India is one of the nations that is severely afflicted by tobacco-related illnesses in the world. Families of innumerable individuals are directly or indirectly affected by these illnesses. Individuals undergo significant pain and suffering due to these conditions. Individuals are initiated into tobacco use when they are very young These habits are very addictive and leads to prolonged use by its users. Dr. Rajesh G, In-charge of Tobacco Cessation Centre, Professor and Head, Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore (MAHE) explains the effects of tobacco on oral health. Read the complete article to find out.
How Tobacco Affect Oral Hygiene?
Tobacco use is one of the leading causes of disease and suffering afflicting mankind all over the world. Tobacco is consumed both as smoking and smokeless forms in India. Smoking tobacco is usually in the form of cigarettes, beedis, chutta, chillum, hookah, hookli. On the other hand, the smokeless form is in the form of paan, beedi, ghutka, zarda, mawa, khaini, snuff and other forms. Based on local customs and traditions, these forms of tobacco have evolved over a long period of time in India. Tobacco consumption puts the youngsters along the path of illnesses that take a long time to manifest. They are rightly called “silent killers” as these diseases are detected during the last stages. By the time these individuals realize their situation, it would be too late to institute treatment procedures. There is a definite need to instill awareness about the ill-effects of tobacco among youngsters.
Signs of oral problems due to tobacco abuse
- The first tell-tale signs and symptoms of tobacco use are clearly manifested in the oral cavity.
- The mouth is the doorway to the body and oral health is the gateway for good general health.
- Use of tobacco initially leads to unsightly staining of teeth. These stains are usually yellowish or brownish stains on the surfaces of teeth.
This is usually accompanied by bad breath or halitosis. The younger generation are nowadays very particular about their appearance and their social interactions. Stains and bad breath have a definite impact on both the appearance and social interactions of individuals.
Alterations in sensations of taste and smell are also noted among tobacco users. Tobacco use also alters the microorganisms in the oral cavity. This increases the risk of infections in the oral cavity and can also lead to gum diseases.
Local inflammatory reactions in the oral cavity might also be altered due to tobacco use. Individuals are therefore more prone to development of bacterial and fungal infections that can impact their oral health. Healing of any cuts or wounds occurring in the oral cavity will also be adversely affected by tobacco use. Tobacco use is also known to decrease the appetite of individuals, which can adversely affect the healing process in them.
Gum diseases due to tobacco and smoking
The use of smokeless tobacco leads to increase in the thickness of the outer layer of cells in the gums due to a process known as gingival keratosis. Tobacco use, both smoking and smokeless can lead to inflammation of the gums, known as gingivitis. The gums will be swollen, red in color and will bleed while brushing. This can further progress in the form of gingival recession, wherein the gums will recede, exposing the root of the teeth.
One of the most frequent manifestations of tobacco use and smoking is infection of the gums leading to a condition known as periodontal diseases. In this condition, the tooth will start to be come loose, the alveolar bone underneath the gums will begin to erode and periodontal pockets will begin to appear. In this condition, the gap between the tooth and gums will deepen, leading to accumulation of food particles and microorganisms within this gap. This will further worsen the infection in the gums and leads to a vicious cycle. If left untreated, this will lead to the loss of teeth among tobacco users.
Changes in the enamel surface
Tobacco use, especially the use of smokeless tobacco leads to flattening of the tooth surface, a process known as attrition of the teeth. This is one of the most commonly observed conditions in elderly individuals who have been chewing tobacco for many years. Smokeless tobacco products contain numerous chemical substances, which decrease the pH of the oral cavity. These chemicals render the pH of the mouth acidic, leading to loss of enamel on the tooth surface by a process known as tooth erosion.
Effect on oral mucosa
Tobacco use leads to a wide variety of manifestations on the mucosal surface in the oral cavity. It leads to increased keratosis, white patches known as leucoplakia and red patches known as erythroplakia. Some individuals tend to place tobacco in the form of a pouch, usually dipped in snuff. This will lead to alterations in the local area in the mouth and is known as tobacco pouch keratosis or snuff dippers’ keratosis. Smokers’ palate is one of the classical findings in smokers wherein the palate surface will be severely involved. The entire palate will be opaque or greyish white in colour and there will be tiny swollen areas with a small red dot in the centre. There can also be diffuse redness in the area of the palate among smokers.
Some individuals smoke chutta or dhumti with the fire end of the tobacco product inside the mouth. This is known as reverse smoking, which leads to several changes in the oral cavity, especially in the palatal area. There can be redness, tiny outgrowths with central red dots, patches, and ulcers in the palate. Due to the high temperatures associated with keeping the fire end of chutta inside the oral cavity, the local reactions are similar to a burn injury occurring inside the mouth.
Need of the hour
Tobacco use is associated with many illnesses and it poses a major threat to the health of individuals and communities. It causes cancers in the mouth, lungs and other parts of the body and potentially malignant lesions which are at greater risk for development of cancer in individuals. It also causes gum diseases, delayed wound healing and adverse treatment outcomes in patients undergoing dental treatment. Youngsters should be sensitized about the ill-effects of tobacco use to prevent them from falling prey to tobacco use. Tobacco related illnesses are a major public health problem and preventing them will pave the way for healthier individuals and societies.
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