Canadian Academy of Periodontology

Smoking and Tobacco

Adverse effects of smoking

1. Direct association with various medical conditions including:
• Various types of cancer
• Pulmonary and cardiovascular diseases
• Low birth weight
2. Risk factor for initiation and progression of periodontal disease.
3. Current smokers are about 4 times more likely to have advanced periodontal disease compared to those who have never smoked.
4. Direct association with:
• Increased calculus deposition
• Deeper pockets and greater attachment loss
• More pronounced radiographic evidence of furcation involvement
• Increased alveolar bone loss
• Less favorable response to periodontal and implant therapy.

Tobacco-associated lesions of the oral cavity

Nonmalignant lesions

1. Dental Conditions
Pronounced tobacco stains	Tooth abrasion and recession
2. Gingival conditions
Necrotizing ulcerative gingivitis	Smoker's melanosis
3. Mucosal conditions
Smokeless tobacco induced lesion	Nicotinic stomatitis

Malignant lesions

Squamous cell carcinoma

Verrucous carcinoma

More information on smoking

• American Academy of Periodontology Risk Factors Page
• The Lung Association
• I Quit Now!