What is snus?
Snus is a tobacco product.
A small rectangular pouch with powdered tobacco is stuffed under the upper lip, which allows the nicotine to be absorbed into the blood.
The amount of nicotine per gram of snus varies from a few milligrams to over 25 mg. The most common amount is around 7–8 mg.
In 2018, for the first time, more snus users than smokers were registered in Norway.
In 2021, 20 percent of adult men aged 16–74 reported using snus daily. For women: 7 percent.
The daily frequency of use of snuff in Norway is 10 portions a day.
(Source: Great Norwegian Encyclopedia)
There is still agreat deal we do not know about what snus does to a person’s health.
One thing iscertain, however: Many snus users have discovered that their dentists candetect their snus use.
So how bad is snus for your gums?
Want young people to know the consequences of using snus
In a studypublished in February 2023, Norwegian researchers investigated nearly 1,400people between the ages of 18 and 20.
They were at thedentist when they were asked to take part in the study. Just over 200 of theparticipants used snus daily.
Simen E. Kopperudis one of the researchers behind the study. He works at the University of Oslo(UiO) and the Nordic Institute for Dental Materials.He is also adentist, and says that one purpose of the study was to be able to use the resultsto let young people know about the effects of using snus.
He himself seesmany snus-related damages at the clinic.
Used snus three years on average
“We mainly wantedto be able to demonstrate local effects in the mouth. If teeth and gumsare affected quite quickly after starting to use snus, that may be more significantfor a young person than the risk of long-term health effects,” Kopperud says.
Most viewed
- This mass grave in Norway contained 19 men, each shot in the head and heart
- Are we really running out of helium?
- European tourists experienced culture shock when they came to Norway in the 1800s
- Norwegian study sheds light on how harmful snus is for your gums
The young adultswho took part in the study had been using snus for an average of three years.
The researchersfound that a lot can happen to the gums over such a short period. Kopperud is not surprised.
Reveals occasional snus users
“That number wassomewhat expected; I see this in the clinic as well,” Kopperud says.
He can almostalways tell if a patient uses snus or not by looking at their teeth and gums.
“Some patients tellme that they only use snus at parties,” Kopperud says.
Even then, it’soften visible.
“In clinicalpractice, I always comment on it when I check the mucous membrane and see snus-relateddamages,” he says.
You can also checkyourself in a mirror. You can lift your upper lip and see that the gums arewhitish and wrinkled where you usually place the snus pouch.
“Hopefully this canbe a motivation to stop using snus,” Kopperud says.
On 18 January 2024,the national newspaper Aftenposten wrote an article about figures on snus usefrom Statistics Norway. These numbers show a doubling of snus use in Norwayover the last ten years. The greatest increase was among the young.
More use, worse outcomes
In the study,Kopperud and colleagues distinguished between loose snus and snus in pre-packagedpouches. However, very few used loose snus.
That meant itwasn’t possible to examine which type of snus is worse for the gums. Participants were also asked how regularly they used snus.
“The study showedthat the more tins of snus you use, the more serious the damage,” he says.
The researchersalso distinguished between two different types of damage. One was changes inthe surface of the gums, when they become white and wrinkled.
A particularly vulnerable group
The damage was moreserious for one in five snus users. These individuals experienced gum recession around some teeth, revealing more of the tooth surface.
“This is far worsedamage because it's permanent,” Kopperud says.
One group wasparticularly vulnerable: boys.
“We speculatewhether it’s the strength of the snus that is the cause – stronger snus with ahigher nicotine content,” he says.
He clarifies thatthis remains pure speculation. He believes it could also be that young boyskeep snus under their lip for longer than other users.
It could be thatsubsequent research will come closer to a definite answer.
Develops quite quickly
The risk of such damages increased with the number of months and years the patientshad used snus. Nevertheless, a significant proportion had such damages after an average of three years of use.
However, there is a silver lining for those who manage to stop using snus.
“The mucousmembrane in the mouth will regenerate quite quickly when you stop using snus,” Kopperudsays.
This means thatsmaller lesions, where the gums are whitish and wrinkled, return to normalagain. This can happen within a few weeks or months, according to Kopperud.
There is also hopefor receding gums. Admittedly, not without effort.
Quitting snus is essential for positive outcomes
“You can help bringthe gums back, but it requires a small operation,” Anders Verket tells sciencenorway.no.He is an associate professor at UiO's Department of Clinical Dentistry.
He says that theoperation is not guaranteed to be successful. And one thing is for certain:
“It obviously requires you to stop using snus; otherwise, nothing will grow back,” he says.
Likely increased risk with poor oral hygiene
Verket also worksas a dentist in addition to conducting research. He sees the same as Kopperud.
“You can see fromtheir mucous membranes that some people are snus users. They develop acharacteristic pattern under their lip. This is a change that is reversible inalmost everyone,” he says.
He assumes thatcertain individuals may be more susceptible to this kind of damage or change.
“Some people havevery thin bones and thin gums,” he explains.
Thin gums are probablymore easily damaged than stronger gums.
“I'm also fairly certain that poor oral and dental hygiene will increase the risk,” he says.
Poor dental hygieneincreases the risk of inflammation in the gums. This in itself is a risk factorfor receding gums.
Using snus adds anadditional risk. Verket clarifies that there has not been enough research conducted on these issues to draw definitive conclusions.
Limited research
Overall, there are few problems with snus that have been proven in research, other than the fact that gums can turn white, wrinkled, and recede.
“But in my eyes,this is one of the areas where there is far too little research. Although we can'tshow an increased risk of gum disease, that does not mean that there is no risk,”Verket says.
The gum disease heis referring to is periodontitis. This is chronic inflammation of the gums thatcauses them to break down.
Snus is used inmany places in the world, but not Scandinavian snus.
It is difficult to studythe damage caused by different types of snus, according to Verket.
Nor is it somethingthat is of international concern, as Norway and Sweden are the only countries that have a significant consumption of the type of snus used in Scandinavia.
Reference:
Kopperud et al. 'Oral lesions associated with daily use of snus, a moist smokeless tobaccoproduct. A cross-sectional study among Norwegian adolescents',ActaOdontologica Scandinavia, 2023. DOI: 10.1080/00016357.2023.2178502
———
Translated by Nancy Bazilchuk
Read the Norwegian version of this article at forskning.no
