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Dental Experts Consider Pouches

Three dental experts have looked at tobacco-free nicotine pouches to see what benefits they offer quitting smokers or travelling vapers…and if they pose any risks

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Three dental experts have looked at tobacco-free nicotine pouches. Joshua Jackson, Anthony Weke and Richard Holliday produced the paper ‘Nicotine pouches: a review for the dental team’ and it has been published in British Dental Journal. They wanted to see what benefits pouches offer quitting smokers or travelling vapers and the level of risk they pose to the oral cavity.

Credited with helping Sweden achieve its incredible drop in smoking, tobacco-free nicotine pouches are inserted into the mouth, held between the lip and gum.

The authors say: “They deliver nicotine through the oral mucosa, being absorbed via mucous membranes and entering the blood stream. Nicotine pouches are of a similar concept to smokeless tobacco products, such as 'snus', which are widely used in countries such as Sweden.”

The pouches are now a common sight in stores but have yet to experience the same level of popularity as they experience in other countries.

The team state:

  • Nicotine pouches provide a source of nicotine but without the main constituent of carcinogen-associated tobacco
  • Nicotine pouches have becoming increasingly popular in the UK since they entered the market in 2019 and are most prevalent among smokers
  • It is of increasing importance for clinicians to have an awareness of such products and their possible implications on oral and general health
  • In addition to nicotine, approximately 80-90% of a nicotine pouch is made up of water and microcrystalline cellulose contained within a permeable pouch
  • Other ingredients, such as additives and flavourings, are also present at food-grade standard
  • Nicotine pouches generally contain artificial sweeteners rather than sugars and so pose little direct risk of the development of dental caries
  • Nicotine pouches are readily available across the UK for a relatively small cost of around £5-6.50 per pack as of March 2023
  • They are sold in a small container consisting of approximately 20 pouches

The trio state: “Due to their lack of combustion and absence of tobacco leaf, nicotine pouches are likely to be a substantially 'lower-risk product' relative to tobacco smoking.”

They remind other dentists that nicotine is not a cancer-causing carcinogen and has been used for decades in the form of nicotine replacement therapy – accepted as safe by the medical community.

They says there is no published data on the health effects of pouches but that it is possible to speculate on what they might be by looking at other oral nicotine products like gum, lozenges and sprays. The World Health Organisation listed those NRT products as an essential medicine in 2009.

In fact, the greatest risk appears to be confined to “localised plaque accumulation on the tooth surfaces near where the pouch is held”.


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Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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