Smoking increases germs and promotes gum disease.

Most people know that smoking is bad for their health. Smoking affects every part of the body and causes diseases like emphysema, cancer, high blood pressure and stroke. In the mouth, smoking impacts taste buds and smokers face twice the risk as nonsmokers of developing periodontal disease. New research from the University of Louisville also shows how smoking promotes bacterial growth in the mouth and opens the immune system to attack. Dentists see firsthand the impact of smoking on the mouth and frequently caution their patients about smoking and tobacco use.

Teeth are covered in bacteria that live in a biofilm. Biofilm is a thin, slimy or sticky film of bacteria that clings to the surface of teeth and gums. One of the most common biofilms in the mouth is plaque. Plaque leads to gingivitis and other periodontal diseases. The Kentucky study suggests that smoking blankets biofilm in the mouth with a protective layer that makes it hard to brush this film away, allows it to thrive and makes treatment with antibiotics difficult. Dangerous biofilm found in the mouths of smokers include Staphylococcus aureas, Klebsiella pneumonia and Streptococcus mutans. Streptococcus mutans is a contributor to tooth decay and causes a life-threatening infection in the lining of the heart known as endocarditis.


Gingivitis and advanced periodontal disease impacts over 90 percent of Americans. Gum disease is an infection of the gum tissue that causes tooth loss, loss of bone and impact overall health. These outcomes are significantly higher for smokers. Smokers are three to six times as likely as nonsmokers to contract periodontal disease. Patients with severe periodontal disease may require below gum line cleaning called scaling, prescription antibiotics or surgery.

Typical signs of gum disease include red, swollen and painful gums, painful chewing and loose teeth, but smokers have less bleeding, swelling and redness. This is due to constriction of blood vessels in the gum tissue and may lull smokers into believing their mouths are healthy. This constriction of blood flow also impacts healing and ups the chance of infection.

"Chemicals found in cigarette smoke limit your body’s natural defenses against infections," says Dr. Amy Norman, D.D.S, P.S., of Everett, Washington. "When healing slows, the opportunity for infection increases." As infection increases, the chance of long-term damage to gum tissue and significant risk to total health goes up.

Norman offers several treatment options for patients looking to treat periodontal disease and other side effects of smoking such as tooth loss. Minimally invasive laser gum therapy can treat gum disease by excising diseased tissue without surgery and pain, but is not always successful for smokers. Additionally, dental implants are an option for patients who have lost teeth to tobacco use. Norman cautions that the success of dental implants is impacted by tobacco use, "Smoking prolongs or prevents healing which allows the implant to join to the bone and open the patient up for infection."

Dentists are often a valuable resource for patients looking to reduce or eliminate tobacco use. Dentists are able to present patients with information on how smoking directly impacts their teeth, gums and overall health and suggest ways patients may quit.

In addition to increased risk of periodontal disease and infection, tobacco users have a risk 6 times greater than nonsmokers for being diagnosed with oral cancer. Many tobacco users also have an elevated risk of developing cancer in the throat, while users of chew tobacco increase their risk of developing cancer in the lips and cheeks.

Norman stresses the importance of quitting smoking, "Reducing tobacco use or eliminating it entirely has tremendous benefits for oral and total health."

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