How can Smoking affect your mouth and teeth?

By now even the most hardened smoker realises that smoking is bad for your general health. They just hope it won’t happen to them.

However, many of our patients have no idea that smoking can also impact on the health of their teeth and gums.

In most cases, smoking will cause staining of the teeth which can become permanent. Smoking also makes the severity of gum disease worse, which can lead to tooth loss. Smoking is the main causative factor in mouth cancer.


The nicotine and tar content of cigarette smoke can cause the teeth to discolour generally, and any areas that are not brushed perfectly will accumulate surface stain.  Long-term smokers often have badly discoloured teeth where the stain has penetrated the tooth structure.

Taste & smell

The taste & smell senses of smokers are materially affected by smoking, but this recovers within weeks of stopping.


The failure rate of dental implants and any dental surgery increases markedly when the patient is a smoker.

Gum disease

Around 15 % of the population appear to be genetically very susceptible to getting severe gum (periodontal) disease. A further 70% are moderately susceptible to some degree.

Smoking appears to have a number of negative effects that alter how people respond to gum disease.

Smoking decreases the blood flow to the gums, probably due to the nicotine and carbon monoxide content. This reduces their ability to heal, so any disease process that starts, such as gum disease, will progress more readily and cause more damage.
The reduction in blood flow also reduces the amount of bleeding from gum edges on brushing that might otherwise warn the patient that they have gum disease. This can make early detection and treatment difficult.

Smokers also have reduced activity of white blood cells, causing a decrease in normal defence systems against plaque bacteria. This allows more tissue damage to occur.

Patients who smoke also generate more bacterial plaque and hard deposits around their teeth, and this plaque is the main cause of gum disease. Research shows smokers are 2.5 to 6 times more likely than non-smokers to lose teeth early.

In many cases, our normal treatment regimes for gum disease are ineffective when the patient continues smoking, most likely due to the reduced capacity for healing caused by smoking.

Smoking and Cancer

Most people are aware of the association between smoking and lung and throat cancer. However, smoking is strongly associated with the development of oral cancer, with smokers being four times more likely to develop oral cancer. The figure jumps to a person being ten times more susceptible to oral cancer if the smoking is combined with the consumption of spirits. High alcohol content mouthwashes are also implicated.

There are around 4000 cases a year of oral cancer in the UK, primarily in men and the over 50’s. It is the eleventh most common cancer in men, and sixteenth in women. It is as common as cervical cancer. The survival rate is poor – 50% at five years - as it is often detected late. It is believed that the risk of oral cancer returns towards normal 5-10 years after smoking stops.

 Please bear in mind that the average dentist will only ever detect two to three oral cancers in a practising lifetime, so don’t panic too much!

All our dentists routinely scan the mouth for any problems at each dental examination.

Smoking and Children

Smoking during pregnancy doubles the incidence of cleft lip & palates and increases the incidence of low birthweight babies.

 Smoking parents are also associated with an increased risk of cot death, plus increased rates of asthma and respiratory disease in their children.

Reasons for Quitting

  • Pregnant women: Increased risk of low birthweight and foetal death
  • Long-term smokers: Increased risk of heart disease, cancer and stroke
  • New smokers: Easier to stop now than later
  • Any smoker: Save money and feel healthier
  • Fresh breath for yourself, benefitting others around you

Organising Quitting

  • Set a date for quitting and stop entirely on that day
  • See your GP or practice nurse for advice and assistance, as this increases the success rate markedly
  • Call the smoking helpline: 0800 169 0169
  • Get friends and family involved to help.
  • Plan ahead so that any problems that may arise can be dealt with
  • Have “substitutes” to smoking arranged, such as gum or exercise

Practical Advice

Arrange a follow-up appointment, preferably within 1-2 weeks of quitting. This may fit in with a subsequent dental appointment or a visit to the hygienist.  Patients may also be referred to local smoking cessation services and helplines.  This is important since studies show that people are twice as likely to successfully quit with regular follow-ups than without. Even with routine contact, most smokers will make three or four attempts to quit before they finally succeed; it is important to understand that relapse is perfectly normal. At the same time, patients should not be put off trying to quit again and again if necessary.

To help smokers overcome nicotine cravings, the following “Four Ds” can help reduce the urge to smoke:

  • DELAY: Don’t act on the urge to smoke by opening a pack or lighting a cigarette because even after a few minutes this urge will reduce
  • DEEP BREATHS: Take three deep, slow breaths in and out
  • DRINK WATER: Sip it slowly and enjoy the taste
  • DO SOMETHING ELSE: Take your mind off smoking by doing some exercise, listen to music or talk to a friend