Tobacco Use and Your Oral Health
- By Connie Brichford | Medically reviewed by Niya Jones, MD, MPH
It's
no secret that smoking is bad for your overall health but using tobacco
products can have serious consequences on your oral health, too.
In addition to affecting your overall
health, tobacco use and smoking can cause a number of oral health issues,
ranging from oral cancer to discolored teeth.
“You can get yellow teeth [and] a
yellow tongue," says Thomas Kilgore, DMD, professor of oral and
maxillofacial surgery and associate dean at the Boston University Henry M.
Goldman School of Dental Medicine. "You see a lot of staining on the
tongue.”
Smoking and tobacco use can lead to
more serious oral health complications as well, including gum disease and oral
cancer.
Smoking and Oral Cancer
“The most serious issue is mouth
cancer,” Dr. Kilgore says. “It’s hard to say what percentage of people who
smoke will get mouth cancer, but the death rate of those who do get it is high
— between 40 and 50 percent of all cases, and that hasn’t changed over the last
few decades.”
The American Cancer Society
estimates that 90 percent of people with oral cancer (cancer affecting the
lips, tongue, throat, and mouth) have used tobacco in some form. Likewise, the
risk of oral cancer is six times higher among smokers relative to non-smokers.
Your individual risk of oral cancer depends on how long you’ve been using
tobacco — the longer you use it, the greater your risk.
Smoking and Periodontal Disease
“Smoking cigarettes doesn’t cause
dental decay, but it does cause periodontal, or gum, disease,” Kilgore
explains. “Bone loss is part of periodontal disease. It starts out as
inflammation of the gums. In the natural and unfortunate progression, the bone
supporting the roots of your teeth becomes inflamed,” and then the underlying
bone can deteriorate, he adds.
“There are surgical and nonsurgical
therapies to reverse or slow the progression of periodontal disease,” Kilgore
says, but without proper treatment, gum disease does eventually lead to tooth
loss and jawbone damage. One study found that smoking was associated with more
than 50 percent of periodontal disease cases.
For Oral Health, No Tobacco Is Safe
People often think that different
forms of tobacco are "safer" than others. However, says Kilgore,
“Tobacco in any form has risks. It’s hard to figure out which is worse” — when
tobacco is chewed, smoked, or inhaled.
The bottom line is that regular
exposure to tobacco in any form can compromise your health. Kilgore points out
that “pipe smokers may not smoke very often, but they can [still] get cancer of
the lips, as they’re always holding the pipe in the same place on the lip.”
Additionally, “there’s a myth that chewing tobacco has less risk, but it’s been
shown pretty clearly that this isn’t true.”
And people who use smokeless
(chewing) tobacco are at a four to six time greater risk of oral cancer than
people who don't use tobacco at all. People who use smokeless tobacco are also
at higher risk of tooth decay and cavities because some varieties of chewing
tobacco contain sugar for a sweeter taste, and sugar is a primary cause of
tooth decay.
Protecting Your Oral Heath
The following three principles can
help to ensure good oral health throughout the years:
- Quit smoking. After you’ve quit smoking, your risk of oral health problems decreases significantly. And the longer you remain a non-smoker, the lower your risk becomes. A decade after you’ve quit, your risk for periodontal disease is similar to that of a person who never smoked at all. “A lot of dentists now are taking the initiative to ask patients about their smoking habits, and are talking about the [nicotine] patch” and other ways to help people quit, Kilgore says.
- Get regular dental checkups. As with most cancers, early detection can improve your outcome. “The good news is that regular checkups by a dentist are a good way to catch oral cancer early,” advises Kilgore. “Any mouth ulcers can be checked out with a biopsy, and you can get a diagnosis.” The sooner you start treatment, the better your odds of survival.
- Brush properly. “Most people who have periodontal disease develop it from not brushing and flossing properly,” Kilgore notes. The heat and carcinogens found in cigarettes and tobacco are also damaging to your mouth and gums. So people who use tobacco need to be doubly careful about brushing and flossing correctly and doing so as often as recommended. Ask your dentist or dental hygienist to watch you brush and floss to make sure you’re doing a thorough job.
Having Trouble Quitting? Visit the
Dentist Regularly
If you do use tobacco, cutting back
and eventually quitting are some of the most important actions you can take to
improve both your oral health and your overall health.
Tobacco use “is a tremendously
addictive habit, so in the meantime, regular dental visits can help with early
detection” of gum disease and precancerous mouth sores, Kilgore says. He adds
that the people at greatest risk for oral cancer are chronic smokers who don’t
visit their dentists regularly. “By the time oral cancer is detected, it’s hard
to treat," he says. Plus, the treatments can be more challenging at later
stages. Surgery and radiation treatments are often disfiguring and can affect
your ability to speak and eat.
Talk to your dentist or general
doctor about what can help you to kick your smoking and other tobacco habits
today.
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