Smokeless Tobacco and Oral Health

Smokeless tobacco goes by many names, such as dip and chew, snuff, chewing tobacco or spit tobacco. No matter what it is called, smokeless tobacco is highly addictive and can harm one's health.

Like cigars and cigarettes, smokeless tobacco products contain a variety of toxins associated with cancer. At least 28 cancer-causing chemicals have been identified in smokeless tobacco products.

Signs and symptoms that could indicate oral cancer include any sign of irritation, like tenderness, burning or a sore that will not heal; pain, tenderness or numbness anywhere in the mouth or lips; development of a lump, or a leathery, wrinkled or bumpy patch inside the mouth; color changes to oral soft tissues; difficulty chewing, swallowing, speaking or moving the jaw or tongue; or any change in the way your teeth fit together.

Patients should see their dentist or physician immediately if such symptoms appear.

Smokeless tobacco can also irritate gum tissue, causing it to recede or pull away from the teeth. Once this gum tissue recedes, the roots of the teeth are exposed, increasing the risk for tooth decay. The roots also may become sensitive to hot and cold or other irritants, which means discomfort may accompany eating or drinking.

Sugars, often added to enhance the flavor of smokeless tobacco, can increase the risk for tooth decay. Smokeless tobacco also typically contains sand and grit, which can wear down teeth.

If using smokeless tobacco has become a habit, help is available to quit. "You Can Quit Spit Tobacco" is one such program sponsored by the National Institute of Dental and Craniofacial Research. For more information, visit "" and enter "spit tobacco" in the search field.

© 2017 American Dental Association. All rights reserved. Reproduction or republication is strictly prohibited without the prior written permission from the American Dental Association.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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Tobacco's greatest threat to your health may be its association with oral cancer. The American Cancer Society reports that:

  • About 90 percent of people with mouth cancer and some types of throat cancer have used tobacco. The risk of developing these cancers increases as people smoke or chew more often or for a longer time.

  • Smokers are six times more likely than nonsmokers to develop these cancers.

  • About 37 percent of patients who continue to smoke after cancer treatment will develop second cancers of the mouth, throat or larynx. While only 6 percent of people who quit smoking will develop these secondary cancers.

  • Smokeless tobacco has been linked to cancers of the cheek, gums and inner surface of the lips. Smokeless tobacco increases the risk of these cancers by nearly 50 times.7