Whether Cigarettes, E-Cigs, Or Pot, Your Oral Health Pays A Price.

added on: April 11, 2019

I’ve been in dentistry for over twenty years. It’s a profession I love, especially in the way it allows me to interact with my patients. I not only provide care for them, I care about them; a commitment that extends far beyond their smiles.

Of course, our primary goal is to care for the oral health and well-being of each. This includes the wellness of teeth and gums along with an appearance that enables each person to feel confident when they smile. Along with our commitment to provide skilled, respectful care, our patients know us as being a “lecture-free zone,” something not all offices are good at.

Nagging and “guilting” someone is an ineffective means of actually helping that person. When we have a smoker in our chair, it is our desire to keep each informed of the condition of his or her teeth and gum health. We also provide pointers that can improve their oral maintenance at home between dental visits. This helps them to minimize the potential for damage, better maintaining their smiles to prevent worsening or new problems.

For smokers, most have heard all the lectures, reasons, and chastising they can handle; we don’t want to add to this. However, we do find that many are not aware of what occurs in the mouth from cigarette smoke (and other tobacco products), e-cigs (known as vaping), and smoking marijuana. We feel that when more people are aware of the repercussions and risks, patients are typically more-involved and committed to take measures that prevent problems from occurring, or minimize the time and expense to treat those that do.

Let’s first address traditional cigarettes.

Simply, smokers have a greater risk of periodontal (gum) disease. Smoking has a drying effect on the soft tissues in the mouth. When saliva flow is insufficient to rinse away oral bacteria, the mouth becomes a bacterial breeding ground. As these bacteria multiply and accumulate in the mouth, gum tissues become inflamed. This is the beginning of gum disease.

In early stages, gum disease causes frequent bad breath, tender and swollen gums, and gums that bleed easily when brushing teeth. As it worsens, the inflammation causes the gums to darken in color, going from a healthy pink hue to red. The gums loosen their grip around the base of teeth and seem more spongy. Breath odor is consistently bad and pus pockets may form at the base of some teeth.

Eventually, oral bacteria attack supporting bone and the tissues surrounding tooth roots, causing teeth to loosen. Some teeth may require removal. Many people are unaware that periodontal disease is the nation’s leading cause of adult tooth loss. Losing teeth compromises the appearance of a smile and one’s confidence in sharing it.

Tooth loss also results in greater time and expense for replacement. And, although dentures and partials can replace the appearance of teeth, the function, stability, and longevity make a poor substitute to the natural teeth that were once in place.

Smokers also have bad breath more often, discolored teeth, and slower healing after procedures such as extractions, gum treatment and oral surgery.  They have higher levels of plaque buildup (a sticky film that coats teeth and gums, made up of oral bacteria). Unremoved plaque can cause the gums to become swollen and tender from inflammation.

For those patients who are able to kick the habit, the benefits can be felt almost immediately. In about 48 hours, damaged nerve endings begin to restore and the sense of smell and taste improves. In just 3 days, breathing is easier, allowing for greater air intake. Oral health improves within 2 weeks as blood circulation in the gums returns to that of non-smokers. Heart attack risk also declines as blood flow greatly improves. Activities are easier and “smokers cough” goes away.

Let’s now look at electronic cigarettes, referred to as e-cigs.

The habit of “vaping” is running rampant as consumers perceive this to be a “healthier” option to cigarettes. While the debate continues, we’d like to address the effects of vaping when it comes to oral health.

Unlike cigarettes that deliver nicotine through smoke, e-cigarettes use a vapor. In this mist is a blend of nicotine, formaldehyde, and other chemicals. Although the components of tar are removed from the mix, the remaining chemicals are still harmful.

Besides nicotine, e-cigarette aerosol can contain cancer-causing chemicals and tiny particles that reach deep into lungs. In a report shared by the Centers For Disease Control & Prevention (CDC), the addictive nicotine contained in most e-cigarettes has known health effects.

A concerning number of users of e-cigs are teens. Not only is their oral health at risk, nicotine exposure can also harm adolescent brain development, which continues into the mid-20s. And, the increasing use of e-cigarettes among youth has shown an unsettling progression to the use of other tobacco products, including cigarettes. (https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm)

Although people think of the lungs when they use electronic cigarettes, it is the mouth that has first contact with the chemicals in the vape moisture and the nicotine. With each inhale, the soft tissues that line the mouth, absorbent by nature, become the initial receptors for the chemical mix.

In one study, oral tissue cells were exposed to the vapor of electronic cigarettes at a rate equal to two 5-second inhales per minute (for a total of 15 minutes a day). The study showed that after one, two and three days, the cells exposed to e-cigs died off at rates of 18, 40 and 53 percent, respectively. A normal rate of cell death in oral tissues is at a daily average of two percent.

Although the full extent of potential damage is still being researched, there has been much concern about elements that can damage this defensive layer in the mouth. This poses an increased risk of infection, inflammation, and gum disease, and a suspected higher risk of cancer.

Finally, we come to marijuana.

Cannabis or medical marijuana was originally legalized to serve as a treatment for pain, seizures and spasms. As legality has broadened to include recreational use, researchers are finding it can have harmful side effects when it comes to oral health.

In the CDC’s 2011-2012 National Health & Nutrition Examination Survey, participants who used cannabis daily for at least 12 months had greater symptoms related to gum disease than lesser or non using participants. (https://www.sciencedaily.com/releases/2017/05/170524152634.htm)

In another study, people who smoked marijuana for up to 20 years had higher levels of gum disease even though other health factors were no worse than those of non-smokers.

While it is widely known that the harmful chemicals of cigarette smoke are harmful to soft tissues in the mouth, the higher risk for developing gum disease should be acknowledged by cannabis users. This way, users can be more proactive in at-home care and stay committed to their 6-month exams and cleanings.

For all patients, we feel it is important to be aware of the signs and symptoms of gum disease. Not only is gum disease the leading cause of adult tooth loss, the bacteria of periodontal disease has been linked to serious health problems. These include heart disease, stroke, memory loss, preterm babies, some cancers, impotency, diabetes and arthritis. As more research is being conducted, a growing number of health problems are showing links to this potent bacteria.

Too, it is now known that the linings in your mouth are important to oral health as well as your overall health. Oral tissues are the body’s first line of defense against microbial infection, actually shielding us from dangerous micro-organisms that live in the mouth.

We want your oral health to complement your overall health through exceptional care. If you are looking for a dental office in Macomb County or in the Shelby Township area, we are always happy to welcome new patients. You may want to begin with a no-charge, private session where, together, we can discuss your specific needs. No lectures. No judgement. Just a  conversation you’ll find supportive. Call 586-739-2155 or tap here to arrange.

For those who struggle with dental fear or anxiety, I can also explain ways to help you relax throughout your visit. (In the meantime, you may want to download our free “Guide For The Fearful Dental Patient.” Just tap here – or call us to request your a be mailed to you.)


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