Both smoking and the use of smokeless tobacco can significantly affect a person’s oral health.  Oral cancer and periodontal (gum) disease are among the most serious oral health problems associated with tobacco use. Other oral health conditions associated with tobacco use include tooth decay, bad breath (halitosis) and stains on the teeth.

Smoking can cause cancer to develop anywhere in the mouth or the pharynx (upper part of the throat behind the mouth). Use of smokeless tobacco or a water pipe (hookah) is just as dangerous to a person’s oral health as any other form of smoking. Any tobacco product may cause cancer because tobacco contains many carcinogenic agents. These chemicals damage cells in the lining of the mouth, pharynx and larynx (voice box). Signs and symptoms of oral cancers vary depending on the location of the cancer, and may begin as abnormal white or red patches in the mouth.

Use of tobacco is among the leading risk factors for developing gum disease. About half of all cases of gum disease among adults in the United States may be attributed to smoking. People who use tobacco also increase their risk of tooth decay and tooth loss. In addition, smokeless tobacco often contains sugar that can promote decay, as well as sand and grit that can wear down the teeth.

Researchers are unclear as to exactly why tobacco causes gum disease. However, many suspect that the chemicals in tobacco interfere with the body’s ability to fight disease and promote healing. People who develop gum disease as a result of using tobacco products may experience symptoms such as swollen, red or sensitive gums. They also may experience gum pain or gums that bleed when brushing or flossing teeth.

Patients who have concerns about their oral health will likely visit a dentist or physician. In either case, an examination of the patient’s mouth, head and neck will likely be performed and a thorough medical history obtained, including any family history of cancer, gum disease or other illnesses. Patients may be asked about their tobacco use, and may undergo additional testing if cancer or gum disease is suspected.  

Treatment depends on the cause of the oral health problem. Treatment options for patients with gum disease include use of antibiotics, scaling, root planing, and gum surgery to clean diseased gum pockets. Treatment options for patients with oral cancer include surgery, radiation therapy and chemotherapy.