Regardless of which form of tobacco is being used, (chewed, smoked or inhaled) there are no “safer” options. Regular exposure to tobacco in any form can compromise your oral health, leading to a number of significant diseases and conditions. Here are some ways long-term tobacco use affects oral health.
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Gum Disease
Gum disease (periodontal disease) is the infection of gums and bone that supports the teeth. The mechanism behind how cigarette smoking influences the onset of gum disease is still unclear, but many dentists believe that tobacco smoke and nicotine can cause small blood vessels to constrict, limiting the amount of nutrients and oxygen to gum tissues, according to the Journal of Clinical Periodontology. More than one-half of the cases of gum disease are attributed to smoking, and as many as three-fourths of all gum disease cases affect current smokers. This statistic from the National Health and Nutrition Examination Survey shows that there is significant evidence to conclude that smoking increases the chances of developing gum disease.
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Tooth and Bone Loss
A study conducted by Boston University’s Goldman School of Medicine compared two control groups: never-smokers and former smokers. Those who smoked cigarettes had a 4.5-fold increase in risk of tooth loss; this number reduced significantly in those who quit smoking. The findings point towards the risk of tooth loss being much higher among smokers, and also found that it may take decades to return to the rate of normal tooth decay.
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Bad Breath
Many people refuse to date smokers because of the “smokey” or “ashy” taste in their mouth after kisses. In general, the odors that result from smoking are just unpleasant. Smoking increases the amount of bacteria in your mouth (dries up the mouth, affects the salivary glands) and thus causes the bad breath.
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Teeth Discoloration
One of the most visible and immediate effects smoking can have on oral health is teeth discoloration. Tobacco stains cause teeth to turn a yellow and brown-ish hue, depending on severity. A 2005 study conducted by BMC Public Health examining 3,215 adults found moderate and severe discolorations were more prevalent in smokers than non-smokers. Also, more than half of smokers reported to have teeth discoloration.
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Oral Cancer
Cigarettes have long been linked to lung cancer, but it is also a leading link to oral cancer. At least 28 toxins and harsh chemicals in cigarettes cause cancer of the voice box, esophagus, colon, and bladder, according to The National Institutes of Health. Oral cancer, however, involves the lips or tongue, palate (roof of mouth), cheek lining, or floor of mouth. Cancerous tumors are formed because of the chemicals found in cigarettes reacting with cells in your mouth, causing a cancerous genetic mutation.
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Leukoplakia
Tobacco is one of the main culprits of developing a condition in which thick, white patches develop on your gums, inside your check, and even on your tongue. These patches are rough, usually raised, and may eventually take on a hardened texture. Eating spicy foods or hard foods may be a challenge for those with leukoplakia. Fortunately, leukoplakia is usually harmless and will go away once the source of irritation is removed.
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Delayed Healing
Smoking increases the chances of getting dry socket, a common condition that interferes with healing after teeth extractions. Dry socket occurs when the blood clot that formed after teeth extractions is lost, exposing the bone underneath to liquids, air, and food, causing discomfort, pain, and bad odor. Smoking can prolong dry socket due to the sucking action involved, according to Dental Health Index. It is advised to not smoke for the first 48 hours after a tooth extraction.

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