Tobacco-associated keratosis, also known as smokeless tobacco keratosis, is an oral condition that is associated with the use of smokeless tobacco, like chewing tobacco or snuff. Here are four things that you need to know about this condition.

What are the signs of tobacco-associated keratosis?

The main sign of tobacco-associated keratosis is the development of lesions on the oral soft tissues. These lesions form on the tissues that frequently come into contact with your smokeless tobacco, like the insides of your cheeks or the insides of your lips. Other nearby tissue, like your gums, can also be affected by your tobacco use.

At first, these lesions tend to be white, thickened areas of tissue with ill-defined borders. Later, the lesions will become grayer and take on a bumpy texture. If you notice suspicious lesions inside your mouth, you need to bring them to your dentist's attention right away.

How does tobacco cause it?

Tobacco causes this condition due to the many dangerous chemicals that it contains. Tobacco contains a wide variety of irritants, toxins, and carcinogens, and when these chemicals are in frequent contact with your oral tissues, the cells are damaged. This damage can manifest as oral lesions such as tobacco-associated keratosis.

Is this condition cancerous?

Tobacco-associated keratosis is not cancerous, although the lesion may become cancerous at some point in the future. Fortunately, the lesion is typically reversible, and malignant transformation is infrequent. However, due to the risk of malignant transformation, you need to take the lesions seriously and seek general dentistry care for them.

How is it treated?

The main treatment for this condition is abstaining from tobacco. Your dentist will tell you to stop using chewing tobacco or snuff, and may be able to recommend quitting aids such as nicotine gum or nontobacco snuff products. As long as you are able to abstain from tobacco, your lesion should go away quickly. Within six weeks of quitting, 97% of these lesions go away by themselves.

If your lesions are still present after six weeks, your dentist may want to take a biopsy of the tissue to make sure that it is not cancerous. Your dentist will remove a small portion of the lesion with a scalpel, and then send it to a laboratory to be analyzed. If no cancer is found, no treatment is needed, but if cancer is present, you will be referred to an oncologist.

If you notice white, thick lesions inside your mouth, you may have tobacco-associated keratosis and should see your dentist right away.