SMOKING AND ORAL HEALTH

OVERVIEW:

People who smoke have a higher risk of gum problems, tooth loss, complications after tooth removal and surgery in the mouth, and developing mouth cancer. They are more likely to get infections and don’t heal as well as non-smokers.

However, quitting smoking improves mouth cancer, reduces the risk of developing gum disease and mouth cancer, and improves the person’s response to gum treatment.

Nevertheless, it is very important for people who smoke to visit their dentist regularly to keep their teeth and gums healthy and check for signs of mouth cancer.

Nonetheless, it is also important for people who vape to visit a dentist regularly to detect and treat any oral health problems. If you vape, make sure to tell your dentist this.

How does smoking affect teeth, gums and oral health?

• Most people are now aware that smoking is bad for their health. It can cause many different medical problems and, in some cases, fatal diseases. However, many people don’t realise the damage that smoking does to their mouth, gums and teeth.
• Smoking can lead to tooth staining, gum disease, tooth loss, and in more severe cases mouth cancer.

The most common oral problems affecting people who smoke are:

• Gum disease.
• Mouth cancer.
• Whitening of the soft tissue in the mouth (called smoker’s keratosis).
• Poor healing after tooth removal (known as dry socket).
• Tooth decay.
• Tooth loss.
• Poor healing after mouth and gum surgery.
• Decreased taste.
• Bad taste in the mouth and bad breath.
• One of the effects of smoking is staining on the teeth due to the nicotine and tar in the tobacco. It can make your teeth yellow in a very short time, and heavy smokers often complain that their teeth are almost brown after years of smoking.

Smoking and gum (periodontal) disease

Gum disease (also called periodontal disease) is caused by an infection that destroys the bone surrounding and supporting your teeth. This bone holds the teeth to the jawbone to chew food.

Moreover, bacteria and food debris called dental plaque can cause gum disease.
If left on teeth and gums, plaque hardens to form calculus or tartar. The plaque and calculus irritate the gums around teeth. This is often seen in people who smoke.

Furthermore, if periodontitis is not treated, the structures that hold the tooth to the gum can become damaged. Teeth may become loose, fall out by themselves, or a dentist may have to remove them. Smoking can also lead to gum disease. People who smoke are more likely to produce bacterial plaque, which leads to gum disease. The gums are affected because smoking causes a lack of oxygen in the bloodstream, so the infected gums don’t heal. Smoking causes people to have more dental plaque and causes gum disease to get worse more quickly than in non-smokers. Gum disease is still the most common cause of tooth loss in adults.

Smoking increases gum disease risk

The risk of gum disease is higher:

• For a person who smokes less than 10 cigarettes a day, compared to someone who smokes none.
• This increases 4 to 5 times more likely for people who smoke heavily.

If you smoke the following may occur:

• Tooth loss (of some or all your natural teeth), making it difficult to chew certain foods, speak clearly or have confidence to smile if lost teeth aren’t replaced.
• Gum disease may be harder to detect. Bleeding gums – usually an indication of gum disease – may not be present as tobacco causes poor blood supply to the gums. Not respond as well to gum treatment (professional dental cleaning) as non-smokers.
• At a higher risk of developing acute necrotizing ulcerative gingivitis. This is very painful condition that causes a terrible smell and taste.

Smoking and symptoms of gum disease

If you smoke, it is important to see your dentist for regular check-ups. Symptoms of gum disease to watch for include:

• Red, swollen, tender, bleeding gums.
• Discharge (pus) coming from your gums.
• Gums that are loose and pull away from your teeth.
• A bad taste or bad breath.
• Loose teeth. This can change the feel of your bite when your teeth are placed together or make dentures fit differently.
• Spaces opening between your teeth.

Smoking and slow healing after dental treatment

Tobacco use makes it harder for the immune system to fight infections. This slows down healing after tooth removal or injuries in the mouth.

Smoking may lead to:

• Dry socket – a slow healing tooth socket after a tooth removal which is very painful.
• Increased pain after oral and gum surgery.
• Less success if you have dental implants.

Mouth cancer and smoking risk

Oral cancer is cancer of the mouth including the tongue, cheek, roof or floor of the mouth, and lips. Smoking is one of the main risk factors for mouth cancer. Most people know that smoking can cause lung and throat cancer, but many people still don’t know that it is one of the main causes of mouth cancer too. Every year thousands of people die from mouth cancer brought on by smoking.

People who smoke and drink alcohol have an even greater risk of developing mouth cancer than those who just do one or the other.

Eventually, those who have quit smoking have the same risk of developing mouth cancer as non-smokers, so it’s never too late to quit.

Mouth cancer in people who smoke is most likely to occur on the side of the tongue, the floor of the mouth and lips. It can also happen in other areas of the mouth.

Early diagnosis is important so treatment can start as early as possible before the cancer advances or spreads to other parts of the body.

Symptoms of mouth cancer

Please see your dentist or doctor immediately if you notice any:

• Persistent mouth sore that does not disappear after 7 to 10 days, particularly if the ulcer is not painful.
• White or red patch in your mouth.
• Swelling in your mouth.
• Dentures suddenly not fitting properly.

Health risks of vaping

Smoking e- cigarette (known as vaping) – may seem less harmful than smoking regular cigarettes. Yet this may not be the case for the health of your mouth.

When you vape, you inhale (also called vaping juice) which, even when labelled ‘nicotine-free’, can contain harmful substances. These include:

• Nicotine.
• Heavy metals.
• Volatile organic compounds (VOCs).
• Cancer-causing chemicals.

The risk of vaping devices causing problems in your mouth is much higher if they contain nicotine.

The long-term effects of vaping are not fully known. Yet there is some evidence that vaping can cause inflammation in the mouth, which can lead to gum disease and other oral health problems.

Temporary loss of taste may happen in some people (also called vape tongue).

Vaping may be seen as a way to quit smoking. Yet vaping may make it harder to quit smoking completely which increases the risk of diseases associated with tobacco use, such as mouth cancer.

Preventing teeth and gum problems in smokers

If you are a smoker, there are some things you can do to prevent tooth and gum problems, including:

• Try to quit smoking – speak to your doctor, dentist. Why should I give up smoking? You will have fresher smelling breath, Your appearance will improve, Your teeth will no longer be nicotine stained, In a few weeks of stopping smoking you may have a, better sense of taste and smell, Children are great imitators and may be encouraged to take up smoking because they are copying you
• If you’re finding it difficult to quit smoking, try and reduce the number of cigarettes you smoke to start off with.
• Clean your teeth and gums twice a day with fluoride toothpaste.
• Use dental floss (for small gaps) or interdental brushes (for big gaps) once a day to clean between your teeth.
• Visit your dentist every 6 to 12 months. They can provide advice about the proper care of your teeth and gums at home and find problems early. Regular visits can help to keep your teeth and gums healthy.
• Avoid having a dry mouth. Drink plenty of water and chew sugar-free gum to stimulate saliva flow. This is especially important if you take medications that cause dry mouth.
• Limit alcohol and avoid recreational drugs.
• There are special toothpastes for people who smoke. They are sometimes a little more abrasive than ordinary toothpastes and you should use them with care. Your dental team may recommend that you use these toothpastes alternately with your usual toothpaste. There are several ‘whitening’ toothpastes on the market. Although they do not affect the natural colour of your teeth, they may be effective at removing staining, and therefore may improve the overall appearance of your teeth