve or combustible tobacco, in comparison to other tobacco products | • Increased lesions with irregularities at the site of application • Irritation is common • Risk of Mechanical injury • Toxic chemicals penetrating soft tissues • Gingival blisters, ulcers • Jaw soreness/discomfort • Xerostomia • Need additional research on all topics and pathology |
| Periodontal Conditions/Bone loss and furcation involvement | • Not as severe or combustible tobacco, in comparison to other tobacco products | • Toxicity in extracts affect cell attachment loss, and localized recession, Inflammatory responses ignited • Compromised tissue, destruction of alveolar bone • Provide a host for periodontal pathogens to harbor • Cytokine levels disrupted • Increased furcation involvement |
| Stain | • Less stain than traditional smoking cigarettes | • Risk increases with dual use with E-cigarettes |
| Cancer | • Nicotine is non-cariogenic | • ONP’s have other toxins that make them considered cariogenic/harmful • More research is needed |