Tobacco

Tobacco: The Smoking Gun Behind Dental Disease

By: Amy Regan

   

                  https://dentalstudio.sg/healthy-teeth-smoke/

We’ve all seen the public service announcements, we’ve all seen the cigarette packaging: “Smoking kills! Smoking is bad for you!” You would be hard pressed to find someone in today’s society who doesn’t agree that smoking tobacco is bad for your health, but most people don’t stop to consider how it’s bad for your health. We’ve all seen the images of yellow, nicotine stained teeth alongside the jarring photos of oral cancers on the packages of cigarettes. These are meant to deter people from smoking, but what exactly are the effects of smoking tobacco on your oral health? Whether you’re someone who smokes and is considering the road of tobacco cessation, or you’re simply curious, let’s dive into how smoking tobacco impacts your oral health.

Tobacco use leads to gum disease

Those who consume tobacco are two times more likely to develop gingivitis and periodontal disease than those who do not (Eke et al., 2012). Gingivitis is the inflammation of the gum tissue and is the body’s response to the presence of bacterial plaque (American Dental Association, n.d.).  Periodontitis is an advanced form of gum disease which can lead to bone loss and tooth loss (Mayo Clinic staff, 2020). When gingivitis is left untreated, it can progress to periodontitis which sees the destruction of bone and loss of tissue surrounding the teeth which can lead to the loss of teeth (Mayo Clinic staff, 2020). Smoking tobacco suppresses the immune system and decreases blood flow to the gum tissue, depriving the tissues of essential nutrients and oxygen required to maintain healthy tissues, while also compromising the ability to defend against oral diseases (CDHO, n.d.). The increased plaque and calculus caused by the chemicals created from smoking tobacco acts as a contributing factor to gingivitis and periodontitis (“Smoking and Oral Health”, 2019).  

Tooth Discolouration and Bad Breath

A common issue among those who smoke is the yellowish/brown discolouration of the teeth and the bad breath that can linger long after the cigarette is gone (“Smoking and Oral Health”, 2019). The culprit behind the signature staining is the tar and nicotine found within the cigarette (Queen Victoria Hospital, 2017). The bad breath is a combination of the tobacco smoke that is inhaled, the xerostomia (dry mouth) caused by smoking, and the build-up of bacteria on the overgrown tongue papillae commonly seen in those who smoke tobacco (Lay, 2019). Choosing a non-alcohol based mouth rinse, such as Biotene, can both help prevent drying of the mouth, as well as improving the smell of their breath (Lay, 2019).  Regular visits to your dental hygienist can help reduce staining through polishing to remove surface stains and removal of stain-collecting plaque and dental calculus (Lay, 2019). 

Increased Risk of Oral Cancers

Incredibly, almost 90% of diagnosed oral cancers occur in people who smoke, or people who had smoked tobacco previously (Queen Victoria Hospital, 2017). The risk of developing oral cancers increased based on both how long a person smoked for, as well as how much a person smoked (Queen Victoria Hospital, 2017). You may be asking how tobacco causes oral cancer? Tobacco smoke contains chemical carcinogens that can initiate and promote the development of oral cancer (“Smoking and Oral Cancer”, 2011). Sadly, 37% of people will die within five years of their oral cancer diagnosis (“Smoking and Oral Cancer”, 2011). The good news though, is that once someone quits, the risk decreases dramatically and after 10-20 years of cessation, the risk is the same as those who have never smoked (“Smoking and Oral Cancer”, 2011). The high risk of developing oral cancers, and the high mortality rate while smoking is why it is so important for those who smoke to regularly visit their dental professional, and also perform oral self-screenings. 

But What About Smokeless Tobacco? Is it safer? 

Well actually, no, smokeless tobacco is not any safer for your oral health than smoking tobacco (“Smoking and Oral Health”, 2019).  While many people rightfully believe that the harmful aspect of tobacco is the smoke itself, that is not the only damaging aspect of tobacco (“Smoking and Oral Health”, 2019). In fact, chewing tobacco contains even more nicotine than cigarettes, making it an even harder habit to kick (“Smoking and Oral Health, 2019). It also contains at least 28 chemicals that are linked to causing or promoting oral cancer as well as esophageal and throat cancers (“Smoking and Oral Health”, 2019). Smokeless tobacco actually spends more time in the oral cavity irritating the tissues than tobacco smoke, contributing to gingival recession (“Smoking and Oral Health”, 2019). The exposed roots caused by gingival recession are at an increased risk of tooth decay, as well as causing sensitivity to hot and cold (“Smoking and Oral Health”, 2019).

What now?

While people have many different reasons for smoking, it’s impossible to ignore the vast amount of research and scientific evidence that outlines just how detrimental smoking is for both oral and systemic health. As dental professionals, we are ambassadors for oral health, and it is our duty to encourage everyone to quit using tobacco products. Quitting can be a long and challenging road, but there are many different strategies and ways to support those who wish to quit using tobacco products. While there is a large amount of support available for those who wish to quit, it begins and ends with the individual and their desire to change and improve their health.

Ready to quit? Here are some helpful links to get started:

• Support to Quit Smoking | Ontario Government: https://www.ontario.ca/page/support-quit-smoking

 

• Smokers Helpline | Canadian Cancer Society: https://www.ontario.ca/page/support-quit-smoking 

• Telehealth Ontario | 24/7 smoking cessation support: Call toll-Free 1-866-797-000 or  text toll-free 1-866-797-0007                                                                 

 

References

American Dental Association (n.d.). Gingivitis. Mouth Healthy. https://www.mouthhealthy.org/en/az-topics/g/gingivitis.

College of Dental Hygienists of Ontario (n.d.). Smoking and your oral health. Retrieved February 11, 2021, from https://www.cdho.org/docs/default-source/pdfs/oral-health-rpt/oralhealthmatters_smoking.pdf?sfvrsn=aeac84a0_36.

Eke, P.I., Dye, B.A., Wei, L., Thornton-Evans, G.O., Genco, R.J. (2012). Prevalence of periodontitis in adults in the united states: 2009 and 2010. Journal of Dental Research, 91(10), 914-920. https://doi.org/10.1177/0022034512457373.

Lay, T.W. (2019, April 5). How to maintain healthy teeth if you smoke. The Dental Studio. https://dentalstudio.sg/healthy-teeth-smoke/.

Mayo Clinic staff (2020). Periodontitis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/periodontitis/symptoms-causes/syc-20354473#:~:text=Periodontitis%20is%20a%20severe%20gum,bone%20that%20supports%20your%20teeth.

Queen Victoria Hospital (2017). The effect that smoking has on your oral health. Retrieved from February 11, 2021, from https://www.qvh.nhs.uk/wp-content/uploads/2017/02/The-effect-that-smoking-has-on-your-oral-health-Rvw-Feb-2020.pdf.

Smoking and oral cancer (2011). Government of Canada. Retrieved February 11, 2021, from https://www.canada.ca/en/health-canada/services/health-concerns/tobacco/legislation/tobacco-product-labelling/smoking-oral-cancer.html.

Smoking and oral health (2019). WebMD. Retrieved February 11, 2021, from https://www.webmd.com/oral-health/guide/smoking-oral-health#3.

[Image of cartoon teeth affected by smoking]. (n.d.). The Dental Studio. https://dentalstudio.sg/healthy-teeth-smoke/.