How smoking affects your teeth – a dentist’s warning

Dr Nigel Jones is based in Abergavenny and has treated Olympic silver medal winning cyclist Becky James, Swansea City players and members of the Ospreys rugby team.

As president of the British Society for Advanced Dentistry, he is one of the UK’s leading authorities on dental implants. He told ASH Wales about the impact of smoking on dental health, how it affects implants and why giving up works wonders for teeth.

What are the main ways in which smoking effects your dental health?

The main way in which smoking affects dental health is that nicotine reduces blood-flow within existing blood vessels, and the formation of new blood vessels. If we think of blood as being the carrier of nutrients and oxygen around our bodies to maintain health, then reducing blood flow by about two-thirds (which smoking does), means that the body has no reserves of oxygen and nutrients when under stress. It would be a little like tripling the size of Abergavenny without improving water supplies, sewerage, or energy production. Smokers take three times as long to recover from wounds, and therefore have three times as many infections. Major studies by Bain in 2002 and Albreksson in 2015 demonstrate that smokers have two to three times as many dental-implant failures as non-smokers. They also have the same failure rates with gums around natural teeth.

In your experience is there enough awareness among patients about the harmful effects of smoking on their dental health?

We have many sorts of studies in medicine, and one of the most reliable is the cohort study where a group of patients is studied for many years to see the long-term outcome of medication or life-style choices. The first big cohort study published in the 1960s looked at the effects of smoking in British doctors. It was this study that established the link between smoking and lung-cancer. I think that as with excessive alcohol consumption and obesity, most people are aware of the dangers, but choose to believe that in some way they will be immune. After all the visual warnings on packs of cigarettes are stark, but people still buy them.

Once smokers stop smoking, does dental health improve?

If smokers quit, then yes their oral health improves. Blood-flow increases along with the ability to grow new blood vessels faster in a number of months as the effects of nicotine wear off. The ‘sludging’ of the blood vessels due to the more sluggish blood flow in smokers can take two years or more to reduce, and so we need people to have stopped smoking for two years in order to offer guarantees on dental-implants. Of course, some smokers swap smoking for other habits such as sucking sweets, and so may see an improvement in the health of their gums, but increased tooth-decay.

What treatments are available if any, to repair the damage to smokers’ teeth?

Fastidious brushing and cleaning of teeth will prevent the build-up of plaque which causes the wounds at their gum edges, thereby reducing the incidence of infections and the need for repair. It’s a bit like owning a car when you live on the coast, you have to be much more careful to remove salt from the underside of the car to prevent rust.

Can you tell us about how smoking affects the healing process following a dental implants procedure?

As above, smokers heal at a third of the rate of non-smokers, and therefore have three times as many infections. We try to lessen the effects of smoking by burying the implants, and not immediately putting temporary teeth onto them, but it’s still a more risky procedure.

What advice would you give to smokers who are hoping to have dental implants?

It’s a bit like someone wanting to buy an all-electric car with the same range as a diesel car. It can’t be done. You either accept the increased risks posed to dental implants by smoking and the responsibility for fastidious cleaning; or you give up smoking.

Find out more about Dr Nigel Jones work

‘My Husband and I Quit Smoking Together’

Susan Hewitson from Barry, gave up smoking last year aged 62, after being told she has COPD. She made a pact with her husband that they would kick the habit together.  

Over the years I tried no end of times to stop smoking but each time something happened to set me back. I gave up for over a year last time but then I had to take my father off his life support machine and I started smoking again there and then.

Why We Decided to Quit

Earlier this year I collapsed with flu and I had an infection for four months after that. I then developed pneumonia. I went back to work but saw my doctor again because I kept getting breathless. They told me to use a ventilator. I eventually got to see a doctor at the chest clinic who said I had minimal COPD and told me to use a different pump once a day. He also told me I should give up smoking and I just said ‘fine’.

In the past I’d found it difficult to give up because my husband smokes like a chimney. This time when I decided to give up he said, ‘pick a date and we’ll do it together’. We quit on the anniversary of Aberfan – on  21st October last year.

This time I went to see the chemist because I liked the fact that they kept testing you with the CO monitor and the pharmacist is a  nice lady.

Feel The Difference

I didn’t tell my husband, but when we both stopped smoking I opened a separate bank account and started putting in the money that we would have spent on cigarettes each week. When I told him how much we’d saved he was gobsmacked. I said: ‘we’re not just going to leave that money sitting in the bank’, so we booked a holiday to Ibiza instead.  It has really spurred him on.

I definitely feel there’s been an improvement since I stopped smoking. I can walk further uphill and I don’t seem to be wheezing anymore.

I don’t think about whether I should have stopped smoking sooner. You can’t change the past, but you can change the future.

