Dental caries and associated factors in a group of Swedish snus users

The aim of this study was to investigate the effects of the Swedish moist powder tobacco product known as "snus" on dental caries and to measure the pH fall in dental plaque. The subjects comprised male and female adults between 26 and 62 years of age (n = 102), all habitual snus users for ≥ 10 years. The control group (n = 101) consisted of similar individuals in terms of gender, age and educational level but with no tobacco use for ≥ 10 years. A clinical and radiographic examination and a questionnaire were completed. The pH fall after a sucrose rinse was estimated in situ in 10 randomly selected subjects per group. The salivary secretion rate was higher in snus users than non-users (2.5 vs 2.2 ml/min, p = 0.005).There was no statistically significant difference regarding salivary buffer capacity. No differences were found between the two groups in terms of the plaque index, primary or secondary enamel and dentine caries, DFS and salivary counts of mutans streptococci or lactobacilli. The pH fall was somewhat more pronounced among non-users compared with snus users (NS). Snus users had a lower intake of snacks between meals and a less frequent intake of cookies (p = 0.000). Furthermore, snus users had a mean gingival index (± SD) for the whole dentition of 20.4 ± 18.2, while the index for non-users was 14.4 ± 13.9 (p = 0.09); the corresponding values for teeth 13-23 were 14.9 ± 20.6 and 7.7 ± 11.9 respectively (p = 0.003). To conclude, this clinical study revealed no statistically significant differences in caries prevalence between snus users and non-users and only minor differences regarding different caries associated factors.