Emerging Oral Nicotine Products and Periodontal Diseases.

Introduction:
This article reviews the potential impacts of oral nicotine pouches (ONPs) on periodontal health. as an emerging product, there are concerns about the potential harm ONPs may cause to periodontal health, especially among adolescents and young adults. Therefore, further studies are warranted to assess how ONPs use affects systemic and periodontal health, identify new biomarkers, explore new anti-inflammatory agents, and ensure that regulatory policymakers avoid generating a new wave of nicotine addiction among youths in the U.S.

Key Points:

* ONPs are preportioned pouches similar to Snus, with a difference from Snus in that there is no leaf tobacco in them.
* Nicotine in ONPs is derived from tobacco leaf or chemical synthesis, and traces of toxic TSNas, metal, and formaldehyde were detected in some nicotine pouch products.
* The primary toxic component of nicotine pouches is nicotine, which interacts with host cells and affects inflammatory responses to microbial challenges.
* Nicotine exposure significantly activated nicotinic acetylcholine receptor (naChR) expression, repressed periodontal ligament (PDL) fbroblasts cells, increased cellular ROS, and induced DNa fragmentation and cell death.
* Nicotine enhances the production of IL-1β and IL-8, IL-6, IL-10, and IFN-c, PGE2, and decreases MMP2.
* Nicotine attenuates alveolar bone regeneration by increasing the number of osteoclasts in periodontal tissues and upregulated expression of NF-κB ligand.
* Flavored nicotine products could induce microbial dysbiosis in the oral cavity and periodontium, inhibit local innate immune responses, and cause the pathogenesis of periodontitis.
* The study found increased risk of dual and poly tobacco product use is associated with favored tobacco.

Main Message:
In summary, emerging oral nicotine pouches pose significant health risks, especially for adolescents and young adults. Further studies are necessary to assess how ONPs use affects systemic and periodontal health, identify new biomarkers, explore new anti-inflammatory agents, and ensure that regulatory policymakers avoid generating a new wave of nicotine addiction among youths in the U.S. The study highlights the potential risks associated with ONPs use, including nicotine exposure, microbial dysbiosis, and inflammation, which could lead to periodontal disease and other systemic health issues. Therefore, it is crucial to regulate ONPs use and ensure that the public is aware of the potential risks associated with their use.

Ye, D., & Rahman, I. (2023). Emerging Oral Nicotine Products and Periodontal Diseases. International Journal of Dentistry, 2023, 9437475–9437475. https://doi.org/10.1155/2023/9437475