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The Impact of Smoking and Tobacco Use on Oral Health

The unsightly dark stains and discoloration caused by tobacco use and smoking can compromise your smile and physical appearance, but the consequences extend far beyond superficial or cosmetic concerns. Tobacco poses significant risks to your oral health, leading to many problems. 

Whether consumed through smoking cigarettes or smokeless methods, tobacco is a prominent contributing factor to the development of red or white lesions, precancerous conditions, periodontal diseases, and oral cancers.

Moreover, smoking directly impacts the well-being of your gums. Those who smoke have a substantially higher chance of experiencing dental decay and severe gum infections. Smokers are at least twice as likely as non-smokers to develop gum diseases.

The Use of Cigarettes and Tobacco and Its Effects on Oral Health

Cigarette smoking leads to various damaging oral consequences, including gum recession, periodontal disease, poor healing post periodontal treatment, oral cancers, mucosal lesions (such as nicotine stomatitis and oral leukoplakia), tooth discoloration, and tooth loss. On the other hand, smokeless tobacco consumption elevates the risk of oral cancer and oral mucosal lesions.

Additionally, the use of tobacco in smokeless forms leads to oral conditions such as tooth discoloration, bad breath, enamel erosion, gingival keratosis, gingival recession, periodontal disease, alveolar bone damage, dental caries on the crown or root due to added sugars in the tobacco product, and tooth loss.

During cigarette smoking, nicotine levels maximize in the blood, reaching the brain. In the absence of direct inhalation of tobacco smoke, nicotine absorption occurs through the mucosa, affecting the brain relatively slowly.

While cigarettes remain the most prevalent method of tobacco consumption, other tobacco-based products, including traditional smokeless tobacco, dissolvable tobacco, smoke pipes and cigars, and e-cigarettes, also pose risks to oral health.

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Oral Cancer: A Serious Public Health Challenge

The prevalence of oral cancer remains alarmingly high, contributing significantly to cancer-related deaths. In 2021 alone, more than 54,000 new cases of oral cancer were reported in the United States, with a five-year survival rate of about 67%. Most oral cancers, around 80-95%, are classified as OSCC or oral squamous cell carcinoma.

The culprit behind oral squamous cell carcinoma is tobacco in its smoked or smokeless forms. Cigarettes and other tobacco products that undergo combustion pose substantial risks, acting as nicotine delivery mechanisms containing a complex blend of tumor promoters, co-carcinogens, and various toxic substances that intensify the impact of carcinogens.

Oral Lesions: A Consequence of Tobacco Use

Tobacco usage has a strong correlation with the development of oral mucosal lesions, encompassing conditions such as leukoplakia, tobacco keratosis localized at the point of tobacco exposure, nicotinic stomatitis, erythroplakia, and smoker's melanosis. 

While some of these lesions may not be malignant, it is essential to conduct thorough investigations into leukoplakia related with tobacco, employing biopsies to ascertain the presence of carcinoma. Studies reveal that up to six percent of leukoplakias eventually become malignant, with the likelihood of such malignancy increasing over time.

Impacts of Smoking on Gum Health

In the United States, smoking plays a significant role in developing severe gum disease. Smoking compromises your body's immune system, weakening its ability to combat gum infections effectively. Once gum damage occurs, smoking further hampers the healing process, making it more challenging for your gums to recover. Recent data from the CDC highlights the following risks associated with smoking:

  • Smokers face twice the risk of developing gum disease compared to non-smokers.
  • The quantity of cigarettes smoked directly correlates with an increased risk of periodontal disease.
  • The duration of smoking is also linked to a higher likelihood of developing gum disease.
  • Gum disease treatments may have reduced effectiveness in individuals who smoke.
  • All forms of tobacco use, including cigarettes and smokeless tobacco, elevate the risk of gum diseases.

Oral Cavities

Dental caries pose a significant health concern, affecting many school-age children (60-90%) and most adults. 

Cigarettes and electronic cigarettes have nicotine, which has the effect of suppressing saliva production. Restricted saliva flow can cause dry mouth, heightening the chances of tooth decay and causing unpleasant breath. Moreover, the use of cigarettes curtails blood circulation to the mouth and gums, thereby increasing vulnerability to infections, tooth decay, gum inflammation, and other oral conditions.

Among children, dental decay is the most prevalent chronic ailment. Notably, a correlation exists between exposure to passive smoking (environmental tobacco smoke) and a heightened risk of dental caries in kids.

Tooth Loss & Jawbone Deterioration

The production of bacterial plaque is heightened among individuals who smoke, leading to an increased risk of gum disease. Exposure to tobacco smoke fosters biofilm formation, making smokers prone to oral infections and the loss of teeth. Smoking contributes to inflammation while simultaneously lowering the oxygen levels in the blood. The gum tissue of a smoker has limited regenerative abilities, hindering recovery from injuries or infections and leading to additional complications.

An extensive research study in the Journal of the American Dental Association unveiled that cigar smokers encounter tooth loss and experience alveolar bone loss (the deterioration of the jawbone that supports teeth) at rates comparable to those observed in cigarette smokers. Similarly, pipe smokers face a tooth loss risk equivalent to cigarette smokers.

The Role of a Dentist

The 2008 practice guideline from the U.S. Public Health Service established that medication and counseling effectively address tobacco dependence. However, combining these approaches yields greater efficacy than either approach alone.

Given the oral health implications of tobacco use, dentists can provide an effective environment for identifying, preventing, and aiding in tobacco cessation. Dental practitioners can assist smokers in quitting by identifying patients that smoke, offering advice on quitting, and sharing information about smoking cessation treatment options.

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Dental Practitioners Utilizing Tips® Resources

Dental professionals assume a pivotal role in combating tobacco use among their patients. Starting in 2018, the CDC’s Oral Health Division, in collaboration with the ADA, the Office on Smoking & Health, and the American Dental Hygienists' Association (ADHA), involved dentists nationwide in the Tips® campaign.

The Tips campaign offers a range of resources, including informative handouts, posters, and educational videos designed for patients and dentists.

Get a Thorough Oral Cancer Screening from Our Highly Rated Dentists

A dentist is your first line of defense against oral cancer. During a routine dental visit at R+R Dental, Dr. Michael Richer and Dr. Nadia Rivera will thoroughly examine your teeth, gums, tongue, and all surfaces of your mouth, including an assessment for oral cancer. The primary objective of an oral cancer screening is to detect mouth cancer in its early stages, increasing the chances of a successful cure. To book your appointment with our top-rated dentist, call us at (347) 431-0657 or fill out this online contact form.


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