Smokeless Tobacco Effects on Oral Health

We have all seen and heard the effects of cigarette and cigar smoking on someone’s health. Smokeless tobacco products may be perceived as safer than cigarette smoking, but that is not the case.

Smokeless tobacco products are just as detrimental to our health as cigars and cigarette. At least 28 cancer-causing chemicals have been identified in various smokeless tobacco products.


Smokeless tobacco products can affect your oral health, along with your overall health.

In this article, we will attempt to understand the negative consequences of using smokeless tobacco products and how to deal with the effects of using them.

What is smokeless tobacco?

Smokeless tobacco can go by many names, namely chewing tobacco, dip or snuff. The different types of smokeless tobacco products present are –

Chewing/oral/spit tobacco

It comes as loose leaves, plugs, or twists of dried tobacco that may be flavored. It’s chewed or placed between the cheek and gum or teeth. The user spits out or swallows the brown saliva that has soaked through the tobacco, and the nicotine is absorbed through the oral tissues.

Snuff or dipping tobacco

It is finely grounded tobacco packaged in cans or pouches. It has many flavorings added and is sold in the following forms:

  1. Moist snuff – it comes in the small, teabag-like pouches or sachets that can be placed between the cheek and gum.
  2. Dry snuff – it is sold in a powdered form and is used by sniffing or inhaling the powder up the nose.
  3. Snus – it is a type of moist snuff, first used in Sweden and Norway. It’s often flavored with spices or fruit and is packaged like small tea bags. It is held between the gums and mouth tissues, and the juice is swallowed.

Dissolvable tobacco

It is available as tobacco lozenges, orbs or pellets, strips, and tobacco-sized sticks. Depending on the type, they are held in the mouth, chewed or sucked until they dissolve and the juices are swallowed.

Health risks of smokeless tobacco

The smokeless tobacco, in any of its forms, is kept in direct contact with your gums for a prolonged period. Lengthier periods of exposure may intensify the negative impact on your gums.

The adverse effects of smokeless tobacco on your oral and dental health are –

  • Oral cancer(1)
  • Periodontal disease can lead to tooth loss and sensitivity (2)
  • Delayed healing after a tooth extraction or other oral surgery
  • Bad breath
  • Stained teeth and tongue
  • A diminished sense of taste and smell
  • Tissue and bone loss around the roots of the teeth
  • Wearing down or erosion of teeth
  • Increase in oral acids-some kinds of chewing tobacco includes sugar, which can increase the risk of tooth decay and gum irritation. (3)

Other harmful effects of smokeless tobacco include –

  • Heart disease and high blood pressure
  • Increased risk of heart attack and stroke
  • Increased risk of early delivery and stillbirth when used during pregnancy
  • Type-2 diabetes
  • Dementia
  • Respiratory disease
  • Increased risk of cancer of the pancreas

Oral cancer is one of the most devastating forms of cancer and is the most significant concern associated with smokeless tobacco use. The first symptoms of oral cancer include – (4)

  • Leukoplakia- mouth sores that appear as a smooth, white patch or as leathery-looking wrinkled skin
  • A sore on the lip or in the mouth or throat that does not heal
  • A lump on the lip or in the mouth or throat
  • A white or red patch on the gums, tongue or lining of the mouth
  • Unusual bleeding, pain or numbness in the mouth
  • A sore throat that does not go away
  • Difficulty or pain with chewing or swallowing
  • Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
  • A change in the voice
  • Pain in the ear

How to quit using smokeless tobacco products?

The only way to avoid gum problems from smokeless tobacco is to quit using it. Chewing tobacco is just like any other addiction that needs to be overcome.

There are various support systems, programs and even prescription medications available to help people quit using chewing tobacco.

Products like nicotine gum, nicotine patches, lozenges, etc. are available to wean a person from nicotine addiction from chewing tobacco.

Prescription medicines such as bupropion SR and varenicline tartrate have been effective in some patients that are trying to quit nicotine.

You should schedule regular visits with your dentist to make sure that your teeth, gums, and mouth are healthy. Your dentist may also refer you to organizations and self-help groups who will have the latest information to help you stop using smokeless tobacco. (5)

In case the signs of oral cancer appear, the treatment will depend on several factors, including the location, size, type and extent of the tumor, as well as the stage of the disease.

Treatment can include surgery (to remove parts of the mouth, jaw, and if cancer has spread, the lymph nodes in the neck), radiation therapy or combination of the two.

Regular visits to your dentist can help in detecting early signs of cancer like leukoplakia or precancerous sores. If oral cancer is detected early, it can be treated successfully.

Take away message

Smokeless tobacco comes in many different forms and is highly addictive. It can harm one’s health just like cigarette smoking.

Smokeless tobacco products contain a variety of toxins associated with cancer. You should visit a dentist or physician if you observe any sign of oral cancer.


Giving up smokeless tobacco can bring many health benefits. Short-term benefits include a better appetite and proper digestion, as well as better teeth and gums. Long-term benefits include less chance of developing a severe disease such as heart disease or mouth cancer.

Smokeless tobacco can be harder to give up than giving up cigarettes. You may need specialist help like nicotine replacement therapy and support to help you cope with how you feel.


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