If you want to stop smoking Help Me Quit is run by NHS Wales and will help you to find the stop smoking service that best suits you. Contact them on 0800 085 2219 or visit www.helpmequit.wales.

Stop smoking author’s guide to giving up

To help smokers quit during Stoptober we asked stop smoking experts for their top tips on how to give up

Gillian Riley, author of How To Stop Smoking And Stay Stopped For Good, is a former smoker who has been helping others to quit since 1982. She runs workshops and individual counselling sessions across the UK and also delivers training seminars for NHS staff.

Her sessions focus on the thinking that drives addictive behaviour and the psychological barriers between success and failure when it comes to giving up smoking.

We asked Gillian for her tips on quitting, cravings and keeping motivated.

What are the biggest challenges smokers face when trying to quit the habit?

The biggest challenge I see in clients is in recognising the influence of the mind; of attitudes and beliefs. There certainly are chemical changes going when a smoker quits, but so many people explain every difficulty in physical terms. Just because sensations are felt in the body, that doesn’t necessarily mean they were created by the body. Consider that gut-wrenching feeling when you stand in the parking lot thinking your car has been stolen. That physical pain is created by your awareness of an empty space where you thought you’d parked it.

Is there anything they should do to prepare themselves before giving up?

It can be good to stop smoking as privately as possible, so keeping it quiet, even before actually quitting, can be worth a try. A lot of people say this one thing has been a game-changer for them compared to previous attempts where others got involved in some way that didn’t turn out to be so helpful. That goes double for anyone in your life who really wants you to quit, because no matter what they say, it will feel like pressure, as if you’re being forced. The automatic reaction to this is to rebel – by smoking.

Is it best to give up gradually or to stop straightaway?

Both! I suggest a few days of gradual reduction using the technique of ‘working through’ desire that I describe in my book. The purpose of these few days is to practise using the technique. It’s important to make a gradual reduction with that in mind – and to have a quit day selected before the practice days begin. So… less than a week of reducing gradually, followed by a stop straightaway.

What tips do you have for those quitting smoking on how to control their cravings?

The tip is there are no tips. Being able to release and heal by ‘working through’ feelings of desire or craving puts most smokers on a steep learning curve. Quitting can feel like a bereavement, loss or tragedy, and it’s no small thing. There’s the adjustment to self-identify and the need to develop self-control in other respects, such as eating habits, when no longer smoking.

How can those quitting smoking best cope with withdrawal symptoms?

They best way for smokers to cope is to recognise the impact of the mind in the process of stopping, and taking steps to shift some of the ways in which they think in order to make the experience easier, and more doable. For example, (as with anything in life) it makes a big difference to feel like you’re freely choosing to do this, rather than feeling victimised or coerced.

How To Stop Smoking And Stay Stopped For Good (Random House, 2007) £9.99, is available in paperback, Kindle and audio versions.

‘I Gave Up Smoking As a Gift To My Son’

Paul Taylor, 48, a dad-of-two and chemist from Barry, gave up smoking ten weeks ago after attending a smoking cessation course at his local pharmacy.

He first started smoking in his early 20s and decided to quit to mark his and his three-year-old son’s birthday. This is his story:

I first started smoking in my early 20s and I’ve got to say I’ve had a few attempts at quitting over the years. Sometimes I’ve gone a year, sometimes a couple of years. This is my latest attempt and although I haven’t smoked for ten weeks I don’t quite feel I’m out of the woods yet.

Why I’m Quitting Smoking

The main reason I decided to quit is because I’ve got two young kids now and I want to be around for them as long as possible. There’s also the financial side of it. A packet of fags costs around a tenner now which is a bit daft really. My wife was keen for me to give up too.

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Setting a Date

I planned this quit attempt to coincide with my birthday which is also a day before my son’s birthday. It’s a good landmark and hopefully a year down the line I can say I smoked my final cigarette on my last birthday. It’s just a nice present to my son really.

In the past I’ve found it difficult to stop smoking because events have come up in my life that have put me under pressure. I’ve then fallen into the trap of having one cigarette and not been able to give myself the message that one leads to another. And then I’m back to where I started.

The last time I stopped was five years ago and I stopped for three years. I used NHS patches and an inhaler. I went to group meetings once a week and did the CO tests. I learnt from that experience that quitting is much easier when you have support both from NRT and from the people around you.

Unfortunately, I fell off the wagon because of stressful events in our lives. Then, seven months down the line, I thought ‘let’s go back and try again’.

We already know High Street Pharmacy because it’s where we collect our prescriptions and they’ve been good to us as a family.
One day when I was collecting my wife’s prescription I saw the poster advertising the 12-week smoking cessation course and I signed myself up.

I’ve tried cold turkey in the past and it’s horrible. The difference between that and using NRT to quit is a quantum leap. This time I’m using nicotine patches and a nicotine inhaler, but mainly the patches.  They really take the edge off the cigarette cravings.

