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Smokers have a much higher risk of developing gum disease, which can ultimately lead to tooth loss. What do you need to know?

What Is Periodontal Disease?

Periodontal (gum) disease is an infection of the gums and structures around the teeth (such as bones and ligaments) which, in severe cases, can lead to tooth loss.

Bacteria start building up on your teeth virtually the second you put your toothbrush down — but when layers of plaque and tartar are allowed to proliferate, it can result in gingivitis or gum disease. You may not even notice the symptoms of beginning gingivitis, but as the disease worsens, your gums start to recede, creating "pockets" — empty spaces in which food can become lodged, creating a haven for germs. The bone and tissue that hold your teeth in place can then degrade, and your teeth may become loose and require extraction. This inflammation of the gums and supporting structures is known as periodontitis.

There are a number of warning signs that might indicate the presence of gum disease: red, swollen, tender or bleeding gums, discomfort or pain when chewing, generally sensitive teeth, loose teeth, and receding gums.  

How Is Smoking Related to Gum Disease?

Research continues as to the effects of tobacco smoke on mouth tissue. Smoking compromises your immune system, which makes it harder for your mouth to fight infection. Cigarettes and other tobacco products further restrict blood flow to the gums, which makes healing more of a challenge. Research reveals that smokers have more calculus (also called tartar, a hardened form of plaque) than non-smokers, which may result from a reduction in the flow of saliva; indeed smoking is considered to be one of the major causes of severe gum disease in the United States.

We all know that cigarette smoking has a negative impact on nearly every aspect of health — but different ways to get your nicotine hit, such as smoking a pipe, using chewing tobacco, or vaping are detrimental to gum health as well. This is acknowledged on labels of smokeless products, which now include warnings that the products can cause oral cancer, gum disease and tooth loss.

Five ways in which smoking can cause gum disease

Smoking increases tartar

Studies indicate that smokers have more tartar than nonsmokers, which is thought to be due to decreased saliva flow.

Smoking tobacco products can cause faster deterioration in oral health

Smokers are, research shows, three to six times more likely to suffer from gum damage than non-smokers — and smokers have a much higher risk of severe bone loss than people who have never smoked at all. Tobacco use in any form — cigarettes, pipes, and smokeless (spit) tobacco — increases your risk of periodontal disease. Smoking pipes increases that risk threefold (compared with a non-smoker), making pipe use even worse than smoking cigarettes.

Smoking can lead to the illusion that gums are healthy

Gum bleeding and redness are less pronounced in smokers than non-smokers, perhaps because smoking restricts blood flow within the mouth. The absence of worrying signs may mean the thought of gum disease never crosses your mind. While everyone should ideally have regular dental checkups, visiting your dentist is thus especially important for smokers — you have a better chance of successful treatment if the issue is caught early. 

Smoking hinders mouth healing

Smoking doesn't just increase your risk of developing gum disease, it also makes existing periodontitis much harder to treat. Even if you do everything you can — short of stopping smoking — you are still more likely to lose teeth within five years of finishing your treatment, research indicates. Various studies further demonstrate that deep scaling treatment has lower success rates in smokers, while dental implants are also less likely to last. All of these poor outcomes relating to gum disease treatment in smokers can be attributed to the fact that smoking interferes with bone healing. 

Cosmetic dental procedures decline in appearance more rapidly in smokers

The effect of popular cosmetic dental procedures, such as crowns, bridges and porcelain veneers, will not last over time in a smoker. Receding gums and bone loss don't just increase the chance that these procedures will ultimately fail, but also impact the cosmetic outcome.

The key points for smokers

  • Smokers have double the risk for gum disease. Long-term heavy smokers have the highest odds of ending up with gum disease.
  • Smoking in general impairs immunity so mouth health generally is at stake. The importance of regular, twice-yearly, dental checkups cannot be understated.
  • Treatments for gum disease and cosmetic procedures may not be as effective or long-lasting.

The good news for smokers

  • You can stop smoking! The good news about smoking and oral health is if you stop now, you can significantly reduce serious risks to your health. It may take as little as  10 years of not smoking to have the same rate of periodontal disease as a someone who never lit a cigarette in their lives.
  • Even reducing the amount you smoke makes a difference: those who smoke half a pack a day have three times the risk of gum disease versus heavy smokers (more than a pack-and-a-half per day) who are six times more likely.
  • Good dental habits help everyone avoid gum disease. So, brush your teeth twice daily, floss frequently to remove plaque and see a dentist twice a year for check-ups and oral hygiene.

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