Chewing tobacco, often referred to as smokeless tobacco, dip, chew, or snus, involves placing tobacco directly into the mouth rather than smoking it. This product comes in various forms, including loose leaves, compressed plugs, or twisted ropes, and is frequently sweetened and flavored. Users typically position a “wad” between their cheek and lower gum, allowing nicotine to be absorbed through the oral tissues.
Visible and Immediate Alterations
Chewing tobacco causes several noticeable changes in the mouth. Teeth discoloration is an apparent effect. The tobacco leaves and their residues contain pigments that can cause brown or black staining on the tooth surfaces.
Persistent bad breath (halitosis) is another common consequence. The tobacco product itself contributes to an unpleasant odor, and it can also foster the growth of bacteria in the mouth, further exacerbating the issue.
Tobacco also triggers increased saliva production. Users often spit out this excess saliva.
Some individuals, particularly new users, may also experience immediate irritation when placing chewing tobacco in their mouths. This can manifest as burning or stinging sensations in the soft tissues.
Harm to Oral Soft Tissues
Chewing tobacco damages oral soft tissues, often leading to serious conditions. Constant irritation from tobacco contact can cause gum recession, where the gum tissue pulls away from the teeth, exposing sensitive tooth roots. This exposure can lead to increased tooth sensitivity and make the roots more vulnerable to decay.
Leukoplakia, white or grayish patches inside the mouth, is a common and concerning development. These patches typically form where the tobacco is habitually held, such as on the inner cheeks, gums, tongue, or the floor of the mouth. Leukoplakia is considered a precancerous condition, meaning that while not cancerous itself, it has the potential to transform into oral cancer over time. Medical attention is important for these lesions to monitor for any malignant changes.
General inflammation and irritation of the cheek lining and gums are prevalent where tobacco rests. The chemicals in chewing tobacco can cause chronic inflammation, which can further contribute to tissue damage. Chemical irritation can also lead to changes in the palate, sometimes referred to as nicotine stomatitis.
Impact on Dental Structure
Chewing tobacco harms teeth through mechanical and chemical processes. Many chewing tobacco products contain abrasive particles, such as sand or grit, which can mechanically wear down the tooth enamel and underlying dentin. This abrasion can result in heightened tooth sensitivity and compromise the structural integrity of the teeth.
Many chewing tobacco products contain high sugar levels. This sugar, combined with altered oral pH and often reduced saliva flow due to constant spitting, creates an environment conducive to dental caries (cavities). The prolonged exposure of tooth enamel to the chemicals present in tobacco can also weaken its structure. This chemical assault makes the teeth more susceptible to breakdown and damage over time.
Risk of Oral Cancers
The most severe consequence of chewing tobacco is its direct link to oral cancers. Chewing tobacco contains numerous carcinogens (cancer-causing chemicals). These harmful substances are absorbed directly through the oral mucosa where the tobacco is placed.
Repeated exposure to these carcinogens damages oral cell DNA, leading to uncontrolled cell growth, a hallmark of cancer. The most common sites for cancer development due to chewing tobacco use include the lips, tongue, floor of the mouth, inner cheek, and gums. The throat (pharynx) and esophagus can also be affected, as tobacco juices may be swallowed.
Early detection of oral cancer is important for treatment. Users should be aware of potential warning signs, such as persistent sores that do not heal, lumps or thickened areas in the mouth or throat, difficulty swallowing, or unexplained pain and numbness in the oral region. Recognizing these symptoms and seeking prompt medical evaluation can significantly impact the course of the disease.