Painful inflammation that takes months or up to a year to heal—this can be seen in the mouth after using white snus. Researchers in oral medicine at the University of Gothenburg will now look more closely at the effects of the popular white snus.

The study is the result of patient cases that have started to be seen within university dental care following referrals from dental clinics. The patients have gum damage extremely different to that seen in those who use traditional brown, tobacco-based snus.

At the same time, high user figures for white snus are noted among young people. According to previously unpublished data from the latest national survey from the SOM Institute at the University of Gothenburg, 25% of people aged 16–29 regularly use white snus. Among women aged 16–29, the proportion is 27%.

Greater concern about white snus

Brown snus users often develop wrinkled mucosa with a white-colored thickening where the snus is placed. Some white snus users, on the other hand, have painful and distinctly red-colored changes to the gums. In certain cases, ulcers can also appear where the white snus is placed against the mucosa.

“We’re more concerned about these lesions. They’re completely different, with redness and thinning of the mucous membrane. Tissue samples have revealed severe inflammation, and we recommend that users stop using snus immediately if they develop problems or notice changes,” says Dr. Gita Gale, specialist dentist and one of the researchers behind the study.

The lesions associated with white snus use also seem to heal more slowly. Among brown snus users, once they stop using it, their gums usually recover within a few weeks. With white snus, however, the damage has been seen to last for several months, even as much as a year.

Changes and risk factors

Research on white snus is currently limited. This new study is financed with independent research funds and will not accept external funding linked to tobacco products or white snus.

The study’s recruitment base comprises Västra Götaland via specialist dental clinics at various hospitals in the region. So far, some 40 patients have been recruited to the study, all with oral mucosal lesions following white snus use.

The researchers will investigate the different types of mucosal changes that white snus can cause and the associated risk factors. They will also study the severity of any inflammation and tissue changes.

The results will be compared to the available data for brown snus. The study will even include a control group of non-users with healthy oral mucosa, with biopsies taken from the parts of the mouth where users normally place their snus.

Widespread use—lack of knowledge

The study will continue for at least five years, with the gradual inclusion of additional study participants. One key driver is the widespread use of white snus among young people, particularly among women.

“White snus use, especially among young people, is alarmingly high given how little we know about the long-term consequences of its use,” says Dr. Gale.

Dr. Gale, Ph.D., specialist and senior lecturer in oral medicine at the University of Gothenburg, is leading the research study together with oral pathologist Jenny Öhman, associate professor and senior lecturer in oral pathology at the University of Gothenburg.