Scandinavian and North American Moist Snuff and Periodontitis: A Systematic Review and Meta-Analysis

Area of Science:

• Oral health research
• Periodontology
• Public health

Background:

• Moist snuff (MS) use is prevalent in Scandinavian and North American populations.
• Understanding the association between MS use and periodontal disease is crucial for public health initiatives.

Purpose of the Study:

• To investigate the effect of moist snuff (MS) use on periodontitis in humans.
• To compare periodontal outcomes in MS users versus non-users.

Main Methods:

• A systematic review and meta-analysis of electronic databases (MEDLINE, EMBASE, Cochrane) and grey literature.
• Inclusion of 22 cross-sectional studies from Sweden, the United States, and Norway.
• Qualitative and quantitative syntheses, including random-effects meta-analysis, were performed.

Main Results:

• MS use was most frequently associated with buccal recession.
• No significant associations were found between MS use and periodontitis (OR=1.49, CI: 0.71-3.16).
• No significant associations were found for gingival recession (ES=-0.04, CI: -0.98 to 0.90) or gingivitis (ES=0.09, CI: -0.36 to 0.55).

Conclusions:

• The current evidence, primarily from cross-sectional studies, indicates a very low certainty of evidence.
• Scandinavian or North American moist snuff (MS) use is not associated with periodontitis.
• Further research with higher quality studies is needed to confirm these findings.