PATHOLOGICAL CHANGES OF THE ORAL MUCOSA CAUSED BY THE USE OF SMOKELESS TOBACCO PRODUCT: A CASE REPORT.

Introduction: "Velo" is a product that belongs to a new type of tobacco originating from Scandinavian countries. According to the law of the Republic of Croatia, it is a smokeless tobacco product. Usage of this product has been increasing in recent years. The product is intended to be used orally in the form of a pad placed in the upper maxillary vestibule area. Case report: A twenty-two-year-old male, self-initiated, arrives at the Department of oral medicine at the University Hospital of Split due to a change in the area of the maxillary vestibule. Anamnestically, the patient denies the existence of any other systemic disease, drug allergy, or allergies to xylitol, cellulose and sodium alginate. He states that he is a former tobacco smoker who only uses oral smokeless tobacco products ("Velo"). The patient noticed changes in the form of a textural shift in oral mucosa after using several packages of oral smokeless tobacco product. He also emphasizes that mentioned changes gradually started to cover more significant areas of his oral mucosa as well as his personal feeling of pain while brushing his teeth. Executed clinical examination of the patient's maxillary vestibule region has shown non-symmetric hyperkeratotic plaques with an erythematous surface. The patient confirms that the area where changes in his oral mucosa are located matches the most frequent part of his "Velo" patches application. The toluidine test was negative, and the patient was advised to stop using the product immediately. At the control examination in 14 days, in which he didn't use an oral smokeless tobacco product, the patient's oral mucosa changes regressed spontaneously. Conclusion: In this case, it can be concluded that the usage of an oral smokeless tobacco product ("Velo"), which is packaged in the form of oral pads, caused hyperkeratotic and erythematous lesions of the oral mucosa. By ending consumption of this product for two weeks, spontaneous lesion regression has occurred. By reviewing several published scientific papers regarding the same issue, we conclude that the long period of usage of smokeless tobacco products could potentially be associated with the appearance of potentially malignant lesions on the oral mucosa. Therefore, we consider that every healthcare worker must point out the harmful health effects of smokeless tobacco products on patients' oral mucosa, as they are not printed on the product packaging. [ABSTRACT FROM AUTHOR]