Tobacco and Oral Disease

Cigarettes are a major cause of periodontitis, also known as gum disease.Footnote 1Footnote 2

Key facts about tobacco use and oral disease

View health-related messages for all tobacco product packaging.

What is oral disease?

Oral diseases affect the inside of the mouth. Most oral health diseases are preventable. Common oral diseases include gum disease (periodontitis), tooth loss, plaque buildup, discoloured teeth, and tooth decay (cavities).Footnote 8

Gum disease is the infection and inflammation of the gums. In the early stages of the disease (gingivitis), gums become red and swollen, and bleed easily. Later stages of the disease can lead to tooth loss and damage to the jawbone which supports the teeth. Other symptoms may include pain in the gums, receding gums, and persistent bad breath.Footnote 9

Treatment for oral diseases include medication, the mechanical removal of plaque and bacteria, and mouth surgery.Footnote 10

How does tobacco use increase the risk of oral disease?

People who smoke are more likely to have harmful mouth bacteria that lead to gum disease.Footnote 1 Smoking promotes the growth of harmful bacteria on teeth and weakens the immune system's response to bacterial infection.Footnote 1 Nicotine, the addictive drug in tobacco, also reduces the body's ability to repair damaged gums.Footnote 1

Even after receiving treatment for gum disease, harmful bacteria are more likely to return and cause re-infection in the mouths of people who smoke compared to people who do not smoke. Smoking increases the risk and progression of oral disease and lowers the chance of successful treatment.Footnote 11

Smoking also damages the bone which supports the teeth. The weakening of the jawbone is a major cause of tooth loss.Footnote 12

How does quitting reduce the risk of oral disease?

Quitting smoking improves oral health and decreases the risk of developing oral disease.Footnote 13Footnote 14Footnote 15

The risk of gum disease decreases as early as one year after quitting. If someone who smokes has gum disease, quitting can slow the progression of gum disease and improve their body's response to treatment.Footnote 14Footnote 15Footnote 16

If someone who smoked has quit for 13 or more years, the risk of tooth loss is the same as someone who has never smoked.Footnote 17

Health benefits of quitting tobacco use at any age

Quitting tobacco use reduces the risk of premature death, improves health, and enhances quality of life.Footnote 18 Quitting at any age is beneficial to one's health.Footnote 18 Even people who have smoked or used tobacco heavily for many years benefit from it.Footnote 1Footnote 18 Quitting is the most important thing someone who smokes can do to improve their health.

Read more about the benefits of quitting smoking.

Call for free help to quit

Call the toll-free pan-Canadian quit line at 1-866-366-3667. Quit line counselling, alone or in combination with cessation medications, increases success in quitting.Footnote 17


Footnote 1

U.S. Department of Health and Human Services. The Health Consequences of Smoking. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.

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Footnote 2

Pesce P, Menini M, Ugo G, Bagnasco F, Dioguardi M, Troiano G. Evaluation of periodontal indices among non-smokers, tobacco, and e-cigarette smokers: a systematic review and network meta-analysis. Clinical Oral Investigations. 2022 May 13:1-4.

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Footnote 3

Bergström J. Tobacco smoking and chronic destructive periodontal disease. Odontology. 2004;92(1):1-8. doi:10.1007/s10266-004-0043-4

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Footnote 4

Mirbod SM, Ahing SI. Tobacco-associated lesions of the oral cavity: Part I. Nonmalignant lesions. J Can Dent Assoc. 2000 May;66(5):252-6. PMID: 10833868.

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Footnote 5

Leite, Fabio R.M. et al. Effect of Smoking on Periodontitis: A Systematic Review and Meta-regression. American Journal of Preventive Medicine. Volume 54, issue 6, June 2018. Pg 831-41.

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Footnote 6

Nociti FH, Casati Jr MZ, Duarte PM. Current perspective of the impact of smoking on the progression and treatment of periodontitis. Periodontology 2000. 2015;67(1):187-210.

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Footnote 7

Health Canada. Report on the Findings of the Oral Health Component of the Canadian Health Measures Survey 2007-2009. 2010. Accessed May 2, 2022.

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Footnote 8

World Health Organization. Oral Health. Updated 2022. Accessed June 29, 2022.

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Footnote 9

Health Canada. Gum Disease. Updated 2018. Accessed June 27, 2022.

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Footnote 10

Tariq M, Iqbal Z, Ali J, Baboota S, Talegaonkar S, Ahmad Z, Sahni JK. Treatment modalities and evaluation models for periodontitis. Int J Pharm Investig. 2012;2(3):106-22. doi: 10.4103/2230-973X.104394.

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Footnote 11

Jiang Y, Zhou X, Cheng L, Li M. The Impact of Smoking on Subgingival Microflora: From Periodontal Health to Disease. Front Microbiol. 2020;11:66. doi:10.3389/fmicb.2020.00066.

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Footnote 12

Zhang Y, He J, He B, Huang R, Li M. Effect of tobacco on periodontal disease and oral cancer. Tobacco Induced Diseases. 2019;17:40. doi:10.18332/tid/106187.

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Footnote 13

Costa FO, Cota LO, Lages EJ et al. Associations of duration of smoking cessation and cumulative smoking exposure with periodontitis. Journal of Oral Science. 2013;55(3):245-253. doi:10.2334/josnusd.55.245.

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Footnote 14

Leite F, Nascimento G, Baake S, Pedersen L, Scheutz F, López R. Impact of smoking cessation on periodontitis: A systematic review and meta-analysis of prospective longitudinal observational and interventional studies. Nicotine & Tobacco Research. 2019;21(12):1600–1608.

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Footnote 15

Heasman L, Stacey F, Preshaw P et al. The effect of smoking on periodontal treatment response: a review of clinical evidence. J Clinical Periodontology. 2006;33(4):241-253.

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Footnote 16

Alexandridi F, Tsantila S, Pepelassi E. Smoking cessation and response to periodontal treatment. Australian Dental Journal. 2018;63(2):140-149. doi:10.1111/adj.12568.

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Footnote 17

Souto, Maria Luisa Silveira et al. Effect of smoking cessation on tooth loss: a systematic review with meta-analysis. BMC Oral Health, 19, Article number 245 (2019). Effect of smoking cessation on tooth loss: a systematic review with meta-analysis | BMC Oral Health | Full Text (

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Footnote 18

U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2020.

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