Lung cancer is the first thing that comes to mind for most people when they think of the adverse effects of tobacco on the human body. However, all of the common ways that people use tobacco begin with the mouth, and the damage tobacco does to oral health can range from subtle to severe. Cigars, cigarettes, pipes, snuff, dip and chewing tobacco can all contribute to oral disfigurement, damage, and disease. Family dentists can be instrumental in the education of children and youth in the dangers of tobacco use, and cosmetic dentists can provide treatments for and repair damage already present in adults.
Nicotine stains and other discolorations on teeth and dentures, lips, and tongue are obvious but relatively harmless effects of every kind of tobacco use, as is halitosis, or bad breath. Less objectively obvious but more harmful effects of tobacco use are the loss or diminishing of the senses of taste and smell, smoker's palate (a reaction of the mucosal lining of the palate to elevated temperatures), contribution to the formation and advancement of cavities, sinusitis (which can cause pain similar to that of a toothache), and damage to dental implants. Tobacco use can also reduce the success of dental procedures, and contribute to delays in the healing of oral wounds.
The gums suffer more severe direct damage than the teeth in tobacco users. Periodontitis, a group of diseases that affect the tissues that support the teeth, is more prevalent and more severe among tobacco users than among those that have never used tobacco, and the majority of periodontitis patients that do not respond well to common treatment are users, particularly smokers. Smokers experience significantly greater bone loss; Also tooth loss is two to three times higher in smokers than in non-smokers. Users of smokeless tobacco will often experience gingival recession (receding gums), and mucosal lesions.
All tobacco users are at elevated risk of developing oral cancers and pre-cancers. The lungs are considered to be the highest risk site for cancer in smokers, with the larynx and mouth being the next-highest risk site. Oral cancer is the eighth-most common cancer type in men, and can rise as high as the third-most common cancer in some parts of the world.
Nicotine use can suppress the immune and cardiovascular systems, and along with other compounds in tobacco, can lead to chronic inflammation, which can contribute to the risk of cancer. Tobacco use negatively affects the efficacy of drugs and other treatments, and can delay and complicate recovery.
The only effects of tobacco use on oral health are negative. Even diligent dental care and treatment can only delay, and not prevent, potential disfigurement and disease. For chronic tobacco users it becomes a question of not if, but when, treatment becomes necessary.
Family dentists and their staffs have a unique opportunity to educate young people on the dangers of tobacco use to oral and overall health. Cosmetic dentists have a wide range of treatments and techniques available to them for treatment after the fact, but the best treatment will always be prevention.
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