The researchers reviewed 26 European studies on Swedish snus and oral health. There is general support that snus can cause gum recession, especially where the snus is placed. Several older studies also show more gingivitis in users of traditional snus, even when taking into account the amount of plaque. The risk of gum recession is lower when using portioned snus than with loose snus. Newer types of portioned products may reduce the risk further.
Not tooth loss
One of the researchers behind the study is Mats Jontell, professor emeritus of oral medicine and pathology at the Sahlgrenska Academy, University of Gothenburg. He comments on the results.
– When we weigh up the research, we see that snus affects the gums locally. It is not just a matter of the snus portion pressing against the tissue, but there also seems to be an inflammatory reaction that causes bone resorption, which results in the gums receding over time. However, we see no clear support that it leads to destructive tooth loss, i.e. the type of disease where teeth gradually lose their attachment to the jawbone, says Mats Jontell in a press release from the University of Gothenburg.
When it comes to caries, the results are contradictory. Overall, it cannot be concluded that traditional snus per se increases the risk of caries.
Cleft palate
One of the larger studies included in the review shows that children of women who used traditional snus during pregnancy tended to have an increased risk of being born with a cleft palate compared to children of non-users. The risk did not apply to women who stopped using snus before prenatal care.
Maria Bankvall is a senior lecturer in dentistry at the Jönköping School of Health Sciences and co-author of the study:
– Although it is an increase in risk and not proof of causation, it is a signal that is important from a public health perspective. The use of nicotine products during pregnancy cannot be considered risk-free, especially when the use of snus is increasing among young women, says Maria Bankvall.
Know a little about white snus
What the researchers particularly point out as a knowledge gap concerns white snus. There are basically no studies on how these products affect oral health in the long term. However, preliminary studies indicate that white snus may give rise to other oral mucosal changes than those previously observed.
Source: Swedish smokeless tobacco and its impact on oral health: a systematic review
