Smoking and Periodontal Disease

The harmful effects of smoking, particularly heart disease and cancer, are well known.  Studies show that smoking also increases the chances of developing periodontal (gum) disease.  In fact, smokers are five times more likely than nonsmokers to have gum disease.  For smokers with diabetes, the risk is even greater.  If you are a smoker with diabetes who is age 45 or older, you are 20 times more likely than a person without these risk factors to get severe gum disease.

The Relationship between Smoking and Periodontal Disease

The risk for developing periodontal disease is much greater in people who smoke.  Several studies note that the prevalence of gum disease is two and a half to three times greater in patients who smoke.

Gum pockets usually are deeper in smokers, which means more plaque can accumulate below the gum line and lead to bone loss.  Smokers can have as much as three times more bone loss than non-smokers.  Additionally, calculus (tartar) levels are much higher and gum recession is seen to a greater extent in smokers.  This is notable when the gums seem to pull away from the enamel, resulting in the roots becoming exposed (visible).  Another unpleasant side effect of smoking is staining of the teeth.

No doubt about it, smoking takes a steep toll on your oral health. This is just one of the many reasons to stop.

Understand the Dangers

Surprising as it may sound, many smokers need to be made more aware of the dangers of tobacco use.  Only 29 percent of smokers say they believe themselves to be at an above-average risk for heart attack compared with their nonsmoking peers, according to a study published by the Journal of the American Medical Association in March of 1999.

While information about the medical problems associated with smoking – such as lung disease, cancer, heart disease and low-birth-weight infants – is widely available, many smokers seem to have tuned out.

If you are a smoker who is concerned about the effects smoking can have on your health, congratulations!  By accessing information about the negative impacts of tobacco use, you are taking the first step toward quitting.

To increase awareness of the dangers of smoking, the American Cancer Society sponsors the Great American Smokeout every November.  Americans are encouraged to quit smoking for a day or to encourage someone else to quit for a day.  The idea is to help someone be smoke-free for a day in hopes of motivating that person to quit for life.

The American Academy of Periodontology wants you to understand yet another good reason to quit: Tobacco use is harmful to oral health.

Time to Quit

Recent studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.  In addition, using tobacco products after periodontal treatment or oral surgery does slow down the healing process and make the treatment results less predictable.

How does smoking increase your risk for periodontal disease?  As a smoker, you are more likely than nonsmokers to have the following problems:

• Calculus / tartar – plaque that hardens on your teeth and can only be removed during a professional dental cleaning
• Deep pockets between your teeth and gums
• Loss of the bone and tissue that support your teeth

If the calculus is not removed during a professional dental cleaning and it remains below your gum line, the bacteria in the calculus can destroy your gum tissue and cause your gums to pull away from your teeth.  When this happens, periodontal pockets form and fill with disease-causing bacteria.

If left untreated, periodontal disease will progress.  The pockets between your teeth and gums can grow deeper, allowing in more of the bacteria that destroy tissue and supporting bone.  As a result the gums may shrink away from the teeth, making them look longer.  Without treatment your teeth may become loose, painful, and even fall out.

Additional Information To Help You Stop Smoking

• http://www.webmd.com/smoking-cessation/quitting-tobacco-use-overview
• http://www.smokefree.gov/
• http://www.cancer.org/Healthy/StayAwayfromTobacco/GuidetoQuittingSmoking/index
• http://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm

Save Your Smile

Research shows that smokers lose more teeth than nonsmokers do.  In fact, according to data from the Centers for Disease Control and Prevention, only about 20 percent of people over age 65 who have never smoked are toothless, while a whopping 41.3 percent of daily smokers over age 65 are toothless.

Research also indicates that current smokers do not heal as well after periodontal treatment as former smokers or nonsmokers. But these effects are reversible if the smokers kick the habit before beginning treatment.

Not Just Cigarettes

Other tobacco products are also harmful to your periodontal health.  Smokeless tobacco can also cause gums to recede and increase the chance of losing the bone and fibers that hold your teeth in place.

A study of cigar and pipe smokers published in the January 1999 issue of the Journal of the American Dental Association revealed that cigar smokers experience tooth loss and alveolar bone loss at rates equivalent to those of cigarette smokers.  Pipe smokers are another group who experience tooth loss at a rate similar to cigarette smokers.

