People who smoke have a higher risk of gum problems, having complications after tooth extractions and surgery in the mouth, and developing oral cancer. Smokers have a lowered resistance to infections and have impaired healing.
Stopping smoking reduces the risk of developing gum disease and oral cancer, and improves the person’s response to gum treatment. It is very important for smokers to visit their dentists regularly to keep their teeth and gums healthy and have regular oral cancer checks.
In 2008, 17 per cent of Victorians smoked. This figure has halved since 1988.
Caring for your teeth and gums
If you are a smoker, there are some things you can do to prevent tooth and gum problems, including:
- Try to quit smoking – speak to your doctor or call Quitline for guidance and support.
- If quitting smoking is too difficult, try and reduce the number of cigarettes you smoke.
- Thoroughly clean your teeth and gums twice a day with a toothpaste that contains fluoride.
- Use dental floss or interdental cleaners every day to clean between your teeth.
- Visit your dentist regularly for advice about the proper care of your teeth and gums at home, early intervention and regular preventive maintenance visits to keep your teeth and gums healthy.
- Avoid having a dry mouth – drink plenty of water and chew sugar-free gum to stimulate saliva production.
- Limit your alcohol intake.
Oral problems affecting people who smoke
The most common oral problems affecting people who smoke are:
- periodontal disease
- oral cancer
- whitening of the oral mucosa (mucus membrane), which is called smoker’s keratosis
- poor healing after tooth extractions (dry sockets)
- poor healing after mouth and gum surgery
- stained teeth
- bad taste and bad breath.
Periodontal (gum) disease
Periodontal (gum) disease is caused by an infection that destroys the bone surrounding and supporting your teeth. This bone holds your teeth into your jawbone and allows you to chew comfortably. Bacteria and food debris called dental plaque can trigger gum disease.
If left on teeth and gums, plaque hardens to form calculus or tartar. The plaque and calculus irritate the gums around teeth. As gum disease progresses, more bone is lost. Teeth become loose and may fall out by themselves or have to be removed by a dentist.
Smokers typically do not have bleeding gums as they have poor blood supply to the gums, so their gum disease is often masked.
People who smoke less than 10 cigarettes per day are two times more likely to develop gum disease. This increases to four to five times more likely in heavier smokers. Also, the more cigarettes smoked, the worse the gum disease. Smokers do not respond as well to gum treatment as non-smokers.
Smokers are at a higher risk of developing acute necrotizing ulcerative gingivitis, a very painful condition of the gum, which smells and tastes terrible.
Encouragingly, people who stop smoking have the same risk of developing gum disease and responding to gum treatment as non-smokers. People who stop smoking may notice that their gums bleed more. The bleeding should stop after gum treatment from your dentist or dental hygienist, and cleaning your teeth properly.
Symptoms of gum disease
Please see your dentist if you notice any signs and symptoms of gum disease, including:
- red, swollen, tender, bleeding gums
- a persistent discharge (pus) coming from your gums
- gums that are loose and pull away from your teeth
- a bad taste or bad breath
- loose teeth – this can change the feel of your bite when your teeth are placed together or make dentures fit differently
- spaces opening between your teeth.
Oral cancer is cancer of the mouth, including the tongue, cheek, palate, floor of the mouth and lips. There were 518 new cases of oral cancer diagnosed in Victoria in 2010. 59 per cent of Victorians with oral cancer will live for another five years.
Of people with oral cancer, 75 per cent are smokers. People who smoke 40 cigarettes per day and drink four alcoholic drinks per day are 35 times more likely to develop oral cancer than non-smokers and non-alcohol drinkers. The risk is much lower in people who only smoke or only drink alcohol.
People who stop smoking and stop drinking alcohol have the same risk of developing oral cancer as non-smokers after 10 years. Also, non-smokers with oral cancer are three times more likely to survive than non smokers.
Oral cancer in smokers is most likely to occur on the side of the tongue and the floor of the mouth. Treatment for oral cancer includes surgery, radiotherapy and tooth extractions.
Symptoms of oral cancer
Please see your dentist immediately if you notice any:
- persistent ulcer in your mouth or on your lip that does not disappear after seven to 10 days, particularly if the ulcer is not painful
- white patch in your mouth
- red patch in your mouth
- swelling in your mouth
- dentures suddenly not fitting properly.
Poor healing after dental work
People who smoke are more likely to develop a 'dry socket'. This is a poorly healing tooth socket after a tooth extraction, which is very painful.
People who smoke are also more likely to have pain after other oral and gum surgery. Dental implants are less likely to integrate or 'take' in people who smoke than in non-smokers.
Contact your dentist if you have any problems after a tooth extraction, oral and gum surgery, including dental implant surgery.
Where to get help
- Your doctor
- Dentist or oral healthcare professional
- Quitline Tel. 13 7848 (13 QUIT)
- Community dental clinics Tel. 1300 360 054 to find your local clinic
- The Royal Dental Hospital of Melbourne:
- General enquiries or to make an appointment Tel. (03) 9341 1000 or 1800 833 039 (outside Melbourne metro) Monday to Friday, 8:30 am to 5 pm.
- Dental emergencies Tel. 1300 360 054 Monday to Friday 8.30 am to 9.15 pm, weekends and public holidays 9 am to 9.15 pm
- Australian Dental Association Tel. (03) 8825 4600
Things to remember
- People who smoke are at a higher risk of developing oral cancer, gum problems and complications after tooth extractions and gum and oral surgery.
- It is important to look after your oral health to prevent gum disease.
- Visit your dentist regularly for advice about how to keep your teeth and gums healthy, and have regular oral cancer checks.
- Try to quit smoking.
This page has been produced in consultation with and approved by:
Australian Dental Association Victorian Branch
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.