Mainpuri tobacco (or Mainpuri) is a traditional form of smokeless tobacco (ST) product, which is widely consumed in certain regions of India, particularly in the northern province of Uttar Pradesh. It derives its name from the Mainpuri district, where it is predominantly used. The precise prevalence of mainpuri usage in the Indian subcontinent and around the world remains unknown; however, it has been reported that in the Mainpuri district in India, every second male and every third female use this ST product. A limited number of clinical investigations have assessed the impact of mainpuri on periodontal health. Mainpuri chewing has been associated with tooth mobility and tooth loss. Alveolar bone resorption involving furcation, gingival recession (Grades III and IV), and community periodontal indices (scores III and IV) have also been linked with the Mainpuri chewing habit. From a statistical point of view, it is worth mentioning that none of these studies that assessed the impact of mainpuri on periodontal tissues were power adjusted. Therefore, their related results and especially the probability values should be interpreted with caution. To date, there are no studies that have assessed peri-implant clinical and radiographic status in mainpuri chewers. However, it is anticipated that habitual mainpuri chewing increases the risk of peri-implant soft tissue inflammation and crestal bone loss in a manner similar to periodontal disease.