Smoking and Oral Health

For many years, we have known that smoking negatively impacts our overall health. In terms of oral health, smoking can lead to an array of complications and illnesses in the oral cavity, such as mouth cancer and gum disease. Although there has been a decline in smoking, there is still about 1 in 5 of the Irish population smoking daily. (HSE,2021) In addition to this, there has been an increase in ex-cigarette smokers turning to e-cigarette products.(HSE,2021)

Nicotine whether it is smoked through cigarettes or vaped through e-cigarettes will still cause issues with oral health. The oral cavity is resilient, however, repeated trauma to the oral cavity causes irreversible issues. On entering the bloodstream, nicotine restricts blood flow throughout the body, which in turn restricts the blood flow to our mouth and gums. This can then lead to the onset of many oral health complications such as;

Gum Disease:

Smoking can affect the cells in our gums and therefore, gum disease can be happening but it may be too far gone before the symptoms are detected. In addition to this, if the individual is a smoker and has poor oral hygiene this will lead to gum disease and more than likely tooth loss.

Teeth Staining:

Smoking can affect the physical appearance of your teeth, mouth and tongue. Many tobacco products contain abrasive particles that when mixed with the saliva in the oral cavity this wears down the teeth, thus leading to staining.

Tooth Loss:

Over 40% of all adults over the age of 65 who are smokers have lost their teeth. (CDC, 2020) Usually this arises from gum disease, otherwise known as periodontal disease, a serious and complex case of gum disease.

Plaque and Tartar Build-up:

Smokers are more prone to plaque or tartar buildup. Nicotine reduces the saliva flow, which can cause dry mouth. A reduced saliva flow tends to allow food and bacteria to attach onto the surface of the teeth which builds up over time, causing large and thick layers of plaque/ tartar buildup. It is estimated that about 2 in 5 smokers have untreated tooth decay in their oral cavity. (CDC, 2020)

Halitosis (Bad Breath):

Smokers can develop a type of halitosis called Smoker’s Breath. This can be caused by lingering in the throat or lungs or alternatively it can be caused by the chemical compounds in the cigarettes mixed with saliva causing bad breath.

Delayed healing:

Often smokers do not heal as quickly from dental or surgical procedures such as tooth extractions.
Smoker Keratosis: These are white lesions that can form on the roof of the mouth.

Oral Cancer:

Smoking has been identified as a major risk factor for developing Periodontal disease. (Komlos et al., 2021) Similarly, periodontal disease is defined as an individual risk factor which puts the smoker at a greater risk of developing oral cancer. (Jiang, 2020)


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.