How Smoking Creates Issues with Your Oral Health

Smoking and Oral Health

At Aria Dental, we have seen firsthand the numerous ways cigarette smoking can negatively impact oral health. It’s not just about stained teeth; the consequences of smoking are far more far-reaching and can be severe. Read on to understand the ways smoking affects your mouth, gums, and teeth and why it’s crucial for smokers to be extra vigilant about how smoking harms their oral health.

Increased Risk of Severe Gum Disease

One of the most significant risks for smokers is the increased likelihood of developing severe gum disease (periodontal disease). Smoking interferes with the normal function of gum tissue cells and impairs blood flow, making the gums more vulnerable to infections. This can lead to the development of periodontitis, a severe form of gum disease that can ultimately result in tooth loss.

Smoking Consequences:

• Impaired Blood Flow: Smoking causes vasoconstriction, reducing blood flow to the gums, which impedes healing and the body’s ability to fight infections.
• Weakened Immune Response: Smokers have a decreased immune response, making it harder for the body to combat gum infections.
• Increased Plaque and Tartar Formation: Smoking promotes plaque accumulation, which hardens into tartar, a significant contributor to gum disease.

Delayed Healing After Dental Procedures

Smokers often experience slower healing after dental procedures like tooth extractions, periodontal treatments, or dental implant surgery. This is due to the impaired blood flow and reduced oxygen in the bloodstream, which are crucial for healing.

Smoking Consequences:

• Prolonged Healing Time: Recovery from dental procedures takes longer, increasing the risk of complications.
• Dry Socket: After tooth extraction, smokers are more susceptible to developing a dry socket, a painful condition where the blood clot fails to form or dislodges from the socket.

Increased Risk of Oral Cancer

Tobacco use is a leading cause of oral cancer. The carcinogens in tobacco products damage the DNA in cells within the oral cavity, leading to cancerous mutations.

Smoking Consequences:

• Location: Oral cancer can occur in the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx.
• Symptoms: Look out for sores, lumps, or rough areas in the mouth, as well as changes in how teeth fit together.

Bad Breath and Stained Teeth

Smoking is notorious for causing bad breath (halitosis) and stained teeth. The tar and nicotine in cigarettes are major culprits for discolouration, while the chemicals in tobacco smoke contribute to bad breath.

Smoking Consequences:

• Stains: Yellow or brown discolouration of the teeth is common for cigarette smoking.
• Halitosis: The smoke’s odour and the effect of smoking on oral bacteria contribute to persistent bad breath.

Decreased Sense of Taste and Smell

Smoking dulls the senses of taste and smell, which can impact the enjoyment of food. This sensory loss often goes unnoticed by smokers for years until they quit smoking.

Smoking Consequences:

• Altered Sensory Cells: The chemicals in smoke can alter the taste buds and olfactory senses.

Dry Mouth (Xerostomia)

Smokers often experience dry mouth, which can exacerbate tooth decay and gum disease. Saliva is crucial for washing away food particles and neutralising acids produced by bacteria.

Smoking Consequences:

• Reduced Saliva Flow: Smoking affects the salivary glands, decreasing saliva production.

Issues with Smoking and Dental Surgery

Impaired Blood Flow and Reduce Oxygen

Recovery from dental procedures takes longer, and the risk of complications increases when patients smoke. Smoking impairs blood flow and reduces oxygen levels in the bloodstream through several mechanisms, primarily related to the effects of nicotine and the inhalation of various harmful substances found in tobacco smoke. Issues smokers have include:

