smoking and gum disease
How Smoking Affects Your Gums and Teeth
Smoking is a big stressor that increases the chances of periodontal disease sevenfold. It also reduces the chances of successful gum therapies. In fact, smoking can cause receding gums and bone loss even when plaque-forming bacteria have not yet led to periodontal disease.
It may be that the body's immune system is so occupied trying to keep tissues functioning despite the toxicity of the cigarettes that there aren't enough resources left to keep the gums, connective tissue and jaw bone safe from bacterial infection. Smoking itself seems to promote inflammation of the gums. There's a type of bacteria in the mouth called P. gingivalis (porphyromonas gingivalis) that's most commonly associated with gum disease. When nicotine combines with these bacteria, there's an increase in the production of cellular cytokines, which signal immune cells that there's a need to come to the site to fight off infection. The immune cells devour and kill targeted cells, which we experience as inflammation.
And while the gums are under chemical assault, smokers produce fewer antibodies against some of the harmful bacteria, so the bacteria can more easily multiply and make inroads against the weakened gums. (See the section on plaque, gingivitis and periodontal disease.) There are studies showing that smokers are eleven times more likely to be host to significant populations of bacteria that cause periodontal disease, four times more likely to have advanced periodontal disease and have a 40% chance of losing their teeth during their lifetime.
Even living in secondhand smoke has a bad effect on teeth and gums. A Japanese study of over 1,000 pregnant women showed that those who were smokers (even light smokers) or who were non-smokers living with smokers had a higher rate of tooth loss, and over one fourth of the women of child-bearing age had lost one or more teeth.
Of course smoking also stains the teeth and tongue and causes bad breath. It also increases the chances of oral cancer six fold. What connection there is, if any, between these conditions and gum disease has yet to be established.
We absolutely recommend quitting smoking, and not relying just on the beneficial effects of oral care. But we also recognize that quitting smoking is often a process that takes multiple attempts before there are no longer any relapses. Until the effects of the last cigarette have faded, we think it's critically important to diligently use effective practices for oral care.
Knowing how smoking affects your gums and teeth can help you take control of your oral health.