Snus and your gums: what a nicotine pouch really does

Quick answer: Snus and nicotine pouches damage your gums at the spot where the pouch sits. New research from the University of Gothenburg (2026) shows that snus use causes gum recession, and receding gums do not come back. Little is yet known about the white, tobacco-free pouches, but they have not been proven safe. If you wear braces, the risk is extra high.

A pouch behind your lip, a light-headed feeling for about a quarter of an hour, and no one who sees it. To many teenagers snus feels more innocent than smoking or vaping: no smoke, no smell, no evidence. The fact that it is now banned seems to make little difference: in a large NOS survey of around 38,000 teenagers, about a quarter said they use or have used snus.

But that pouch does not sit "somewhere" in your mouth. It presses for hours on exactly one spot against your gums. And that is where it goes wrong. New Swedish research shows that the gums recede at that spot, and receding gums do not grow back. At our orthodontic practice on the Museumplein in Amsterdam we see teenagers in the chair every six to eight weeks, which means we often spot this damage first. Here you can read honestly what we know, what we do not yet know, and why the combination with braces is extra unfortunate.

Let us line up the terms, because they get mixed up in practice:

• Snus is originally a Swedish tobacco product: a pouch of moist tobacco that you place between your lip and your gums. Its sale has been banned throughout the EU (except Sweden) for years.
• Nicotine pouches ("white snus") contain no tobacco, but do contain nicotine, often more than a cigarette. This is what most young people in the Netherlands use, in flavours such as mint, watermelon or cola.

Since 1 January 2025 nicotine pouches also fall under the Dutch Tobacco Act and may no longer be sold. Yet they are still widely available via foreign web shops and social media. The ban is not there for nothing: nicotine is highly addictive, and a developing teenage brain is extra sensitive to it.

In early 2026 researchers from the University of Gothenburg published a systematic literature review in the journal Acta Odontologica Scandinavica: 26 European studies on snus and oral health. The outcome was strikingly consistent on one point: snus use is linked to gum recession (receding gums) precisely at the spot where the pouch sits.

The pouch causes a local inflammatory reaction in the gums. Over time the gums recede there and even the jawbone underneath can break down. You see it in a tooth that looks "longer", a sensitive tooth neck or a receding edge of gum, usually at the front, where the pouch sits.

The researchers also found more gum inflammation among snus users, even if they brushed their teeth just as well as non-users. To be fair: whether snus also causes more cavities did not become clear from this research. So we are not scaring you with unproven things, but for the damage to your gums the evidence is convincing.

This is the sentence to remember: gum tissue that has receded does not grow back. It is not a graze that heals. The exposed tooth neck stays exposed: more sensitive to cold and warm, more vulnerable to wear and root decay, and visible when you smile.

The only thing that can then be done is gum surgery: a periodontist moves a piece of gum (often from your palate) to the bare spot. A real operation, then, which usually only partly repairs the damage, not something you want to go through at seventeen. Stopping snus prevents worse, but reverses nothing. Prevention is literally the only good option here.

"Yes but, I use the white pouches, without tobacco. Those are less bad, right?" We get that question quite often, and the honest answer is: nobody knows. The same Swedish researchers establish that there are virtually no studies on the long-term effects of white nicotine pouches on your mouth. No evidence of harm is something very different from evidence of safety.

Two things we do know for sure. One: a white pouch too presses for hours on the same spot against your gums. Two: nicotine narrows your blood vessels, including the small vessels in your gums. The nasty part: inflamed gums then bleed less quickly, which means the problem stays invisible while it continues. And if something needs to heal, that goes more slowly.

Here comes the part that directly concerns us as orthodontists, because the group that uses snus is precisely the group sitting in our chair.

During an orthodontic treatment your gums are already under pressure anyway. Around the brackets of a fixed brace brushing is harder, which means gum inflammation lurks. And with aligners such as Invisalign your gums are covered under a tray for hours. Put a nicotine pouch on top of that, and you stack risk on risk: gums that already have to work hard get a source of inflammation and poorer blood flow added on.

Extra treacherous: because nicotine suppresses bleeding, your gums can look perfectly fine while all sorts of things are going wrong underneath. Fortunately, during your braces treatment you come by every six to eight weeks, and at every check-up we also look at your gums. We notice early recession before you feel anything of it.

• Use snus? Stop, preferably today. Stopping does not restore receding gums, but it prevents it from getting worse. If stopping does not work on your own (nicotine is highly addictive), your GP can help.
• Be honest at your check-up. You will not get a lecture from us. If we know you use snus (or have used it), we keep a targeted eye on the spot where the pouch sat.
• Check your own mouth. Does one tooth look longer than before, are your gums receding somewhere or is a tooth neck sensitive? Show it at your next appointment, or make one sooner.
• Are you a parent reading along? Banning out of panic rarely works; calm information does. Use the facts above, and know that the braces check-up is a natural moment at which this damage is spotted early.

Our practice is in the centre of Amsterdam, within walking distance of the Museumplein. We treat many teenagers and young adults, precisely the group among which snus is now circulating. What you can expect from us:

• No judgement, but honesty. If you tell us you use snus, you get facts and a plan, not a telling-off.
• Gums are part of the treatment. We look further than the position of your teeth; healthy gums are the basis of every braces result.
• Being there early. Because we see you every six to eight weeks, we signal beginning damage before it becomes irreversibly large.
• Reachable for the whole family. Easily accessible by tram, bike or car from all over Amsterdam and the surrounding area.

Unsure about your gums, or want to know whether a treatment suits you? View our treatments or plan a no-obligation consultation at our practice in central Amsterdam.

Do my gums come back if I stop using snus?

No. Receding gums do not grow back, even if you stop. Stopping does prevent the recession from progressing further. Only with gum surgery (a graft by the periodontist) can the damage sometimes be partly repaired.

Are white nicotine pouches without tobacco safer than snus?

That is unknown: there is virtually no research on the long-term effects of white pouches on your mouth. No evidence of harm is not the same as evidence of safety. The nicotine in them narrows the blood vessels in your gums anyway, and the pouch presses on the same spot.

Can I use snus while wearing braces or aligners?

Our advice is clear: do not. Your gums are already under pressure during the treatment, and a pouch adds a source of inflammation and poorer blood flow. If you do use it, tell us, then we keep an extra eye on your gums.

How do I notice myself that my gums are receding?

A tooth that seems to get "longer", a sensitive tooth neck with cold or sweet, or a gum edge that visibly recedes around one or a few teeth, often precisely at the spot where the pouch sits. If you see this, have it checked soon.

Is snus not simply less bad than smoking or vaping?

It is not that simple. For your lungs there is no smoke, that is true. But for your gums snus is demonstrably harmful at the spot where the pouch sits, and the nicotine makes you just as addicted. "Less bad than smoking" is not a safety stamp.

Want to know more or request a no-obligation consultation? Contact our practice in Amsterdam.