1. Nicotine-Induced Vasoconstriction: Nicotine, a key component of tobacco smoke, is a potent vasoconstrictor. When you smoke, nicotine enters your bloodstream and stimulates the sympathetic nervous system. This stimulation causes the body’s small blood vessels, or arterioles, to constrict or narrow. This narrowing of blood vessels reduces the diameter through which blood can flow, thereby diminishing overall blood flow to various tissues, including those in the oral cavity.
2. Reduced Oxygen Carrying Capacity: Another major issue with smoking is the presence of carbon monoxide (CO) in tobacco smoke. CO has a much higher affinity for haemoglobin (the molecule in red blood cells that carries oxygen) than oxygen. When you inhale cigarette smoke, the CO binds to haemoglobin much more readily than oxygen. This binding significantly reduces the amount of oxygen that the blood can carry and deliver to tissues. As a result, the tissues, including those in the gums and oral cavity, receive less oxygen than they need for normal function and healing.
3. Endothelial Dysfunction: Smoking also causes damage to the endothelium, the inner lining of blood vessels. Endothelial cells play a crucial role in maintaining vascular health, including regulating blood flow and blood vessel diameter. Smoking can lead to endothelial dysfunction, characterised by a reduced ability to dilate blood vessels and a propensity for inflammation and clot formation. This dysfunction can further impair blood flow.
4. Increased Blood Viscosity: Smoking can increase the viscosity or thickness of the blood. This change makes it harder for blood to flow through the small vessels, especially those already narrowed due to nicotine-induced vasoconstriction. Higher blood viscosity also increases the risk of clot formation, further impeding blood flow.
5. Promotion of Atherosclerosis: Long-term smoking contributes to the development of atherosclerosis, a condition where plaque builds up inside the arteries. This buildup narrows the arteries and limits blood flow. In oral health, reduced blood flow due to atherosclerosis can compromise the health of the gums and other oral tissues.

Decreased Immune Response

Smokers often have a decreased immune response due to the harmful effects of cigarette smoke on the body’s immune system. This weakened immune function can make smokers more susceptible to infections, including those affecting oral health. Here are the key reasons why smoking leads to a decreased immune response:

1. Impaired Function of Immune Cells: Tobacco smoke contains numerous harmful chemicals that can directly affect the function of various immune cells, such as lymphocytes, neutrophils, and macrophages. These cells are crucial for fighting infections and maintaining a healthy immune response. The toxic substances in cigarette smoke can impair the ability of these cells to respond effectively to pathogens, thereby reducing the body’s immune defence.
2. Inflammation and Oxidative Stress: Smoking induces chronic inflammation and oxidative stress in the body. The chemicals in cigarette smoke stimulate the production of inflammatory cytokines and free radicals, which can damage tissues and cells. Chronic inflammation and oxidative stress from tobacco smoking are known to weaken the immune system, making it less effective at responding to infections and healing wounds.
3. Suppression of Antibody Production: Smoking can interfere with the immune system’s ability to produce antibodies. Antibodies are proteins that recognise and neutralise foreign invaders like bacteria and viruses. The chemicals in tobacco smoke can reduce the production of these antibodies, leaving the smoker more vulnerable to infections.
4. Altered Immune Cell Distribution: Smoking can alter the distribution and function of dendritic cells, which are essential for initiating immune responses. It also affects the balance of different types of immune cells in the body, which can disrupt the normal immune response.
5. Impaired Wound Healing: The immune system plays a crucial role in wound healing. Smoking impairs this process, leading to slower and less effective wound healing. This is particularly relevant in oral health, where healing from dental procedures or gum injuries can be significantly delayed in smokers.

Dry Socket

Dry socket, also known as alveolar osteitis in medical terms, is a painful dental condition that may occur after a tooth extraction or dental surgery. It usually occurs when the blood clot that forms in the socket where the tooth has been removed fails to develop, is dislodged, or dissolves before the wound can heal. As a result, the underlying bone and nerves are exposed to air, food, fluid, and bacteria, causing severe pain and increasing the risk of infection.

Typically, dry socket pain can start one to three days after the tooth extraction. The pain can be intense and may radiate to the ear, eye, temple, or neck on the same side. In cases of dry socket and oral surgery, if the protective blood clot is missing, sometimes the bone is visible in the socket and exposed, causing extreme pain.

