Tobacco use and oral health

On the occasion of World No-Tobacco Day, at Ortiz-Vigón Clinic we would like to make our own small contribution to raise awareness of the risks of tobacco use, specially of those related to oral health.

Last May 10, the workgroup created by the Spanish Society of Periodontics and Osseointegration (SEPA in Spanish) and the National Committee for Smoking Prevention (CNPT) presented at Gum House in Madrid a report about “Smoking cessation and oral health”. As specialists in Periodontics and professionals with sanitary responsibility, we consider that the publication of the summary of the research is a great contribution to society. And that is why we have prepared a brief summary pointing out the main ideas of the report we consider fundamental that should be of common knowledge.

General specifications about tobacco consumption

According to the study, in Spain there are 28% of habitual smokers, which represents one of the highest rates of the European Union. In addition, it is estimated that smoking causes more than 52.000 annual deaths, half of them of cancer. Tobacco use is narrowly tied to the following diseases:

  • Obstructive Chronic Pulmonary Disease: as they indicate in the report of the study, 85-90% of OCPD’s cases is due to tobacco. On the other hand, it is indicated that 15-20% of the smokers can develop OCPD throughout their life.
  • Cancer: besides lung cancer, tobacco is involved in the development of 30% of all the tumors of diverse typology.
  • Cardiovascular disease: smoking is an independent factor for cardiovascular risk. In fact, it multiplies by 2-3 times the risk of suffering from a heart attack of myocardium, ictus and artery disease.
  • Diabetes: the risk of having diabetes is 30-40% higher for active smokers in comparison with non-smokers.

Tabaco y salud bucodental: el tabaco es un factor de riesgo para la diabetes, que además está estrechamente relacionada con la salud dental

Do not forget that any of the diseases indicated here, have a stretch relation with periodontal diseases.

How affects tobacco use to oral health

Smoking produces many negative effects in oral cavity. As they indicate in the report of the study announced by SEPA and CNPT, “from a qualitative point of view, its relation with oral cancer is obviously the most serious harmful effect to bear in mind (…). Nevertheless, quantitatively, its importance seems to be more focused on periodontitis, so this disease concerns an important percentage of population. In addition (…) major relevancy is given to the relation of tobacco and survival of dental implants“.

As we say, some of the complications smoking can motivate is oral cancer. Oral carcinoma of the scaly cells is the most frequent malignant tumor in the oral cavity. Heavy smokers (those who consume more than two packages a day) represent 85% of the cases.

Beside affecting other pathologies as oral leucoplasia or smoker melanosis, smoking provokes an alteration of the quantity and the composition of saliva. Nevertheless, as they explain in the report, the results of the studies realized till now are very variable and turn out to be difficult to compare. According to some studies, tobacco use seems to be related to a decrease of the salivary secretion, thus further developing a dry mouth sensation. In addition, smoking changes the composition of saliva, producing a loss of hydration and lubrication and increasing the sensation of burning.

Due to these changes in the quantity and in the composition of saliva, smokers may face different symptoms:

  • Halitosis.
  • Difficulties to chew or to speak.
  • Taste and smell disorders.
  • Problems with removable protheses on having diminished the adhesion of the prothesis. Friction injuries may also occur.
  • Greater predisposition to oral infections.

Tabaco y salud bucodental: en España hay un 28% de fumadores habituales

Another consequence of smoking is delayed wound healing. And it is that, as it is indicated in the report, because tobacco concerns “the treatment of periodontal tissues because of a toxic effect on fibroblasts, indispensable cells in the healing process due to their relation with the synthesis of collagen”.

It cannot be ignored neither the effect of tobacco use in dental aesthetics. Smoking stimulates the discoloration and appearance of spots in the teeth, dental restorations and dentures.

Tobacco use has direct consequences on saliva, wound healing, response to periodontal treatments, percentage of success on implants and dental aesthetics

Tobacco use and periodontal disease

As the workgroup of SEPA and CNPT explain, tobacco use is an independent risk factor for the development of the periodontal disease. According to the information reflected in the study, the risk of loss of insertion of the smokers is between 2,5 and 6 times higher in comparison with non-smokers.

If periodontal smoker patients are compared to periodontal non-smoker patients, the studies prove that the first group presents higher tooth loss and alveolar bone loss, major depth of catheterization (higher distance between the part of the gum that surrounds the tooth to the base of the bone) and furcal affectation (visibility of the zone of the tooth where roots divide). Likewise, periodontal smoker patients present a worse response to the periodontal treatment and worse healing of the tissues.

Tobacco use and implants

Los implantes dentales son raíces artificiales de titanio que sustituyen a los dientes naturales, que se insertan en el hueso maxilar de los pacientes y sirven para soportar sus nuevos dientes fijos. Se ha demostrado que es un tratamiento eficaz para la recuperación de la función y de la estética de un diente perdido.

After placing an implant, and even if it is not common, complications may arise. A failure in the osseointegration may occur, as well as a peri implant supporting bone loss which can lead to an implant loss. In both cases, tobacco is an important risk factor. According to the summary of the study, “the information suggests people who smoke before or after the placement of a dental implant might suffer a 35-70% higher risk of failure“.

Definitively, there are enough reasons to stop smoking. It is never lat. And the sanitary professionals, we are here to help in this process. In case of any doubt, do not hesitate to make an appointment. To read the complete report, click here.

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