Dental caries and associated factors in a group of Swedish snus users.

The aim of this study was to investigate the effects of the Swedish moist powder tobacco product known as "snus" on dental caries and to measure the pH fall in dental plaque. The subjects comprised male and female adults between 26 and 62 years of age (n = 102), all habitual snus users for ≥ 10 years. The control group (n = 101) consisted of similar individuals in terms of gender, age and educational level but with no tobacco use for ≥ 10 years. A clinical and radiographic examination and a questionnaire were completed. The pH fall after a sucrose rinse was estimated in situ in 10 randomly selected subjects per group. The salivary secretion rate was higher in snus users than non-users (2.5 vs 2.2 ml/min, p = 0.005).There was no statistically significant difference regarding salivary buffer capacity. No differences were found between the two groups in terms of the plaque index, primary or secondary enamel and dentine caries, DFS and salivary counts of mutans streptococci or lactobacilli. The pH fall was somewhat more pronounced among non-users compared with snus users (NS). Snus users had a lower intake of snacks between meals and a less frequent intake of cookies (p = 0.000). Furthermore, snus users had a mean gingival index (± SD) for the whole dentition of 20.4 ± 18.2, while the index for non-users was 14.4 ± 13.9 (p = 0.09); the corresponding values for teeth 13-23 were 14.9 ± 20.6 and 7.7 ± 11.9 respectively (p = 0.003). To conclude, this clinical study revealed no statistically significant differences in caries prevalence between snus users and non-users and only minor differences regarding different caries associated factors.

Dental caries in relation to smoking and the use of Swedish snus: epidemiological studies covering 20 years (1983-2003).

OBJECTIVE: The aim of this study was to evaluate some intra-oral caries-associated variables and tobacco use on dental caries. MATERIALS AND METHODS: The participants were randomly recruited from three cross-sectional studies in Jönköping, Sweden, in 1983, 1993 and 2003. Each study consisted of 130 individuals in each of the 20, 30, 40, 50, 60 and 70-year age groups. Of these, 550, 552 and 523 dentate individuals attended respective year of examination. They were all examined both clinically and radiographically. A questionnaire was completed in conjunction with the examination. In the studies, 345 were smokers, 104 snus users and 1142 non-tobacco users, in total 1591 individuals. RESULTS: In 1983 and 1993, there were no significant differences in mean DFS between non-users and smokers, but a statistically significantly higher mean DFS in comparison with snus users. In 2003, there was no statistically significant difference in mean DFS between the groups. Multiple regressions showed that, after adjusting for age, gender and socio-demographic variables, there was a statistically significant association between DFS and smoking in 1983 (smoking excluded in favour of lactobacilli when further analysed) and DFS and plaque index (PLI) in 1993. In 2003, there was no association, apart from buffer capacity (Power rising) between DFS and the examined intra-oral caries-associated variables and tobacco use. CONCLUSIONS: The results of these epidemiological studies, performed in 1993 and 2003, indicate that daily smoking or snus use does not increase the risk of dental caries.

Effect of nicotine-free and nicotine-containing snus on plaque pH in vivo.

The aim was to investigate pH changes in plaque in vivo during the use of nicotine-free and nicotine-containing snus. The carbohydrate content of the products was also analysed. Ten subjects, all regular snus users, participated in an experimental crossover study, on eleven occasions with an interval of one week. Six nicotine-free and four nicotine-containing products, which are sold on the Swedish market, were included and a sucrose solution was used as a control. The subjects did not brush their teeth for three days before coming to the laboratory, without eating, drinking or using snus/smoking for two hours prior to the test. pH was measured at three approximal sites up to 45 min with the test product placed under the upper lip. The carbohydrate analysis showed that the nicotine-containing products contained only traces of glucose, fructose and sucrose (0.5-1%) and starch (approximately 1.5%). Some of the nicotine-free products contained up to 6.5% low-molecular-weight carbohydrates and 26.0% starch. The intraoral pH measurements showed that four nicotine-containing products increased the plaque pH, in contrast to three of the six nicotine-free products, which lowered the pH. These pH changes may have an effect on the caries risk, both positively and negatively, depending on which product is used.

Effects of snuff on the oral health status of adolescent males: a comparative study.

PURPOSE: The purpose of this study was to investigate effects of snuff on the oral health status of adolescent males. MATERIALS AND METHODS: The participants consisted of 80 adolescent males between 16-25 years, 40 snuff users and 40 non-users. The snuff users and non-users were matched with reference to their age. Data were collected using a questionnaire containing questions on general and oral health, daily oral hygiene and tobacco habits. The clinical examination was carried out in a dental office by two experienced dental hygienists. Snuff lesions were clinically classified on a four-point scale and documented on colour slides. The examination also assessed the number of teeth, restored tooth surfaces, plaque index and gingival index, probing pocket depth and gingival recessions. RESULTS: Out of 40 snuff users, 35 showed snuff incluced lesions. The clinical diagnosis of snuff users' mucosa showed snuff lesions of different severity clinically classified as degree 1, 2 and 3. When explaining snuff lesions of degree 2 and 3, hours of daily snuff use and package form (portion-bag snuff versus loose snuff) was statistically significant. There were no statistical differences between snuff users and non-users regarding restored tooth surfaces, presence of plaque, gingival inflammation and probing pocket depth. Seventeen percent of the cases showed loss of periodontal attachment as gingival recessions. CONCLUSION: In spite of mucosal lesions caused by snuff there were no statistical differences in prevalence in plaque and gingivitis between snuff users and non-users. However, some cases showed loss of periodontal attachment as gingival recessions.