The negative health impacts of smoking are well known: cigarette smoke has been definitively shown as a causal factor in a range of diseases and conditions including heart disease, stroke and many forms of cancer.
However, the impacts of smoking cigarettes on oral health is somewhat less publicised, despite the wealth of scientific evidence which demonstrates the detrimental impact of smoking on oral health. As a dentist, you undoubtedly have a number of patients who smoke and your position gives you a unique opportunity, and some may even say responsibility, to educate them on the danger of smoking for their oral health.
On a more positive note, the damage is far from irreversible: once smokers quit, significant improvements are seen in both oral health and general wellbeing. This is a useful tool in convincing patients to give up smoking and should be communicated effectively.
Impact Of Smoking On Oral Health
Smoking cigarettes has a range of adverse impacts on the mouth, gums and teeth. Smoking has been shown to be one of the main causes of mouth cancer. Along with cancer, smoking can cause tooth staining, gum disease and tooth loss. In fact, the impact of smoking on oral health is quite staggering and therefore complete duty of care to our patients should arguably include preventing them from smoking whenever possible.
Stained teeth are very common in smokers. This is caused by the nicotine and tar in tobacco which causes teeth to turn yellow and over the long-term teeth can even turn brown. Gum disease is another effect of smoking, due to the increased levels of bacterial plaque which are produced by smokers. This is compounded by reduced oxygen levels in the blood (caused by damage to the respiratory system due to smoking), which means that infected gums are less likely to heal. This can lead to teeth loosening and even falling out completely.
Smoking cigarettes attacks the body’s overall health in many ways, which can have flow-on effects for oral health. Smoking damages the immune system in the long-term as well as reducing blood oxygen levels. This in turn contributes to gum and periodontal disease, hinders recovery after dental surgery, causes inflammation in the gums and around teeth, and irritates bones such in the jaw. Other effects on oral health linked to smoking include bad breath, plaque and tartar build-up, tooth decay and diminished taste sensations.
Improvements To Oral Health After Quitting
The good news is that once a smoker quits, these health problems start to recover essentially straight away. A conversation with a patient around the impacts of smoking on oral health could also persuasively include an outline on oral and general health recovery after giving up cigarettes.
Just some of the effects that have been documented after quitting smoking include:
- The immune system starts to recover almost immediately after quitting smoking
- Blood circulation starts to recover from 2 weeks after quitting
- Nerve endings in the nose and mouth start to recover within 48 hours of ceasing smoking, and sense of taste and smell begins to recover
- Oxygen levels in the blood begin to improve within 72 hours of the last cigarette as bronchial tubes start to open up, and lung function improves up to 30% within 2 weeks. This reduces breathlessness, making physical activity easier and improving energy levels as well as reducing risks of infection
- Risks of contracting lung, esophageal, kidney, bladder and pancreatic cancer are significantly reduced within 3-5 years of quitting, and risk of heart disease has returned to the same level as non-smokers
When it comes to oral health specifically, the results are equally impressive. Plaque, bad breath and risk of oral infections are substantially reduced within a week of quitting. A study by the Journal of the American Dental Association also found that within 6 weeks of quitting, almost all cases of mouth lesion leukoplakia had completely resolved.
For those who aren’t ready to quit, even reducing the amount of smoking can make a difference. For example, research shows those smoking more than a pack and a half a day have six times the risk of developing gum disease compared to non-smokers, but for those who reduce this to less than half a pack a day this risk is only three times that of non-smokers. Additionally, a 2012 study from the American Cancer Society showed that not only 90% of those suffering from cancer of the mouth, lips, tongue and throat use tobacco products, but that the risk increase based on the amount used and the duration of the habit.
Impacts on Quality Of Life
If these radical improvements to oral and general health aren’t enough to convince smokers to give up, quitting smoking has also been shown to improve general quality of life.
Being able to breathe easier means ex-smokers can now participate in physical activity they struggled with before, greatly improving their quality of life. The considerable financial savings made from quitting smoking also means ex-smokers now have a lot more money to spend on fun activities.
Additionally, studies have shown that quitting smoking improves mental and emotional wellbeing. Research has consistently shown that levels of anxiety, depression and stress reduce following giving up smoking, while positive mood and overall quality of life improves. There is even evidence that quitting smoking has the same effect on anxiety and depression as taking anti-depressants.
Using E-Cigarettes To Quit
If your patients are struggling to quit smoking by going “cold turkey”, there are alternatives, such as using e-cigarettes to phase down nicotine addiction to eventually kick the habit.
One of the misconceptions of vaping is that it is just as bad for you as smoking cigarettes. However, while e-cigarettes contain the same nicotine, they do not have the over 4000 toxic and carcinogenic chemicals found in tobacco products. Major studies have found that vaping is much safer than smoking cigarettes. Research by Public Health England, for example, showed that vaping is 95% safer than smoking cigarettes. Another study published in the Annals of Internal Medicine found that former smokers who switched to e-cigarettes showed significantly lower levels of toxic chemicals and carcinogens.
Additionally, the Public Health England report recommended vaping as a tool to help smokers to quit smoking cigarettes. Because the e-liquids used in vaping are available in various levels and strengths of nicotine, smokers can use e-cigarettes to phase down their nicotine intake over time. This is much easier than trying to quit cold turkey, as nicotine is a highly addictive chemical.
Furthermore, vaping satisfies the habitual needs of those accustomed to the action of smoking. By giving up smoking and switching to vaping in order to step down nicotine addiction gradually, immediate results to oral and general health will be seen.