Oral effects of tobacco

Periodontal Factors
ANUG & ANUP
Increase risk for bone loss
localized recession and clinical attachment loss

Soft tissue problems

Nicotine Stomatitis
Smokers melanosis
Black hairy tongue
Median rhomboid glossitis
Leukodema
Hyperkeratosis
Tobacco pouch keratosis
Dry socket
Delayed wound healing

Hard tissue problems

Occlusal or incisal abrasion

Cervical abrasion
Dehiscence of bone
Tooth loss

Esthetic factors

Halitosis
Dental stains
Prosthesis stains
Discoloration of restorations
Impaired taste or smell

How is smoking related to Periodontal Disease

Smoking weakens your body's infection fighters
(your immune system).
This makes it harder to fight off a gum infection.
Once you have gum damage, smoking also makes
it harder for your gums to heal.

Periodontal Disease

Periodontal disease is a chronic

inflammatory disease of the gum and
tissues that surround and support the
teeth. If left untreated, periodontal
disease can lead to tooth loss.

Gingivitis is an inflammation of the

gingiva.
Periodontitis occurs when the gum
tissues separate from the tooth and
sulcus.

Warning Signs and Symptoms:

Red & swollen gums

Tender or bleeding gums

Loose teeth

Painful chewing

Periodontal pockets

What does this mean for me if I am a smoker?

You have twice the risk for periodontal disease compared with a
nonsmoker.
The more cigarettes you smoke, the greater your risk for periodontal
disease.
The longer you smoke, the greater your risk for periodontal disease.
Treatments for periodontal disease may not work as well for those who
smoke.
Tobacco use in any formcigarettes, pipes, and smokeless (spit) tobacco
raises your risk for gum disease.

Increase risk for oral cancer

Squamous cell
Leukoplakia
Verrucous
carcinoma

Nicotine Stomatitis
Pipe and cigar
smoking.

Stains
Nicotine and tar are
the two culprits in
regard to tobacco
stains on teeth.
Yellowish/brown
discoloration.
Luckily, tobacco stains
are extrinsic and can
be removed.

Hairy Tongue

Occurs when the solids &

gases in tobacco help
prevent the tongues
surface cells from
sloughing off normally.

Yellowish, white, brown

or black papillae are
formed
Hair-like projections,
they trap bacteria & food
debris on the tongues
surface.
Contributes to Halitosis

 Have you thought about stopping smoking

(or the use of smokeless tobacco)?

Self-Help

Go Cold Turkey!
Exercise & diet.
Reduce number of daily tobacco exposures.
Select OTC nicotine replacement patches, gum or
lozenges.

References
Esther Wilkins. Clinical Practice of the Dental Hygienist. Lippincott,
Williams, & Wilkins, 11th Ed., 2013.
Understanding Nicotine Addiction and Tobacco Intervention Techniques
for the Dental Professional. Continuing education course.
www.dentalcare.com ( Jan 6, 2012)
Lexicomp online for Dentistry. https://online.lexi.com/lco/action/home