World No Tobacco Day: The shocking impact of smoking on oral health

Even though smoking`s detrimental effects on general health are well known, many of us continue to underestimate how much of an impact it has on our oral health, which is often subtle. 

Apart from the known risks to your heart and lungs, smoking tobacco can silently and rapidly accelerate a number of crippling dental issues. The repercussions go far beyond appearances, ranging from disfigured teeth and persistent foul breath to severe gum disease, substantial tooth loss, and even increased risks of oral cancer.

On World No Tobacco Day, observed on May 31, Dr Shivangi Sharma, consultant- dentistry at Nanavati Max Hospital, Mumbai, and Dr Shobhit Raizada, consultant – maxillofacial prosthodontist and oral implantologist at Manipal Hospital, Goa highlight the frequently overlooked oral health effects of smoking. They also outline the vital precautions you can take to safeguard your smile.

The Smoker`s Mouth: A breeding ground for problems
Smoking has a profound and often irreversible impact on your oral well-being. Here`s how it accelerates and worsens common dental issues:

Compromised immune response and impaired healing
Dr Shobhit explains, “Smoking compromises your body’s immune systems, making it harder to beat off infections, especially in the gums.” He adds that “Nicotine tightens the blood vessels in your mouth, cutting off blood flow to the gums reducing oxygen and necessary nutrients, which will negatively affect the healing process.” This reduced ability to heal means that damage to your gums or other soft tissues will repair slowly, if at all, and it significantly lowers the success rates of dental procedures like deep cleanings or gum surgery.

Increased risk and severity of gum disease 
“Smoking plays a major role in causing gum diseases, particularly periodontitis,” states Dr Shivangi, continuing, “Periodontitis is a serious infection that damages the gums and can destroy the jawbone. The toxins present in cigarette smoke cause inflammation and swelling of the gums, making them more prone to infection.” 

On the other hand, the Goa-based doctor further highlights the severity, stating, “Smokers are two to seven times more likely than non-smokers to develop gum disease.” He also points out a critical danger: “Smoking also cloaks early signs of gum disease like bleeding gums, since it decreases the blood flow. This makes that a lot of smokers overlook the first symptoms and only have themselves treated when the disease is advanced.”

Increased risk of tooth decay
“Tobacco and its constituents modify the composition and function of saliva,” says he says, adding, “It raises acidity, so the saliva becomes less able to neutralise damaging acids and flush the mouth.” This more acidic environment, he explains “contributes to carbohydrates feeding harmful bacteria responsible for the growth of plaque and associated increased risk for tooth decay”.

Warning signs you might be missing
Many early symptoms of smoking-related dental issues are mild and can easily be overlooked or mistaken for temporary problems.

Dr Shobhit recommends paying attention to these indicators:

1. Chronic bad breath (Halitosis): Be mindful if you sense a persistent, hard-to-mask smell, even after brushing or using mouthwash. Halitosis arises from bacteria build-up enhanced by the dry mouth smokers commonly experience.
2. Stained teeth and plaque build-up: Due to the residue from tar, teeth can turn an unhealthy yellow or brown appearance, which also leads to increased plaque accumulation.
3. Dry mouth: Smoking decreases saliva flow, leaving you with a dry, uncomfortable mouth, making it more susceptible to bacteria and plaque.
4. Loss of soft tissue plumpness: A cigarette smoker may start to observe that their cheeks, lips, and gums begin to look a little thinner.
5. Inflamed salivary gland ducts: The ducts in the salivary glands can become irritated from smoking and cause swelling and inflammation that may go unnoticed until serious problems arise.

Since many of these symptoms develop slowly and often without pain, they`re frequently dismissed until significant damage has occurred.

The broader impact: taste, appearance and cancer risk
Long-term smoking carries several serious consequences for overall oral health. 

Sharma lists some of the significant possibilities below:
1. Dull sense of taste: The chemicals in tobacco smoke dull taste receptors on the tongue, reducing the ability to taste foods properly. Smokers often find food bland, resulting in increased salt or spice intake, common in Indian diets, which can lead to further dietary imbalances.
2. Impact on social interactions and self-esteem: Tooth discolouration and persistent bad breath can significantly impact social interactions and self-esteem.
3. Significantly increased risk of oral cancer: Smoking drastically raises the risk of developing oral cancer, a severe and potentially fatal condition.

What can you do?
In India, where tobacco products like cigarettes, bidis, and chewing tobacco are widely used, understanding these risks is paramount. Many Indian smokers start due to social pressures or stress, common in fast-paced urban lifestyles. However, the financial strain from treating smoking-related oral diseases adds significant socioeconomic burdens to families already facing health disparities.

Dr Shobhit recommends three ways for you to mitigate the damage and prioritise your oral health:

1. Quit smoking immediately and completely
The most important advice any dental professional can give to patients who smoke is clear and firm: Quit smoking immediately and completely. This is the most effective way to protect not just your oral health, but your overall wellbeing. He further advises seeking professional tobacco cessation programs that offer not only behavioural support, but also medication options and personalised tactics to help patients quit — for good.

2. Practice better oral hygiene
Smokers frequently report these symptoms [gingival bleeding, tooth stains, persistent bad breath], indicating poorer oral hygiene practices and greater plaque accumulation. Brush your teeth two times a day with fluoride toothpaste, floss once a day, and rinse with an antimicrobial mouthwash. 

3. Schedule regular dental visits
Frequent check-ups and cleanings allow your dentist to monitor for early signs of damage and intervene before problems escalate.

A clear path to a healthier smile
The message is clear: Smoking profoundly damages oral health, leading to severe conditions like gum disease, tooth loss, impaired taste, and oral cancers. Understanding these risks, adopting healthier lifestyle choices, and promoting smoke-free environments can drastically reduce these impacts.

Dr Shivangi states, “Public health initiatives aimed at reducing smoking through education, cessation programs, and stricter tobacco control policies can substantially improve oral health outcomes in India.” Encouraging smokers to quit through increased awareness about these specific risks can ultimately enhance their quality of life, reduce healthcare costs, and promote a healthier, more productive society,” she concludes.

This article first appeared on Mid Day