Abstract
Oral tobacco is an addictive substance. This form of smokeless tobacco is applied to the body by inserting a pouch with the product into the vestibule of the oral cavity.
The term "smokeless tobacco" includes not only oral tobacco, but also snuff and moist snuff, so called snus, however these are not discussed in this short article. Nicotine pouches contain nicotine salts and additives and they have a similar application as oral tobacco, i.e. inserting the pouches into the oral vestibule.
The use of both of these addictive substances in the Czech Republic is increasing especially among children and young adults, for example during collective sports activities. Repeated application of oral tobacco can lead to clinical changes of the mucosa in the form of a keratotic lesion - the so-called smokeless tobacco keratosis - in the places where the pouches are placed.
Nicotine pouches can cause similar mucosal manifestations as oral tobacco. Mucosal changes vary in clinical appearance depending on the frequency of application of these products.
Most of the keratotic lesions on the mucosa disappear within 6 weeks from stopping inserting the pouches into the oral vestibule. However, with long-term irritation of the same place in the mouth, there is a risk of developing squamous cell carcinoma.
The dentist should inform the users of oral tobacco and nicotine pouches about the appearance of a keratotic lesion, monitor its changes, or refer the patient to a specialist for diseases of the oral mucosa.