The practice of placing a small amount of smokeless tobacco or chewing tobacco in the oral cavity and leaving it in place for extended periods of time appears to be finding its way onto middle school, high school, and college campuses as a socially acceptable and popular habit. Numerous reports in the literature, have described the oral changes that appear to be associated with the use of smokeless tobacco in adults.The most prevalent oral manifestation of smokeless tobacco (ST) use is a white mucosal lesion at the habitual site of tobacco placement. The clinical appearance of ST-induced lesions ranges from superficial lesions of normal mucosal color with slight wrinkling to more pronounce furrowed lesions that are white to red in color with obvious mucosal thickening.