Smoking & Oral Health

Happening Issue 82 Jul, 2010

Can I protect my mouth if I smoke?
No. Nonetheless, there are two things that a smoker can do to keep his oral health in a better shape.

  • Go for a regular half yearly check-up with a dentist.
  • Give up smoking. If smoking is stopped in time it is often possible to maintain a healthy mouth and keep the teeth for a lifetime. The chance of getting oral cancer is halved in 3-5 years after you quit smoking, and the risk decreases gradually with time.

Does smoking affect the teeth, gums or mouth?
Yes. Most people are aware that smoking poses a problem to general health. It contributes to heart disease, stroke, and to a third of all cancer deaths, to name just a few. In 1992, an estimate linked almost five thousand deaths in Victoria to smoking.
What is less known is the effect smoking has in the mouth The main damage is to the gums and mucosa, or lining of the mouth. The likelihood of smokers developing oral cancer as against the non-smokers is substantially higher (about five times more). Smokers invariably suffer some gum or, periodontal disease. Other than staining, smoking does not affect the teeth. However, it also has a profound effect on the saliva. It promotes the formation of the thicker ‘mucous’ form of saliva at the expense of the thinner watery ‘serous’ saliva reducing its acid-buffering capacity. This effect of nicotine explains why some heavy smokers get decay even if they are brushing well

Does smoking always lead to gum disease?
No, but it does increase the chance of getting it by about six times and increases the severity by the same factor. However, it can hide the signs of periodontal disease which can take years to progress. The condition can be very advanced before a person actually notices the damage. Gum disease is normally coupled with plaque and calculus that collects at the base of the tooth, which leads to bacteria infecting the gums. Smoking reduces the body’s ability to combat this condition.

Slight infections around the edges of the gums are common and easily treated, but smoking allows the condition to progress more deeply and seriously. Plaque and tobacco are a dangerous combination. X-rays of the teeth of even young smokers usually show bone support shrinking away from the tooth roots. Flossing and careful brushing tends to slow down the deterioration, but smokers often have reduced sensation in their mouths and it is difficult to detect and remove all the plaque in the gum margins.

Does smoking lead to oral cancer?
Yes, smoking is a major cause of cancers in the mouth. It is the single biggest risk factor. Even if there is no cancer, dentists can often detect changes in the lining of the mouths of young smokers. As the changes become pronounced, they predispose to cancer. The mucosa becomes hard and white and develops corrugations. Such areas should be observed routinely and are one more reason why people should have regular dental check-ups. Detecting and treating precancerous lesions and early cancers is vital in improving survival rates.

Does smoking stain the teeth?
Yes. Tobacco staining on the teeth is often superficial in the first few years of smoking and dentists usually readily remove it. Unfortunately, as the years pass, the staining tends to spread into microscopic cracks in the enamel (the outer layer of teeth) and this is far more difficult to remove. Teeth can become permanently stained.

How will a smoker know if their gums are being damaged?
Attend your dentist for regular checkups because a major problem of smoking is that the damages are not apparent until it is pretty late. At a glance the gums of smokers look as if they are healthy. Usually infected gums are red, puffy and bleed easily when brushed. Smokers’ gums, however, are pale and thin and do not bleed readily. The appearance, however, is very deceptive.

The nicotine in tobacco smoke is called a vaso-constrictor—it contracts blood vessels (in a way a garden hose is twisted) reducing the blood flow to the gum and bone. The lessened blood supply does two things; it masks the signs of disease and also undermines the body’s ability to combat the infection.

In the meantime, chemicals in the smoke combined with plaque bacteria continue to damage the gums and bone. Most of the deterioration is deep and out of sight. Unfortunately, there are only a few early warning signs.

Advanced Dental Care
Lazimpath, Kathmandu (opp. palace)
Tel: 443.3800, Email: