Smoking, Gum Disease, and Tooth Loss

What Is Gum Disease?

Gum (periodontal) disease is an infection of the gums and can affect the bone structure that supports your teeth. In severe cases, it can make your teeth fall out. Smoking is an important cause of severe gum disease in the United States.¹

Gum disease starts with bacteria (germs) on your teeth that get under your gums. If the germs stay on your teeth for too long, layers of plaque (film) and tartar (hardened plaque) develop. This buildup leads to early gum disease, called gingivitis.²

When gum disease gets worse, your gums can pull away from your teeth and form spaces that get infected. This is severe gum disease, also called periodontitis. The bone and tissue that hold your teeth in place can break down, and your teeth may loosen and need to be pulled out.³

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Warning Signs and Symptoms of Gum Disease²

• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth
• Gums that have pulled away from your teeth

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How Is Smoking Related to Gum Disease?

Smoking weakens your body's infection fighters (your immune system). This makes it harder to fight off a gum infection. Once you have gum damage, smoking also makes it harder for your gums to heal.^4,5,6

What does this mean for me if I am a smoker?

• You have twice the risk for gum disease compared with a nonsmoker.¹
• The more cigarettes you smoke, the greater your risk for gum disease.⁵
• The longer you smoke, the greater your risk for gum disease.⁵
• Treatments for gum disease may not work as well for people who smoke.³

Tobacco use in any form—cigarettes, pipes, and smokeless (spit) tobacco—raises your risk for gum disease.⁷

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How Can Gum Disease Be Prevented?

You can help avoid gum disease with good dental habits.³

• Brush your teeth twice a day.
• Floss often to remove plaque.
• See a dentist regularly for checkups and professional cleanings.
• Don't smoke. If you smoke, quit.

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How Is Gum Disease Treated?

Regular cleanings at your dentist's office and daily brushing and flossing can help treat early gum disease (gingivitis).²

More severe gum disease may require:³

• Deep cleaning below the gum line.
• Prescription mouth rinse or medicine.
• Surgery to remove tartar deep under the gums.
• Surgery to help heal bone or gums lost to periodontitis. Your dentist may use small bits of bone to fill places where bone has been lost. Or your dentist may move tissue from one place in your mouth to cover exposed tooth roots.

If you smoke or use spit tobacco, quitting will help your gums heal after treatment.³

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References

1. Eke PI, Dye BA, Wei L, et al. Prevalence of Periodontitis in Adults in the United States: 2009 and 2010. Journal of Dental Research 2012; 91(10):914–20 [accessed 2014 Jul 18].
2. Centers for Disease Control and Prevention. Periodontal Disease [last updated 2013 Jul 10; accessed 2014 Jul 18].
3. National Institute of Dental and Craniofacial Research. Periodontal (Gum) Disease: Causes, Symptoms, and Treatments [last updated 2012 Aug; accessed 2014 Jul 18].
4. Centers for Disease Control and Prevention. Highlights: Smoking Among Adults in the United States: Other Health Effects [last updated 2004 May 27; accessed 2014 Jul 18].
5. U.S. Department of Health and Human Services. A Report of the Surgeon General. The Health Consequences of Smoking. Atlanta: 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 [accessed 2014 Jul 18].
6. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: 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 [accessed 2014 Jul 18].
7. Centers for Disease Control and Prevention. Oral Health for Adults [last updated 2013 Jul 10; accessed 2014 Jul 18].