Dubai: Even as Dubai continues its tobacco-free campaign, tobacco use among university and school students is on the rise, and being called a major contributor to gum disease.
According to a 2011 Dubai Health Authority (DHA) survey of the 14.6 per cent of school students who used tobacco, 21.7 per cent were men and 6.2 per cent women. In universities, of the 17.8 per cent of smokers, 35.3 per cent were men and 10.4 per cent women. Also, 29.1 per cent of school students and 46.4 per cent of university students were exposed to second-hand smoke. About 8.6 per cent of Emiratis were found to be smokers.
Crawford Bain, Professor of Periodontology at the Dubai School of Dental Medicine, cautions that smoking is the largest cause of periodontal disease. “Increases in smoking in younger age groups and women is a cause for concern, as early use of tobacco leads to early periodontal bone loss and, in women, increases risks of complications in pregnancy.”
Bain added that the incidence of gum disease is high among smokers: “Aside from poor oral hygiene, by the age of 50, heavy smokers are up to 25 times more likely to have periodontal bone loss than non-smokers. After 20 years of smoking 20 cigarettes a day, the smoker is around six times more likely to lose teeth due to gum disease.”
Explaining how smoking actually works to erode dental health, he added: “Smoking greatly reduces the blood flow to the mouth, creating a low oxygen environment in the gum tissue, which attracts the most damaging bacteria in plaque [anaerobic organisms]. The products of these bacteria combine with a reduced response of the body’s white blood cells (also caused by smoking) to accelerate bone loss, and eventual tooth loss. This reduced blood supply and compromised immune response is similar to diabetes, another major risk factor for gum disease. A study from Saudi Arabia shows that shisha smoking is equally damaging to the gums,” he warned.
It is important for chronic smokers to understand that apart from superficial signs of bad health, gum disease aggravates chronic health issues.
Gum disease
“Several major systemic diseases are worsened if the patient also has gum disease. Most notably, diabetes has a bi-directional relationship with periodontal disease. The higher the blood sugar level, the more likely the patient is to have periodontal bone loss. The mechanism is similar to the effects of smoking, involving compromised circulation and reduced white blood cell responses. Importantly, recent research has shown that controlling a patient’s gum disease will bring down blood sugar levels and could potentially prevent a pre-diabetic from becoming a diabetic and reduce the needs of drug treatment of the diabetic. We hope to conduct research with regional health authorities to determine the effectiveness of this combined approach to care. Diabetics with gum disease are also at greater risk of chronic kidney disease. There is also growing evidence that the presence of gum disease is likely to increase the risk of adverse pregnancy outcomes,” added Bain.
It is never too late to give up smoking, as that helps to reverse its ill effects. “Stopping smoking can slow the progression of diseases, but has to be combined with specialist periodontal treatment to fully stabilise the situation. Usually, about six weeks after the patient stops smoking, their gums actually begin to bleed! This is not a bad sign, it actually means the circulation has improved to close to that of a non-smoker. The key to long term disease control is a combination of keeping away from cigarettes and a thorough professional cleaning with a well trained dental hygienist every three months,” says Bain.