This case report explores the oral effects of nicotine pouch use, focusing on two patients with mucosal changes. Findings include gingival inflammation, white lesions, and gingival retraction. Evidence suggests a link between nicotine pouches and periodontal damage. Though considered less harmful than smoking, their discreet use may lead to intense usage. Clinicians should remain vigilant for early signs of harm and inform patients about potential risks. Further research is needed to clarify long-term health effects.