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Most people are aware of the adverse health effects of tobacco use due to nicotine and other harmful chemicals. Longer and more frequent use of tobacco products dramatically increases the risk of health conditions such as cancer, respiratory diseases, and cardiovascular disease. In addition, smoking reduces the oxygen level in your bloodstream. It also weakens your immune system, making it harder to fight infections and affecting your ability to heal.

Tobacco can also have serious, negative effects on your oral health. The effects are not limited to tobacco users either. "Research shows that exposure to secondhand smoke may increase a person's risk of developing lip, mouth, and throat cancers by more than 50%. Individuals exposed to secondhand smoke for more than 10 to 15 years may be twice as likely to develop oral cancer as those not exposed to passive smoke."1

Tobacco use of any kind, including cigarettes, cigars, chew, snuff, pipes, vaping (e-cigarettes), or betel nut, immediately affects your mouth's soft tissues, jawbones, lips, and throat. Like the effects of tobacco on other parts of your body, longer and more frequent use of tobacco dramatically increases your risk of developing unhealthy oral conditions.

Common effects of tobacco use on your mouth include:

  • Tooth decay: Tobacco users tend to produce more of the bacteria that cause tooth decay than non-users and accelerates its progression.2 Untreated tooth decay is higher in people who smoke cigarettes. According to the CDC, over 40% of adults aged 20 to 64 who currently smoke cigarettes have untreated tooth decay. Seniors who smoke cigarettes are twice as likely to have untreated tooth decay as those who never smoked.3
  • Periodontal disease: Ongoing tobacco use accelerates periodontal disease, which begins when bad bacteria on your teeth multiply and get under your gums. This can lead to inflammation (gingivitis) and progress to damage the soft tissue and bone surrounding your teeth (periodontal disease).
  • Missing teeth: In severe cases of untreated periodontal disease, the bone and soft tissue that hold your teeth in place begin to break down. Your teeth may loosen and need to be removed.4 About 43% of adults aged 65 or older who currently smoke cigarettes have lost all of their teeth versus 12% who don't smoke.3
  • Failed restorations: Tobacco use slows healing and increases the failure rates of procedures to replace missing teeth, such as dental implants. It also impairs both blood circulation essential to good healing and effective immune response to fight infection. This is why studies have demonstrated that tobacco users are up to 20% more likely to experience an implant failure than non-tobacco users.5
  • Oral cancer: Oral cancer is diagnosed in over 50,000 Americans a year, and the 5-year survival rate is only about 60%.2 Tobacco use, especially in men over 50, greatly increases the risk of developing cancer of the lips, mouth, and throat. Furthermore, combining tobacco with heavy alcohol use (more than two drinks a day for men and one per day for women) can increase your risk of oral cancer by 5-14 times versus people who do not smoke, chew, or drink alcohol.6
  • Appearance: Tobacco use causes stains on your teeth and bad breath. While you may reduce the outward effects of tobacco use with tooth whitening procedures, toothpaste specially designed for tobacco users, or tooth replacement, none of these will protect against, reverse, or cure the underlying oral disease.2 Severe cases of oral disease can lead to missing teeth and the need for surgery.

What to do

At home

  • Don't use tobacco. If you do, stop.
  • Avoid secondhand smoke as much as possible.
  • Brushing at least twice a day along with daily flossing will help to remove plaque.
  • Use mouthwash to kill germs that cause bad breath and contribute to gingivitis and periodontal disease.
  • If you notice anything suspicious in your mouth, contact your dentist immediately.

At the dentist

  • See your dentist regularly for oral exams and professional teeth cleanings.
  • Be honest with your dentist about your past and current tobacco habits, including the use of vaping or e-cigarette devices.
  • The use of vaping and e-cigarette devices has risen significantly among middle and high school students over the last ten years.7 If you suspect your child may be using tobacco or vaping products, tell their dentist so they can support your efforts to explain the dangers of continued use.
  • Dentists and hygienists are trained to conduct soft-tissue and external oral cancer screenings. If your dentist does not perform these essential parts of your exam, do not hesitate to ask for them. Your dentist may also be trained to remove suspicious lesions and send them to a laboratory for analysis.
  • You may be asked if you would like tobacco counseling. Follow all of your dentist's directions regarding the impact of tobacco on your oral health.

Author: Fluent staff
Last updated: 1/11/2022Medical review: Thomas J. Greany DDS, 5/15/2021
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