Approach Considerations
The only definitive treatment for nicotinic stomatitis is smoking cessation. Myung et al reported from a meta-analysis of randomized controlled trials that sufficient clinical evidence exists to support the use of computer- and Internet-based smoking cessation programs in adults who smoke. [17]
If any of the smoking-cessation medications appear to be effective, continue medications in conjunction with support groups. The most effective long-term smoking-cessation results are observed in patients who are members of support groups.
Consultations
If a patient is interested in stopping the tobacco habit, a referral to a comprehensive smoking-cessation program is indicated. This program should include peer-group sessions. [18, 19]
Prevention
To prevent nicotinic stomatitis lesions and other more serious tobacco-induced lesions in the oral cavity, counsel patients on the dangers of tobacco use. Once they understand the need to stop using tobacco products, make a referral to a comprehensive tobacco-cessation program.
Long-Term Monitoring
Monitor patients with nicotine stomatitis. If after smoking cessation the lesion does not resolve, further investigation is warranted.
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Classic nicotine stomatitis. Note the speckled white and red appearance from the hyperkeratosis and minor salivary gland openings.
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Fissured appearance of nicotine stomatitis. Notice the gingival-palatal areas where a partial denture protects the mucosa from the heat and smoke.
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Nicotine stomatitis in a reverse smoker. Notice the increased hyperkeratosis, hyperplasia, and swelling of minor salivary glands.
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Inflamed salivary gland ducts in nicotine stomatitis.
