Nicotine Stomatitis Workup

Updated: Aug 10, 2018
  • Author: James E Cade, DDS, FACD; Chief Editor: Jeff Burgess, DDS, MSD  more...
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If unable to make the diagnosis of nicotinic stomatitis by clinical appearance or if the lesion does not resolve after cessation of smoking, perform a 5-mm punch biopsy or scalpel biopsy. A biopsy is also indicated in a patient with a symptomatic lesion, even if it appears consistent with a benign smoker’s palate, or if the patient reports that he or she is a reverse smoker.


Histologic Findings

Histologically, nicotinic stomatitis lesions appear acanthotic and hyperkeratotic, with some mild-to-moderate chronic inflammation. The epithelium of the minor salivary ducts often shows squamous metaplasia.