how does smoking impact your teeth?

Thursday 31st May 2018 is World No Tobacco Day, raising awareness of the health problems smoking can cause and the benefits of giving up.

You're probably aware that smoking can increase your risk of developing lung cancer, heart disease and other serious diseases, but you might not know just how much it can affect your oral health too.

As well as the noticeable effects like bad breath and staining your teeth, tobacco use is a risk factor for a number of dental diseases. It can also affect your recovery and healing times following a dental procedure. [1]

Why does smoking affect your oral health?

The mouth is the first part of the body that's exposed to smoke and tobacco during smoking, so naturally that’s where you might first notice smoking leaving its mark. Tobacco can stain teeth, causing them to turn yellow over time, while smoke breathed into the lungs can scent your breath for up to several hours afterwards. As smoking can also diminish the sense of smell, many smokers don't realise how their breath smells.

More seriously, frequent smoking can also damage the hard and soft tissues in your mouth over time, such as the gums and ligaments that support your teeth. This can cause the teeth to loosen and make it easier for plaque to spread, increasing your risk of conditions such tooth decay and gum disease. Smoking is also the leading risk factor for oral cancer, which can develop in and around the mouth.[2]

What oral health problems can affect smokers?

Smoking can increase your risk of some dental diseases, even if you only smoke a few cigarettes a day. For heavy smokers, the risk can be considerably higher. These diseases include:

Gum disease

Plaque that reaches the gum line of your teeth can cause gingivitis (commonly known as gum disease) ,an irritation of the gums that can cause them to appear red or swollen. Irritated gums may also bleed when brushed, though this is less likely in smokers, as smoking restricts the blood supply to the gums.

Smoking can interfere with gum disease treatment and accelerate its progress into periodontitis, which can lead to tooth loss. Smoking is believed to be the primary cause of around one third of moderate-to-severe periodontitis in Australia. [3]

Oral cancer

Oral cancer can develop in many parts of the mouth, including the cheeks, lips, palate and tongue. Early diagnosis greatly improves the chances of successful treatment, which is why you should get an oral cancer screening at your dentist if you haven’t been checked for this recently.

Smoking is the number one risk factor for oral cancer, with around 75 percent of people who develop mouth cancers being smokers. Smoking 40 cigarettes a day makes you 35 times more likely to develop the disease compared to a non-smoker. If you quit smoking, your risk returns to that of a non-smoker within 10 years. [1]

Tooth decay

If plaque is allowed to build up on your teeth, this can erode their hard enamel surface over time. This can lead to cavities and toothache, as well as infection if bacteria reaches the soft interior. Smokers are more likely to have tooth decay than non-smokers, which can lead to gum disease if plaque reaches the gum line. [4]

Tooth loss

With tooth decay and gum disease being the main causes of tooth loss, and smoking increasing your risk
of both, it shouldn't be a surprise to learn that smokers are more likely to have missing teeth. According to the Sax Institute's 45 and Up Study of New South Wales residents, smokers are 2.5 times more likely to have no teeth remaining compared to people who have never smoked.[5]

Tooth stains

Beyond oral health, smoking can also have an aesthetic impact on your teeth. Frequent smoking can deposit nicotine and tar on the teeth, which can be difficult to remove through brushing alone, though teeth whitening treatments may be successful in some cases.

Dental complications

If you have a dental treatment to address an oral health problem, smoking can affect your recovery and the success of the treatment. Studies have found that smoking can double the risk of a dental implant failing. [6]

How you can protect your teeth

Giving up smoking is one of the single biggest improvements you could make to your oral health, not to mention the other health benefits.

However, if you still want to smoke, or you're finding it difficult to give up, there are ways you could reduce its effects, such as:

  • Smoking fewer cigarettes every day
  • Drinking plenty of water throughout the day
  • Drinking less alcohol
  • Following good oral hygiene by brushing your teeth twice a day and flossing daily
  • Visiting your dentist every six months for your regular check-up, or as your dentist recommends.

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References

[1] Better Health Channel. Smoking and oral health [Online] 2013 [Updated March 2017, accessed April 2018] Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/smoking-and-oral-health

[2] Tobacco In Australia. Dental diseases [Online] 2013 [Updated March 2015, accessed April 2018] Available from: http://www.tobaccoinaustralia.org.au/chapter-3-health-effects/3-11-dental-diseases

[3]
Do LG, Slade GD, Roberts-Thomson KF and Sanders AE. Smoking-attributable periodontal disease in the Australian adult population. Journal of Clinical Periodontology 2008;35(5):398-404. Available from: http://dx.doi.org/10.1111/j.1600-051X.2008.01223.x

[4] US Department of Health and Human Services. The health consequences of smoking-50 years of progress. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Available from: http://www.surgeongeneral.gov/library/reports/50-years-of-progress

[5] Arora M, Schwarz E, Sivaneswaran S and Banks E. Cigarette smoking and tooth loss in a cohort of older Australians: the 45 and up study. Journal of the American Dental Association 2010;141(10):1242–9.Available from: http://jada.ada.org/cgi/content/full/141/10/1242

[6] Anner R, Grossmann Y, Anner Y and Levin L. Smoking, diabetes mellitus, periodontitis, and supportive periodontal treatment as factors associated with dental implant survival: a long -term retrospective evaluation of patients followed for up to 10 years. Implant Dentistry 2010;19(1):57–64. Available from:
http://journals.lww.com/implantdent/pages/articleviewer.aspx?year=2010&issue=02000&article=00009&type=abstract