Tobacco-free nicotine pouches reduce smoking impacts on oral health

Romania’s Titu Maiorescu University Professor Dr. Mihaela Rãescu

Professor Dr. Rãescu feels not enough attention is being paid by health practitioners or governments to improving oral health and safer oral products for smokers and other consumers alike. She notes it becomes difficult to convince people when they haven’t seen for themselves the impacts, which is why more studies and evidence becomes important. As public health strategies evolve, integrating THR into comprehensive tobacco control policies will be essential for achieving lasting improvements in global oral health and reducing the disease burden associated with tobacco use. She feels the evidence is already there and is compelling, but different countries and regimes will react differently

• Call for global strategy to rethink oral medicine – Prof. of Dentistry

Completely switching to tobacco-free nicotine pouches significantly boosts oral health of cigarette smokers, and more attention must be paid to the link between oral hygiene and smoking, avers Professor Dr. Mihaela Rãescu, from the Titu Maiorescu University in Romania.

Speaking to the Daily FT, Prof. Dr. Rãescu opined that health professionals must be made aware of the existing nicotine alternatives and be empowered to present them to adult smokers as a step to completely transition out of smoking and improve overall health. However, she says it is important to note the willingness of the patients to switch from smoking, as she finds if a patient is accepting of their weakened state of health as a smoker it becomes more difficult to drive change. 

“In my office, a lot of people complain of halitosis, discoloration and periodontal disease when you are a long-term smoker. I saw from experience the most important words are preventive oncological examination, and that is something that scares you. So, it’s about how you approach it as oral health professionals.” 

“It is almost like long-term counselling, where you explain to the patient what potential stage they are in and offer advice on what (nicotine) alternatives and options are available. It is a long-term process in most situations, but in the end the most important thing is that oral health will be improved and entire body management will be different,” Prof Dr. Rãescu said.

The professor has thus far published two scientific reports on reducing oral health impacts of smoking. She writes that as the first part of the digestive tract it is the first point of impact be it smoking, food, drinks and any other products. There is an ample focus on the liver and lungs but not so much attention on what is happening in the mouth, when it is in fact something which is much easier to see. She states it is easier to identify first impacts and changes from the oral cavity, whereby it becomes easy to control or prevent oral cancers. Accordingly, oral examinations should become mandatory if not top-of-mind for smokers, Prof. Dr. Rãescu opines. She notes that alternative tobacco and nicotine products lend a lot of promise to persons trying to reduce and switch from smoking. 

“There is no argument that innovative tobacco-free nicotine pouches are going to be a game-changer to help people improve their oral health. I did some studies for patients who switched from traditional cigarettes to non-combustibles, and within just nine months I saw quite a significant decrease of bacterial plaque and even bone resumption when they tried to make implant treatment. That is another discussion on implant treatment, where after surgery you need at least three months for osteo-integration of the implant and in smokers the vascular dynamics is very challenging.” 

“So, patients must stop smoking during these months. If patients cannot quit they can easily use one alternative at least for these three months. When patients switch from cigarettes to heated tobacco products or other nicotine alternatives we saw several good changes and benefits to oral health. Nociceptors, when they come in contact, make the oral cavity react like a self-defence mechanism. Such steps are needed to prevent anarchic structures that can lead to the beginning of premalignant lesions. It becomes the base of every sickness, not only in the oral cavity but for the entire body,” she said. 

Tobacco control policies have contributed to better oral health outcomes, but they are inadequate to fully address the global burden of toxic and unregulated tobacco-related oral diseases. Tobacco harm reduction activities provide a pathway for individuals who cannot or will not quit smoking, allowing them to reduce exposure to harmful substances and improve oral health outcomes. 

Tobacco control policies have contributed to better oral health outcomes, but they are inadequate to fully address the global burden of toxic and unregulated tobacco-related oral diseases. Tobacco harm reduction activities provide a pathway for individuals who cannot or will not quit smoking, allowing them to reduce exposure to harmful substances and improve oral health outcomes

Professor Dr. Rãescu feels not enough attention is being paid by health practitioners or governments to improving oral health and safer oral products for smokers and other consumers alike. She notes it becomes difficult to convince people when they haven’t seen for themselves the impacts, which is why more studies and evidence becomes important. As public health strategies evolve, integrating THR into comprehensive tobacco control policies will be essential for achieving lasting improvements in global oral health and reducing the disease burden associated with tobacco use. She feels the evidence is already there and is compelling, but different countries and regimes will react differently. 

“I think we still need long-term studies, but in our short-term studies like I mentioned before over a period of just nine months, the results are very convincing. But, long-term studies must take place in different countries. I would like to add that a global strategy must be done and I feel the oral cavity must be looked at as a holistic point of treatment. We have to look at the oral cavity as something that can influence the entire body’s health.”