Dental Caries

Oral nicotine pouches contain additives and flavorings made of artificial sweeteners. More clinical research is needed to better appreciate the impact of ONP related sweeteners on caries risk rate. Compared to natural sucrose, artificial sweeteners have shown to reduce dental caries.^5,22 However, if used in conjunction with e-cigarettes, as a dual source of nicotine, the risk of dental caries increases. Synthetic flavors in e-cigarettes disrupt the microbe in biofilm and create an environment for S. mutans to flourish.²³ Caries risk assessment tools, such as CAMBRA, should be implemented as a standard procedure of care, determining if a patient is more susceptible to caries, allowing the clinician to treatment plan accordingly.²⁴