The Effect of Smoking on Your Teeth, Gums & Oral Health

What is ‘Smoker’s Teeth?’

‘Smoker’s teeth’ is an oral condition characterized by tooth stains (discoloration) and bad breath. Excessive, long-term smoking causes it. 

Regular smoking can turn white teeth brown or yellow. The more a person smokes, the faster tooth discoloration happens. This is brought about by the nicotine and tar in tobacco. 

Additionally, smoking has been known to cause halitosis or bad breath. It dries the mouth, making halitosis even worse.

How to Remove Smoking Stains from Teeth

Brushing your teeth several times daily can help improve their appearance while preventing staining and periodontitis (advanced gum disease).

Certain toothpastes exist specifically for those who smoke. These toothpaste contain special ingredients that help fight tooth discoloration. 

When looking for a toothpaste for smokers, look for these ingredients:

• Hydrogen peroxide
• Baking soda
• Coconut oil
• Turmeric

Over-the-counter teeth whitening products can also help, including teeth whitening strips, gels, and pens. For severe teeth stains, professional teeth whitening services are recommended.

It is also possible to whiten teeth at home using homemade toothpaste. Add a few drops of hydrogen peroxide to baking soda and mix until it forms a paste. 

Be careful not to use too much peroxide because it can damage your teeth.

How to Combat Bad Breath from Smoking

Smoking decreases saliva production, which dries out the mouth resulting in “smoker’s breath.”

To help eliminate smoker’s breath:

• Brush and floss your teeth at least twice a day
• Drink a lot of water to prevent dry mouth
• Use an antibacterial mouthwash meant for dry mouth
• Chew on sugarless gum to stimulate saliva production
• Suck on peppermint to freshen your breath
• Visit your dentist regularly for plaque and tartar removal
• Take steps to reduce or stop smoking

Serious Oral Health Risks of Smoking

Regular smoking can cause other, more serious oral health conditions. These include, but are not limited to:

Oral Cancer

Smoking is known to cause a high incidence of oral cancers, including cancer of the pharynx, larynx, tongue, and oral cavity. The most common type of oral cancer is squamous cell carcinoma.

According to the Centers for Disease Control and Prevention, if someone smokes, their risk of oral cancer is about 5 to 10 times greater than someone who has never smoked.³

Can Smokeless Tobacco Cause Cancer?

Smokeless tobacco also increases a person’s risk of oral cancer.

Smokeless tobacco can also cause leukoplakia, which is when gray or white patches develop inside the mouth.⁴

Gum Recession

Periodontitis, also known as advanced gum disease, is a serious gum condition that can lead to bone and tooth loss.⁶ It is also the most common cause of gum recession. 

Smoking has been linked to periodontitis because it also weakens the immune system, impairing the body’s ability to repair tissues and fight infection.⁵

Cavities

Studies have shown that the development of dental cavities is higher in those who smoke tobacco compared to those who indulge in smokeless tobacco use.^7,8

Smoking causes a buildup of tartar, plaque, and bacteria in the mouth, which, if left untreated, can lead to cavities.⁶ Additionally, smoking weakens tooth enamel, making it prone to breakage. 

What is the Link Between Smoking and Oral Health?

People who regularly smoke cigarettes and tobacco are at risk for oral health issues like gum disease, oral cancer, and tooth loss.¹ 

Smoking also increases the risk of complications following mouth surgery and tooth removal.

What are the Most Common Oral Health Issues for Smokers?

The most common oral health problems that affect people who smoke include:

• Periodontal (gum) disease
• Oral cancer
• Smoker’s keratosis (whitening of the mouth’s soft tissues)
• Dry socket (poor wound healing after tooth extraction)
• Tooth loss
• Tooth decay
• Tooth discoloration
• Leukoplakia (white patches inside the mouth)
• Decreased sense of taste
• Tartar and plaque buildup on the teeth
• Bad breath
• Increased risk of bone loss in the jaw
• Complications with dental implants and following gum and mouth surgery 

Quitting smoking can help improve oral health by reducing the risk of gum disease, cavities, oral cancer, and complications after mouth surgery. 

What is the Link Between Smoking and Tooth Decay? 

