Periodontitis & Tooth Loss
Smokers lose 6 extra teeth: smoking = periodontitis = tooth loss
A former three pack-a-day smoker who has been quit for ten years, last week I had two additional teeth pulled, bringing my total to six. Oh, they were both dead, likely for a number of years. You see, I had five root canals during my final two years of smoking. A 2006 study found that the male ex-smoker's risk of smoking related tooth loss remained “significantly elevated for the first 9 years of abstinence but eventually dropped to the level of men who never smoked after 13 or more years.”
A 1998 study found that, unrelated to differences in oral hygiene, by age 35 the average smoker had 0.6 fewer teeth than the average non-smoker, by age 50 1.5 fewer, by age 65 they had 3.5 fewer and by age 75 the average smoker had 5.8 fewer teeth. I'm 55 and heavy smoking (roughly 50 pack years) has accelerated my decline by 20 years. But why? Periodontitis.
Periodontitis (peri = around, odont = tooth, -itis = inflammation) refers to inflammatory diseases affecting the periodontium, the tissues surrounding and supporting our teeth. Periodontitis results in gradual loss of bone supporting our teeth, which eventually results in tooth loss.
The exact cause of periodontitis in smokers is poorly understood. Research suggest that it may have little to do with how well or often we brush. Researchers suspect that it's likely associated with years of assaults by scores of smoked toxins. The same double whammy effects of carbon monoxide and nicotine that make circulatory disease smoking's #1 cause of death deprives gums, bone and teeth of normal oxygen levels and blood flow.
Read Joel's Smoking and Circulation article if you don't yet undestand why interrupted blood flow kills more smokers than lung cancer. Smoking not only kills heart muscle via attacks and brain regions via strokes but teeth via disease.
Most disturbing is that we can have rather serious periodontitis and not realize it. As a vasoconstrictor nicotine squeezes blood vessels, which often masks and hides gum bleeding until nicotine use ends. Symptoms of periodontitis can include breath odor, gums that bleed easily, appear shiny or bright red, are swollen or tender when touched but otherwise painless, or loose teeth. The primary treatment objective is to reduce inflamation.
For me, my teeth seemed to all feel smoking's destructive effects about the same time. I found myself living in my dentist's chair. Having inflamed nerve roots ripped from five teeth was a real wake-up call. The incidence of root canals in smokers is 70% higher. What still bothers me is that my dentist never once mentioned the likely cause until setting in the chair during my final root canal. It was clearly too late by then anyway as my smoking pack-years had caught up with me. I guess he simply assumed I somehow knew that smoking destroys teeth. I didn't. Well, maybe deep down I did or at least should have. But like that river in Egypt I was swimming in denial.
"John, smoking is killing your teeth!"
The good news is that I've always been pretty good about brushing. My remaining teeth don't look too bad, are mostly up front and form a nearly solid facade that fools most, until I begin talking. The bad news is that I'll likely lose more.
What I'd like to do with this thread is share with you smoking related tooth and gum related research. It's my hope that doing so might help you further appreciate the importance of the mission at hand ... no nicotine today! But should you experience the worst dental nightmare imaginable, I sincerely hope you feel as I do. I'll take toothlessness any day over ever going back to living as nicotine's slave! Anyway, if at all concerned about relapse, what sense would relapse make if it means losing more teeth sooner?
Knowledge and understanding isn't just power but a quitting method. We hope you'll continue reading at Freedom and WhyQuit, and become smarter than your addiction is strong. Millions of words but just one rule ... no nicotine today!
Breathe deep, hug hard, live long,
John (Gold x10)