An ENT specialist explains what smoking can do to your oral health

Chewing and smoking tobacco can adversely impact your oral health. On World No Tobacco Day, Dr Nitin Gupta shares his take on how to stay ahead of the curve when it comes to tobacco related health ailments.
World No Tobacco Day
Dr Nitin Gupta shares his insights on how tobacco impacts oral health. image courtesy: Shutterstock
Dr Nitin Gupta Published: 31 May 2021, 10:33 am IST
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Smoking and tobacco chewing are very common in the Indian subcontinent. Moreover, along with cigarettes, beedis are heavily consumed in India as they are much cheaper than commercial cigarettes. Due to this, the incidents and cases of oral diseases vary in the Indian subcontinent as opposed to the western countries. 

Oral, head and neck cancers are rampant in India in contrast to lung cancer in the western world due to the high rate of tobacco chewing and beedi smoking. Chewing tobacco, beedi, cigarettes and cigar pipes have almost 28 types of chemicals along with nicotine which increases the risk of oral, throat and oesophageal (food-pipe) cancers.

On World No Tobacco Day, let’s look at the impact of tobacco chewing and smoking on the body
1. Oral hygiene

Tobacco causes inflammation of gums, jaw bones, tissues and mucosa of the mouth. It further causes inflammation of the salivary glands. Tooth decay and plaque formation are 30% more aggravated in people who smoke and chew tobacco. In smokers, incisors (front cutting teeth) are more affected, while in tobacco chewers, the molars are more affected. Incidents of tartar (yellow sticky substance) deposition on the tooth are frequent in smokers. Plaque and tartar destroy the tooth enamel slowly seeping into the pulp of teeth. The pulp is full of vascular and nervous tissue, and its degradation causes extreme pain and could lead to a tooth cavity as well.

World No Tobacco Day
Compromised oral health is what smoking can bestow on you. Image courtesy: Shutterstock

Tobacco chewing causes irritation in the gum tissues which leads to the receding of the gum, causing teeth exposure. Exposed teeth have a higher rate of decay and become more sensitive to hot and cold food. Moreover, edentulism (Toothlessness or loss of teeth) is very common among smokers and bad breath is also a common side-effect of smoking. Moreover, smokers may also notice frequent gum bleeding while brushing or flossing.

There are various kinds of toothpaste available that can help to remove tartar and delay tooth decay. Oral hygiene is very important and one should visit an E.N.T. and a dentist at least twice a year to rule out any gum or oral problems.

2. Oral cancer

Due to constant chronic oral inflammation and the presence of carcinogens in the mouth, there are mutations in the oral tissues. This leads to the formation of pre-malignant (pre-cancerous) cells, thus causing lesions. These lesions can be seen in the form of Leukoplakia (white patch), Erythroplakia (red patch) and Melanoplakia (black patch). The Erythroplakia is the most dangerous of three and has a 40% more chance of getting cancerous.

Leukoplakia and Melanoplakia have 2 to 5% chances of getting cancerous. In the Indian subcontinent, due to beedi and tobacco chewing, pyriform fossa cancers are much more common than vocal cord cancer. These lesions can be detected early and surgically treated. Visit your ENT to get checked for such premalignant lesions or gum problems, if any.

Further, keeping tobacco in the mouth for long hours or sleeping with tobacco in the mouth is most dangerous. Pan-chewing is another sub-continental feature, which involves chewing betel leaves that are carcinogenic (cancer-causing).

Tobacco with alcohol increases cancer incidents by 8 folds. 96% of oral cancers are seen in tobacco users (chewing and smoking) and 90% of lung cancers are seen in smokers. Oral cancers are more common in males than females (this can be due to the fact that males are having more tobacco and alcohol than females). However, increasing incidents of tongue cancers have been reported in females as more and more women have started smoking.

3. Disrupted blood circulation

Oxygen absorption in the lungs of tobacco users significantly decreases as smoking destroys the cilia in the airway. Tobacco also leads to chronic inflammation of lung tissues, thus resulting in lung tissue fibrosis. This in turn causes a significant reduction in the expansile capacity of the lungs, making the lungs susceptible to various microorganisms like bacteria, viruses and fungus. As the infection stagnates in the lungs, the patients become more prone to fatal diseases.

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World No Tobacco Day
Lung damage may be inevitable if you continue to smoke. Image courtesy: Shutterstock

Reduced lung function has made tobacco users more vulnerable to coronavirus. Many cases of Mucormycosis also known as the Black Fungus have been seen in tobacco users. Black fungus grows in the nasal sinuses then spreads to the lungs, eyes, and even brain. Diabetic patients who are also tobacco smokers are at even higher risk of getting such fatal diseases as increased sugar levels attract these microorganisms.

Also, tobacco users have a low oxygen concentration in their bloodstreams leading to delayed wound healing.

Here’s how to reduce your dependency on tobacco

1. Use nicotine patch or nicotine chewing gum to reduce your dependence on nicotine and try to quit chewing or smoking tobacco eventually.

2. Take the help of a psychiatrist or a psychotherapist to understand the root cause of your cravings. This will help you quit for good.

3. Do breathing exercises and meditation to curb your urges.

4. Use an oral antiseptic mouthwash to maintain adequate hygiene levels.

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5. Visit your ENT every 6 to 12 months. They can provide advice about the proper care required for your oral and respiratory system. Regular ENT visits can help detect problems such as cancers in the initial stages, hence increasing your chances of fighting the disease.

The crux of it all lies in your self-motivation and determination that prevent relapse and help you lead a healthier life.

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About the Author

Dr Nitin Gupta, ENT, Head and Neck cancer surgeon Otorhinolaryngology (ENT), Neuro-otology, Masina Hospital  ...Read More

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