Snus & Health
How snus can affect your oral health
Receding gums
Snus use can increase the risk of mucosal changes and damage to the gums where the snus is placed. These injuries can lead to gingival retractions, i.e. the gums recede and eventually risk exposing the necks of the teeth. This in turn can cause hypersensitivity, caries and, in the worst cases, tooth loss. The degree of oral mucosal damage is related to the number of hours of use per day, daily consumption and years of active snus use.
Snuff lesions
Snuffles in the oral mucosa and inside of the lips. These may resemble wrinkled “elephant skin”. The lesions are graded in 4 different degrees of damage according to the Axell scale. The grades are defined as follows
- Grade 1: A superficial lesion with a color similar to the surrounding mucosa and with slight wrinkles. No obvious mucosal thickening.
- Grade 2: A superficial, whitish or yellowish lesion with wrinkles. No obvious thickening.
- Grade 3: A white-yellow to brown wrinkled lesion with intervening furrows of mucous membrane colors. Clear thickening.
- Grade 4: A markedly yellowish to brown and heavily wrinkled lesion with intervening deep reddening furrows and/or severe thickening.
Snuff lesions usually heal within a few weeks after the person has stopped using snuff completely.
Gingivitis
Gingivitis, irritated gums or gingivitis as it is called by dentists. This means that the gums become red and irritated. With gingivitis, you may experience pain in your gums when you sniff. Many other oral health problems linked to snus are preceded by gingivitis. Gingivitis usually goes away after a few days if you stop using snus.
Snus and dental caries
(cavities in the teeth)
The effect of snus on caries risk is unclear and more research is needed in this area. At present, there are studies indicating a slightly reduced risk of caries, an unchanged risk of caries and an increased risk of caries.
Snuff pit
Snus can cause so-called “snuff pits” in the gums at the site where the snus is placed. The gums are compressed by the snus, which can result in the thinning of the jawbone and the formation of a so-called 'snuff pit'. In the worst case, the jawbone can become so thin that it causes gum recession, which can expose the tooth root.
Other oral health problems
Snus use can affect saliva production and oral flora. The latter can lead to dry mouth, bad breath and fungal infections.
Tobacco snuff can affect tooth color and result in discolored teeth.
Survey on oral health problems
In 2022, Sting Free AB conducted a large survey of Swedes' snus habits and snus attitudes, as well as self-assessed oral health problems due to snus use. Participants were also asked to indicate which type of snus they currently preferred, i.e. traditional portioned snus containing tobacco, loose snus or tobacco-free nicotine pouches (white snus). Over 1000 snus users responded to the survey, 37% of whom were women. The invitation to respond to the survey was published in two ads on Facebook and Instagram.
The results of the survey showed that
- 67% of women and 49% of men had concerns about their oral health related to their use of snus or nicotine pouches in 2021.
- 51% of men and 38% of women had had oral health problems, related to their snus use, pointed out by their dentist.
- 51% of all respondents had or had had gingivitis.
- 50% of all respondents had receding gums.
- 59% of all respondents had or had had snuff lesions.
The impact of snus on public health
diabetes
There is not much research in this area, and the results are not conclusive. Some studies have shown that snus users have an increased risk of type 2 diabetes compared to non-users, especially with high consumption of snus. Other studies have found no association between snus and diabetes.
Pregnancy and snus
Snus and nicotine pouches should never be used during pregnancy as they contain nicotine. Nicotine increases the risk of low birth weight and miscarriage.