Smoking causes not just cancer, heart diseases.

The risks of smoking on oral and bone health are not as widely known as risks of coronary heart diseases, cardiovascular diseases and lung cancer.

Tobacco products now have mandatory graphic health warning images and a message that reads 'Smoking causes lung cancer'. However, lesser-known health risks are rarely in public consciousness.

Ahead of World No Tobacco Day 2014, observed annually the World Health Organisation (WHO) on May 31, medical specialists at Dubai Healthcare City (DHCC) point to the lesser known health risks associated with smoking.

The risks of smoking on oral and bone health are not as widely known as risks of coronary heart diseases, cardiovascular diseases and lung cancer.

Smoking causes dental problems, ranging from bad breath, tooth discoloration and gum (periodontal) diseases. It also causes delayed healing process following tooth extraction, gum treatment or oral surgery, and reduces the success rate of dental implant procedures.

Dr Khalaf Moussa, German board-certified orthopaedic surgeon, Dubai Bone and Joint Centre at the DHCC, said, "Recent studies show a direct relationship between tobacco use and decreased bone density. Bone mass is compromised in a smoker under the age of 30, leading to a smaller skeleton and less bone mass compared to non-smokers in the same age bracket. In women, due to the normal process of aging and loss of oestrogen, normal bone loss takes place; in women smokers, bone loss is more rapid."

Dr Moussa said that smokers are at an increased risk for osteoporosis. "Smoking is identified as a risk factor for osteoporosis and bone fracture. Osteoporosis can trigger bone loss for many years without symptoms until a fracture occurs."

Citing a study 'Smoking and bone health' by the National Centre for Smoking Cessation and Training in the UK, he said smokers have a 25 per cent increase in fracture risk and are nearly twice as likely to experience hip fractures.

"Smoking also delays bone healing following operations to repair fractures. However, stopping smoking has been shown to partially reverse the risk of suffering fractures, and smoking cessation is therefore advised in national guidelines for the prevention and treatment of osteoporosis."

Crawford Bain, Professor of Periodontics at the Dubai School of Dental Medicine at DHCC, said according to an average from multiple studies, a patient who smokes 20 cigarettes a day for 20 years is around 600 per cent more likely to lose teeth from gum disease than a non-smoker.

A study titled 'Tobacco Intervention: Tobacco and oral disease', co-authored by Prof Bain and published in the British Dental Journal, said smoking was associated with discolouration of teeth and dental restorations, halitosis (bad breath), periodontal disease and higher dental implant failure rates.

He said, "With both implants and gum problems it is thought that reduced circulation caused by smoking can lead to less dense bone and lower oxygen levels in the bone and soft tissues. This reduced oxygen environment is attractive to certain aggressive bacteria known to cause bone loss."

Prof Bain believes that smoking counselling should be a fundamental part of the dental curriculum and any practice prevention programme.

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