Snus and gums: snus lip, gum damage and recovery

Dental studies link regular snus use to changes on the gums at the spot where the pouch sits. The findings include gum recession, gum inflammation, white or red changes in the mucosa and stained teeth. Changes of the mucosa can go back after a person stops (Larsson et al., 1991). For receded gums, the studies cited here report no regrowth. This guide explains what research says about snus and the gums, the so-called snus lip and the chances of recovery. The sources are listed at the end.

Here, "snus" means two product types: classic snus with tobacco and tobacco-free nicotine pouches, which many people call white snus. If you want the basics first, read what snus is. The studies cover both types, and the results differ in some points.

What snus does to the oral mucosa

What does snus do to the gums? The pouch lies on the same spot of gum and lip for a long time. Snus is buffered to an alkaline pH so that nicotine passes through the oral mucosa more easily (Benowitz et al., 2009; BfR, 2022).

A systematic review from 2026 evaluated 26 studies on Swedish snus and the mouth. The authors name the mechanical pressure of the pouch and a toxic action on cells as factors that contribute to gum recession (Bankvall and Jontell, 2026). Tobacco-free pouches also irritate the mucosa. In a study by the German Federal Institute for Risk Assessment (BfR) and LMU Munich, all tested pouches caused irritation of the oral mucosa, including a pouch without nicotine. The pouch with 30 mg nicotine caused the most pronounced irritation (BfR, 2022).

Snus causing sore gums: the typical symptoms

A Swedish study from 2026 counted the changes at the contact point. Dentists at nine clinics in Stockholm examined 272 young adults aged 18 to 30: 126 users of nicotine pouches, 63 users of tobacco pouches and 83 non-users (Daneshian et al., 2026). They looked for these findings:

• Redness of the mucosa (erythema)
• Swelling (oedema)
• Open sore spots (ulceration)
• White, thickened mucosa (hyperkeratosis)
• Gum recession and bone defects

The dentists found oral lesions in 79% of nicotine pouch users and in 89% of tobacco pouch users. Nicotine pouch users had redness more often and reported more symptoms in the mouth. White, thickened mucosa was more typical for tobacco pouches.

Snus lip: the indentation inside the lip

Snus lip is the common name for the visible change on the inside of the lip at the spot where the pouch usually sits. Users describe a groove or dent, thin or wrinkled tissue and a white or grey colour. Some say that the lip feels sore or looks swollen from inside. Others describe a "broken" lip or small holes at the spot. The section on gum damage below explains what such holes can be.

A study from Germany shows what such a spot can look like under the microscope. Doctors in Munich and Ulm examined 50 patients with mucosal changes linked to regular snus use (Greber et al., 2026). The changes were white, firm and had a wrinkled surface. Biopsies of the most severe cases showed inflammatory cells, a thickened and keratinised surface layer and scar-like tissue in the deeper layer (submucosal fibrosis). The authors compare this pattern to oral submucous fibrosis from betel nut use. Doctors count that condition among the oral disorders that can turn into cancer in some cases.The authors therefore ask for careful clinical monitoring of people with these changes.

Changes of this kind are therefore more than a cosmetic issue. Only an examination can show what a change at the contact point really is.

Snus gum damage: recession and holes in the gums

Gum recession means that the gum line moves back and more of the tooth neck becomes visible. The 2026 review found an association between snus and gum recession, particularly in users of loose snus (Bankvall and Jontell, 2026). The Munich study also recorded gum recession in its patients (Greber et al., 2026).

The review also found gum inflammation (gingivitis) more often in snus users. This result remained after the researchers controlled for plaque. For periodontitis, the deeper disease of the tooth support, the review found no significant association.

Many people search for a "hole in the gums" after snus. This can be a local spot where the gum has moved back at the contact point, so that a notch forms. It can also be an open sore, which can appear on the gums and on the inside of the lip. The Stockholm study examined exactly these findings: ulceration, bone defects and gum recession (Daneshian et al., 2026). A dentist can tell which one it is.

