Tobacco + Teeth = ? Published Sept. 9, 2011 By By Capt. Carl Bhend 509th Medical Operations Squadron Advanced Clinical Dentist WHITEMAN AIR FORCE BASE, Mo. -- It's that time of year again; your annual dental exam is approaching. You immediately know that the dentist will ask "Are you flossing?" Or, "I see you are still using tobacco; are you interested in quitting?" The reason dentists ask those questions is because we care about you, the patient. Kicking tobacco is no easy feat (pun intended). Nicotine is the culprit. So why should you quit? You'll lower the chances of having a heart attack, stroke or cancer, including oral cancer. A smoke-free environment is healthier for those around you. If you're pregnant, you'll improve your chances of having a healthy baby. And think of all the money you will save and what you can do with it. What is the impact of tobacco? Smoking increases the risk of oral cancer, as well as periodontal (gum) disease, which is the leading cause of tooth loss and sensitivity. Smoking results in delayed healing after a tooth extraction or other oral surgery. Smoking limits the options for some kinds of dental care (smokers can be poor candidates for particular treatments such as implants). And smoking gives you bad breath, stained teeth and tongue, and diminishes your sense of taste and smell. "But doc, I don't smoke, I just dip." Like cigarettes, smokeless tobacco products contain a variety of toxins associated with cancer. At least 28 cancer-causing chemicals have been identified in smokeless tobacco products. Smokeless tobacco is known to cause cancers of the mouth, lip, tongue and pancreas. Users also may be at risk for cancer of the voice box, esophagus, colon and bladder, because they swallow some of the toxins in the juice created by using smokeless tobacco. Smokeless tobacco can irritate your gum tissue, causing periodontal disease. Sugar is often added to enhance the flavor of smokeless tobacco, increasing the risk for tooth decay. Smokeless tobacco also typically contains sand and grit, which can wear down your teeth. "Doc, how do I know if I have oral cancer?" Signs and symptoms that could indicate oral cancer include: 1. Any sign of irritation, like tenderness, burning or a sore that will not heal. 2. Pain, tenderness or numbness anywhere in the mouth or lips. 3. Development of a lump, or a leathery, wrinkled or bumpy patch inside your mouth; color changes to your oral soft tissues (gray, red or white spots or patches), rather than a healthy pink color. 4. Difficulty chewing, swallowing, speaking or moving the jaw or tongue 5. Any change in the way your teeth fit together. See your dentist or physician if you notice any of these changes. Tobacco + Teeth = nothing good. The negative impacts on oral health are so significant that the Food and Drug Administration will require graphic health warnings (as the example graphic) to be placed on all cigarette packs, cartons, and ads no later than Sept. 22, 2012. "Doc, I am interested in quitting." If this is you, great! The Health and Wellness Center is a great place to start. You can contact them at 660-687-3936. There are also many resources online, or you can call 1-800-QUIT-NOW. I hope that you are victorious in quitting tobacco and I look forward to celebrating that victory with you.