Smoking and Oral Health Tobacco use is also a risk factor for, or cause of, numerous other illnesses and conditions of the mouth, such as oral cancer, halitosis (bad breath), tooth decay and gum disease. Oral cancer
All forms of tobacco use are known to cause oral cancer – which includes cancer of the lips, tongue, gum, all of the membrane lining the mouth and the throat.
It has been estimated that tobacco use accounts for more than 90% of oral cancers. Smokers have a three-fold increased risk of oral cancer – and this risk is dependent on both how much they smoke, and for long they have been smoking.
Smokers who consume alcohol are at an even higher risk of oral cancer due to the synergistic effects. The combination of tobacco and alcohol use raises the risk for oral cancer significantly more than the use of either substance alone. Alcohol increases the permeability of the membrane lining the mouth, which is thought to enhance the carcinogenic (cancer-causing) effect of tobacco based products.
Quitting smoking reduces the risk of oral cancer. Diseases of the mouth
Smoking and chewing tobacco stains and discolours the teeth. Tobacco, whether smoked or chewed, also causes halitosis (bad breath).
Another disease commonly associated with smoking is smoker’s palate – a change in the hard palate caused by heavy smoking. This is when the palate turns white and can be littered with red dots located within small raised lumps. This condition disappears after smoking is stopped.
Smokers’ melanosis – another condition which is reversible on smoking cessation – is a condition whereby smokers are more likely to develop local areas of melanin pigmentation of the oral membranes.
Smoking is also a risk factor for oral Candidosis - an opportunistic fungal infection of the mouth. It is thought that tobacco use depresses the immune system, making smokers more susceptible to infection.
Periodontal diseases are inflammatory disorders of the periodontium (the tissue which surround and support the teeth) and include gingivitis, which affects the gums, and periodontitis, which may involve all structures and bone supporting the teeth. There is a clear association between tobacco use, including smokeless tobacco, and periodontal disease.
The effect of tobacco on the immune system plays a major role in the development of periodontal disease and impairs healing after treatment for the disease.
It has been estimated that a smoker has between a 5 and 20 fold increased risk of periodontal disease. The risk of oral diseases increases with greater use of tobacco. There is clear benefit to quitting tobacco use because the risks of oral cancer and periodontal disease decline with increasing time after smoking cessation. References:
- Action on Smoking and Health. ASH Research Report. Tobacco and Oral Health. [Internet]; January 2012 [cited 2013 Apr 3]. Available from: http://www.ash.org.uk/files/documents/ASH_598.pdf
- Winn DM. Tobacco Use and Oral Disease. Journal of Dental Education 2011 April; 65(4):306-312