Clinical appearance of lesions associated with the use of loose and portion-bag packed Swedish moist snuff: a comparative study.

The aim of this study was to register and compare clinical oral mucosal lesions and gingival recessions associated with the use of two different smokeless tobacco products, loose snuff and portion-bag packed snuff. Selected for the study were 252 men (mean age 36.3 yr) of whom 184 (mean age 36.0 yr) used exclusively loose snuff and 68 (mean age 36.9 yr) exclusively portion-bag snuff. Oral mucosal lesions were registered according to a four-grade clinical scale. There was a significantly larger proportion of less pronounced lesions, Degrees 1 and 2, among the users of portion-bag snuff compared with the users of loose snuff. This was also valid when differences in consumption data were considered. Smokeless tobacco-associated gingival recessions were found in 42 (23.5%) subjects among the users of loose snuff and in 2 (2.9%) subjects among the users of portion-bag snuff. The results of this study support previous preliminary assessments that clinical changes of the oral mucosa and the gingival margin are less pronounced among those who use portion-bag snuff than among those who use loose snuff.