So much is known about smoking and the risk it poses to general health - lung cancer, heart disease, loss of limbs from vascular damage and respiratory diseases are well publicised conditions that can result from smoking. Gross pictures of these diseases are portrayed on cigarette packets to strip away any element of glamour associated with the habit. . .
So is it really necessary to talk about the links between smoking and dental disease?
Whilst people continue to smoke and new smokers pick up this habit, it is important to keep the conversation about the harms of smoking going.
No guilt, no blame, no put downs - just simple straight facts about what happens with smoking, and a little bit of the why it is so bad for us.
Smoking impacts on every aspect of the health of the mouth
Nicotine stains the teeth - Although the staining is superficial when the habit is first taken up, consistent smoking results in darkening of the tooth structure and deep staining at the edges of fillings.
Smoking dries the mouth - The dryness is caused immediately by the inhalation of smoke through the mouth. There are also long term impacts on saliva quality probably due to impacts of nicotine on the saliva glands. The result is thicker saliva that is less protective in long term smokers.
Smoking familiarises and encourages mouth breathing - This is a personal observation made over many years of treating smokers. Smoking forces and enforces a habit of using the mouth as the 'primary breathing hole'. Mouth breathing contributes to chronic dry mouth and all of the problems associated with it.
Smoking reduces taste sensation - Many smokers do not notice how severely their taste is impacted until they quit. This may be a factor that unconsciously encourages smokers to consume more sugar, seeking the extra taste sensation.
Smokers experience more tooth decay than non smokers - Dry mouth is the major culprit, but this is made worse by the fact that regular long term smokers have been shown to have poorer oral hygiene than non smokers. Smokers who used sugar based breath mints to hide the smell of their breath place themselves at great risk of tooth decay.
Cigarette smoking produces bad breath - Seriously. Smoking does make the breath smell like a stale ash tray. And nothing disguises it. Nothing.
Gum disease is more likely to develop in smokers, and is more aggressive and destructive - Smoking reduces the flow of blood to the tissues of the gums. Nicotine dissolves in saliva and is directly toxic to gum tissue. Smoking reduces the amount of oxygen in the mouth making the perfect conditions for the nasty organisms that cause gum disease. Smoking interferes with the ability of white blood cells to fight the infection.
Poor and delayed healing after tooth extractions - This is due to the same mechanisms that drive gum disease.
Poor prognosis with gum treatment - Same reasons as above.
Poorer outcomes for dental implants than non-smokers - Same reasons as above. Some dentists will not place implants for people who smoke because they consider the risk of failure to be too great.
Smokers develop a condition called keratosis - This is the thickening of the soft tissues of the mouth in response to the toxic products contained in the inhaled smoke. This is a warning sign that the body is not coping with the amount of smoke being inhaled.
Smokers are at significantly higher risk of developing oral cancer - The compounds in cigarette smoke are highly toxic to cells and damage their DNA. Oral cancer rates are rising globally. This is cancer is difficult to diagnose and treat. The longer a person smokes and the more they smoke, the greater the risk.
Recommendations for all smokers
Do all you can to quit. Ask for support with this - medically, emotionally and physically. There is more support now than ever in the past and you do not have to do it alone.
If you simply cannot quit, reduce the amount you smoke. And keep on reducing. Reduced exposure does make a difference to your body.
Vaping is not a good alternative. In fact I have witnessed teeth deteriorate more severely and rapidly with vaping than smoking.
Reduce your sugar intake. A lot of smokers consume even more sugar when they quit, so don't fall into this trap. Talk to your GP, your dentist, a dietician or a naturopath for good dietary advice. . . or just stay away from the sweets.
Reduce your alcohol intake. Alcohol exacerbates all of the effects of smoking, especially in regard to oral cancer. Alcohol also encourages smoking and this does not help in the quitting process.
Make friends with your dentist. Ask us to advise you on the best ways to improve your oral health...of course, we will advise you to quit. But we can also give you great tips on how to care for your dental hygiene in the lead up to quitting, and forever after you let it go.
Take care of your mouth with a solid and consistent oral hygiene routine. Teeth and gums are valuable assets and worth taking care of.
Smoking is another one of the strange, addictive and harming habits that only human beings are capable of inventing. The impacts on overall health from cigarettes and nicotine are so compellingly negative that it is worth doing all you can to let it go, and move on with developing real wellbeing.