One of the most common effects of smoking is tooth decay. 

Smoking supports tartar, plaque, and bacteria buildup, which leads to the development of cavities. Large cavities along the gum line can weaken the teeth and cause tooth decay. 

Over 40% of adults (20 to 60 years old) who smoke cigarettes have been diagnosed with untreated tooth decay.²

Untreated tooth decay will lead to pain and worsened infections, which may necessitate a root canal or tooth extraction.

Signs of Tooth Decay

The signs and symptoms of tooth decay vary depending on extent and location.

Untreated tooth decay can lead to cavities. However, if a cavity is in its early stages, a person might not experience any symptoms. 

As tooth decay progresses, the signs and symptoms can include:

• Visible pits or holes in the tooth
• White, black, or brown stained teeth
• Tooth sensitivity (pain that may range from mild to sharp when drinking or eating something hot, cold, or sweet)
• Toothache
• Pain when biting down

Approximately 2.3 billion people have cavities worldwide. Over 530 million children have caries in their primary teeth, also known as baby teeth.⁴

What is the Link Between Smoking and Gum Disease?

Gum disease, also called periodontal disease or periodontitis, is caused by a bacterial gum infection made worse by the lack of oxygen from smoking. 

Smoking constricts blood vessels, thereby lessening the oxygen supply in the bloodstream. Gum infections won't heal properly because oxygen cannot reach the infected tissues. 

Untreated infections can severely impact gums and lead to tooth loss. 

Approximately 43% of smoking adults aged 65 and above have lost all their teeth.¹

Signs of Gum Disease

Gum disease begins in subtle ways before becoming noticeable. Signs to look out for include:

• Bleeding gums
• Gums that are red, swollen, and tender
• Loose gums, pulling away from the teeth
• A bad taste in the mouth
• Bad breath or halitosis
• Loose teeth
• Spaces in between the teeth
• Painful chewing
• Pus between gums and teeth

People who smoke cigarettes or use tobacco must visit their dentist regularly to check for signs of gum disease and receive treatment early.

Can Dentists Tell if You Smoke?

A dentist can quickly identify a smoker’s mouth. Smoking severely impacts oral health, affecting teeth and gums in various ways. 

Some common telltale signs of smoking include the presence of plaque, tartar buildup, discolored teeth, white spots in the mouth, and receding gums.

The odor of nicotine in the mouth or clothing is also an indicator.

Tips for Preventing Smoking-Related Oral Health Issues

The best way to prevent smoking-related oral health issues is to quit smoking. For some people, this is easier said than done. 

There are preventive measures that one can take, such as:

• Avoid food and drinks that may stain the teeth
• Avoid sweet and starchy foods
• Brush your teeth properly, at least twice a day, using a good quality toothbrush and toothpaste
• Clean your tongue
• Drink plenty of water
• Eat foods rich in fiber and calcium
• Use toothpaste specially formulated for smokers 
• Use an antibacterial mouthwash
• Visit a dentist regularly

Tips for Quitting Smoking 

Here are some helpful tips for quitting smoking:

• Avoid triggers — This includes people, places, and situations that tempt you to smoke.
• Find a distraction — Staying busy with a hobby or focusing on other things will take your mind off the urge to smoke.
• Nicotine therapy — Some people have successfully quit smoking using a nicotine patch or gum to reduce cravings.
• Know your reason — Find an anchor to motivate you to stop smoking. 
• Don't be too hard on yourself — If you relapse, know it's a temporary setback and try again.
• Seek help — Consider seeking behavioral therapy or custom treatments if you need professional intervention.

Are Vapes and Smokeless Tobacco Products Better for Oral Health?

Smoking water pipes or e-cigarettes (also known as vaping) is as harmful to oral health as smoking tobacco. 

Vaping causes you to inhale vaping juice (or e-liquids) that contain harmful substances even though they are labeled “tobacco-free,” such as:

• Carcinogenic (cancer-causing) chemicals
• Heavy metals
• Nicotine
• Volatile organic compounds (VOCs)

Additionally, daily use of e-cigarettes has been associated with a 78% higher chance of a person having poor oral health.⁹