The association between duration of nicotine pouch use and oral mucosal lesions in male dental students and interns: A cross-sectional study.

INTRODUCTION: The increasing popularity of oral nicotine pouches (ONPs) has raised significant public health concerns regarding their impact on oral health. These products deliver nicotine through mucosal membranes without combustion, prompting the need for comprehensive research into their effects on the oral mucosa. The objective of this study was to investigate the association between duration of nicotine pouch use and oral mucosal lesion severity. METHODS: This was a cross-sectional study of a convenience sample of 42 male students and interns at King Abdulaziz University Faculty of Dentistry (KAUFD), Saudi Arabia, who used ONPs. Clinical examinations were conducted to assess the severity of oral mucosal lesions, which were categorized ordinally. Duration of ONP use was measured using a combined index [duration (months) × frequency (pouches/day)]. Ordinal logistic regression was used to evaluate the association between duration of ONP use and severity of oral mucosal lesions, adjusting for age, smoking status, and pouch placement behavior. RESULTS: In adjusted analyses, oral mucosal lesion severity was not significantly associated with duration of ONP use (AOR=1.001; 95% CI: 1.000-1.002, p=0.161), age (AOR=0.77; 95% CI 0.21-2.87, p=0.697), or smoking status (AOR=0.68; 95% CI: 0.20-2.25, p=0.523). CONCLUSIONS: Oral mucosal lesion severity was not associated with the duration or frequency of ONP use. Future research should focus on examining the long-term effects of nicotine pouch use on oral health to better understand and mitigate health risks.