Oral Changes Associated with Tobacco Use

The evidence is overwhelming that smoking contributes to periodontal disease and that continued smoking results in a reduced response to periodontal treatment. There is a greater amount of bone loss around teeth in smokers and individuals who smoke are more likely to lose teeth than nonsmokers. It is reported that more than half of advanced gum disease can be linked to tobacco use.

Nicotinic Stomatitis
In nicotinic stomatitis, the hard palate (roof of the mouth- pictured above) appears white instead of pink, and numerous, small raised areas with red centers are found throughout the palate. These red areas are irritated minor salivary glands whose duct openings are inflamed in response to the heat from tobacco products. This lesion is most commonly seen in older male tobacco users who smoke pipes but it also can be found in cigar and cigarette smokers.

There is an increased risk for cancer of the tonsils, posterior mouth, and lungs in individuals who develop nicotinic stomatitis from their tobacco use. However, if the individual stops their tobacco use, the appearance of hard palate typically returns to normal within a few weeks.