Nicotine Stomatitis (Smoker's Palate) Clinical Presentation

Updated: Feb 15, 2022
  • Author: James E Cade, DDS, FACD; Chief Editor: Jeff Burgess, DDS, MSD  more...
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Presentation

Physical Examination

Lesions of nicotine stomatitis are exclusively found on the palatal mucosa. They have a white cobblestone appearance, often with a red dot in the center of the cobblestone. The nicotine stomatitis lesion cannot be wiped off and can have some fissuring. Nicotine stomatitis is primarily limited to the posterior hard palate and less often to the adjacent soft palate.

(See the images below.)

Fissured appearance of nicotine stomatitis. Notice Fissured appearance of nicotine stomatitis. Notice the gingival-palatal areas where a partial denture protects the mucosa from the heat and smoke.
Nicotine stomatitis in a reverse smoker. Notice th Nicotine stomatitis in a reverse smoker. Notice the increased hyperkeratosis, hyperplasia, and swelling of minor salivary glands.