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What is the impact of nicotine pouches on oral health: a systematic review
Dulyapong Rungraungrayabkul1, Piyada Gaewkhiew2, Tippanart Vichayanrat2
1Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Ratchathewi, Bangkok, 10400, Thailand.
Insights
Nicotine pouch use is rising, especially among young people. This review found oral mucosal changes, dry mouth, and soreness linked to nicotine pouch use, highlighting the need for more research.
Area of Science:
- Oral Health
- Public Health
- Nicotine Products
Background:
- Rising nicotine pouch (NP) use, particularly among youth, necessitates understanding oral health impacts.
- A systematic review was conducted to identify potential oral side effects of NP usage.
- PROSPERO Registration number CRD 42,024,500,711.
Purpose of the Study:
- To systematically review the oral side-effects associated with nicotine pouch usage.
- To assess the short- and long-term oral health implications of nicotine pouch consumption.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searched Medline, Scopus, Cochrane Trial, and Google Scholar databases up to February 2024.
- Assessed study quality and bias using Newcastle-Ottawa Scale and ROBINS-E tool.
Main Results:
- Three studies (190 participants) with high risk of bias were included.
- Oral mucosal changes (wrinkling, white lesions) at the placement site were common.
- Reported side effects include dry mouth, soreness, gingival blisters, and jaw sensation.
Conclusions:
- Current research on nicotine pouch oral health effects is limited.
- Short- and long-term oral health consequences of nicotine pouch use require consideration.
- Further research is crucial to fully understand the oral health implications of nicotine pouch usage.
Background:
Increase in nicotine pouch (NP) users, particularly among the young, is a matter of concern requiring a comprehensive understanding of its short- and long-term oral health implications. The objective of this research was to systematically review potential oral side-effects associated with NP usage.
Methods:
This systematic review was conducted following the PRISMA guidelines. Databases (Medline via PubMed, Scopus, Cochrane Trial, and Google Scholar) were searched for relevant studies up to February 2024. Modified Newcastle-Ottawa Scale (NOS) and the Risk Of Bias In Non-randomized Studies - of Exposure (ROBINS-E) tool were used to assess the quality and bias of the included studies.
Results:
Three studies were included for this review, two from Europe and one from USA, and considered of a total of 190 participants. All studies were deemed to have a high risk of bias. Participants used NP for periods ranging from 1 month to 10 years. Among these studies, only one study provided information on the usage pattern between 1 and 5 units for an average of 11 ± 7 min per session. Oral mucosal changes at the site of placement were common among NP users. Oral lesions varied from slight wrinkling to various white lesions, seemingly related to the NP units consumed per day and their duration of usage. Other oral side effects included dry mouth, soreness, gingival blisters, and a strange jaw sensation.
Conclusions:
Research on the use of NP and its effect on oral health are currently limited. The use of NP should take into consideration the short-and-long-term effects, especially on oral health. Further studies are crucial to understand oral health implications associated with NP usage.
Systematic Review Registration:
PROSPERO Registration number CRD 42,024,500,711.
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