Smoking has detrimental effects and is the cause of several general and oral health problems. Even though most people associate smoking with cigarettes this is not the only form of smoking that has negative effects on your health. Both cannabis and shisha smoking have similar or worse effects than cigarettes. When smoking cannabis filters tend not to be used and even when the substance (cannabis or 10-15% tobacco/shishra) is vaporised (with water either in a bong or shisha pipe) the user takes longer and deeper breaths making it more potent. Overall all of these forms of smoking release carbon monoxide, bronchial irritants, tar and carcinogens that cause health problems.
Smoking is a vaso-constrictor which restricts blood flow and oxygen to soft tissues and bone. This leads to impaired healing and immunity, as oxygen (good circulation) and waste removal (carbon dioxide) are required for healing and immune function (defence against infection). Making smokers more susceptible to developing viral and bacterial infections. An example of this is periodontal disease (gum disease). The first stage and clinical signs of periodontal disease is gingivitis which presents with red inflamed bleeding gums and discomfort, although, due to the vaso-constriction and reduced immune response in smokers the gums are pink, fibrosis and deceptively appear healthy. Even though disease is present it is masked, the combination of reduced oxygen, poor immune response, chemicals in smoke and bacteria in the oral tissues aid the progression of periodontal disease. Leading to irreversible damage to the periodontium (supporting structure of teeth, gums, bone and periodontal ligament) and with time tooth loss.
Smokers are 6x more likely to have periodontitis than non-smokers and 3x more likely to suffer more severe peiodontitis than their counterparts. There is a dose-response relationship between cigarettes and periodontitis, so the more you smoke the greater chance of developing it. As smokers have reduced sensation in their mouths it is difficult to detect disease and plaque in the gingival margin further exacerbating disease progression. Smoking is a contraindication to periodontal treatment and 90% of cases not responsive to periodontal treatment are smokers. By quitting smoking your risk of developing periodontitis is reduced and further damage is prevented.
The lack of healing also leads to a poor response to other dental treatments such as implants and tooth extractions. Dental implants have a failure rate of 11% in smokers compared to 4.8% and there is a greater incidence of complications after an extraction in smokers. Smoking also changes the consistency of saliva making it thicker causing decay even with good oral hygiene, as saliva is needed to neutralise acid after eating which causes decay.
As well as a reduced sensation in the mouth smoking diminishes taste and leads to halitosis (bad breath). The periodontium is not the only tissues smoking changes. The teeth and other tissues of the face and mouth are affected. Smoking stains the teeth, tongue and fingers. Wrinkles of the face and lips are more evident in smokers and the longer/extent of smoking increases the risk of premature wrinkling. There are also distincitve smoker’s lesions which are oral leukoplakia and smoker’s keratosis. Oral leukoplakia is a white patch and smoker’s keratosis grey/white palate with raised papillae, both of these will go once smoking is cessation.
Another change in the oral tissues is oral cancer and smoking can cause and increase ones risk 9x than a non-smoker. Oral cancer can occur in the mouth, throat, oesophagus, pharynx, larynx, tongue, lips and salivary glands. It presents as a white/red area or ulceration that changes in appearance or does not heal. Smoking more and for longer periods further increases your risk of developing oral cancer, more than 80% of oral cancers occur in smokers. Early detection and smoking cessation are key to reducing ones risk, after 5 years of quitting your risk of developing oral cancer is halved. Smoking can also cause other systemic cancers such as lung cancer. It also can cause lung and cardiovascular diseases, poor pregnancy outcomes, stokes, impotence in males and many more.
The benefits of quitting outweigh the associated risks and effects. You no longer harm yourself or others (passive smoking) and your wallet. The table below briefly lists some of the health benefits of quitting.
Health Benefits of Quitting
| Time | Benefit |
| 2 weeks | Circulation, energy and fitness levels improves and lung function increases by 30% |
| 3 months | Lungs stop producing extra phlegm caused by smoking. |
| 1-5 years | Risk of coronary heart disease and oral cancer is half that of a smoker |
| 10 years | Risk of lung cancer is 30-50% less than a smoker |
| 15 years | Stoke and coronary heart disease risk is the same as a non-smoker |
Quitting is not an easy process and requires help, dental professionals can provide this and at Vision Dental we are equipped to diagnose oral cancer and treat the aforementioned oral complications whilst providing smoking cessation.