SMOKERS: SO YOU THINK YOU’VE HEARD IT ALL BEFORE?

         We all know that cigarette smoking has been linked to increased risk of heart disease, stroke, poorly controlled diabetes, respiratory disease and premature babies.  If that information isn’t enough to make you quit, consider this…”Smokers who smoked less than half a pack per day were almost three times more likely than non-smokers to have periodontitis. Those who smoked more than a pack and a half per day had almost six times the risk,” explains Scott Tomar, D.M.D., Dr.P.H. of the Division of Oral Health at the Centers for Disease Control and Prevention (CDC).  And don’t think these statistics are specific only to cigarette smokers.  Cigar and pipe smokers also have a much higher prevalence of moderate to severe periodontitis, compared to former smokers and non-smokers. Not only that, smokers are also at a higher risk of alveolar bone loss than non-smokers.  Carcinogens in smoke interfere with healing, making smokers more likely to lose teeth and not respond to treatment.
     That may not look all that bad to you at first glance, but lets elaborate on that for a minute. The toxins from use of tobacco products are actually melting the jawbone away, elongating the tooth surface, restricting blood flow and creating an unstable environment. The teeth will become loose and will eventually be lost, even if there is no decay and the tooth itself is not diseased. Even if you live with a smoker, you are at risk from secondhand smoke endangering your oral health. A study published in the Journal of Periodontology found that subjects with periodontitis who were exposed to secondhand smoke were more likely to develop bone loss, the number one cause of tooth loss.
     Most smokers are well aware of increased cancer risk being directly correlated to smoking, but studies show that 90% of people with cancer of the mouth and throat use tobacco. That number should be cause for alarm. 
     Smoking Marijuana (also known as Cannabis) can be just as detrimental. Cannabis smoke acts as a carcinogen and is associated with tooth decay, periodontal disease and pre-malignant lesions. Users are also prone to oral infections, possibly due to the drug’s immunosuppressive effects. 
      Just in case you are wondering if smokeless tobacco is a better option, the simple answer is no. Like cigars and cigarettes, smokeless tobacco products (for example, snuff and chewing tobacco) contain at least 28 chemicals that have been shown to increase the risk of oral cancer and cancer of the throat and esophagus. In fact, chewing tobacco contains higher levels of nicotine than cigarettes, making it harder to quit. One can of snuff delivers more nicotine than over 60 cigarettes. 

Smokeless tobacco can irritate your gum tissue, causing it to recede or pull away from your teeth. Once the gum tissue recedes, your teeth roots become exposed, creating an increased risk of tooth decay. Exposed roots are also more sensitive to hot and cold or other irritants, making eating and drinking uncomfortable.

     Regardless of how long you have used tobacco products, quitting now can greatly reduce serious risks to your health. Studies show that eleven years after quitting, former smokers’ likelihood of having periodontal (gum) disease was not significantly different from people who never smoked. If you need help kicking the habit, don’t be afraid to ask your doctor or dentist for tips and resources. 
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Do you know what to do if you knock out a tooth?

Over the summer one of our patients had a bicycle accident and knocked out her front teeth. Due to quick thinking on the scene, the teeth were re-implanted and are still in the healing process, the outcome is still unknown. Unfortunately accidents happen, but it brought up the question, would you know what to do if this happened to you?

Dentists refer to a knocked-out tooth as an “avulsed” tooth. When a tooth has been knocked out, the nerves, blood vessels and supporting tissues are damaged, too. The nerves and blood vessels can’t be repaired which is why all avulsed teeth will need a root canal treatment. If you act quickly after an accident, being careful not to damage the tooth further, the bone can reattach to the root of the tooth once it’s put back into place and the tooth can be saved. An avulsed tooth is fragile and needs to be handled delicately to give it the best chance at survival. Try not to touch the root (the part of the tooth that was under the gum). If the tooth is dirty, hold it by the upper part (the crown) and rinse it. Don’t wipe it off with a washcloth, shirt or other fabric. This could damage the tooth. Keep the tooth moist. Many people have heard they should store it in a glass of milk. While this is a better option than water it is best if you keep the tooth moist with your saliva, by either placing the tooth in your mouth between the cheek and gum or placing it in a cup or container with your saliva. If nothing else is available it is ok to place the tooth in a cup of water, the most important thing is to keep the tooth moist. If you feel comfortable, try slipping the tooth back into its socket. In many cases, if the accident just happened it will slip right in. Make sure it’s facing the right way and that it is in straight. Don’t try to force it into the socket. If it doesn’t go back into place easily and without pressure, then just keep it moist (in saliva, milk or water) and get to the dentist as soon as you can.

It is very important to re-implant the tooth as soon as possible, ideally within the hour of the accident. After slipping your tooth back into the socket, your dentist will decide if a root canal treatment needs to be done immediately or at a later date. The tooth will then be splinted with a wire to the teeth on either side of it for stability. If the bone around the tooth was not fractured, the root usually will reattach firmly to the bone in about three to four weeks. More damage to the area may require six to eight weeks of repair time. Your dentist should examine the tooth again in three to six months. Unless there are signs of infection, the next visit will occur at your yearly checkup. The dentist will follow up for the next two to three years to ensure that the tooth re-implanted successfully.