Dental Effects of Smoking

How harmful is smoking to my oral health?

Using tobacco or e-cigarettes (vapes) can hurt your whole body, including your mouth. It’s one of the biggest risk factors for gum disease.¹ The most common signs of tobacco use include receding gums, chronic bad breath, tooth decay, and stained or loose teeth. Tobacco and vaping can also cause more serious problems, such as oral cancer, periodontal (gum) disease, and heart disease.

Other health risks from smoking and using tobacco include:

• Dark circles under the eyes
• Dulls sense of smell and taste
• Increased risk of leukoplakia, which are white patches inside the mouth
• Slow healing after tooth extraction or other mouth surgery

Can smoking cause cavities?

Smokers and e-cigarette users have a higher chance of developing oral health issues like cavities. People who smoke are more likely to produce bacteria which can lead to plaque build-up. The bacteria in the plaque and tartar can build up on your teeth to produce an acid that eats away at your enamel, causing cavities.

Does smoking cause gum disease?

Tobacco and nicotine use can increase your risk of gum tissue damage, receding gums, and gum disease. Gums are affected because smoking causes a lack of oxygen in your blood, making it harder for infected gums to heal. Smoking also weakens your immune system, so your body needs to work twice as hard to fight off a gum infection.

Learn more about your gum disease risk.

Does smoking cause tooth decay?

Smoking and tobacco use can damage your teeth and gums. Cavities can start to form after smoking and using tobacco products over time. Large cavities can lead to infections and weak teeth, which results in tooth decay. Teeth may even break down the road which can be costly and painful.

Does smoking cause bone loss in teeth?

Smoking affects the tissue in the gums which makes them vulnerable to infection. Smoking also lowers bone mineral density and decreased calcium absorption. This can lead to bone loss in the jaw and make it harder for your mouth to repair damaged tissue.²

How harmful is vaping to my oral health?

Vaping is the inhaling of a vapor created by an e-cigarette or some other electronic device. E-cigarettes are also called “e-cigs,” “vapes,” “e-hookahs,” and “vape pens”.

Vaping has been shown to lead to an increase in cavities, gum disease, and other oral health problems. People who vape also have a higher chance of developing gum recession, tooth sensitivity, gum disease, tooth loss, and tooth damage due to clenching or grinding.³ E-cigarettes can cause facial injuries, such as bone fractures, tooth loss, and burns (if the battery catches fire).

What are the health effects of smokeless tobacco?

Smokeless tobacco products can contain nicotine, which is addictive and can lead to nicotine addiction. These products can also cause nicotine poisoning in children.

Smokeless tobacco products are associated with many health problems, such as:

• Cancer of the mouth, esophagus (passage that connects the throat to the stomach), and pancreas (gland that helps with digestion and maintaining proper blood sugar levels).⁴
• Diseases of the mouth, such as leukoplakia and cancers of the oral cavity, pharynx, or larynx.⁴
• Increased risk for early delivery and stillbirth when used during pregnancy.⁴
• Increased risk for heart disease and stroke.⁴

Do all tobacco products cause health problems?

Any form of tobacco can cause serious health problems. Here are a few of the health issues that smoking and tobacco can lead to:

Addiction

Smoking and tobacco products contain nicotine, which is addictive. Using any tobacco product can lead to a nicotine addiction. This is because nicotine can change the way the brain works, causing the user to crave more of the substance. Some tobacco products are designed to deliver nicotine to the brain within seconds, making it easier to become dependent on nicotine and more difficult to quit.

Cancer

Tobacco can cause different types of oral cancers, including cancer of the mouth, throat, esophagus, cheek, gum, lip, and tongue cancer. Chewing tobacco and other smokeless tobacco products contain about 28 cancer-causing chemicals.⁵

Cavities and gum disease

Chewing tobacco has a lot of sugar, which can erode your tooth enamel and cause gum infections. Cigarettes, smokeless tobacco, and other forms of tobacco cause cavities, oral cancer, gum disease, and additional oral health problems.⁶

Heart disease

Some forms of smokeless tobacco can cause an immediate and long-term increase in heart rate and blood pressure, which can reduce blood flow from the heart and the amount of oxygen that reaches the body's tissues. This can lead to heart disease and stroke.

Precancerous mouth lesions

Chewing tobacco can cause lesions where the chew is placed. Smokeless tobacco lesions can vary widely, depending on the duration and frequency of use. Without monitoring and getting lesions checked, they can become cancerous.

How long does it take for gums to heal after quitting smoking?

Quitting smoking is good for your oral and overall health. It lowers your risk of a heart attack, stroke, or cancer, including oral cancer. When you quit smoking, it can take one year to see the health improvements of your gums. After one year after quitting, your risk of heart disease is half that of a smoker’s. Then after five years after quitting, your risk of cancer of the mouth, throat, esophagus, and bladder are cut in half.³

What are ways to quit smoking, using tobacco products, or vaping?

If you smoke tobacco or vape, it is important to look after your oral health to prevent dental problems and gum disease. There are many resources for more support and information to help you quit smoking. Here are some ways to start:

• If you’re a Cigna Healthcare^SM customer, visit myCigna^® for tools and tips to help you quit.
• Call the national tobacco quit line at .
• Use free smartphone apps such as the quitSTART app.
• Check out other online smoking cessation tools and programs, like those on Smokefree.gov.
• Ask your Primary Care Provider (PCP) for tips, tools, and support.

¹ Smoking, Gum Disease, and Tooth Loss, Centers for Disease Control and Prevention, October 13, 2023, https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html

² 7 damaging effects smoking is having on your mouth, Bounds Green Dental Practice, https://www.woodgreendental.co.uk/blog/7-damaging-effects-smoking-is-having-on-your-mouth, accessed August 27, 2024

³ Effects of Smoking and Vaping on Oral Health, Better Health, https://www.betterhealth.vic.gov.au/health/HealthyLiving/smoking-and-oral-health, accessed August 26, 2024

⁴ Health Effects of Smokeless Tobacco, Centers for Disease Control and Prevention, May 15, 2024, https://www.cdc.gov/tobacco/other-tobacco-products/smokeless-tobacco-health-effects.html

⁵ Health Effects of Smokeless Tobacco Products, American Lung Association, May, 31, 2023, https://www.lung.org/quit-smoking/smoking-facts/health-effects/smokeless-tobacco

⁶ Tobacco Use and Oral Health Facts, Centers for Disease Control and Prevention, May 15, 2024, https://www.cdc.gov/oral-health/data-research/facts-stats/fast-facts-tobacco-use-and-oral-health.html