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Is Smokeless (Chewing) Tobacco Harmful To My Child's Oral Health? 
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Smokeless (chewing) tobacco use in the United States continues to increase each year, especially among teens who mistakenly believe that it is a safe alternative to smoking cigarettes. It may be smokeless, but it isn't harmless. Why should you care? Keep reading.
Tooth Abrasion - Grit and sand in smokeless tobacco products scratches teeth and wears away the hard surface or enamel. Premature loss of tooth enamel can cause added sensitivity and may require corrective treatment.
Increased Tooth Decay - Sugar is added to smokeless tobacco during the curing and processing to improve its taste. The bacteria found in plaque, the colorless, sticky film that forms daily on teeth, use this sugar to produce acid. The acid damages tooth enamel and leads to decay.
Gum Recession - Constant irritation to the spot in the mouth where a small wad of chewing tobacco is placed can result in permanent damage to periodontal tissue. It also can damage the supporting bone structure. The injured gums pull away from the teeth, exposing root surfaces and leaving teeth sensitive to temperature and especially vulnerable to decay. Erosion of critical bone support leads to loosened teeth that can be permanently lost.
Nicotine Dependence - Nicotine blood levels achieved by smokeless tobacco use are similar to those from cigarette smoking. Nicotine is a highly addictive substance that produces withdrawal symptoms when use is discontinued. Nicotine constricts the blood vessels that are necessary to carry oxygen-rich blood throughout the body. This raises both heart rate and blood pressure and increases the risk for heart disease. Additionally, athletic performance and endurance levels are decreased by this reaction.
Tooth Discoloration And Bad Breath - Common traits of long-term smokeless tobacco users are stained teeth and bad breath. Moreover, the habit of continually spitting can be both unsightly and offensive.
Unhealthy Eating Habits - Chewing tobacco lessens a person's sense of taste and ability to smell. As a result, users tend to eat more salty and sweet foods, both of which are harmful if consumed in excess.
Oral Cancer - With the practice of "chewing" and "dipping," tobacco and its irritating juices are left in contact with gums, cheeks and/or lips for prolonged periods of time. This can result in a pre-cancerous condition called leukoplakia. Leukoplakia appears either as a smooth, white patch or as leathery-looking wrinkled skin.
Other Cancers - All forms of smokeless tobacco contain high concentrations of cancer-causing agents. These substances subject users to increased cancer risk not only of the oral cavity, but also the pharynx, larynx and esophagus.
Danger Signs - If you use smokeless tobacco, or have in the past, you should be on the lookout for some of these early signs of oral cancer:
- A sore that does not heal
- A lump or white patch
- A prolonged sore throat
- Difficulty in chewing
- Restricted movement of the tongue or jaws
- A feeling of something in the throat
Pain is rarely an early symptom. If not caught early on, oral cancer can require extensive and potentially disfiguring surgery, and even death! For this reason, all tobacco users need regular dental check-ups.
Oral Health America's NSTEP program provides cessation resources specifically for smokeless tobacco users. Visit www.nstep.org to access The Cessation Process, 7 Steps to Recovery.
Tobacco Use and Tobacco Cessation Facts & Stats According to the Centers for Disease Control and Prevention (CDC), more than 46 million Americans smoke cigarettes while nearly 9 million develop at least one serious illness in their lifetime due to smoking. CDC also reports that tobacco use causes more than 440,000 deaths each year in the United States. Smoking is the number one cause of death in America, killing more people than alcohol, illegal drugs, car accidents, suicide, homicide and AIDS combined.
