Dentists have a unique view into your overall health – not just your teeth. During a routine cleaning and exam, dentists can pick up on signs and symptoms that may indicate conditions like diabetes, eating disorders, substance abuse, and more. One of the most common health indicators dentists look for is smoking. But can your dentist actually tell if you smoke just by looking in your mouth? Let’s take a closer look.
How Smoking Affects Oral Health
Smoking negatively impacts oral health in a number of ways:
Discoloration
Tobacco smoke contains thousands of chemicals that can stain and discolor teeth. The tar and nicotine in cigarette smoke sticks to the enamel of your teeth, leaving unsightly yellow or brown stains. These stains build up over time, becoming more pronounced the longer you smoke. While surface stains can be removed through professional teeth whitening, deep-set stains are often permanent.
Bad Breath
In addition to staining teeth, smoking also causes bad breath. The chemicals from inhaled cigarette smoke enter your bloodstream and are eventually excreted through your lungs and mouth. This leads to a distinctive smoky smell. Smokers are also more prone to gum disease and tooth decay, which can worsen bad breath.
Gum Disease
Smoking is one of the biggest risk factors for gum disease. Chemicals in tobacco smoke irritate gums and damage your immune system. This makes gums inflamed, swollen and more prone to bleeding. Gum disease occurs in stages, progressing from gingivitis (reversible inflammation) to advanced periodontitis (irreversible gum and bone loss). Periodontitis is the main cause of tooth loss in adults.
Tooth Loss
In addition to increased gum disease, smoking can directly lead to tooth loss. Tobacco use impairs blood flow and the delivery of nutrients and oxygen to tissues in your mouth. This can weaken the jawbone and cause teeth to loosen or fall out prematurely. Tooth loss due to smoking usually occurs in combination with severe gum disease.
Oral Cancer
Smoking raises your risk of developing oral cancer by up to 10 times. Dangerous chemicals from tobacco can damage cells in your lips, tongue, cheeks and throat. Oral cancer often starts as a tiny white or red lesion that develops into a sore or ulcer. Early detection greatly improves survival, but these cancers are often caught in later stages once they become symptomatic.
Delayed Healing
The nicotine in cigarettes restricts blood vessels, limiting blood flow to your gums and other oral tissues. This can delay healing after dental procedures like tooth extractions and implants. Smokers tend to have higher rates of complications like dry socket, infections and implant failure due to impaired healing.
How Dentists Can Tell You Smoke
So with all the ways smoking harms your mouth, how exactly can your dentist tell if you smoke? There are a few giveaways:
Teeth Staining
One of the most obvious signs is yellow or brown stained teeth. Heavy smoking can cause deep intrinsic stains on the dentin (inner layer) of your teeth. Superficial extrinsic stains on the outer enamel can also accumulate over time. While coffee, tea and wine can also stain teeth, the deep nicotine stains of smokers are usually more pronounced and stubborn.
Gum Disease
Careful examination of your gums can reveal signs of periodontal disease like redness, swelling, bleeding and receding gums. Gum disease occurs in nearly 75% of smokers, compared to just 10-15% of non-smokers. The level of gum disease and bone loss seen on x-rays can indicate a smoking habit.
Odor
In addition to visually inspecting your mouth, your dentist may also notice a smoky tobacco smell. This lingering odor emanates from residual nicotine and chemicals in your mouth. Asking about smoking could be prompted by complaint of bad breath that persists despite good oral hygiene.
Oral Cancer Screenings
A full oral cancer screening includes careful examination of all tissues in your mouth. Your dentist may pay particular attention looking for any suspicious lesions, especially if you smoke. Tobacco use makes you much more likely to develop potentially cancerous mouth sores and growths.
Medical History Forms
As part of your medical history, your dentist office will have you fill out a health questionnaire asking about smoking. Lying about smoking could negatively impact your dental care, so it’s best to be honest!
Evidence of Other Health Issues
Smoking is a major risk factor for many chronic illnesses like heart disease, lung disease, diabetes and osteoporosis. If your dental exam reveals signs of these related health issues, smoking may be the common link.
Dental Exam Findings in Smokers
Here are some statistics on what dentists find during routine exams of smokers versus non-smokers:
| Oral Health Issue | Smokers | Non-Smokers |
|---|---|---|
| Cavities and Tooth Decay | 2 times higher rate | Lower rates |
| Gum Disease (Periodontitis) | Up to 8 times higher rate | Lower rates |
| Tooth Loss | 5 times higher rate | Lower rates |
| Leukoplakia (White Patches) | 5 times higher rate | Lower rates |
| Oral Cancer | 10 times higher rate | Lower rates |
| Bad Breath | 5 times higher rate | Lower rates |
The statistics clearly show how smoking significantly increases the risk of nearly all oral health problems.
Conclusion
While examining your teeth and mouth, a dentist can pick up on many subtle signs that you smoke cigarettes. Staining, gum disease, odor and oral cancer screenings can all indicate if you use tobacco. Quitting smoking can drastically improve the health of your mouth. Be honest with your dentist about your smoking so they can provide appropriate treatment and refer you to resources to help you quit. With the right interventions, you can reverse much of the oral damage caused by smoking.