Oral Health and Nicotine Pouches: Reducing Your Risk of Gum Disease

Oral Health and Nicotine Pouches: Reducing Your Risk of Gum Disease


Nicotine pouches are tobacco and sugar free making them an ideal option if you are concerned about the negative effects smoking has on your oral health. Nicotine is not carcinogenic and is not linked to any oral cancer risks associated with tobacco use.

Oral Health and Nicotine Pouches: Reducing Your Risk of Gum Disease

Nicotine addiction is powerful and quitting cigarettes can seem like an insurmountable challenge without help. Emerging nicotine delivery alternatives allow you to switch to safer methods without having to do battle with your cravings. Oral nicotine products like nicotine pouches are an excellent harm-reduction tool that can help you remove tobacco from your life and drastically reduce your risk of known related health risks including heart disease and various types of cancer.

Your dental health stands to benefit as well. Smoking is one of the leading causes of poor oral health and, as you’ll see in this article, nicotine pouches can provide an effective solution that is much kinder to your dental health. You may be curious to find out exactly what nicotine pouches do to your teeth and gums. In this article we'll show you what they are made of, look at the causes of gum disease and reveal how nicotine pouches can improve your oral hygiene when you switch from smoking.

What are the main ingredients of nicotine pouches?

Pouches contain nicotine, artificial sweeteners and flavourings soaked in a silica gel base. As a nicotine replacement therapy, nic pouches provide a completely tobacco-free and sugar free experience - two of the main causes of poor oral health. Lets take a look at how these ingredients can affect your mouth.

Icon of nicotine chemical structure

The nicotine used in smokeless tobacco products like nic pouches can be derived from tobacco or synthesised chemically. Nicotine extracted from tobacco leaf is 100% free of any harmful carcinogenic chemicals associated with tobacco.

Sugar Free icon

Each brand will use its own choice of artificial sweeteners such as sucralose, sorbitol or xylitol to name a few. None of the nicotine pouch brands sold at Alternix contain any sugar. Artificial sweeteners produce more saliva which is benificial to maintaining healthy oral flora.

Yummy emoji icon

Fruits and mint/menthols are the most popular flavours. You can also find dessert and drink options like coffee or cola, as well as spicier jalapeno chili or liquorice. All these flavourings are food grade and contain no sugars, which is great for your teeth.

Plant based icon

Plant based silica granules form the substrate of nicotine pouches. They absorb the nicotine and flavourings and provide a gradual release for up to an hour. There is a very low risk of abrasion from the silica granules, provided you don't move the pouch around frequently.

What causes gum disease?

Gum disease is an umbrella term for an infection in the gums that starts with inflammation and bleeding (gingivitis), and if left untreated can cause gum recession and tooth loss (periodontitis). It is caused by an imbalance between the good bacteria in the mouth that defend against decay and the damaging bacteria that cause plaque and infection. Poor oral hygiene and unhealthy eating habits such as consuming too many processed and sugary foods and drinks can cause bad bacteria to thrive, leading to plaque buildup and eventually the first signs of gum disease.

Smoking and the use of tobacco products are a major risk factor for periodontal disease and poor gum health. In addition to stained teeth and bad breath, smoking is also globally recognised as a major cause of poor oral health. Tobacco use promotes the growth of harmful bacteria in the mouth, restricts blood flow and inhibits your cells from being able to repair themselves.(1) Combined, these factors pave the way for inflammation and gum disease which can lead to gum recession.(2)  

What are the signs of gum disease?

  • Swollen, red or sore gums - The first stage of gum disease, also known as gingivitis.

  • Bleeding gums - Can be remedied with good oral hygiene and a visit to the dentist. Not permanent.

  • Gum recession - Untreated gingivitis can develop into periodontitis. Irriversable damage that may require surgery to repair.
  • Loose teeth - Eventually the infection can spread to the bone causing permanent damage and tooth loss.

an image showing the 3 stages of gum disease

It may surprise you to know that more than 50% of the population in the UK is affected by gum disease and nearly everyone will experience some form of it in their lifetime.(3) The initial symptoms are swollen gums (gingivitis) and bleeding when brushing or flossing, caused by a build up of plaque bacteria in the mouth. At this early stage of gum disease, regular check ups with the dentist and ensuring you maintain good oral hygiene, like brushing twice a day for two minutes and flossing, can combat the disease.(4) Switching from cigarettes to a safer form of nicotine consumption can greatly reduce the risk of gum disease.

If gingivitis is not treated, it can develop into a a more severe condition known as periodontitis, which causes shrinking gums and in more serious cases, permanent damage to gums and tooth loss. Repairing gum recession is painful and can cost anywhere between £500 to £3000.(5)

A graphic showing 8 ways to prevent gum disease

Does nicotine damage your gums?

After numerous lab studies in the US, there is no direct evidence that nicotine causes gingivitis and gum disease.(6) A recent medical review by the British Dental Association reported evidence that nicotine causes an increase in new blood vessels (known as an angiogenic effect), which was the opposite of what was observed in tobacco users.(7) The studies surmised that the increase in blood flow could help oral tissues heal themselves faster. Nicotine pouches are still quite new to the market and there are no long term studies on their affects on oral health, however the current literature suggests that they are much less harmful than tobacco products like snus or cigarettes, and so can be viewd as a positive change for your oral well being.

That being said, when you use nicotine pouches for the first time, you may notice a tingling sensation. This is a sign that the nicotine is entering your bloodstream via the oral mucosa of the mouth. However, if you are using high levels of nicotine in your pouch, you may feel an unpleasant burning sensation. Some people do find that they develop ulcers or soreness from using nicotine pouches. This may be due to a sensitivity which can be overcome by starting with lower strength pouches, or you may be experiencing an allergic reaction, in which case you should consult your doctor about alternative nicotine replacement like sublingual nicopearls or vaping. It may take your gums a short while to get used to the feel of nicotine and we recommend that you start with a lower strength at first and work your way up, to avoid discomfort.