A foul odour or taste might come from the socket due to exposed tissue and possible bacterial growth.

Dry socket is a relatively rare but severe complication, and prompt treatment is essential to alleviate pain and facilitate healing.

Tobacco Smoking Affects Your Taste and Smell

Smoking can dull the senses of taste and smell, two closely linked senses that contribute significantly to our enjoyment of food and overall quality of life. This dulling effect occurs due to several factors related to the chemicals in cigarette smoke and their impact on the mouth, nose, and brain. Cigarette smoking affects these senses:

1. Direct Damage to Taste Buds and Olfactory Receptors: Cigarette smoke contains various harmful chemicals that can directly damage the tongue’s taste buds and the nose’s olfactory receptors. These sensory receptors are responsible for detecting taste and smell, respectively. The chemicals in smoke can cause inflammation and atrophy of these receptors, reducing their sensitivity and effectiveness.
2. Altered Function of Sensory Cells: Chronic exposure to the toxic compounds in cigarette smoke can cause the sensory cells responsible for taste and smell to become less effective. Over time, these cells may not regenerate as effectively, leading to a decrease in the number of functional taste buds and olfactory receptors.
3. Reduced Saliva Production: Smoking affects saliva production, which is essential for dissolving food chemicals that stimulate taste buds. Reduced saliva flow impacts taste perception and leads to dry mouth, which can further diminish taste and smell sensations.
4. Nasal Congestion and Inflammation: Cigarette smoke can cause irritation and inflammation of the mucous membranes in the nose, leading to nasal congestion. This congestion can block the passage of odour molecules to the olfactory receptors, impairing the sense of smell. Since smell is a significant component of taste perception, this congestion can also affect the sense of taste.
5. Neurological Effects: Nicotine and other chemicals in cigarette smoke can also affect the brain areas responsible for processing tastes and smells. Nicotine alters neurotransmitter levels in the brain, which may indirectly affect how taste and smell information is processed and perceived.
6. Accumulation of Tar and Chemical Residues: The tar and other residues from cigarette smoke can accumulate on the tongue and in the nasal passages, creating a physical barrier that interferes with the interaction between taste/smell receptors and their respective stimuli.

It’s important to know that the impairment of taste and smell from smoking is often gradual and may not be immediately noticeable to the smoker. However, many smokers report a significant improvement in these senses after quitting smoking, as the body begins to heal and the sensory cells recover from the effects of tobacco smoke.

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung condition that causes restricted airflow from the lungs. It is a progressive disease, which means it gradually gets worse over time. The primary cause of COPD is long-term exposure to irritating gases or particulate matter, usually from cigarette smoke. People who have COPD are at higher risk of developing heart disease, lung cancer, and other related illnesses.

Quitting Smoking

Smoking profoundly affects oral health. If you’re a smoker, it’s crucial to maintain excellent oral hygiene, visit your dentist regularly for check-ups and cleanings, and consider quitting smoking for the sake of your oral and overall health. Remember, your mouth is the gateway to your body, and taking care of it is essential for maintaining your overall well-being.

Smoking and Oral Health. While Aria Dental can assist patients with their biological and dental issues, patients need to take responsibility for their own personal habits and behaviours. The health effects of smoking are widely known and are scientifically proven. Smokers can seek help and support from the Make Smoking History network – or a GP, who can support them through nicotine replacement therapy or stop-smoking medications.

Smoking impairs blood flow and reduces oxygen in the bloodstream through vasoconstriction, reduced oxygen-carrying capacity due to carbon monoxide, endothelial dysfunction, increased blood viscosity, and the promotion of atherosclerosis. These effects collectively contribute to various oral health issues, including delayed healing, increased risk of gum disease, and other complications of dental problems.

If you are considering dental implants or oral surgery treatment, it is best to review your medical history with your Aria Dental dentist, who can help in the planning process.