Periodontal Disease & Tobacco

According to the American Dental Hygiene association, as if the oral effects of bad breath, stained teeth, loss of taste and smell, mouth (canker) sores, failure of dental implants, and oral cancer weren’t enough, tobacco use is implicated in the gum recession, bone loss, and tooth loss associ- ated with periodontal (gum) disease.

Smokers who smoked less than a half a pack of cigarettes per day are almost three times more likely than nonsmokers to have periodontitis, ac- cording to a study by researchers at the Centers for Disease Control and Prevention in Atlanta, Georgia. The same study found that those who smoked more than a pack and a half of cigarettes per day had almost six times the risk.

Recent studies have shown that tobacco use in the form of cigarette, cigar, or pipe smoking, as well as smokeless tobacco use, are significant risk factors in the development and progression of periodontal disease. In turn, research links periodontal disease to increased risk of heart disease, stroke, poorly controlled diabetes, respiratory disease, and premature babies.

Research shows that cigarette, cigar, and pipe smokers have a higher prevalence of moderate to severe periodontitis and higher prevalence and extent of attachment loss and gum recession than nonsmokers. They also have a higher number of missing teeth than nonsmokers; and although their gums are healthier. In addition, tobacco smokers are more likely than nonsmokers to have calculus (hardened or calcified dental plaque) formation on their teeth, to have developed periodontal pockets, to have lost bone that supports teeth, and to have lost supporting tissue that attaches the tooth to the bone.

Tobacco use can also affect the success of periodontal treatment. Cigarette smoke contains over 4,800 chemicals, 69 of which are known to cause cancer. When a smoker lights a cigarette and inhales, these toxins are drawn into the lungs. From there, they enter the bloodstream, which delivers them to every cell throughout the body, which cannot defend itself from them. Smoking also reduces the delivery of oxygen and nutrients to the gingival tissue, and it interferes with healing and makes smokers less likely to respond to treatment, lengthening the time it takes for treatments to work.

Smokeless tobacco – tobacco or a tobacco blend that users chew, inhale, or suck rather than smoke – also contributes to gum disease. Studies have shown that about 7-27% of regular smokeless tobacco users have gum recession and may lose the bone around the teeth and experience tooth loss. In addition, smokeless tobacco causes leukoplakia, white patches that form on the site where the user holds the tobacco. Research has also linked chewing tobacco to dental caries.

Problems cause by tobacco include:

• Lung disease
• Heart disease
• Cancer
• Mouth sores
• Gum recession
• Loss of bone and teeth
• Bad breath
• Tooth staining
• Less success with periodontal treatment and with dental implants