Smoking, Vaping and Gum Disease
For anyone who smokes or vapes: how smoking raises gum disease risk, hides its signs and weakens treatment, what is known about vaping, how gums change after quitting, and where to find NHS support. UK guidance says stopping tobacco use can prevent further deterioration of gum health.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, GDC 301711, a General Dental Practitioner and the principal dentist at Deepcar Dental Care, reviewed this page. His qualifications include BDS, BSc (Hons) and MSc (Leeds).
Does smoking cause gum disease?
Poor oral hygiene is the main cause of gum disease, Leeds Teaching Hospitals NHS Trust says, but smoking significantly increases the risk.
Delivering Better Oral Health (DBOH) says tobacco has a profound effect on the risk of developing periodontitis. A 2018 analysis of 14 prospective studies estimated that smoking increases the risk of periodontitis by 85%.
The Oral Health Foundation (OHF) says smoking can make more plaque build up, reduce the blood supply to your gums and slow down healing, so gum disease can develop more quickly and become more severe. Our periodontitis page covers gum disease that has caused loss of the tooth's attachment.
How does smoking hide gum disease?
Smoking can mask the warning signs of gum disease, so smokers may not notice bleeding gums as easily, the OHF says.
Leeds Teaching Hospitals lists gums that bleed easily, less so in smokers, among the signs of gum disease, which often causes no pain.
A 2004 US national survey study of 12,385 people found that smoking strongly, chronically and dose-dependently suppresses gum bleeding on probing. In never-smokers, gum sites with tartar or pockets of 4 mm or more were more likely to bleed (odds ratio 5.7); in people smoking more than 10 cigarettes a day, that relationship was less evident.
The British Society of Periodontology notes you can have gum disease without being aware of its signs, and calls regular dental examinations essential. Our page on gums that bleed during cleaning covers bleeding more broadly.
Does gum treatment work less well in smokers?
Tobacco impairs the response to gum treatment, DBOH says. For smokers, Leeds Teaching Hospitals says, treatment is less likely to work and the disease more likely to return.
A 2021 review of 17 studies found smaller gains from non-surgical gum treatment in smokers: on average, gum pockets reduced by 0.33 mm less and attachment gain was 0.20 mm less than in non-smokers.
Our page on treatment for gum disease below the gum line explains deep cleaning, which is not the same as a routine scale and polish, and our page on whether smokers can have dental implants covers implant healing.
What does the evidence say about vaping and gums?
Evidence on vaping and gum health is limited and inconsistent.
DBOH says findings on vaping and gum health are inconsistent but suggest that people who vape are at greater risk of gum disease than non-smokers. It notes that most people who vape are former smokers already affected by smoking, that a clear picture needs long-term research, and that e-cigarettes may have a lower risk of periodontitis than tobacco.
A 2024 review of 12 studies found no significant link between e-cigarette use and harm to gum health, but called the research limited and longer-term studies necessary.
The OHF says vaping may increase the risk of gum disease, and that nicotine can reduce blood flow to the gums, slow healing and hide early warning signs such as bleeding.
Questions about this treatment? Book online or call the practice.
What changes in your gums after you stop smoking?
Studies of quitters report gum changes; reviews call the evidence limited.
- Gum bleeding, at 4 to 6 weeks: in a small study of 27 people on a quit-smoking programme, bleeding on probing rose from 16% to 32% of sites despite better cleaning, which the authors took as evidence that smoking's effect on the inflammatory response is reversible on quitting. If your gums bleed after you quit, show them to a dentist.
- Pocket depth and gum attachment, at 3 to 6 months: a 2026 review of six studies (1,934 people) found that quitting, compared with continuing to smoke, may be associated with modest short-term improvements in pocket depth (3 and 6 months) and attachment (3 months), not sustained at 12 months; no significant link was found with bleeding or plaque.
- Response to non-surgical gum treatment, at 12 to 24 months: a 2019 review of six studies found an extra 0.32 mm reduction in pocket depth, and up to 0.2 mm more attachment gain, in quitters than in people who kept smoking.
- Gum disease risk and bone loss: the 2019 review found the risk of periodontitis starting or progressing in quitters was not significantly different from never-smokers. A 2014 review of limited evidence reported about 30% less bone loss in quitters than in smokers over 10 and 20 years (two studies).
Where can you get support to stop smoking?
Local NHS stop smoking services are free and can improve your chances of quitting for good, NHS guidance says.
Your GP, pharmacist or health visitor can refer you, or you can phone your local service. In England, the free Smokefree National Helpline is 0300 123 1044.
NHS Better Health's Quit Smoking website offers a free Personal Quit Plan and the NHS Quit Smoking app.
When should you see a dentist about your gums?
NHS guidance gives these actions; if you do not have a dentist or cannot get an emergency appointment, call 111 or visit 111 online:
- Gums that bleed when you brush your teeth or eat hard foods, gums that are painful and swollen, bad breath, or a child with sore, bleeding gums: see a dentist.
- Gum disease, in you or your child, with other symptoms such as very sore and swollen gums, teeth becoming loose or falling out, ulcers or red patches in your mouth, or a lump in your mouth or on your lip: ask for an urgent dentist appointment.
- Toothache that lasts more than 2 days, does not go away with painkillers, or comes with a high temperature, pain when you bite, red gums, a bad taste or a swollen cheek or jaw: see a dentist.
- Toothache with swelling around your eye or neck, or swelling in your mouth or neck that makes it difficult to breathe, swallow or speak: go to A&E, but do not drive; ask someone to drive you or call 999 and ask for an ambulance.
How much does gum disease treatment cost?
Non-surgical periodontal therapy and treatment of advanced gum disease have no line on the practice's current fee list. Neither does smoking cessation advice. Ask us about the cost.
Frequently asked questions
Does smoking affect healing after gum treatment?
It can. Leeds Teaching Hospitals says smoking reduces the gums' ability to heal, and UK guidance counts poor healing after operations among tobacco's most significant harms in the mouth. The European Federation of Periodontology guideline gives a Grade A recommendation, from six prospective studies, for stop-smoking interventions during periodontitis treatment and in supportive periodontal care afterwards.
Can vaping help you stop smoking?
It can. A 2026 Cochrane review found high-certainty evidence that regulated nicotine e-cigarettes help more people quit than nicotine replacement therapy, and no evidence of serious short-term harm, but uncertain evidence of more non-serious side effects than with behavioural support or none. Longer, larger trials are needed to fully evaluate safety; illicit or THC-containing products may differ in harm.
Is cutting down on smoking enough?
Delivering Better Oral Health says the health benefits come from stopping smoking altogether, and that any benefits of simply reducing are unclear. For people not ready or willing to stop completely, it suggests a nicotine-containing product may help them cut down on the way to reducing harm.
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Deepcar Dental Care is at 334 Manchester Road, Deepcar, Sheffield, S36 2RH, with free parking directly outside.
Our guide to how gum disease develops covers its causes and stages, our hygiene appointments page covers professional hygiene visits, and our patient reviews show what patients say.
Smoking cessation advice is available at Deepcar Dental Care.
334 Manchester Road
Deepcar, Sheffield S36 2RH
0114 288 2121
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