Ye Dongxia, Rahman Irfan
Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA.
Int J Dent. 2023 Feb 10;2023:9437475. doi: 10.1155/2023/9437475. eCollection 2023.
Oral nicotine pouches are emerging as a new "modern oral" nicotine product. These prefilled pouches contain nicotine, flavorings, and filling agents that dissolve in the mouth. Nicotine can be derived from tobacco leaf or chemical synthesis. Traces of TSNAs and toxic chromium were detected in the pouch products. This raises the concern about general and periodontal health. This review aims to update the current oral nicotine products research relating to periodontal disease and its relevance in periodontal inflammation. Nicotine interacts with host cells and affects inflammatory responses to microbial challenges. It may directly or indirectly deteriorate periodontal tissues by activating nicotinic acetylcholine receptors, repressing PDL fibroblasts cells, increasing cellular ROS and cytokines/chemokines, growth factors, breaking microbiota balance, and dysregulating miRNAs expression. Studies show that appealing flavorings contained in nicotine pouches pose harm to periodontal innate immune responses and increase penetration of nitrosamines. In addition, flavored ONPs increase the risk of dual or poly-tobacco products among young adults, stacking up detrimental effects on the periodontium. Given the recent growth of users, further studies are needed to elucidate the impact of ONPs, even poly-tobacco use, on systemic and periodontal health. Moreover, policymakers should ensure to avoid generating a new wave of nicotine addiction among youths in the U.S.
口腔尼古丁袋正在成为一种新型的“现代口腔”尼古丁产品。这些预填充袋含有溶解于口腔中的尼古丁、调味剂和填充剂。尼古丁可来源于烟叶或化学合成。在袋状产品中检测到痕量的烟草特有亚硝胺和有毒铬。这引发了对全身健康和牙周健康的担忧。本综述旨在更新当前与牙周病相关的口腔尼古丁产品研究及其在牙周炎症中的相关性。尼古丁与宿主细胞相互作用并影响对微生物挑战的炎症反应。它可能通过激活烟碱型乙酰胆碱受体、抑制牙周膜成纤维细胞、增加细胞活性氧和细胞因子/趋化因子、生长因子、破坏微生物群平衡以及失调微小RNA表达，直接或间接损害牙周组织。研究表明，尼古丁袋中含有的诱人调味剂对牙周固有免疫反应有害，并增加亚硝胺的渗透。此外，有调味剂的口腔尼古丁产品增加了年轻人使用双重或多种烟草制品的风险，叠加了对牙周组织的有害影响。鉴于近期使用者的增加，需要进一步研究以阐明口腔尼古丁产品甚至多种烟草使用对全身健康和牙周健康的影响。此外，政策制定者应确保避免在美国年轻人中引发新一轮尼古丁成瘾。