Key Tobacco Use Statistics:
- Smoking is the most preventable cause of death in America
- Of the 46 million Americans who smoke, 70 percent say they want to quit
- One in every five deaths is attributed to tobacco use
- The chance of heart attack decreases 24 hours after ending tobacco use
- Nerve endings regenerate, enhancing the ability to smell and taste, within 48 hours after stopping tobacco use
- Two weeks to three months after quitting tobacco use, circulation improves, walking becomes easier and lung function improves
- One year after ending tobacco use, risk of coronary disease decreases to half that of a smoker
- Five years after quitting, the risk of stroke is reduced to that of a non-smoker
- Former pack-a-day smokers save about $120 to $190 per month
- Spit tobacco is not a safe substitute for cigarettes
- Spit tobacco contains nicotine, the same addictive drug in cigarettes
- Spit tobacco causes chronic bad breath, discoloration of teeth, gum disease and recession, tooth decay and tooth loss, high blood pressure and an increased risk for heart disease
Tongue Piercing, Is It Harmful? top^
As with any new fashion trend, young people rush to try it, and body piercing is no exception. But when young people pierce their tongues and lips they are risking numerous dental problems. Tongue piercing involves punching a hole in the tongue and placing a decorative metal stud in the hole. Due to the numerous nerve endings in the tongue, piercing can often result in severe swelling and pain, making eating and talking very difficult, not to mention that a severely swollen tongue can block a person's airway. Infection is also real danger with tongue piercing. Allergic reactions may occur if the stud is not pure metal. Blood poisoning and blood clots are other potential concerns. And since the tongue is constantly moving, healing from tongue piercing is slow, sometimes up to a month. Tongue and lip piercing also affect teeth and gums. Teeth can become cracked or chipped from the metal stud or barbell moving around inside the mouth. Gum tissue may also be damaged by continuous contact with the metal stud. Extra dental care needs to be taken with pierced tongues. When brushing your teeth be sure to also brush your tongue. The barbell should be removed daily and thoroughly cleaned, although not with jewelry cleaner, warm water and soap will work fine. The hole in the tongue should also be rinsed with a small stream of water.
Periodontal (Gum) Disease: What Is It And How Can It Be Prevented? top^
Periodontal or gum diseases can range from gingivitis (swollen gums that bleed easily) to the more serious periodontitis (disease affecting the gums and supporting bone). Although less common in children than in adults, gingivitis is still relatively common in children, and can lead to periodontitis and eventual tooth loss! Furthermore, children with periodontal disease have an increased chance of having periodontal disease as adults. There are many forms of gingivitis and periodontitis, that have a variety of different underlying causes. Most of the time, gingivitis is caused by improper oral hygiene and plaque accumulation. Certain medications your child may be taking or hormonal changes during puberty may intensify the problem. There are also some much rarer forms of gingivitis that are not induced by plaque and may have bacterial, viral, fungal, genetic, systemic, or traumatic injury origins. Periodontitis that may affect your child is most commonly seen during the hormonal changes of puberty and is called aggressive periodontitis. Those affected by this condition are usually otherwise healthy. This may occur as a localized problem (localized aggressive periodontitis - LAP) that only affects certain areas of the mouth and may involve bone loss around the teeth of the molars (back teeth) or incisors (front teeth). There not seem to be a lot of plaque in this form of aggressive periodontitis and hygiene may be generally good, in fact the gums may seem perfectly healthy. It most likely has a genetic/hereditary basis. The generalized form (generalized aggressive periodontitis - GAP), however, involves rapid bone loss around most of the teeth in an affected mouth and is accompanied by much more plaque and inflammation of the gums. GAP rarely affects individuals over the age of 30. One rare form of periodontitis that affect very young children is called Leukocyte Adhesion Deficiency (LAD). This can affect infants shortly after their baby teeth arrive and also comes in localized and generalized forms. Leukocytes are white blood cells responsible for fighting off infections, and in LAD, there is a defect in their normal action. If your child has advanced periodontal disease that, in particular, is not responsive to treatment, then they may also have underlying systemic disease and should be evaluated by their pediatrician.
Gum disease can cause bad breath, affect appearance, and is certainly detrimental to health. A bright smile, pleasant breath, and healthy teeth can heighten your child’s interpersonal relationships, boost self-esteem, and maintain positive psychological well-being. Dr. Hsu will check your child’s x-rays and evaluate your child’s gums during exams to catch these potential problems early! Parents: You can help your child prevent gum disease by practicing good oral hygiene and establishing healthy dietary habits early for your child (for brushing and flossing tips, please see the topic “How Should I Take Care Of My Child’s Teeth?” in the Dental Q & A section). Check your child’s gums and teeth periodically by having them open their mouth and lifting the lip. If you see visible plaque and gums that are red, swollen, and/or bleeding; then your child has gum disease. Bad breath may also be an indication of periodontal disease. Being a good role for your child is important so practice good hygiene and nutrition habits, and visit your dentist regularly. Also, the pathogenic bacteria responsible for periodontal disease has been shown by research to transmit from one family member to another. Periodontal disease has been linked to systemic diseases such as heart disease, stroke, obesity and low birth weight, or pre-term babies. It can also pose a serious threat to those whose health is compromised by diabetes, or respiratory disease.
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