Evidence map›Paper›PMID 41877126›Full record

Trial reportBMC oral health2026

Single-use and six-week effects of a non-tobacco nicotine pouch on dental plaque characteristics: a randomized crossover study with observational follow-up.

Sara Alizadehgharib, Anna Lehrkinder, Ali Alshabeeb, Peter Lingström

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Sara AlizadehgharibDepartment of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. sara.alizadehgharib@gu.se.ORCID 0000-0003-1587-9508
Anna LehrkinderDepartment of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0002-5915-734X
Ali AlshabeebDepartment of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0001-7851-9396
Peter LingströmDepartment of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0002-0798-8520

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study measures the short- and long-term acidogenicity in dental biofilms of tobacco-based snus users who switch to nicotine pouches (ZYN® Dry) for delivering nicotine. ZYN Dry contains microcrystalline cellulose (MCC) and maltitol rather than grounded tobacco leaves. Although MCC and maltitol are not typically associated with changes in biofilm acidogenicity, prolonged exposure (30–60 min) may cause vulnerability and increase the caries risk.

methodsThis study consists of two parts. Part A was an open-label, randomized, four-way crossover study involving single-dose administration in 18 participants. It tested flavored and unflavored ZYN products as well as 10% sucrose and 10% xylitol rinses as controls. The pouch was placed in the vestibule for 60 min, while the control mouth rinses were performed for one minute each. Part B was an open-label, observational, and follow-up study which lasted for six weeks and included 56 participants. Exposure to 10% sucrose was tested at baseline (week 0) and after 2, 4, and 6 weeks of ZYN use. Dental plaque acidogenicity was measured on two approximal surfaces in the upper jaw at baseline and up to 60 min after administration using the microtouch method. Areas under the curve for pH 7.5 were calculated (AUC7.5). Six tooth surfaces were used to score the amount of plaque (0–3). Ethical approval and informed consent were obtained.

resultsAfter single-dose administration (Part A), AUC7.5 for dental plaque acidogenicity was significantly less pronounced for the ZYN products and xylitol compared to sucrose. There were no statistical differences between the flavored and unflavored ZYN products. Ad libitum administration of ZYN (Part B) resulted in a significant reduction in the AUC7.5 for plaque acidogenicity compared to baseline. No statistically significant changes in plaque amount were observed during the six-week study.

conclusionsIn healthy tobacco-based snus users, dental plaque acidogenicity decreased following ad libitum use of ZYN nicotine pouches, suggesting a reduced acidogenic response under the conditions of this study.

trial registrationThis clinical trial was retrospectively registered at: https://www.isrctn.com/ (ISRCTN16087707).

Indexed as

Dental PlaqueNicotineTobacco, SmokelessTobacco Use Cessation DevicesBiofilmsCelluloseCross-Over StudiesFollow-Up StudiesHumansHydrogen-Ion ConcentrationMaltoseMouthwashesSucroseSugar AlcoholsSweetening AgentsXylitolCellulosemaltitolMaltoseMouthwashesNicotineSucroseSugar AlcoholsSweetening AgentsXylitolAcidogenicityCaries preventionDental plaqueNicotine pouch

Identifiers

PMID41877126
PMCPMC13064286

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.