How Tobacco Use Affects Oral Health
On this page:
- How Do Cigarettes, Cigars, and Hookah Affect Oral Health?
- How Do E-Cigarettes Affect Oral Health?
- Does Smokeless Tobacco Affect Oral Health?
- Will My Teeth Get Better After Quitting Cigarettes and Other Tobacco Products?
- How Can I Quit Tobacco and Protect My Teeth?
How Do Cigarettes, Cigars, and Hookah Affect Oral Health?
Smoking cigarettes, cigars, and hookah can negatively affect your oral health.
Using products that burn tobacco puts you at risk for developing oral cancers. Smoking cigarettes can cause cancer of the oropharynx; larynx; trachea, bronchus, and lung; acute myeloid leukemia; esophagus; stomach; liver; pancreas; kidney and ureter; bladder; cervix; colorectal system.1 Smoking cigars can cause mouth and throat cancers, even if you do not inhale.2 Long term use of waterpipe tobacco, also known as hookah or shisha, is associated with mouth and lip cancers.3
Cigarettes can also contribute to tooth decay. In fact, smoking can cause periodontitis, a serious gum infection that can cause pain and tooth loss.4 Cosmetically, smoking can stain your teeth.5
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This poster presents a stylized artistic interpretation of the effect of smoking on teeth and gums.
If you currently smoke, learn how you can quit smoking to protect your teeth and health.
How Do E-Cigarettes Affect Oral Health?
E-cigarettes are still relatively new products on the market and our understanding of their oral health impacts is still in development. That being said, e-cigarettes may negatively impact oral health. E-cigarette use may promote periodontal disease.6
Aerosols from e-cigarette liquids are likely to stick to exposed surfaces, such as gums, the tongue, insides of the mouth, and teeth as well as dental implants. This may make bacteria more likely to stick as well, potentially leading to oral infections, such as dental decay or cavities; flavored and sugary e-liquids may make this worse.7
People using e-cigarettes or having direct exposure to e-liquids report experiencing dryness, burning, irritation, bad taste, bad breath, and pain or discomfort.8
While e-cigarettes can generally be a lower-risk alternative for adults who smoke cigarettes, e-cigarette use is not risk-free. If you use e-cigarettes, speak with your health care provider about the right quit method for you, especially if you have concerns about your oral health.
Does Smokeless Tobacco Affect Oral Health?
Yes, smokeless tobacco such as dip, snuff, and chewing tobacco can negatively affect oral health. People who use smokeless tobacco products have a strongly increased risk of oral cancer, such as mouth and throat cancers, particularly for the tissues that come in contact with the tobacco.9
People who dip or chew often develop white patches in their mouths, known as leukoplakia, that can turn cancerous.10 They can also develop red patches in their mouth, known as erythroplakia, which have a high likelihood of becoming cancerous.11
Smokeless tobacco can stain your teeth and contribute to tooth decay.12 Additionally, smokeless tobacco can cause inflammation at the site where it is placed. It can also contribute to gingivitis or periodontitis.13
For those who quit using smokeless tobacco, the white patches may resolve or disappear over time.13
Talk to your health care provider about your oral health and options to quit smokeless tobacco use.
Will My Teeth Get Better After Quitting Cigarettes and Other Tobacco Products?
Quitting cigarettes and other products can stop further damage to your oral health.
Quitting smoking can benefit your oral health, including improving the health of your teeth. Your risk of developing cancers of the mouth, throat, and esophagus are cut in half five years after quitting.14
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How Can I Quit Tobacco and Protect My Teeth?
Although quitting smoking is difficult, it is achievable.
If you smoke cigarettes or use other types of tobacco products, quitting is a healthy decision for many reasons. For concerns about your teeth and oral health, consult with your health care provider about nicotine replacement therapies (NRTs) or other ways to quit to help protect your teeth.
FDA-approved nicotine replacement therapy (NRT) may be able to help you on your quit journey. NRTs are proven safe and effective to help you quit smoking by delivering smaller amounts of nicotine without the toxic chemicals found in cigarette smoke.
If you smoke, using FDA-approved NRTs can help you get through the first steps of quitting by reducing cravings and symptoms of withdrawal.
- U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking - 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
- Food and Drug Administration (FDA). Rules and Regulations. Federal Register. 2016; 81(90):29061.
- Munshi T, Heckman CJ, Darlow S. Association between tobacco waterpipe smoking and head and neck conditions: a systematic review. The Journal of the American Dental Association. 2015; 146(10):760-766.
- U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004: 23.
- Karanjkar RR, Preshaw PM, Ellis JS, Holliday R. Effect of tobacco and nicotine in causing staining of dental hard tissues and dental materials: A systematic review and meta-analysis. Clin Exp Dent Res. 2023 Feb;9(1):150-164. doi: 10.1002/cre2.683. Epub 2022 Nov 13. PMID: 36372903; PMCID: PMC9932248.
- Charde P, Ali K, Hamdan N. Effects of e-cigarette smoking on periodontal health: A scoping review. PLOS Glob Public Health. 2024 Mar 20;4(3):e0002311.
- Kim SA, Smith S, Beauchamp C, Song Y, Chiang M, Giuseppetti A, et al. (2018) Cariogenic potential of sweet flavors in electronic-cigarette liquids. PLoS ONE 13(9): e0203717. https://doi.org/10.1371/journal.pone.0203717).
- Yang I, Sandeep S, Rodriguez J. The oral health impact of electronic cigarette use: a systematic review. Critical Reviews in Toxicology. 2020; 50(2), 97-127.
- U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Using Smokeless Tobacco—A Report of the Advisory Committee to the Surgeon General. Bethesda, MD: U.S. Department of Health and Human Services, National Institute of Health, 1986.
- National Cancer Institute. (n.d.). Chapter 4: Health consequences of smokeless tobacco use. In Smokeless Tobacco and Public Health: A Global Perspective. National Institutes of Health. Retrieved June 6, 2024, from https://cancercontrol.cancer.gov/brp/tcrb/smokeless-tobacco.
- Villa A, Villa C, Abati S. Oral cancer and oral erythroplakia: an update and implication for clinicians. Australian Dental Journal. 2011; 56(3): 253-256.
- U.S. Department of Health and Human Services (USDHHS). Preventing Tobacco Use among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2012.
- International Agency for Research on Cancer (IARC). Smokeless Tobacco and Some Tobacco-Specific N-Nitrosamines. Lyon, France. World Health Organization, International Agency for Research on Cancer; 2007.
- U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020. Table 4.1, page 178.