July 19, 2005 Smokers who give up are much less likely to lose their teeth prematurely than those who don't kick the habit, pioneering research has shown.
Dental researchers at the University of Newcastle upon Tyne, UK, observed a group of cigarette smokers with chronic gum disease over one year and found some symptoms were more likely to improve in the people who quit during the study period.
Chronic gum disease, which is characterised by inflamed gums that increasingly recede from the teeth, can lead to tooth loss in its advanced stages if preventive action is not taken.
The researchers' findings, revealed today in the academic publication, the Journal of Clinical Periodontology, therefore provide yet another reason for the 12 million UK adult smokers (just over one-quarter of the adult population) and smokers worldwide to quit their habit for the good of their health.
Statistics show that smokers are still up to six times more likely to develop gum disease than non-smokers, because the detrimental effect the habit has on their body's immune system makes them less well-equipped to fight back.
The study, which is the first of its kind, followed 49 smokers with chronic gum disease over one year. All were encouraged to stop smoking through counselling and, in some cases, using nicotine replacement therapy and/or medication. All of the patients also received treatment for their gum disease.
One-fifth of the patients quit smoking, and in those patients, gum health was significantly improved compared to those who continued to smoke over the 12 months.
Gum disease is initiated by a build up of bacteria in plaque, the sticky white substance that accumulates on the teeth if they are not properly cleaned. The bacteria cause the gums to become inflamed, and they begin to recede from the teeth. At the same time, the bone that holds the teeth in place is gradually destroyed so that over a number of years, teeth may start to become loose and may fall out, or need to be extracted.
The disease is usually painless and thus only discovered when people visit their dentist. The progression of chronic gum disease can often be prevented by a good, daily oral health routine, together with preventive care by a dentist and dental hygienist.
Dr Philip Preshaw, a clinical lecturer in periodontology (the specialist's term for gum disease) with Newcastle University's School of Dental Sciences, led the research. He said: "Our study shows that people should stop smoking now if they want to increase their chances of keeping their teeth into old age.
"Often the dentist is in the best position to help them stop smoking, because most people, if they are going for regular dental appointments, have more contact with him or her than with their doctor.
"Dentists have known for some time that smokers have worse oral and gum health than non-smokers but for the first time we have shown that quitting smoking together with routine gum treatment results in healthier gums."
Dr Preshaw added: "It is very important to look after your teeth, because losing them will have a huge influence on your life. Not only will this affect your appearance, it can also impact on your confidence, lifestyle, and so much more.
"For example, losing teeth could prevent you from eating a healthy diet. You are less likely to chose to eat something like an apple if your teeth are loose, because it would be difficult to bite and chew it."
The UK Government's Department of Health has promoted the idea of smoking cessation counselling by dentists, and dental students at Newcastle University are now taught how to counsel patients on this issue as part of their degree. Newcastle Dental Hospital has a full-time smoking cessation counsellor to whom patients can be referred.
Professor Raman Bedi, the Government's Chief Dental Officer, welcomed this research, stating: "Cigarette smoking is a major risk factor for periodontitis, which affects the support structures of the tooth and is an important cause of tooth loss.
"All members of the dental team, just like any health professional, can play an important role in helping people stop smoking. On 31 May 2005 the UK hosted the launch of the World Health Organisation World No Tobacco Day, and its theme focused upon how to engage health professionals at every level in tobacco control.
"Newcastle University's Dental School is a shining example by ensuring dental students are now taught how to counsel patients on this issue as part of their dental degree."
Amanda Sandford, Research Manager for ASH, commented: "As gum disease is often painless, smokers may be completely unaware of the impact their smoking can have on oral health.
"But the increased risk of tooth loss may be enough to persuade many to quit smoking. Dentists must do all they can to inform patients of the risks and to assist patients who smoke to stop before the disease takes hold."
The research was funded by the Special Trustees of the Newcastle Hospitals NHS Trust, Newcastle upon Tyne.
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