Hidden Hazards

In short

Explore the surprising ways that habits like smoking, vaping, using snus, consuming energy drinks and getting piercings can affect your oral health.

Smoking, vaping and other tobacco products

Vaping, cigarettes and other tobacco products like snus have been found to cause and worsen a wide range of health issues: compromised immune system, diarrhoea, nausea, heartburn, asthma and other lung diseases, halitosis, and even oral and lung cancer – among others. Even if you don’t smoke or vape yourself, being near someone who does can also impact your health in the same ways as actively doing it. 

Cigarettes

The tar and nicotine from tobacco not only stain teeth and cause bad breath, but can also lead to other problems like gingivitis, leucoplakia, delayed healing process or even oral cancer. Cigarettes contain more than 7,000 chemicals, at least 70 of which have been proven to be carcinogenic.  Smoking furthermore harms the mouth’s ability to heal, which can cause complications following surgery in the mouth or other dental procedures. 

Oral cancer appears as a growth or sore that does not heal up or disappear by itself. It can crow on the lips, tongue, cheek, floor of the mouth, hard and soft palate, sinuses and throat. If it is not treated early, it can be life threatening. However, it is curable, especially when it is detected early. If you notice irregularities, it is best to schedule an appointment sooner than later.

Vapes

Vapes are a relatively new product, which is why their long-term effects on general health have not been studied thoroughly. However, considering the ingredients, as well as how the devices function and how they are used, there is reasonable concern to be had. 

For one, the liquids contain nicotine, and both the liquids themselves as well as the added flavours contain several types of sugar. The vapor produced by vaping devices is thick and viscous and much of it is retained on oral tissues. 

Smokeless Tobacco Products

Besides smoking, tobacco is also sold in smokeless form, for oral and nasal consumption. Especially orally administered tobacco can impact your oral and dental health, as the so-called “Snus” is stuck between the inside of the lips and the gums and kept there for extended periods of time. The salt within the Snus irritates the soft tissue and allows the nicotine to enter the bloodstream. Using this smokeless tobacco product is directly linked to oral leucoplakia forming right where it was applied to the tissue, and these lesions can become cancerous. 

Oral Piercings

Piercings are a popular way of expressing oneself and are generally harmless, granted they are installed by a professional. Piercings inside the oral cavity as well as lip and cheek piercings, however, can damage your teeth and injure your soft tissue. 

Therefore, it is important to properly clean the piercings, as well as ensuring that the jewellery is of high quality, and that you are not allergic to any of the materials. If a medical professional encourages you to remove your piercing altogether, it’s best to follow their advice, as it could prevent you from experiencing painful complications like chipped teeth and gum disease.

Acidic carbonated beverages and sugary drinks

Dangers of sugar

Did you know that a can of fizzy sugary drink can contain up to 9 cubes of sugar? One cube is equivalent to 4g of sugar, and even for adults, a maximum daily intake limit of 7 cubes is recommended. It’s also important to remember that many foods and drinks also contain sugar naturally, mostly in the form of fructose and lactose. Consuming high amounts of sugar is not only bad for your general health, but it can also damage your oral health.

The bacteria in your mouth feed on sugars, producing acids that can erode tooth enamel, leading to cavities and tooth sensitivity. In fact, sugar is a leading cause of tooth decay, especially in children and adolescents. Even though the sugar-free alternatives may seem like the wiser choice, their acidity can damage your teeth as well.

Dangers of acids

Sports and energy drinks, fruit juices, and carbonated soft drinks are in the most acidic beverage categories, considerably reducing enamel surface hardness owing to mineral loss.

Ingredients like citric acid, phosphoric acid, and carbonic acid are common in these drinks. These acids can erode tooth enamel over time. The enamel, once eroded, exposes the softer dentin underneath, leading to increased tooth sensitivity and vulnerability to decay. Daily consumption of carbonated drinks increases the risk of tooth erosion, which can involve both milk and permanent teeth. 

The pH level of the mouth is directly affected by the foods and drinks you consume, and your oral pH level has a direct effect on your teeth and gum health. The normal pH range for saliva is 6.2 to 7.6, and it acts as a protective barrier against acidic foods and drinks. When the pH levels in your mouth dip below 5.5, this increased acidity starts to break down the protective enamel on your teeth and places you at a higher risk of developing cavities. Furthermore, an organic acid produced by the fermentation of sugar in beverages by oral microorganisms present in plaque further leads to demineralization and caries.

Energy drinks are especially harmful, as they are high in sugar and acidity, with a pH level between 1.5 to 3.3. 

In conclusion, consuming water as your main beverage decreases your chances to develop erosions by roughly 70%. However, if you don’t want to do without sugary, acidic and carbonated beverages, you can minimise direct contact with your teeth by using a straw. Drinking water afterwards neutralises the acids, and of course, maintaining good oral hygiene limits the erosive effects.

Sources:

• Inchingolo AM, Malcangi G, Ferrante L, Del Vecchio G, Viapiano F, Mancini A, Inchingolo F, Inchingolo AD, Di Venere D, Dipalma G, Patano A. Damage from Carbonated Soft Drinks on Enamel: A Systematic Review. Nutrients. 2023 Apr 6;15(7):1785. doi: 10.3390/nu15071785. PMID: 37049624; PMCID: PMC10096725.
• Mendel JR, Baig SA, Hall MG, Jeong M, Byron MJ, Morgan JC, Noar SM, Ribisl KM, Brewer NT. Brand switching and toxic chemicals in cigarette smoke: A national study. PLoS One. 2018 Jan 11;13(1):e0189928. doi: 10.1371/journal.pone.0189928. PMID: 29324749; PMCID: PMC5764241.
• Nijakowski K, Walerczyk-Sas A, Surdacka A. Regular Physical Activity as a Potential Risk Factor for Erosive Lesions in Adolescents. Int J Environ Res Public Health. 2020 Apr 26;17(9):3002. doi: 10.3390/ijerph17093002. PMID: 32357436; PMCID: PMC7246606.
• National Health Service (NHS). (2024, 7. August). Sugar: the facts. nhs.uk. https://www.nhs.uk/live-well/eat-well/food-types/how-does-sugar-in-our-diet-affect-our-health/
• National Health Service (NHS). (2024b, August 15). Tooth decay. nhs.uk. https://www.nhs.uk/conditions/tooth-decay/

Glossary: 

• Halitosis: bad breath.

• Leucoplakia: a whitish, thick patch on your gums, tongue or on the inside of your cheek, which may lead to cancer.

• Carcinogenic: potential to cause cancer; can lead to cancer

• free sugars: sugar that is added to foods and drinks during the processing or preparation but is not naturally present in the other ingredients.