A new pilot study offers promising news for people using oral nicotine products: even mild damage to the gums and oral lining caused by products like nicotine pouches or snus may be reversed by switching to a new, gum-protective technology.
Twenty-three Swedish dentists, all regular users of snus or nicotine pouches, participated in the five-week observational study. The participants switched exclusively to using a new technology nicotine pouch featuring a plant-based inner barrier, designed to protect sensitive tissues in the mouth by reducing direct contact with the gums and the oral mucosa from the contents of the pouch. Self-reported oral health status and photographic documentation of their oral conditions were noted before and after the study.
KEY FINDINGS from the study include:
- Reduced Lesions: The prevalence of self-reported snus lesions decreased significantly from 95.7% to 69.6%. The severity of these lesions also decreased dramatically (-52%), with moderate-to-severe lesions (39%) completely disappearing by the end of the study.
- Less Irritation: Self-reported cases of gingivitis (gum inflammation) were eliminated, and gingival irritation decreased by 90%.
- No Worsening: No participants reported worsening oral irritation or the development of new lesions during the study.
In conclusion, the study suggests that even minor oral tissue damage caused by nicotine pouch use can be effectively reversed through the adoption of technologies such as the Stingfree Protex ® technology barrier.
Catania, 28 May 2025 – It’s well established that the combustion of tobacco generates over 7,000 harmful chemicals — many causing serious diseases. By contrast, non-combustible nicotine delivery systems, like nicotine pouches, are increasingly shown to reduce tobacco-related harm.
Nicotine pouches are small fiber sachets containing a nicotine-infused cellulose matrix. Similar in appearance to Swedish snus (a smokeless tobacco product), they differ in one crucial aspect: they contain no tobacco. While these products are considered lower-risk alternatives to cigarettes, some research has raised concerns about their potential impact on oral health, particularly regarding gum recession, mucosal irritation and lesions
In response, a team of researchers from universities and dental clinics in Sweden, Poland, Indonesia, Moldova, and the UK — with support from the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) in Catania — conducted a pilot study, recently published in Acta Odontologica Scandinavica.
In this study, regular users of snus or nicotine pouches switched exclusively to a new nicotine pouch, a product designed with a soft and impermeable barrier that shields the gums from direct contact with irritants in the pouch content.
After just five weeks: 65.2% of participants reported improvement in oral lesions; 34.8% remained stable; and importantly, none experienced worsening symptoms. Those who used nicotine pouches only, saw a 46.2% reduction in lesion severity, while snus-only users reported a 37.5% reduction.
“Although this pilot study has limitations, the preliminary findings are encouraging” said Dr. Giusy La Rosa, lead author and researcher at the University of Catania. “They indicate that this new technology may significantly reduce oral irritation compared to traditional snus and nicotine pouches, even over a short timeframe. These results underscore the importance of continued research into innovative product designs aimed at mitigating the oral health impacts of nicotine delivery systems.”
The oral assessments were self-reported by participants using standardized photographic protocols. Images were reviewed by an independent blinded expert.
“We know that many people use snus and nicotine pouches, and one of their main concerns is oral health” said Prof. Karl Fagerström, one of the authors of the study. “This new technology could be a step forward in reducing those concerns. No one experienced worsening — which is quite rare in trials like this.”
The findings support the idea that technological innovation can make nicotine products less harmful, especially for adults seeking alternatives to smoking.
“Not all nicotine pouches are created equal! This is a positive step forward for tobacco harm reduction,” said Prof. Riccardo Polosa, Founder of CoEHAR. “This development marks real progress in tobacco harm reduction. By engineering products that minimize risk and help smokers quit, we achieve an unequivocal win for public health.”