The great thing about the pharmacy is that they don’t just give you support to cope with the physical side of withdrawing from nicotine but also to overcome the psychological challenges.

Feeling the Difference

This time has honestly been ok, and I feel fine. I miss cigarettes occasionally, but I don’t think about them that much. I’ve definitely noticed the difference in my pocket, but I won’t lie and say ‘I feel so much better now’. I think the health benefits are incremental and you notice them more over time. You don’t wake up straight away and suddenly feel better.

For now, I’m taking this one week at a time and hoping I can make a success of it this time. I do think you have to be in the right place mentally in order to have the strength to quit. Of course, you need NRT to deal with nicotine cravings, but you also need to have built up resilience within yourself.

My message to other smokers who are thinking of quitting would be, that it doesn’t have to be hell on earth.  There is support out there. You just need to be ready to accept it.

If you want to stop smoking Help Me Quit is run by NHS Wales and will help you to find the stop smoking service that best suits you. Contact them on 0800 085 2219 or visit www.helpmequit.wales.

How I Finally Quit Cigarettes After 36 Years of Smoking

Grandmother Angela Howarth, 58, a service driver from Wrexham, gave up smoking nine years ago, having smoked since the age of 13. She told ASH Wales about the effect smoking had on her life and how she quit:

I was 13 when I first started smoking on the way to school. It was peer pressure at the time really. I ended up smoking around 20 to 25 cigarettes a day until I was 49.

When I was a smoker, cigarettes ruled my life. If I knew I had to go to a place where I couldn’t smoke I would avoid going. For instance, I’d have a real problem going on public transport.  If I had to go to Manchester on the train I’d put it off because I knew I wouldn’t be able to smoke. I look back on that now and think that’s really bad.

I found that cigarettes slow you down. While I was smoking I didn’t have the energy I have now. I felt lethargic and it also affected my moods. People say they smoke because they feel stressed. But in fact it’s the cigarettes themselves that make you feel stressed because of the cravings.  Then there’s the amount of money you spend on cigarettes. Nowadays they are so expensive I don’t think I could afford to smoke.

I had used patches in the past to try to quit but they made my skin itch so didn’t work for me. Then one day I went into a bookshop and saw the Allen Carr Easy Way to Stop Smoking book and it was reduced to £2. People used to joke that I never have change on me because I usually only use a bank card. But that day I just happened to have £2 in my pocket. I thought ‘Ok I’m going to give myself a kick up the backside and give it a try’.”

 

For me it was a miracle cure really. You’re allowed to smoke all the way through while you’re reading it then once you’ve finished you smoke your last cigarette and that’s that. I’ve never hankered after a cigarette since and there was nobody I knew that was more addicted to smoking than me. I used to think ‘once a smoker, always a smoker’ but now I know that’s not the case.

I’ve persuaded lots of people around me to give up smoking using the same method. My only regret now is that I didn’t try it sooner.

‘How I finally quit cigarettes after 36 years of smoking’

Grandmother Angela Howarth, 58, a service driver from Wrexham, gave up smoking nine years ago, having smoked since the age of 13. She told ASH Wales about the effect smoking had on her life and how she quit:

I was 13 when I first started smoking on the way to school. It was peer pressure at the time really. I ended up smoking around 20 to 25 cigarettes a day until I was 49.

When I was a smoker, cigarettes ruled my life. If I knew I had to go to a place where I couldn’t smoke I would avoid going. For instance, I’d have a real problem going on public transport.  If I had to go to Manchester on the train I’d put it off because I knew I wouldn’t be able to smoke. I look back on that now and think that’s really bad.

I found that cigarettes slow you down. While I was smoking I didn’t have the energy I have now. I felt lethargic and it also affected my moods. People say they smoke because they feel stressed. But in fact it’s the cigarettes themselves that make you feel stressed because of the cravings.  Then there’s the amount of money you spend on cigarettes. Nowadays they are so expensive I don’t think I could afford to smoke.

I had used patches in the past to try to quit but they made my skin itch so didn’t work for me. Then one day I went into a bookshop and saw the Allen Carr Easy Way to Stop Smoking book and it was reduced to £2. People used to joke that I never have change on me because I usually only use a bank card. But that day I just happened to have £2 in my pocket. I thought ‘Ok I’m going to give myself a kick up the backside and give it a try’.

For me it was a miracle cure really. You’re allowed to smoke all the way through while you’re reading it then once you’ve finished you smoke your last cigarette and that’s that. I’ve never hankered after a cigarette since and there was nobody I knew that was more addicted to smoking than me. I used to think ‘once a smoker, always a smoker’ but now I know that’s not the case.

I’ve persuaded lots of people around me to give up smoking using the same method. My only regret now is that I didn’t try it sooner.