Warwick Busby 
Smoking and the use of tobacco in any form can cause serious oral health problems. These include stained and discolored teeth, bad breath (halitosis), and gum disease.
Smoking traditional cigarettes, e-cigarettes, cigars, pipes, and hookah can also weaken the immune system, which slows healing after oral surgery or tooth removal.
1. Gum Disease
Regular smokers are twice as likely to suffer from gum disease which leads to tooth loss. Smoking and the chemicals found in tobacco decrease the regular function of gum tissue cells, making gums more susceptible to infection and deterioration.
Smoking also increases the speed at which teeth fall out and the severity of gum disease, as it makes it more difficult to get rid of plaque and tartar. Smokers also experience more pain and discomfort from gum disease, as well as a less favorable prognosis for dental implant placement.
Smokers have a decreased immune system, which can lead to weakened defenses against oral diseases and slow recovery after a dental surgical procedure. Studies have shown that smoking cessation significantly reduces the risks of many oral health problems and improves the prognosis for prosthodontic care.
2. Tooth Decay
Tooth decay is a major dental problem caused by food particles and bacteria that stick to teeth. The bacteria produce acids that attack and break down the tooth enamel. A cavity (a hole in the tooth) develops and needs to be repaired with a filling.
Smokers are more prone to tooth decay because smoking slows down the production of saliva, which helps wash away food and neutralise acids. They also tend to snack and sip sugary drinks throughout the day, which gives the mouth bacteria more fuel to produce acid attacks on the teeth.
A comprehensive tobacco cessation program that includes brief behavioral interventions complemented with pharmacological treatment is an important part of oral healthcare. The dental team should discuss and promote tobacco product cessation with all patients at every visit.
3. Mouth Sores
People who smoke are twice as likely to develop mouth ulcers. These are painful sores that occur on the lining of the lips and inside the mouth. They vary in size and appearance. They can be red, white, or filled with clear fluid (these are called vesicles or bullae).
Some mouth sores, like cold sores caused by the herpes simplex virus, are contagious and can spread by kissing or sharing food. Other sores, like those in the genitals, nose, eyes, or mouth can be caused by a condition called pemphigus vulgaris, an autoimmune disease that causes the body to attack its own tissues.
Doctors usually diagnose mouth sores by taking a history and doing a physical examination, noting the location and nature of any lesions. They may do blood tests and a biopsy to determine whether there is a systemic cause for the mouth sores.
4. Mouth Ulcers
Mouth ulcers (also known as aphthous ulcers) are small sores that appear on the mouth’s mucous membranes. They can be painful and may bleed or become infected. They are more likely to occur in people who smoke or chew tobacco.
Symptoms of mouth ulcers include painful, swollen and red sores on the inside of the cheeks, tongue, gums or lips. They can also be itchy or sting. Other symptoms may be a burning sensation, dry mouth or difficulty eating and speaking.
A health professional can diagnose a mouth ulcer by examining your mouth and taking a sample of the skin from an ulcer. Alternatively, blood tests can be done to check for an underlying deficiency such as iron, folate or Vitamin B2. Mouth ulcers are also a sign of serious medical conditions like Crohn’s disease and coeliac disease.
5. Heart Disease
Heart disease is a term that refers to problems with your heart and blood vessels. It can include issues with your heart muscle or its blood supply (coronary artery disease), your heart valves, the fluid that surrounds your heart (pericardium) and other issues with your heart’s electrical system.
Several risk factors can increase your chances of having heart disease, including age, genetics, unhealthy diet and physical inactivity, high blood pressure, cholesterol, obesity and smoking. These risk factors can lead to cardiovascular diseases like stroke, heart attack and atherosclerosis.
Using tobacco products increases your risk of developing oral health problems including gum disease, tooth loss and mouth sores. Smoking also can cause lung problems and impact your immune system, making you more likely to get infections.
