Nicotinic Stomatitis
(Nicotine Stomatitis, Smoker's Palate, Smoker's Keratosis, Smoker's
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

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)


European Association of Oral Medicine

IARC Screening Group

Useful Articles:

J Can Dent Association 2000.  Tobacco-Associated Lesions of the Oral Cavity: Part I. Non-Malignant Lesions