Through many years of publicity and awareness-raising, we all know that smoking and drinking are bad for us. Yet, despite the known dangers, both practices continue to hold high popularity. Over the last six weeks, national campaigns such as Stoptober, Alcohol Awareness Week and Mouth Cancer Action Mouth, have all promoted the health risks caused by tobacco and alcohol and what it has meant for us as a society. In this article, we discuss the impact smoking and drinking has on our mouths and what this could mean for our overall health too.
There is a growing body of evidence to suggest those of us who smoke and drink are three times more likely to suffer from severe gum disease.1 This may not seem like a serious health problem but it is the main cause of tooth loss in adults and has been linked to a raft of systemic diseases such as strokes, heart disease, diabetes, meningitis, pneumonia and mouth cancer.
With an estimated 85% of deaths in the UK being as a result of chronic disease2, taking care of our oral health has never been more important.
Worryingly though, as a population, we seem to be drinking more and more these days and, with many so called 'social smokers' having a cigarette while they drink, the likelihood is that poor oral health and increased cases of chronic diseases will continue to rise until people are forced to take notice.
Even those who don't drink or are occasional drinkers are susceptible to health problems. Almost one in five of us that drink occasionally display signs of severe gum disease, a problem exasperated by smoking. Binge drinking, alcohol abuse and tobacco smoking have long been cause for concern for health experts, accounting for in excess of 110,000 deaths a year in the UK3 while putting financial strain on an already over-burdened health system.
Putting oral health at risk through tobacco and excessive alcohol use is becoming a particularly concerning problem in young people, with almost one in two 11 to 15 year olds consuming alcohol, and more than one in four admitting to smoking.4 We're in an especially troubling situation where young people now deem it acceptable to try smoking and drinking, creating a dangerous path for their lifestyle habits in future years.
Drinking alcohol to excess
The number of alcohol consumers in the UK has increased substantially over the last century. Around 40 million UK adults regularly consume alcoholic drinks5 and while many do so moderately, about one in four exceeds Department of Health guidelines. Alcohol increases the risk of a person developing gum disease, tooth decay, erosion and mouth cancer.
Those with alcohol abuse problems have been found to have a higher level of tooth decay, and more seriously, potentially pre-cancerous oral lesions.
To take responsibility for your health means to be aware of the issues and look after yourself. Many people enjoy alcohol but moderating your drinking is a must, so it is important that you are aware of the risks and are confident you are not hurting your health.
Mouth cancer is one of the UK's fastest growing cancers and only of very few that is predicted to rise in the coming decade. One person every four hours current dies from mouth cancer in the UK, with around three in every four of all mouth cancer patients frequently consuming alcohol prior to diagnosis. People who drink more than the recommended units of alcohol per week and smoke more than one pack of cigarettes per day are up to 30 times more likely to develop mouth cancer.6
Alcohol can also cause dental erosion, which is the loss of tooth enamel that protects the sensitive dentine underneath. Fizzy and acidic drinks such as ‘alcopops' and white wine are also more likely to cause damage. In the run up to the festive season many people over indulge in alcohol which can damage their teeth, but it is possible to protect them while still enjoying a few drinks:
- Avoid fizzy drinks and fruit juice mixers.
- Be aware that acidic drinks such as cider, white wine, champagne can cause dental erosion.
- Avoid drinking more than the weekly recommended units of alcohol (14 units for women and 21 units for men).
- Wait for an hour before brushing your teeth after you have had a fizzy and/or acidic drink.
- Chew sugar-free gum after drinking to help produce more saliva to help cancel out the acids which form in your mouth after drinking.
Smoking and tobacco use
On average, smokers lose about 16 years of their life.7 And after decades of campaigning, it seems like the message is finally getting through. But despite the fall in numbers over the last few years, smoking remains a significant concern. It accounts for more than 1.6 million hospital admissions every year - a figure which, despite there being fewer smokers, is still rising.8
Smoking can cause a variety of oral health problems including tooth staining, dental plaque, bad breath, tooth loss and gum disease. Staining on the teeth is due to the nicotine and tar in tobacco, which can make the teeth yellow in a very short time, and heavy smokers often complain that their teeth are almost brown after years of smoking. Smoking may also change the type of bacteria in dental plaque, increasing the number of bacteria that are more harmful. It also reduces the blood flow in the gums and supporting tissues of the tooth and makes them more likely to become inflamed. Smokers' gum disease will get worse more quickly than in people who do not smoke and because of the reduced blood flow smokers may not get the warning symptoms of bleeding gums as much as non-smokers.
Of more concern is the significant risk of developing life-threatening diseases such as lung disease and mouth cancer. More than one in four of us are still unaware that smoking is the leading cause of mouth cancer - attributing to more than three in every four cases.9
In contrast to traditional cigarettes, cigar and pipe smoking and smokeless chewing tobacco, popular in South Asian groups, pose an equally dangerous threat, as do some of the newer trends such as e-cigarettes and sisha pipes. Not more so, because of their relatively low levels of awareness. More than half of us mistakenly think e-cigarettes and shisha pipes are safe alternatives to smoking while just under half believe smokeless tobacco is a safer substitute.10
While it is encouraging to see the level of smokers fall, from an oral health aspect, it is clear we still have some way to go in order to eradicate habits detrimental to oral hygiene. More must be done to educate risk groups on the hazards that smoking and alcohol both pose. Together they act as a deadly cocktail that not only poses a danger to our mouth, but has a life-threatening impact on our general health.
1. Lages, E. J. P., Costa, F. O., Lages, E. M. B., Cota, L. O. M., Cortelli, S. C., Nobre-Franco, G. C., Cyrino, R. M. and Cortelli, J. R. (2012), ‘Risk variables in the association between frequency of alcohol consumption and periodontitis', Journal of Clinical Periodontology, 39: 115-122, doi: 10.1111/j.1600-051X.2011.01809.x
2. WHO (2005), ‘The Impact of Chronic Disease in the United Kingdom', online at http://www.who.int/chp/chronic_disease_report/media/uk.pdf
3. ASH (2013), ‘Smoking Statistics: illness and Death', online at http://ash.org.uk/files/documents/ASH_107.pdf AND Office for National Statistics (2012), ‘Alcohol-related deaths in the United Kingdom, 2011', online at http://www.ons.gov.uk/ons/rel/subnational-health4/alcohol-related-deaths-in-the-united-kingdom/2011/alcohol-related-deaths-in-the-uk--2011.html
4. British Dental Health Foundation (2011), ‘Mouth Cancer Action Month: Survey', conducted by 4MediaRelations, sample size 1,002.
5. National Audit Office, Department of Health (2008), ‘Reducing Alcohol Harm: Health Services in England for Alcohol Misuse', London: The Stationery Office.
6. Cancer Research UK (2012), ‘Oral Cancer Statistics', online at http://www.cancerresearchuk.org/cancer-info/cancerstats/types/oral/
7. Smokefree (2013), ‘Smoking & Family Life', online at http://smokefree.nhs.uk/why-quit/smoking-and-family-life/
8. Health and Social Care Information Centre (2013), 'Statistics on Smoking: England, 2013', online at https://catalogue.ic.nhs.uk/publications/public-health/smoking/smok-eng-2013/smok-eng-2013-rep.pdf
9. British Dental Health Foundation (2013), ‘Mouth Cancer Action Month: Survey', conducted by OnePoll, sample size 2,000.