Other Oral Problems

Researches have found that the following problems occur more often in people who use tobacco products:

• Oral cancer
• Bad breath
• Stained teeth
• Tooth loss
• Bone loss
• Loss of taste
• Less success with periodontal treatment
• Less success with dental implants
• Gum recession
• Mouth sores
• Facial wrinkling

Study Shows Yet Another Reason Why Quitters Are Winners
Smoking may be responsible for more than half of the cases of periodontal disease among adults in this country

CHICAGO – May 30, 2000 – Smoking may be responsible for more than half of the cases of periodontal disease among adults in this country, according to a new study published in the Journal of Periodontology.  The study found that current smokers are about four times more likely than people who have never smoked to have advanced periodontal disease.  However, 11 years after quitting, former smokers' likelihood of having periodontal disease was not significantly different from those who had never smoked.

Researchers analyzed government health data on 13,650 people aged 18 and older who had their teeth.  This is the first study to estimate the proportion of periodontal disease cases that can be attributed to cigarette smoking.

"Cigarette smoking may well be the major preventable risk factor for periodontal disease," said the study's lead researcher, Scott Tomar, D.M.D., Dr.P.H., of the Division of Oral Health at the Centers for Disease Control and Prevention (CDC). "The good news is that quitting seems to gradually erase the harmful effects of tobacco use on periodontal health."

The study also found that there is a dose-response relationship between cigarettes smoked per day and the odds of periodontitis.  "Smokers who smoked less than a half a pack per day were almost three times more likely than nonsmokers to have periodontitis.  Those who smoked more than a pack and a half per day had almost six times the risk," explains Tomar.

A recent online survey of periodontists conducted by the AAP found that the vast majority of periodontists routinely (79 percent) or most of the time (14 percent) advise their patients to quit smoking.

"Everyday periodontists see the destruction smoking causes in the mouths of their patients," said Jack Caton, D.D.S., M.S., president of the American Academy of Periodontology.  "I hope the staggering statistics from this study will compel even more dental care providers to get involved in tobacco cessation efforts."

Tobacco's negative effect on periodontal health is well documented.  Smoking interferes with healing, making smokers more likely to not respond to treatment and to lose teeth.  "Tobacco use reduces the delivery of oxygen and nutrients to gingival tissue," explains Robert Genco, D.D.S., Ph.D., editor of the Journal of Periodontology.  "Smoking impairs the body's defense mechanisms, making smokers more susceptible to an infection like periodontal disease."

In addition to being a major cause of tooth loss, periodontal disease has been linked to increased risk of heart disease, stroke, poorly controlled diabetes, respiratory disease and premature babies.

"We hope smokers will think about the fact that they are putting their teeth and their health at jeopardy," said Caton.  "We encourage smokers who want to quit to ask their health and dental care providers for help."

SMOKING CAN CAUSE DENTAL IMPLANTS TO FAIL
Smokers with dental implants saw implants fail at higher rate than nonsmokers

CHICAGO - February 6, 2007 - Smoking can harm the integrity of dental implants and cause them to fail more often than in a nonsmoker, according to a new study that appeared in the February issue of the Journal of Periodontology (JOP).

Researchers from University of Murcia in Spain investigated if smoking impacts the ability of a dental implant to succeed.  They found that smoking is a risk factor with regard to tooth loss and dental implant failure.

“People who smoke are at a greater risk of infection following surgery, and may heal more slowly,” said Dr. Arturo Sanchez Perez, Department of Periodontology at the University of Murcia.  “When an implant is placed in a smoker, it is more likely to fail.  This means a patient’s smile may be negatively affected, and the potential for more bone loss in the areas surrounding the gums and teeth.”

Smoking negatively affects blood flow to the bone and tissues surrounding the gums and teeth, which impairs bone healing.  Implants fail because of a failure to integrate with the surrounding bone tissues.  The study followed 66 patients over five years, who received 165 implants.  They found that 15.8% of implants failed in smokers, versus 1.4% of implants in non-smokers.

“Tobacco use has been shown to be a risk factor for periodontal diseases, which is the main cause of tooth loss in adults,” said Dr. Preston D. Miller, DDS, President of the American Academy of Periodontology, “This research shows that if you want your dental implant to last, you should not smoke.  Also, the treating dentist should make sure their patients are aware of this before placing an implant, and emphasize the importance of quitting smoking.”

 

A portion of the above information has been provided by the American Academy of Periodontology (AAP).  The AAP is the professional organization for periodontists - specialists in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants.  Periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.