Nicotine Products and Their Effect on Your Mouth

By Premier Dental of Ohio

Nicotine can effect your dental health

In 2015, almost 49 million people in the United States used some type of tobacco product.  That is almost one in five Americans!  The addictive substance in tobacco is the chemical nicotine.

Both tobacco users and those trying to quit are taking in nicotine.  This article will cover the various products people use and how they affect oral health.

Oral Health Effects of Nicotine

Any nicotine use will have an effect on the health of your mouth, teeth, and gums.  We will cover the overall effects of nicotine on oral health before going into the specific effects of various nicotine-containing products.

Gum Disease

One of the most important physiological effects of nicotine on the body is its ability to constrict blood vessels.  This is why tobacco users often experience high blood pressure.  The effect is most noteworthy, for oral health considerations, on the tiny blood vessels in the gum tissues.  The constriction of these vessels leads to a lack of good, consistent blood vessel to the gums.  Blood flow is important in fighting the attacks of bacteria in dental plaque and tartar.

Specifically, a lack of blood flow makes it more difficult for your body to fight gum disease, which allows it to progress faster and with fewer noticeable symptoms.  Patients who use nicotine products may not experience the swelling, redness or bleeding that typically accompanies the initial stages of gum disease.  Without these noticeable symptoms, they may not seek dental care in the early stages of gum disease.  Without the good blood flow required for the body to fight gum disease, it can worsen faster than it would in an otherwise healthy patient.

Delayed Healing

The lack of blood flow caused by nicotine also makes it more difficult for the mouth to heal from injuries or surgery.  Because a good blood supply is necessary for the cells to regrow and close cuts or extraction sockets, nicotine users will take longer than the average time to heal.  This also places them at a higher risk for post-operative infection and may lead to more pain after injuries to the mouth or oral surgery.

Oral Health Effects of Specific Products

Now that you understand how any form of nicotine affects your mouth, we will move on to additional effects that these specific nicotine products can cause.


Cigarettes are the most commonly used form of nicotine in the U.S.  In 2018, over 34 million Americans were active smokers.  Cigarettes are terrible for your overall health, and they have an awful effect on your mouth.

  1. Dry Mouth

Cigarettes have a drying effect on the inside of the mouth.  A dry mouth has a much higher risk for both cavities and gum disease.  Saliva is necessary for fighting the bacteria that cause these dental diseases, and when you constantly dry your mouth out by smoking cigarettes, you counteract that protective effect of saliva.

  1. Bad Breath

The increased bacterial levels allowed by the dry mouth plus the natural odor of cigarettes combines to give the characteristic bad smell we often call “smoker’s breath”.  An overgrowth of bacteria in the mouth always leads to a bad smell.  The dry mouth makes plaque stickier and more difficult to remove with brushing and flossing, so the bad breath in a smoker tends to be more persistent than in a nonsmoker.

  1. Dark Stains on Teeth

The chemicals in cigarettes that you pull over and through your teeth during the smoking process collect on the surfaces of the teeth in the form of stains.  Over time, these superficial stains become embedded in the tooth structure, transitioning into deep, internal stains, requiring professional teeth whitening to correct them and return the teeth to a natural shade.

  1. Increased Risk for Post-Extraction Complications

When smokers have a tooth extracted, they suffer a higher risk for complications following the procedure.  The sucking pressure of cigarette smoking can pull out a blood clot, leading to the painful complication of dry socket.  The dryness inside the mouth increases the risk of a post-operative infection.

  1. Dental Implant Failures

Dental implants are more likely to fail in smokers due to the lack of good blood flow to the implant surgical site.  An implant failure means that the surrounding jawbone does not attach to the dental implant.  Eventually the implant will loosen and could even fall out of the mouth.

  1. Oral Cancer

Smokers are six times as likely as nonsmokers to develop oral cancer.  The effects of the carcinogenic chemicals in cigarettes on the soft tissues on the inside of the mouth greatly increase the risk of cellular changes that lead to cancer.  (This risk increases exponentially if you smoke and drink alcohol regularly!)

Smokeless Tobacco (Dip, Chewing Tobacco)

Smokeless tobacco use is slightly less common than cigarette smoking but no less dangerous!  The specific ingredients in smokeless tobacco cause visible damage to the soft tissues in the mouth.  Most noticeable is a phenomenon called tobacco pouch keratosis, in which the area holding the smokeless tobacco shows thickening and a color change in the lining tissues.  These surface level changes often lead to deeper changes and oral cancer over time.

Smokeless tobacco users have a risk for oral cancer that is almost fifty times higher than non-tobacco users!

This type of tobacco also causes staining on the teeth and a higher risk for post-operative infections at surgical sites.

Nicotine Gum

Typically, people use nicotine gum to wean themselves away from tobacco use.  Nicotine gum is sugar-free, and the chewing motion actually stimulates saliva production.  For this reason, chewing nicotine gum does not increase your risk for cavities or gum disease (aside from the inherent risk for gum disease with any nicotine, covered in the first section).

There are two potential dental risks associated with nicotine gum.  Patients with old dental work could experience dislodging or loosening of fillings or crowns.  It is important to see a dentist regularly to confirm that chewing gum will not lead to a dental emergency.

Constant gum chewing could aggravate symptoms of TMJ disorder.  If you have problems with your jaw joints, such as clicking, locking, or pain, you should not chew gum without consulting your dentist first.

Nicotine Lozenges

Another form of nicotine commonly used to help tobacco users quit is the nicotine lozenge.  It is similar to the gum in that it releases small amounts of nicotine as the user holds the lozenge in his mouth.  These are also sugar-free and should not cause any increased risk for cavities.  They do not provide as much saliva stimulation as chewing gum, but the flavor of the lozenge may stimulate a small increase in production.

Lozenge users must resist the urge to bite into the lozenge as a hard candy.  This can lead to broken dental restorations and cracked teeth.  Make sure to see your dentist regularly for consistently evaluations and professional teeth cleanings to keep your mouth healthy as you quit using tobacco.

More Questions about Nicotine Products?

Call your nearest Premier Dental of Ohio location today to schedule a consultation.  We can answer any question you have about how a specific product will affect your mouth.

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