What are the oral health effects of nicotine pouches?

There is no current evidence to suggest that nicotine pouches are bad for your oral health. Using nicotine pouches instead of smoking can significantly reduce your risk of gum disease by eliminating the thousands of chemicals found in cigarette smoke. obacco use has been well documented for decades and thoroughly established as being a major cause of various types of oral cancer. Recent studies in the US report that there are no carcinogenic risks from nicotine pouches as they do not contain any tobacco or sugars and they report that nicotine is not a known carcinogen.(8)

Randomised controlled trial studies of oral NRTs (nicotine replacement therapies), undertaken by the British Dental Association, reported no evidence of increased oral diseases such as cancer, cavities or periodontal disease and they concluded that nicotine pouches posed a low risk to oral health, comparing them to similar replacement therapies like gum or lozenges.(9) Echoing the US study, they also reported that nicotine pouches are free of tobacco and sugar and they pose a low carcinogenic risk.

Good news all around for oral health; tobacco free nicotine pouches show no evidence of damaging cells, they improve blood flow and healing and are not carcinogenic. This makes them an excellent harm reduction option that can provide you with long lasting nicotine satisfaction whilst greatly reducing your exposure to tar, sugar and the plethora of other harmful chemicals found in cigarettes.

Are nicotine pouches bad for your teeth?

According to the British Dental Journal, nicotine pouches pose no risk of tooth decay as they contain food grade artificial sweeteners and flavourings instead of sugars. However, they also state that there is no published long-term evidence of any negative oral health impacts, as nicotine pouches are such a recent product. They do go on to say, however, that due to the lack of combustion and the removal of tobacco, nicotine pouches are substantially safer and pose a much lower risk of oral disease compared to smoking and chewing tobacco products.(10)

It's all about choosing the safer option at the end of the day, you are swapping a dangerous nicotine delivery system for a substantially safer alternative can help you lead a healthier lifestyle.

Nicotine pouch FAQs

1. Can nicotine pouches stain your teeth?

There is no evidence that nicotine pouches stain teeth. The absence of tobacco and sugars means there is no risk of staining. The nicotine and flavourings in pouches are food-grade quality and colourless, the tar in tobacco is what causes staining.

2. Do nicotine pouches cause bad breath?

The main cause of bad breath comes from an excess of bad bacteria that can be exacerbated by a drying out of the mucosa in the mouth, eating sugary foods and tobacco use. Nicotine pouches have a similar effect to chewing gum; they create more saliva in your mouth, they are sugar and tobacco-free and are flavoured so if anything, your breath should smell better.

3. Are nicotine pouches better for your teeth than Snus?

Findings from a study by the Cold Spring Harbor Laboratory in the US revealed that nicotine pouches exhibit lower cell toxicity compared to Snus tobacco pouches.(11) Unlike Snus, nicotine pouches won't stain your teeth or promote the bacteria that can lead to gum disease and tooth loss.

4. Can nicotine pouches cause oral cancer?

Nicotine is not a known carcinogen and nicotine pouches do not contain any tobacco, there is no evidence that they cause oral cancer.


Nicotine pouches do not contain any of the ingredients known to cause gum disease. They are free from tobacco, tar and sugar, and provide an effective alternative that can deliver nicotine without staining your teeth or damaging your gums. If you are not ready to combat your nicotine addiction, taking a harm reduction approach is a sensible decision and nicotine pouches are one of the most effective and affordable products you can choose.

When combined with good oral hygiene like brushing twice a day, flossing and using a mouthwash, switching from cigarettes to nicotine pouches is a huge leap in the right direction. If maintaining good oral hygiene is important to you, take that leap now. Visit Alternix where we stock the largest selection of premium nicotine pouch brands in the UK, with multi-buy deals that will save you a fortune when compared to your smoking habit.



(1,6) National Library of Medicine - Effect of nicotine on human gingival, periodontal ligament and oral epithelial cells. A systematic review of the literature. May 25, 2019. https://pubmed.ncbi.nlm.nih.gov/31136818

(2) National Library of Medicine - Effect of tobacco on periodontal disease and oral cancer. May 9, 2019.

(3) Dentistry - The Great British Oral Health Report. January, 2022. https://dentistry.co.uk/app/uploads/2022/01/the-great-british-oral-health-report-2021.pdf

(4) NHS - Gum Disease. February 18, 2022. https://www.nhs.uk/conditions/gum-disease

(5) London Dental Specialist - Gum Recession Treatement Costs in London. https://london-dental-specialists.co.uk/the-ultimate-guide-to-understanding-gum-recession-treatment-costs-in-london

(7,8,9,10) ResearchGate - Nicotine pouches: a review for the dental team. October, 2023. https://www.researchgate.net/publication/375048796_Nicotine_pouches_a_review_for_the_dental_team

(11) BioRxiv - Flavor Classification/Categorization and Differential Toxicity of Oral Nicotine Pouches (ONPs) in Lung Epithelial Cells. July 6, 2022. https://www.biorxiv.org/content/10.1101/2022.07.06.498919v1.full


Disclaimer: The content presented on www.alternix.com is for informational purposes only and is centered around nicotine pouches and heated tobacco products—alternatives to traditional smoking methods. The information provided on this website, including blog posts and social media interactions, is not intended as medical advice, nor should it substitute for professional medical guidance or treatment.