Nicotine, Smoking, Vaping And Your Mouth


I know that most of you understand the health risks of smoking, but I am not sure how many of my patients realize just how truly bad smoking is for your mouth. Most of the damage is from the tar content and toxic chemicals, rather than the nicotine. Nicotine is not harmless, as it is a stimulent. Studies have concluded that it does not cause cancer, nor contribute to heart diseas. Think of it more like caffeine.

I can easily identify my smoking patients by looking in their mouth. First, there is usually a distinct unpleasant odor. Secondly, there are usually chronic inflammatory shanges to the pink tissues of the mouth. Typically the palate becomes inflamed by the heat and harsh chemicals in the smoke. This is called Stomatitis Nicotine which is a misnomer as the problem is caused by heat and harsh chemicals.

Stomatitis Nicotina

Stomatitis Nicotina

Lastly, there is usually staining on the teeth. Below is a real-life composite photograph of stained teeth before and after tooth whitening.

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Many studies have concluded that the number of decayed surfaces, missing teeth, and filled surfaces in smokers mouths is significantly higher than nonsmokers. Teeth are usually lost due to gum disease and smoking increases the chance of having gum disease. Smoking also causes the incidence of cavities to increase. I have noticed that my patients who smoke get more cavities by the gumline, which is known as cervical decay. This has been proven to be true with smokeless tobacco products, who’s use leads to increased risk for oral cancer. Many factors have been implicated for the increase in oral problems with smoking. The toxins in smoke can hurt the tissues of the mouth. Smoke also hurts the mouth’s immune system. This leads to an increased probabiliy if getting gum disease and a poorer prognosis to healing it. Other confounding factors are:

  • Poorer or hygiene habits in smokers

  • increased sugar in smokers diets

  • less dental visits in smokers

  • less use of adjunctive items like floss

  • less concern over keeping teeth

  • less concern over the appearance of teeth

    It is interesting that tobacco contains high levels of sugars, and sugars are added to cigarettes. There is a well known link between sugars and tooth decay.

Obviously the problems associated with smoking generally get worse with increased frequency and prolonged use.

Several studies have concluded that children who are around smokers have increased decay rates in their baby teeth. There is no known direct cause, but several confounding factors similar to the list above are implicated. Smoking while pregnant is of course not indicated at all, so I won’t bother getting into the ramifications.

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There is also a known increased risk of all cancers with smoking, especially lung cancer. In short, There is nothing good about smoking. The risks vary as to the kind of material smoked, and the delivery method suchas pipe smoking versus cigar and cigarette smoking, but they are all bad!

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I would like to comment on the new vaping phenomenon. Vaping produces NO SMOKE. Vaping produces vapor which carries nicotine with it. The vapor by itself is not harmful. Tar and toxic chemicals pose almost all of the long term health risks. I am not suggesting that vaping is good for you. Who knows what else they put in the ingredients. I have noticed that most of them are flavored, and am suspicious of the risks posed by additive. Studies are now showing that the flavorings are indeed toxic, so don’t do it!

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Quitting smoking can be one of the most difficult things to do. The addictive nature of nicotine is of course the reason. In my practice, I have found that about 100% of my patients who have successfully stopped smoking have done so by being ready and making a firm decision. There is usually no hypnosis or gimmicks, not to say these can’t work. Click below for professional advice on how to quit smoking today.

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