Snus and teeth: staining and cavities

Staining is one of the visible dental changes. The Munich study recorded tooth discolouration in snus users, together with gum recession and erosions (Greber et al., 2026).

For cavities, the evidence is mixed. Some studies in the 2026 review found higher caries values in snus users, others found no connection (Bankvall and Jontell, 2026). The Stockholm study found no increased risk of caries or periodontal disease in young adults with up to six years of use (Daneshian et al., 2026). That result only covers a young group and a short period.

The review also links snus to tooth wear. Snus users also reported more problems with the jaw joint (temporomandibular disorder).

Nicotine pouches and the gums

Tobacco-free does not mean that the mouth shows no reaction. If you want to know how these products are made up, read what nicotine pouches are. The Stockholm study found oral lesions in most nicotine pouch users (see the numbers above). The authors conclude that nicotine pouches appear to cause broader reactions in the mucosa than tobacco snus (Daneshian et al., 2026). Pouches with mint flavour showed a trend to more pronounced lesions. This trend was not statistically significant.

The data have clear limits. The BfR describes nicotine pouches as new products. The BfR states that the long-term consequences of nicotine pouch use cannot be assessed because only few data exist (BfR, 2022). The Stockholm authors also call for more research on local and systemic consequences.

Can gums recover after snus?

Changes in the mucosa can go back. A Swedish follow-up study examined 29 users of loose snus with marked mucosal changes and repeated the examination after 3 to 6 months (Larsson et al., 1991). Twenty of them had stopped using snus or had changed their habit (portion snus at a different spot). All 20 showed normal mucosa at the old biopsy site, both in the clinical examination and under the microscope. Seven people who switched to portions and used less snus showed smaller changes than before. The authors conclude that these tissue changes are reversible after the habit stops.

Receded gums behave differently. None of the studies cited here reports that gum tissue grows back by itself after recession. The same is true for the scar-like tissue from the Munich study. If you see that your gum line has moved back, ask a dentist about the situation and the options.

When to see a dentist

Some changes need a professional examination. See a dentist if you notice one of these signs:

• A white or red patch that you cannot wipe away and that does not go away
• A spot that feels hard or has a wrinkled surface
• An open sore that does not close
• A gum line that visibly moves back, or teeth that look longer
• Gums that bleed often

Tell your dentist that you use snus or nicotine pouches. The dentist can then examine the contact point in a targeted way and compare it at later visits. A different question is what happens if you have swallowed a snus pouch. A separate guide covers that topic.

Sources

• Bankvall M, Jontell M. Swedish smokeless tobacco and its impact on oral health: a systematic review. Acta Odontologica Scandinavica. 2026;85:84-95. doi:10.2340/aos.v85.45421
• Daneshian M, Fredriksson L, Skott P, Garming Legert K. Oral lesions and dental status in individuals using oral tobacco-free nicotine pouches. Oral Diseases. 2026. doi:10.1111/odi.70409
• Greber L, Otto S, Poxleitner P, René T, Ihrler S. Clinical and histopathological manifestations of snus use in Germany: parallels to betel nut-related oral submucous fibrosis in Asia. Virchows Archiv. 2026;488(4):879-885. doi:10.1007/s00428-026-04414-4
• Larsson A, Axéll T, Andersson G. Reversibility of snuff dippers' lesion in Swedish moist snuff users: a clinical and histologic follow-up study. Journal of Oral Pathology and Medicine. 1991;20(6):258-264. doi:10.1111/j.1600-0714.1991.tb00924.x
• Benowitz NL, Hukkanen J, Jacob P. Nicotine chemistry, metabolism, kinetics and biomarkers. Handbook of Experimental Pharmacology. 2009;(192):29-60. doi:10.1007/978-3-540-69248-5_2
• Bundesinstitut für Risikobewertung (BfR). Gesundheitliche Bewertung von Nikotinbeuteln (Nikotinpouches). Aktualisierte Stellungnahme Nr. 023/2022, 7 October 2022. doi:10.17590/20211221-131258. PDF

For adults 18+ only. Nicotine is an addictive substance. We sell the products mentioned in our guides. Our editorial content is written independently.