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There are several conditions that we need to consider and rule out when diagnosing specific oral abnormalities commonly associated with smokeless tobacco use: Smokeless Tobacco Keratosis: Frictional keratosis Leukoplakia Squamous cell carcinoma Leukoplakia: Leukoedema Linea alba Morsicatio buccarum/linguarum Squamous cell carcinoma Erythroplakia: Mucositis Candidiasis Psoriasis Vascular lesions Squamous cell carcinoma Verrucous Carcinoma: Proliferative verrucous leukoplakia Verruca vulgaris Squamous papilloma Squamous Cell Carcinoma: Erythroleukoplakia Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) Oral manifestation of deep fungal infection What to expect with Pathologic Manifestations of Smokeless Tobacco The outlook for smokeless tobacco keratosis, a condition often found in people who use chewing tobacco, is generally good but depends largely on the patient

Similar to the smoked tobacco section, picture cards for chewing tobacco were developed during qualitative studies of tobacco use in rural Cambodia, and their use on a survey was validated by comparison with salivary cotinine tests 20

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The more often it happens, the worse it gets

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