Dental

Smoking and Oral Health

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Smoking is widely recognised as a major risk factor for serious health problems, but it’s effects on oral health are often underestimated. In 2025, smoking remains one of the leading preventable causes of gum disease, tooth loss and oral cancer, and emerging research shows that newer nicotine products such as vaping are not harmless to the mouth either.

How Smoking affects your Mouth

Tobacco smoke contains over 7,000 chemicals many of which are toxic or cancer-causing. When inhaled, these substances

  • Reduce blood flow to the gums
  • Suppress the immune response
  • Disrupt saliva production
  • Encourage harmful bacteria to thrive

Together, these effects weaken the mouth’s natural defences and make it harder to fight infection or heal properly.

Tooth Staining & Discolouration

One of the most visible effects of smoking is tooth staining.

  • Nicotine and tar penetrate tooth enamel, causing yellow or brown stains that brushing alone cannot remove.
  • Over time, smoking can leave teeth looking dull, darker and uneven in colour.
  • While vaping causes less staining than cigarettes, frequent users may still experience surface discolouration due to increased dental plaque biofilm build-up and dry mouth.

Professional cleaning or whitening can help, but staining often returns if smoking continues.

Gum Disease (Periodontitis)

Smoking is one of the strongest risk factors for gum disease.

  • Smokers are significantly more likely to develop periodontitis, a serious infection that damages the gums and bone supporting the teeth.
  • Smoking masks early warning signs such as bleeding gums, meaning disease can progress unnoticed.
  • Reduced blood supply and a weakened immune response allow harmful bacteria to destroy gum tissue more rapidly.

Without treatment, advanced gum disease can lead to tooth loosening and tooth loss.

Tooth Decay & Dental Plaque Biofilm Build-Up

Smoking increases the risk of cavities and dental plaque biofilm accumulation by

  • Reducing saliva flow, which normally helps neutralise acids and wash away bacteria.
  • Encouraging thicker, more harmful dental plaque.
  • Making teeth more vulnerable to decay.

Research also suggests that vaping may contribute to tooth decay, particularly flavoured e-liquids, which can alter the oral microbiome and increase dental plaque biofilm formation.

Delayed Healing & Dental Treatment Complications

Smoking has a major impact on healing after dental procedures.

  • Smokers heal more slowly after tooth extractions, gum treatment and oral surgery.
  • The risk of infection and complications is higher.
  • Dental implants are more likely to fail in smokers due to impaired bone healing.

Nicotine itself, regardless of how it is delivered, reduces blow flow and interferes with tissue repair. Dentists often advise stopping smoking before and after procedures to improve outcomes.

Oral Cancer Risk

Smoking is a leading cause of oral cancer, including cancers of the lips, tongue, cheeks, throat and floor of the mouth.

  • Smokers are several times more likely to develop oral cancer than non-smokers.
  • The risk increases further when smoking is combined with alcohol.
  • Long-term exposure damages oral cells, increasing the likelihood of malignant changes.

While the long-term cancer risk of vaping is still being studied, e-cigarettes expose oral tissues to chemicals that may cause irritation and cellular damage. Research in this area is ongoing.

Second-hand Smoke & Oral Health

It’s not only smokers who are affected.

  • Regular exposure to second-hand smoke increases the risk of gum disease and oral cancer.
  • Children exposed to smoke are more likely to experience dental decay and gum problems.
  • Creating a smoke-free environment benefits everyone’s oral and general health.

Recommendations

It is recommended that smokers attend their dentist regularly. A regular dental examination can detect symptoms of the oral health complications caused by smoking as early as possible. In addition to this smokers should maintain a good oral hygiene routine, which includes brushing twice daily, flossing and attending the hygienist regularly. Ideally, it would be recommended that people stop smoking as soon as possible as the benefits of giving up smoking are endless. In just a few weeks the effects of stopping smoking can be seen not only in the oral cavity but in your overall health as well.