How Does Smoking Cause Gum Disease?

In the last couple of blogs, we discussed that smoking impairs the reparative (healing) process that is required for successful restoration of the gums and bones when an implant is placed and also when a tooth is extracted.

Smoking also leads to gum disease….but how?

The ingredients in the smoke (all of those nasty chemicals) affect the attachment of bone and soft tissue of the roots that are anchored into the bone. Remember, the roots of the teeth are anchored into the bone of the jaw (see blog “Periodontal Disease….What exactly is it? Posted on March 2, 2012).

In addition to the gums or soft tissues that hug the ‘necks’ of the teeth, there are also specialized connective tissue fibers. These aid in holding the roots in the bone and prevent the entry of bacteria and food debris down the side of the roots.

Effect of the Smoke
The normal function of the gum tissue cells is compromised due to the chemicals in the smoke. There is a decreased oxygen carrying capacity to the cells of the gums and the bone. Eventually, over time, the result is a loss of the attachment apparatus which holds the roots into the bone. This may present as gum recession (exposure of the roots of the teeth- see blog ‘’ Causes of Gum Recession….The need for a Gum Graft”) and also periodontal pockets (see blog, “Pocketing Measurements, posted on October 8th, 2012.)

A False Sense of Security
Smoking causes a vasoconstriction of blood vessels in the mouth…..Vasoconstriction means ‘a marked narrowing.’

1) Results in an absence of the normal nutrients and oxygen that help cells in the mouth repair and heal.
2) Prevents inflammation of the gums from occurring.

You may think that a decrease in inflammation is a good thing, but it isn’t. Inflammation is a normal physiological response that is supposed to occur in our bodies.
This lack of inflammation occurs in certain individuals who smoke and may present as a false sense of security. This is because the gums in these individuals look healthy I.e.,pink, tight with little bleeding when they are probed with a dental instrument. So although their gums may look like the picture of health, in fact they are not.

Nicotine reduces the ability of the body to respond to the bacteria that causes gum disease.
In the next blog, we will continue with our discussion on how smoking affects your oral health…..until then.

Yours in good oral health, Dr. F. Keshavarz Dentistry

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