What smoking does to your gums.

Smokers often do not notice their gum disease until it is well advanced. That is not a coincidence. Nicotine and the other compounds in tobacco products suppress the usual warning signs, particularly bleeding gums, that would normally prompt someone to get evaluated. The disease is there. The signal is muted.

Tobacco use is one of the most significant risk factors in the development and progression of gum disease. Smokers are more likely to accumulate calculus, which is hardened plaque that forms below the gum line and can only be removed during a professional cleaning. When calculus is not cleared, the bacteria in it trigger an inflammatory response in the gum tissue. Pockets form. Bone and tissue are destroyed. The disease advances in the same way as in a non-smoker, but faster and with fewer visible warnings.

The American Academy of Periodontology notes that tobacco reduces the delivery of oxygen and nutrients to gum tissue. This slows healing and makes the results of periodontal treatment less predictable. A procedure that works reliably in a non-smoker may not achieve the same outcome in someone who is still smoking, for reasons that have nothing to do with technique.

Detection is the other problem. A periodontist evaluating a smoker cannot rely on the same clinical signals as with other patients. The tissue may look less inflamed than it actually is. Pocket depths and bone loss on X-rays tell the honest story. That is why smokers need periodontal evaluations on a more frequent schedule, not a standard one.

Quitting is the most effective thing a smoker can do for their periodontal health. The research shows that the harmful effects of tobacco on gum tissue gradually reverse after quitting. Not instantly, but measurably. Former smokers respond better to treatment and maintain results better than current smokers.

If you smoke and have not had a periodontal evaluation recently, the picture in your mouth is probably different from what your general cleaning visits are showing. Gum disease treatment for smokers starts with an accurate read of what is actually there. New patients are welcome. (310) 903-7674.

Dr. Sharyar Baradaran, DDS, MS is a periodontist in Beverly Hills and a member of the American Academy of Periodontology. He has been in practice for more than 32 years.