Self-reported oral health outcomes after switching to a novel nicotine pouch technology: a pilot study.

Objective: Nicotine pouch use has been linked to oral health concerns, including oral lesions and gingival irritation. This pilot study examines self-reported oral health outcomes following the use of a novel nicotine pouch (Stingfree Strong Blue Mint), with an impermeable barrier on the interior side designed to reduce mucosal irritation.

Materials and methods: A total of 23 Swedish dentists who were current snus or nicotine pouch users participated in a 5-week observational study. Baseline and follow-up assessments included self-reported oral health status and photographic documentation of mucosal conditions, reviewed by an independent blinded dental expert. Primary outcomes included changes in self-reported snus lesions, gingival recession, gingival irritation, and gingivitis.  Results: The prevalence of self-reported snus lesions decreased from 95.7% (n = 22) to 69.6% (n = 16). Median Axell-scale lesion severity declined from 2 (interquartile range [IQR]: 1-3) to 1 (IQR: 0-2) (z = 3.756, p = 0.0002). Moderate-to-severe lesions (Axell score ≥ 3) dropped from 39.1% (n = 9) to 0% (n = 0). Self-reported gingivitis cases (n = 3) were eliminated, and gingival irritation decreased by 90.0%.

Conclusions: Preliminary findings suggest that the use of the Stingfree Strong Blue Mint nicotine pouch may reduce mucosal irritation. While promising, these findings warrant validation through large randomised controlled trials to establish long-term effectiveness and safety.