Smoking and the Gums

Smoking and the Gums (depressing stuff)

It is said that quitting smoking is harder than giving up heroin- so the odds aren’t great. Heroin is also bad for the teeth but I’m going to focus on the smoking. I’m sure there are lots of smokers out there who are fed up of being told what to do by condescending dentist types. However…while most people know about the links between smoking and cancer, heart disease, emphysema etc. I find that a surprising number of patients don’t know about the catastrophic effects of smoking on the gums. Numerous times over the course of a year I’m forced to extract the lower front teeth and fit a denture for people in their twenties and thirties directly because of it. I find this profoundly depressing- largely because the teeth are perfect but the gums and bone which are the foundations for the teeth have collapsed.
Losing your front teeth is hugely psychologically damaging to anybody, particularly young people. I remember doing it once for an older lady who was a heavy smoker and losing a lot of her front teeth. The denture looked much better than what was there previously but she cried for twenty minutes afterwards when I told her they were gone.
The facts: Periodontal disease is the most common reason for people losing their teeth. Its a complicated process but after poor oral hygiene, smoking is the major preventable risk factor. It happens when bacteria in the mouth attack the gum and underlying jaw bone. Periodontal disease can be treated but if the patient is still smoking the success of the treatment is greatly reduced. At the age of sixty-five 41% of smokers have lost all their teeth. Smokers are seven times more likely to have it than non-smokers.
Smoking causes the blood vessels in the gum to constrict. This reduces the oxygen and nutrient supply to the area. It also reduces the numbers of white blood cells and antibodies which are needed to fight infection. The number of periodontal disease linked bacteria can be up to eleven times higher in smokers than in the mouths’ of non-smokers. This rapidly increases the rate at which it progresses and explains the decreased chances of successful treatment.
Other than the gums, smoking causes increased rates of: oral cancer, bad breath, mouth sores, loss of taste, tooth staining and wrinkling. Memorably one of my patients who smokes descibed her mouth as being “like a cat’s arse” because of the cigarettes. Oral cancer in particular is a nightmare scenario with only a 40% 5-year survival rate.
Giving up smoking is something that I often speak to patients about. I find that it generally takes five attempts or more to actually give up for good. Often patients who have given up say the same thing:
I had to mentally accept that I was going to give up, no matter what, before I was able to do it. The next thing they say is: I wish I’d done it sooner.
The HSE have a website that might be worth a look if anyone’s intersted: