3 minute read

When you smoke, your mouth is the first part of your body to be exposed to tobacco and its harmful effects. This exposure can increase your risk of developing a range of oral health problems, including gum disease. Smoking can also impair the healing process when you receive dental care to treat these conditions.

Quitting smoking or even cutting down can significantly help lower your risks for gum disease as well as a number of other diseases. It’s also important to attend regular check-ups so your dentist can spot early signs of a problem and treat it at the earliest opportunity, before permanent damage sets in.

What causes gum disease?

Gum disease (periodontal disease) is caused by bacteria that build up on teeth around and under the gumline. These form a sticky layer of plaque that hardens into calculus (tartar) if it’s not removed.

Plaque and calculus can irritate and infect the gums, leading to an inflammation response in the body. This can cause the gums to swell, redden and sometimes bleed. However, it’s also possible for you to experience no symptoms and still suffer from active gum disease.

The early stage of gum disease is gingivitis. This can cause your gums to look red and swollen, feel tender and bleed when you brush or floss your teeth.

If gingivitis isn’t treated, it can develop into periodontitis. This is the advanced stage of gum disease that can cause gums to recede and irreversibly damage the supporting structures around teeth, eventually leading to tooth and bone loss.

How does smoking cause gum disease?

Smoking contributes to gum disease in several ways.

  • Chemicals in tobacco reduce your saliva production, which is important for cleansing and disinfecting the mouth. This allows more plaque to build up on teeth.
  • Smoking affects the behaviour of gum tissue cells and the body’s response for fighting infection, making gum disease more likely to develop.
  • Smoking also reduces blood supply to the gums. This means infected gums are less likely to bleed, which can lead to gum disease going undiagnosed for longer. This also affects the success of gum disease treatments and prevents infected gums from healing as quickly.

The risk of gum disease increases the more often you smoke. Heavy smokers are 4 to 5 times more likely to develop gum disease and smokers are 80% more likely to have advanced gum disease than non-smokers, according to a 2017 review of studies.

Smokers are also more likely to develop acute necrotising ulcerative gingivitis, a type of gum disease that can cause pain, bad breath and a bad taste in the mouth.

How is gum disease treated?

In its early stages, gum disease (gingivitis) can usually be treated by following a good oral hygiene routine every day and visiting your hygienist, oral health therapist or dentist for a professional clean. This may include:

  • Cleaning and scaling teeth to remove plaque and calculus from above the gum line
  • Applying fluoride to protect teeth from plaque build-up

If you have advanced gum disease (periodontitis), periodontal treatments may include:

  • Deep scaling and/or;
  • Root planing to remove plaque around tooth roots and below the gum line
  • Taking antibiotics to control any infection

Treating severe gum disease, may require minor surgery. There are a number of surgical treatment options that may be provided by either a general dentist or specialist periodontist, depending on the severity of the condition. Surgical treatments include:

  • Guided bone regeneration/ tissue regeneration
  • Piezosurgery (laser surgery)
  • Pocket reduction surgery


Impacts of smoking on oral health

Besides gum disease, smoking can increase your risk of developing other oral health problems, from stained teeth to tooth loss and oral cancer.

Tooth decay

The bacteria that cause gum disease can also cause tooth decay. This happens when bacteria in plaque feed on sugar and other carbohydrates in your mouth and release an acid that wears down tooth enamel, eventually forming cavities.

Cavities and tooth pulp infections can develop at a faster rate in smokers. This is because smoking reduces saliva flow, which helps to slow the build-up of plaque and neutralise plaque acids. For this reason, smokers are more likely to need fillings and root canal treatment to seal cavities and remove infection.

Gum recession

When plaque is left to build up on teeth and around the gums, bacteria can spread below the gum line, attacking the tooth structures and surrounding gum tissues. As a consequence, gums can start to wear away or pull back, exposing more of the tooth or tooth root. As gums recede, pockets may form between teeth and the gum line making it easier for infection to accumulate.

Tooth loss

Untreated tooth decay, periodontitis or a tooth pulp infection may eventually lead to tooth loss. This can happen if a tooth or its supporting structures are severely damaged and the tooth becomes loose or falls out, or if your dentist recommends extracting and replacing a damaged tooth to stop the infection from spreading to surrounding teeth and gums.

Missing teeth can cause a number of problems, including affecting your ability to chew and speak normally, alignment issues, poor nutrition and digestion and a sagging facial appearance. If you are missing one or more teeth, your dentist may discuss missing teeth replacement options such as dental implants, a bridge or dentures.

Bone loss

In the same way untreated gum disease caused by smoking can result in tooth loss, it can also lead to jaw bone loss. This is because the jaw bone relies on natural teeth and tooth roots to stay healthy. If there is nothing to stimulate the jaw bone when you chew food, the jaw bone begins to shrink away.

Oral cancer

Oral cancer or mouth cancer can refer to a range of cancers that develop in or around the mouth, including the cheek, lip or tongue. Smoking is the main risk factor for oral cancer, and smoking combined with excessive alcohol can increase your risk factor even further.

Your dentist should provide an oral cancer screening every 3 years if you’re under the age of 40, or every 12 months if you’re over 40 years old. Early detection is the key to beating oral cancer with successful treatment. Possible signs of oral cancer include ulcers or red or white patches in your mouth that last for longer than a week.

Complications after dental treatments

Smoking and tobacco use weakens the immune system’s response and can affect your mouth’s ability to heal after a dental procedure.

Smokers are more likely to experience pain and other complications following oral surgery, such as dry socket after a tooth has been removed.

Similarly, smokers who have dental implant surgery to replace missing teeth are at a greater risk of dental implant failure, as it inhibits the healing process. Dental implant patients are always advised to quit smoking before starting treatment.

Tooth stains

Nicotine and tar in tobacco can leave yellow or brown stains on teeth. These may not be removed through normal brushing or professional teeth cleaning and may require cosmetic dentistry such as teeth whitening to remove.

How to lower your oral health risks

You can lower your risk of developing gum disease and other oral health problems by quitting smoking and improving your daily oral hygiene routine. This includes:

  • Brushing teeth twice a day, using a soft toothbrush and fluoride toothpaste
  • Flossing once daily
  • Cutting down on alcohol and sugar
  • Following a balanced diet
  • Visiting your dentist every six months for a check-up and professional clean

World No-Tobacco Day

Tuesday, 31st of May 2022 is World No Tobacco Day. It aims to raise awareness of the harmful and deadly effects of smoking on your health.

If you need help to break the habit, you can talk to your doctor or other support services or call Quitline on 13 7848 (13 QUIT).

Book an Oral Cancer Screening in Kelmscott

If you’d like to book an oral cancer screening or you’re due for a check-up, call our team at Kelmscott Dental to book an appointment.

Call us on (08) 9495 7999 or book an appointment online. We also serve all nearby suburbs including Gosnells, Armadale and Roleystone.


  1. Winnall, WR, Purcell, K, Greenhalgh, EM & Winstanley, MH. 3.11 Dental diseases. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021. Available from http://www.tobaccoinaustralia.org.au/3-11-dental-diseases
  2. https://www.betterhealth.vic.gov.au/health/healthyliving/smoking-and-oral-health
  3. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/gum-disease