Tobacco use and oral health – are you thinking of quitting?

Tobacco use and oral health – are you thinking of quitting?

40,000 Canadians will die this year from oral cancer caused by tobacco use. It is highly preventable and if caught early enough, can be treated.

Oral cancer is highly preventable and when caught early enough, it can be treated. Regular visits to the dentist will ensure that you are screened for oral cancer. As with many cancers, the earlier it is detected the better is the chance for survival.

Sadly, despite much research and education over the decades about the perils of smoking, 40,000 Canadians will die this year from oral cancer that was caused by smoking or chewing tobacco.

In Ontario, cancer due to smoking is the most preventable cause of premature death, with 13,500 people dying each year.

The death rate from oral cancers, which includes cancers of the tongue, mouth, gums, tonsils and pharynx, is greater than the death rate from cervical cancer. Deaths due to oral cancer are five times the number of deaths caused by traffic accidents, suicides and AIDS combined.

Smoking is decreasing in Canada

Although the smoking rate among Canadians is steadily decreasing, oral cancer due to tobacco use continues to be a major health problem.

Approximately 5.3 million people (17.7% of Canadians 12 years and older), smoked either daily or occasionally in 2015. This was an improvement from the year before when 18.1% of the population smoked.

What is Oral Cancer?

Oral cancer is a tumour that starts as a growth of abnormal cells in the mouth. Squamous cell carcinoma is the most common type of oral cancer. Some of the chemicals in tobacco smoke cause cancer by triggering genetic changes in the cells of the mouth cavity.

Oral cancer usually presents on the tongue for both men and women but men tend to also have it on the floor of their mouth cavity while women have it mainly on the gums.

oral cancer tumour red spots white tobacco use

Oral Cancer

Photo credit: Dr. Arden Christen, Indiana University School of Dentistry, Department of Oral Biology.

Regular screenings by your dentist for changes in your mouth can help to detect and prevent problems. Dental health professionals can also help their patients with solutions and support to stop smoking.

How does Tobacco Use cause Oral Cancer?

Nicotine in tobacco is highly addictive, but it’s the other toxic substances in tobacco that cause oral cancer and other diseases. There are about 4,000 chemicals and poisons in cigarette smoke. Tar and carbon monoxide are two of the more than 70 that can cause lung disease and cardiovascular disease.

If you are trying to quit, there are many programs to support you, but nicotine is a powerful drug, so it could take four or five attempts before you are successful.

The Dangers of Smoking

Thirty-seven percent of people diagnosed with oral cancer are expected to die within 5 years of the diagnosis.

In addition to oral cancer, which affects the mouth, tongue, throat, esophagus, air passages, lungs and stomach, smokers have a higher risk of developing many other life-threatening health conditions. These include heart disease, chronic lung disease, stroke, and cancers of the bladder and pancreas.

Smokers have a higher chance of dying from oral cancer than do non-smokers, and the amount smoked each day also influences the risk of death from oral cancer.

smoking alcohol cigar cigarette danger oral cancer

This year it is estimated that:

• 4,700 Canadians will be diagnosed with oral cavity cancer

• 1,250 Canadians will die from oral cavity cancer

• 3,200 men will be diagnosed with oral cavity cancer and 860 will die from it

• 1,450 women will be diagnosed with oral cavity cancer and 400 will die from it

Source: Canadian Cancer Society

Symptoms and impact of oral cancer on overall health

Long-term tobacco use reveals itself not only on teeth, gums, the tongue and cheeks but also on the lips, neck and face.

• Red or white spots in the mouth, which can turn into open sores

• Mouth sores or lesions that do not heal (leukoplaki)

• Oral and pharyngeal (throat) cancers

• Cancers of the lungs and/or other parts of the body

• Heart disease and stroke

• Chronic bronchitis, emphysema

• Tooth decay

• Tooth loss (edentulism)

• Severe periodontal disease

• Premature aging

Side Effects

Nicotine addiction - chewing an average amount of chewing tobacco for 30 minutes is like smoking four cigarettes

• Reduced sense of smell and taste

• Bad breath, stained teeth; recession of the gum line and changes in the colour and texture of mouth tissue

• Accumulation of tartar (calculus) and plaque

• Ulcers, upset stomach and increased bowel activity

• Increased tooth sensitivity to hot and cold

• Delayed healing after dental work

• Increased heart rate

• Possible breathing difficulties and/or a "smoker's cough"

Complications for Implants

Smokers further complicate their dental health if they have dental implants.

The risk of developing peri-implantitis, which is a deep mucosal pocket with inflammation of the peri-implant mucosa around dental implants.

This can also cause more resorption of peri-implant bone, and can result in failure of the implant if untreated.

Another complication for smokers is the higher chance of bleeding.

In most cases, if the patient stops smoking they have a higher probability of successful implants.

Would quitting now after years of smoking make any difference?

No matter how long you have smoked, quitting can quickly reduce your risk of developing oral cancer. In most cases, as soon as people stop smoking their risk of getting oral cancer very quickly decreases. 10 to 20 years after quitting, the risk of getting oral cancer is almost the same as for someone who never smoked.

The other benefit to quitting is the reduced chance of getting a repeat case of oral cancer.

nicotine stained teeth smoking cigarettes

Before: 37-year-old heavy smoker with a heavy build up of dental calculus, stains, and severely offensive tobacco breath

Photo credit:  Dr. Arden Christen, Indiana University School of Dentistry, Department of Oral Biology.

cleaning dentist remove stains teeth smoking

After: After quitting and a thorough cleaning, this smoker's teeth were restored to their original whiteness. Failure to remain tobacco-free will cause the staining to recur in weeks.

Photo credit: Dr. Arden Christen, Indiana University School of Dentistry, Department of Oral Biology.

Treatment for oral cancer

Fortunately there is treatment for oral cancer. While quitting smoking will help greatly in the longer term, most patients will require surgery and radiation therapy to treat the cancer.

The affected tissue will be surgically removed. When cancer is in the jaw, then part of the jawbone has to be removed. This could cause a change in the person’s appearance and affect their ability to chew, swallow and talk.

Ontario Government

The benefits of quitting

When people quit smoking, the risk of oral cancer starts to decrease rapidly. After 10 to 20 years of quitting, the risk is reduced to almost the same level as that of someone who has never smoked.

Quitting can also decrease the risk of developing a new, second oral cancer in smokers with a previously treated oral cancer.

Quitting is more effective than other measures to avoid the development of oral cancer and other smoking-related diseases.

quitting smoking no cigarettes prevent oral cancer improve  health

How can you start the quitting process?

Once you have made up your mind to quit, plan a strategy with your doctor and dentist.

• It’s a smart idea to be screened by your dentist to check if you have any signs of periodontal disease and oral cancer

• Start by delaying the time you smoke your first cigarette of the day

• Learn what triggers you to smoke and be prepared to avoid triggers with strategies planned in advance.

• Take one day at a time and reward yourself with a small gift for reaching each goal, no matter how small. (You’ll be saving money on cigarettes)

• If your cravings are strong then have some sugarless gum on hand

• Drink plenty of water to flush out nicotine and reduce cravings faster

• Plan an exercise routine

• Take up a new activity

• Take deep breaths instead of smoking

• Eat plenty of fruits and vegetables

If you are interested in learning more about reducing your risk of oral cancer from tobacco use, we would be happy to meet with you. Please contact Dentistry in Waterloo for a consultation.