Nicotine Stomatitis

Nicotine Stomatitis is sn uncommon condition caused by smoking tobacco and manifesting as leukoplakia of the hard palate with raised red dots signifying the openings of minor salivary gland ducts; smoking cessation results in improvement of nicotine stomatitis. This condition is caused by smoking pipes, cigars, and cigarettes directed toward the mucosa of the hard palate that produces this lesion.

The clinical features of this condition are unique. The hard palate takes on a gray to white color depending on the amount of smoke directed toward it. Scattered raised areas with red centers complete the clinical picture. The raised areas are clumps of minor salivary glands and the central red dots are the openings of their ducts. It is because ducts are lined with nonkeratinizing epithelium that they appear red.

Cessation of smoking will cure nicotine stomatitis, attempts should be made to eliminate tobacco use. If that is successful, the lesion will subside. If not, incisional biopsies are needed to rule out the presence of dysplasia and anaplasia. As stated earlier, SCC of the hard palate is uncommon; therefore, it is unlikely that the lesion will progress to invasive SCC. It needs to be remembered however that while the palatal effects of smoking may not be serious, the habit may cause mucosal dysplasia or carcinoma-in-situ elsewhere.