Posted on 29th May 2019
It’s widely known that smoking is bad for your general health, but it’s perhaps in the area of oral health that it can cause the most significant damage.
World No Tobacco Day is an annual initiative of the World Health Organisation (WHO), which aims to highlight the health risks associated with tobacco use and to advocate for effective tobacco-control policies to reduce tobacco consumption.
“Tobacco use is the largest preventable cause of death and disease in Australia,” CEO of the Australian Dental Association WA, Dr David Hallett, says. “There is an estimated tobacco-related death of an Australian every 30 minutes.
“While the prevalence of tobacco use has declined, far too many Australians continue to smoke, and importantly, many non-smokers continue to be exposed to the smoke created by those smoking around them.
“Dentists are able to provide quality smoking-cessation advice to their patients as part of a comprehensive oral examination.”
Although the focus this year is on Tobacco and Lung Health, oral health still needs to be put under the spotlight. ADAWA asked Oral Medicine Specialist and Director of the Australian Centre for Oral Oncology Research and Education, Dr Camile S Farah, to highlight the most common issues associated with smoking tobacco.
“Tobacco smoking has wide-ranging effects on oral health, as it does on general health. It increases the risk for gum disease and oral cancer, can cause tooth staining and contribute to bad breath, and also decreases the body’s ability to defend itself by affecting its regenerative capabilities. It is known to cause molecular mutations in cells and tissues, hence its role in inducing oral cancer.
“The most significant issues surrounding smoking tobacco revolve around its role in causing oral cancer and precancerous lesions. What’s worse is the significantly increased risk of this happening when patients smoke tobacco and drink alcohol together. Alcohol increases the cancer-causing risk of smoking tobacco.
“Many lesions caused by smoking are reversible, so we always recommend that patients cease smoking.”
Chewing tobacco is also a risk behaviour, causing an increased risk in oral cancer formation, as well as initiation of oral mucosal lesions that may present as white or red patches.
“Some patients place chewing tobacco or similar products in their mouth mixed with other products such as betel quid, and this increases the risk of causing a debilitating condition known as oral submucous fibrosis, which has a high rate of turning into cancer.”
Tobacco-associated risk of oral cancer is dose dependent. The risk increases substantially with increasing frequency, duration, and pack years of cigarette smoking.
“For example, if a person smokes 80 cigarettes per day, he or she will have a 3-fold greater risk than someone who smokes 40 cigarettes per day, whose risk, in turn, will be 17 times higher than that of someone who has never smoked.”
It’s never too late to quit tobacco, so ADAWA encourages all West Australians to make today the day.
“White patches of the mouth can resolve after smoking cessation, and this typically takes between 3-6 months,” Dr Farah says. “Patients will also notice better breath, less staining on teeth and other soft tissues such as the dorsal tongue, and overall improvement in their gum health. They will also benefit from having better taste, as smoking can mask taste and smell. Needless to say, they will feel better overall.”
Tobacco-smoking cessation has been associated with a risk decrease of 30% if an individual stops smoking within 9 years. Remarkably, 20 years of sustained non-smoking are needed to clear a user’s body and reduce his or her risk to the level of someone who has never smoked.
Importantly, e-cigarettes are not yet determined to be appropriate substitutes for smoking cessation. They still carry their own risks in turns of oral health, and not much is known about them in terms of reducing oral cancer risk.