It is known that besides the negative effects of smoking on the respiratory and cardiovascular systems, it also has harmful effects on the oral environment and periodontium that it first comes into contact with. And these effects are too great to be underestimated.
We can list the harms of smoking and tobacco use as follows:
• Tar residues and dark-brown stains accumulate on the teeth.
• It causes a black-purple coloration in the gums, resulting in a bad appearance.
• Red-colored inflammatory formations accumulate on the palate.
• There is a higher predisposition to dental disease than non-smokers.
• Bad breath occurs.
• Since smokers do not pay attention to oral hygiene, excessive plaque formation is observed.
• A black hairy tongue appears.
• A decrease in the sense of taste occurs. Since smokers cannot taste many things they eat, they stop consuming especially healthy and beneficial fruits.
• Tissue disorders in the mouth, oral mucosal lesions are more common.
• Gingival recession is more common.
• The susceptibility to oral cancers is higher.
It has been determined that 75% of oral cancers, one of the harms caused by smoking, are cigarette and alcohol habits. Smoking also paves the way for oral cancers in the lips, palate, cheeks and gums. If a person quits smoking, the risk of developing oral cancer is significantly reduced. 10 years after quitting smoking, the risk of developing oral cancer is equivalent to a person who has never smoked.
• Painless swelling in the mouth,
• Pain that does not go away with the destruction of tissues in advanced cases,
• White-red foci in the mouth,
• Difficulty in swallowing, difficulty in speaking,
• Bleeding foci in the mouth occur with difficulty in opening the jaw.
We can briefly list the effects of smoking on the periodontium and periodontal tissues as follows:
• Pocket depth and attachment loss are higher in smokers.
• The risk of contracting periodontal disease is high.
• It masks the signs of inflammation of the gingiva, the gingiva becomes more fibrous and has a pale pink appearance.
• Delays in wound healing occur and complications increase as it negatively affects fibroblast functions.
• It unnecessarily prolongs the effect time of the given local anesthesia.
• Tooth loss is increasing due to periodontal destruction.
• Due to damage to the perodontium and periodontal tissues, it negatively affects the success of the implant and causes failure.
Cigaret; It has been accepted as the biggest factor of periodontal disease among the predisposing factors such as age, gender, socioeconomic status and oral hygiene. Smoking is one of the factors that negatively affect the course of gum disease. It has been proven by many researchers that gingivitis and periodontitis are more severe in smokers. Smoking facilitates the adhesion of bacteria to the tooth surface. It disrupts the gingival defense system. Thus, it makes the gums more vulnerable to bacteria. It prevents the early signs of the disease from appearing. It weakens the response to treatment. In studies on tartar formation, it has been determined that smoking reduces the salivary flow rate and therefore increases the formation of tartar. Nicotine is thought to stimulate the sympathetic nervous system. One of the effects of this warning is that it reduces saliva. Dry mouth caused by lack of saliva facilitates the formation of bacterial plaques on teeth and gums. This increases the formation of calculus. Tobacco smoke affects some types of microorganisms by changing its oxidative reduction potential and can facilitate the formation of various infections by allowing the growth of anaerobic bacteria. Due to the vasoconstricting effect of nicotine, blood flow in the gingiva decreases. It prevents adequate oxygen and blood cells from reaching the gums. In this case, it weakens the self-protective and repairing properties of the gingiva. Decreased local oxygen pressure allows anaerobic bacteria to proliferate and grow. It can also increase the attachment of bacteria to the cheeks and gums. It is thought that smoking reduces gingival bleeding by suppressing the inflammatory changes in the gingiva caused by microbial dental plaque, and also, alveolar bone loss, pocket depth and frequency of tooth loss are higher in smokers. It is possible to reduce the damage to the gums by performing dental calculus and gingival treatment in 6 months. Those who smoke longer have more pocket and periodontal bone loss than those who smoke less. After osteoporosis, the gums recede (bone level decreases) and teeth are lost over time.
One of the problems caused by smoking in the mouth is that it increases the formation of white lesions called leukoplakia, which can be seen in the soft tissue of the mouth.
Symptoms of the disease are seen on the salivary membranes or the oral cavity and are observed as white or bluish-white thickenings on the inside of the cheeks, palate, gums, tongue, pharynx wall. These thicknesses are sometimes encountered as protruding, sometimes as hardened or crusted.
Although the actual cause is unknown, mouth irritation from smoking is thought to be an important factor in the development of the disease, as it is most common in smokers. In addition, roughened tooth tips, poorly placed dentures, etc. They are thought to cause leukoplakia.
Often there are no symptoms and the disease is discovered accidentally by the patient himself or may occur during a doctor’s or dental examination. In some cases, burning and tingling is felt.
It is important because leukoplakia can be a precursor to cancer.
Treatment of leukoplakia;
· Quitting smoking.
Eliminate all possible causes of irritation, such as poorly fitted dentures or roughened denture surfaces.
· The part with leukoplakia is treated by cleaning it with either an electric needle or surgical intervention.
Smoking also causes lesions on the tongue. Tobacco use, too spicy or too hot food can cause redness or irritation of the tongue.
In addition to its direct harmful effects on the periodontium, smoking also causes the clinical picture seen in systemic diseases to be more severe. It causes significant increases in all clinical parameters of periodontal disease, especially seen with diabetes.
In general, in the studies carried out; osteopenia ( osteopenia; thinner-than-average bone ) has been agreed to play a role in the formation of periodontal disease. Periodontal disease, which plays a role in osteopenia, is characterized by alveolar bone resorption, soft tissue attachment and tooth loss. Oral bone loss due to osteopenia may be an important basis for periodontal disease, with the primary cause of periodontal disease being microbial dental plaque. In addition, osteopenia and periodontitis share the factors that can directly or moderately affect the development of the disease, one of which is smoking. According to the results of studies investigating the relationship between periodontal disease, smoking habit and severity of osteoporosis; Smoking increases the severity of the disease more than non-smokers.
As a result, smoking causes serious problems in the formation and prognosis of periodontal diseases, as in many diseases. Today, it is known that even inhalation of cigarettes has negative effects on human health as much as smoking. It is undeniable that cigarettes, which start out of curiosity and then enslave the person, not only cause damage to general health and oral and dental health, but also economic damage to the person. It should not be forgotten that; If starting to smoke is a personal choice, quitting is also a choice that a person can make by using his will and getting the support of a professional physician when necessary. When we quit smoking, a healthy body and fresh breath, healthy and white teeth, healthy gums will await us and we will have the chance to say hello to a better quality life in every way.