Smoking and vaping

Apart from the other well-documented smoking related health problems, smoking and vaping both affect the health of the mouth. Smokers are more likely to lose their teeth than non-smokers. If you do smoke or vape, it is especially important for you to visit the dentist regularly to ensure your teeth and gums are healthy and there are no signs of oral cancer are present.

There are some differences in how smoking and vaping can affect your oral health. Keep reading as we break down how each affects your oral health.

How smoking affects the mouth

It is well known that tobacco smoking is associated with many negative health effects. It can also affect the mouth, gums and teeth in many ways. The tobacco and nicotine in cigarettes can cause the teeth to become stained and yellow and cause bad breath. Smoking can also affect your ability to taste foods and drinks.

Smoking is associated with an approximately 80 percent increased risk of developing severe gum disease, known as periodontitis, bone loss and other periodontal diseases compared to people who do not smoke.

Tobacco smoking can increase your risk of developing severe gum disease called periodontitis. This results in loss of the supporting bone structures around the teeth and can cause teeth to drift and become loose. Without treatment, the damaged teeth may fall out or need to be removed. Early signs of gum disease like bleeding gums (gingivitis, or inflamed gums) are harder to pick up - both by individuals and dentists, due to the reduced blood supply to the gums.

Smoking can cause wounds or lesions inside the mouth to heal slowly. This is also due to the decreased blood flow to the gums. After oral surgery, such as a tooth extraction, smoking can increase the risk of a dry socket developing. A dry socket is where the extraction socket stops healing properly. This can be a very painful condition. It is important to avoid smoking for as long as possible after having a tooth removed.

Saliva is an important factor in protecting our teeth. Smoking can affect how much saliva your body makes. A decrease in the amount of saliva or saliva that is thick and frothy instead of thin and runny, means your teeth are less protected.

Oral cancer is two times more likely to develop in people who use tobacco compared to those who do not. This includes tobacco that is smoked and chewed. Drinking alcohol and smoking at the same time can increase your risk of oral cancer even more than each alone. Tobacco use and alcohol consumption cause about 75% of oral cancers. Once you quit using tobacco, your risk of developing oral cancer will start to decrease.

Will quitting smoking improve my oral health?

Yes, definitely! Quitting smoking can decrease your risk of developing periodontitis and oral cancer.

Recent research has shown that the risk of developing periodontitis in people who quit smoking becomes similar to people who have never smoked.

It is never too late to quit, even if you have been a smoker for a long time. Your dentist can help and discuss with you your options for quitting the use of cigarettes or e-cigarettes. For more information visit www.quit.org.au or call Quitline 13 78 48.

How to fight 'smoker's breath'

Smoking cigarettes is known to affect breath and you may hear this sometimes referred to as 'smoker's breath'. The substances in the cigarettes have their own smell and in addition smoking dries out the mouth which can allow certain bacteria to flourish. These bacteria produce toxins and gas which have an odour and cause bad breath. In addition, smoking predisposes to gum disease which produces bad breath. The bacteria associated with gum disease accumulate in the gum pockets which develop as a result of this disease.

If you are looking to combat breath problems associated with cigarette smoking, the best way to improve this is to quit smoking. Other good oral health habits include:

• Brush your teeth twice per day and use a fluoride toothpaste
• ​Clean between your teeth at least once a day
• Stay hydrated by drinking tap water throughout the day.

Chew sugarless gum - this may also help to increase saliva levels. If you choose to use chewing gum, be sure to choose sugar-free gum.

If you continue to have bad breath, book an appointment with your local dentist for them to check that there are no other possible causes. If you do not have a regular dentist, you can find one local to you using the ADA's Find-A-Dentist search tool.

How to remove smoking stains from teeth

The nicotine and tar in tobacco smoke can cause yellow or stained teeth. Quitting smoking will stop this staining from developing.

For smokers, brushing your teeth twice a day can help to prevent stains from forming or decrease the amount of stain that forms. Smoking stains that form on the outside surface of the teeth may not be able to be removed with at-home brushing. A professional teeth clean, commonly known as a scale and clean, by a dental hygienist, oral health therapist or dentist can remove these stains from the surface of the teeth.

If smoking has caused the colour of the teeth to change, tooth whitening treatment may be necessary to try and lighten the colour of the teeth. This treatment is best performed by a dental professional.

How vaping affects the mouth

Whilst there is no tobacco in e-cigarettes, vaping can still have a negative effect on your oral health and is not recommended as a replacement for smoking. Many vapes still contain nicotine and other chemicals, including heavy metals that have a similar negative effect as regular smoking.

Research has shown that the oral effects of e-cigarettes may include mouth and throat discomfort, changes to the soft tissues in the mouth and damage to the teeth and gums. This research is based on e-cigarette use by non-smokers.

Is vaping better than cigarettes for oral health?

The use of e-cigarettes or personal vaporisers (vaping) is not encouraged as a replacement for tobacco smoking or as a method of quitting tobacco smoking. There is currently insufficient evidence to demonstrate that e-cigarettes are effective in helping people to quit smoking.

These items are commonly marketed as 'harmless' compared to traditional cigarettes. However, they have been found to cause damage to the lungs as vaping liquids can contain harmful substances including heavy metals, volatile organic compounds and cancer-causing chemicals. E-cigarettes should not be considered safer than smoking conventional cigarettes.

A 2018 review of the research on public health consequences of e-cigarettes suggests vaping poses fewer oral health risks than smoking tobacco cigarettes. However there is very limited research on e-cigarettes that is currently available and there may be further oral health risks that are not yet known. More evidence about the safety of e-cigarettes is still required. For best oral and general health, avoid both traditional cigarettes and e-cigarettes.

Read more about e-cigarettes and vaping

Are nicotine vapes worse?

There is some evidence that e-cigarettes could act as a path for users to develop an addiction to nicotine or tobacco cigarette smoking. The use of e-cigarettes, whether they have nicotine or no nicotine, are not recommended.

Summary

Smoking in all its forms can have a detrimental impact on your oral health, increasing your risk of severe gum disease, tooth loss, and oral cancer. If you are struggling to quit smoking, you can still take care of your teeth. Make sure you brush at least twice a day with fluoride toothpaste, clean between your teeth daily and see your dentist at least once per year for a check-up.

The best way to improve your oral health if you smoke is to quit. It is never too late to quit, even if you have smoked for a long time. You will still see immediate and long-term benefits. Your dentist can discuss with you your options for quitting the use of cigarettes or e-cigarettes. For more information visit www.quit.org.au or call Quitline 13 78 48.