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1. Smoking causes
» Bad breath or Helitosis
» Plaque/tartar build up leading to Gum inflammation or Gingivitis.
» Smoking can cause damage and ulceration to salivary glands in the palate causing a lesion.
» Smoking increases risk of precancerous lesions like leukoplakia,
» Smoking tobacco is a proven carcinogen, increases risk of Oral Cancer.
» Smoking can interfere with proper healing of the tissues following tooth extraction, oral surgery, dental implant placement etc.
» Chronic smoking also reduces bone density.

2. Are all kinds of smoking and tobacco bad?
Yes use of cigarettes, pipes, cigars, chewing tobacco all are not conducive to maintenance of healthy oral tissues. Chewing of tobacco releases acids and products in the mouth which cause ulceration in the gums, cheek tissue etc. This can lead to chronic irritation of the tissues, causing leukoplakia, oral cancer, vessiculo-bullous lesions in these tissues. a study of cigar and pipe smokers published in the January 1999 issue of the Journal of the American Dental Associationrevealed that cigar smokers experience tooth loss and alveolar bone loss at rates equivalent to those of cigarette smokers. Pipe smokers experience tooth loss at a rate similar to cigarette smokers.

Smokeless tobacco and nicotine products, like chewing tobacco, are also bad for the oral tissues, as they very often have sugar additives, sand and grit which lead to cavities, abrasion of enamel etc.

3. How does smoking increase the risk of tooth loss?
Research shows that smokers loose more teeth than nonsmokers do. In fact, according to data from the Centers for Disease Control and Prevention, only about 20 percent of people over age 65 who have never smoked are toothless, while a whopping 41.3 percent of daily smokers over age 65 are toothless.

Smoking and chewing of tobacco effects the gums directly, by interfering with the cellular repair abilities of these tissues, causing detachment of gum from the teeth and bone. Build up of tartar and stains further increases the rate of onset of gum disease. As the gum attachment reduces, so does the attachment of bone to the tooth get weaker and eventually the teeth start shaking and tooth loss is the ultimate result. Nicotine is considered the most pharmacologically active compound in tobacco smoke. Most is absorbed through the lung alveoli, but nicotine can also be absorbed, though more slowly, through the oral mucosa in sufficient quantities to have a pharmacological effect.

4. Smoking and Dental Implants

Smoking negatively affects blood flow to the bone and tissues surrounding the gums and teeth, which impairs bone healing. Implants fail because of a failure to integrate with the surrounding bone tissues.

Cigarette smoking may adversely affect wound healing, and, thus, jeopardize the success of bone grafting and dental implantation. Bone grafts and sinus lift operations are both common and well-documented procedures before dental implant placement. Heat as well as toxic by-products of cigarette smoking, such as nicotine, carbon monoxide, and hydrogen cyanide, have been implicated as risk factors for impaired healing, and, thus, may affect the success and complications of those surgical procedures. An association among dental implants, grafting procedures (i.e., bone grafts, maxillary sinuses augmentation), and history of smoking has been reported. A higher degree of complication, or implant failure rates, were found in smokers with and without bone grafts.

5. Smoking and Oral Cancers
smoking is the major cause of cancers of the mouth, throat, oesophagus, pharynx, larynx (voice box), tongue, lips and salivary glands.The longer you smoke, and the more you smoke, the greater the risk of these cancers.

More than 80% of cancers of the mouth, nose and throat occur in people who smoke cigarettes, cigars or pipe.When you combine tobacco with heavy use of alcohol, your risk is significantly increased, as the two act synergistically. Those who both smoke and drink, have a 15 times greater risk of developing oral cancer than others.

It may appear as a white or red patch of tissue in the mouth, or a small indurated ulcer which looks like a common canker sore. Because there are so many benign tissue changes that occur normally in your mouth, and some things as simple as a bite on the inside of your cheek may mimic the look of a dangerous tissue change, it is important to have any sore or discolored area of your mouth,which does not heal within 14 days,looked at by a professional. Other symptoms include; a lump or mass which can be felt inside the mouth or neck, pain or difficulty in swallowing, speaking, or chewing, any wart like masses, hoarseness which lasts for a long time, or any numbness in the oral/facial region. Unilateral persistent ear ache can also be a warning sign.Individuals that use chewing tobacco, are likely to have them develop in the sulcus between the lip or cheek and the soft tissue (gingiva) covering the lower jaw (mandible) where the plug of tobacco is held repeatedly.

6. Quit Smoking Now
Five years after you quit smoking the risk of oral cancer is reduced by half. 97.5% of leukoplakia lesions resolved six weeks after quitting smokeless tobacco product.

To quit smoking one must have Firstly a good reason in their mind, why they want to quit. They should keep reminding themselves of this reason. Various pharmaceutical aids like nicotine gum , nicotine patches, prescribed medicines etc help in quitting.

Support classes, hypnotics etc also are supportive in this endeavour. But in the end it all comes down to a WILL TO QUIT and Reason for the same.