Nicotinic Stomatitis
(Nicotine Stomatitis, Smoker's
Palate, Smoker's Keratosis,
Smoker's Patch)
What is Nicotinic Stomatitis?

Nicotinic Stomatitis (Smoker's Palate) is a lesion of the roof
of the mouth.  The concentrated heat stream of smoke from
tobacco products causes
Nicotinic Stomatitis.  These
changes are observed most often in pipe and reverse
cigarette smokers and less often in cigarette and cigar
smokers.  Generally, it is asymptomatic or mildly irritating.  
Patients typically report that they are either unaware of the
lesion or have had it for many years without changes.

What are the Signs & Symptoms of Nicotine Stomatitis?

Nicotinic Stomatitis first becomes visible as a reddened
area and slowly progresses to a white, thickened, and
fissured appearance.  The roof of the mouth has numerous
minor salivary glands.  They become swollen, and the
orifices become prominent, giving the tissue a speckled
white and red appearance.  It cannot be wiped off and can
have some fissuring.  Patients usually are asymptomatic.
Photos of Smokers' Keratosis
Close-up of Smokers' Keratosis
What are the causes of Nicotinic Stomatitis?

Nicotinic Stomatitis is been associated with pipe, cigarette,
and cigar smoking, and, rarely, with chronic ingestion of
high-temperature liquids.  The mechanism of action is heat
irritation from a tobacco product that acts as a local irritant,
stimulating a reactive process.  In patients who wear them,
dentures often protect the palate from these irritants.

How is it treated?

Nicotinic Stomatitis generally is a reversible lesion once the
irritant (that is, smoking) is removed.

The prognosis is excellent.

Useful Websites:

New Zealand Dermatological Society

Bond's Book of Oral Diseases (4th Edition) / The
Maxillofacial Center for Diagnostics & Research

Emedicine.com (Dermatology)

Useful Articles:

J Can Dent Association.  Tobacco-Associated Lesions of the
Oral Cavity: Part I. Non-Malignant Lesions
Last Updated 24th November 2010