When it is said...

Teeth and Smoking

The foundation of healthy teeth is consistent care of the oral cavity and the teeth themselves. This means not only brushing your teeth properly, but also making an overall effort to maintain a healthy natural environment in the mouth.

Saliva plays an important role in protecting the teeth. It contains substances with antimicrobial properties that weaken and destroy bacteria. Toxic substances from cigarettes reduce the protective effects of saliva.

The Effects of Smoking on the Oral Cavity

Cigarette smoke also dries out the mouth. Smoking alters the oral microbiome, while carbon monoxide promotes the growth of anaerobic bacteria.

Smoking also has an indirect negative effect on the quality of oral hygiene, as smokers tend to pay less attention to their overall health, including their oral health. This is associated with increased amounts of dental plaque and unpleasant breath. All of these factors can contribute to the development of tooth decay.

Smoking is a significant risk factor for plaque-induced gingivitis (gum inflammation), which can eventually progress to periodontitis, an inflammatory disease affecting the tissues that support the teeth. Destruction of these tissues can ultimately result in tooth loss.

In smokers, the disease tends to progress more rapidly and healing is more limited. However, the condition is associated more strongly with inadequate oral hygiene than with smoking itself. Treatment of gingivitis can therefore also be considered a form of prevention against periodontitis.

Aesthetic Effects on the Teeth

Smoking also causes teeth to become yellow and leads to brown-black or black staining on the surface of the teeth, dental restorations and tartar. These stains are not known to have a direct pathogenic effect and are primarily an aesthetic concern.

Smokers are less able to distinguish smells and flavours that are easily recognised by non-smokers.

Carbon monoxide produced by smoking readily binds to haemoglobin, the pigment in red blood cells. This reduces the blood’s ability to transport oxygen to the tissues, including the tissues surrounding the teeth. Inadequate oxygen supply can contribute to tissue damage.

Long-term smoking a pipe while holding it in the same position can cause abrasion of the front teeth, resulting in exposure of the dentin.

Some heavy smokers may develop so-called smoker’s melanosis, a brown or brown-black discolouration of the gums, the lining of the cheeks or the lips. Again, this is primarily an aesthetic rather than a health concern.

Leukokeratosis

Smoking can cause a condition known as smoker’s leukokeratosis. It appears as a whitish discolouration of part or all of the hard and soft palate, often accompanied by visible red dots representing the openings of individual salivary gland ducts. There is no specific treatment; the only effective measure is to reduce or stop smoking.

Oral Leukoplakia

Another condition associated with smoking is oral leukoplakia, which causes white patches to develop on the mucous membranes of the mouth. These patches can sometimes transform into squamous cell carcinoma. This is one of the most serious diseases of the oral mucosa associated with smoking. It is often diagnosed only at an advanced stage, when treatment is less effective.

Smoking also negatively affects the integration of dental implants and significantly increases the risk of implant failure.

Problems with Wound Healing

Wounds in smokers, including those in the oral cavity, take longer to heal. One possible complication is dry socket (alveolar osteitis), which can occur after tooth extraction. The extraction socket becomes empty because the blood clot is lost prematurely.

An empty socket can be extremely painful. The surrounding gum becomes red and swollen. Treatment involves the local application of antiseptics, analgesics and materials used to temporarily cover or fill the empty socket, together with eliminating smoking.

The effects described above can also occur, to a lesser extent, in passive smokers. It is therefore advisable to avoid spending extended periods in smoky enclosed spaces, clubs and bars. Think about your children too, and do not smoke at home.

Smoking does not only increase the risk of oral health problems. It also significantly increases the risk of lung cancer and other serious diseases.