Reports & Studies

The long-lasting effects of smoking on our teeth …

PD Dr. Kristina Bertl, PhD MSc MBA

The topic of smoking and oral health was recently touched on in the Community questions, and of course we know the slogan ‘smoking is bad for your health – and the oral cavity is one of the most vulnerable parts of the body!’

But how can we demonstrate to our patients exactly how bad smoking is for the teeth? We already tackled this topic in one of the first scientific articles and were able to provide a very vivid example (Smoking & periodontitis): ‘Smoking substantially reduces the ability of the periodontium to heal during periodontal treatment – it is thought that the healing capacity of a 50-year-old smoker’s periodontium roughly corresponds to that of an 86-year-old non-smoker’s periodontium – that is a difference of 36 years!

A recently published retrospective study (Ravidà 2020) contains even more excellent and vivid examples for our patients: Based on a population of 258 periodontitis patients who had been in regular periodontal maintenance therapy for at least 10 years and up to nearly 50 years, the authors were able to make the following calculations regarding periodontitis-related tooth loss and smoking:

  • The yearly periodontitis-related rate of tooth loss in non-smokers, former smokers, light smokers (< 10 cigarettes/day) and heavy smokers (≥ 10 cigarettes/day) was 0.03, 0.05, 0.08 and 0.11, respectively. In other words, the teeth of a heavy smoker were at a 4.4-, 2.6- and 2.7-times greater risk of periodontitis-related tooth loss than the teeth of non-smokers, former smokers and light smokers.
  • After an individual stops smoking, their risk of periodontitis-related tooth loss decreases by only approximately 6% per year. This means it takes approximately 15 years before the periodontitis-related rate of tooth loss among former smokers is comparable to that among non-smokers.
  • Even after a patient has successfully stopped smoking, it continues to make a difference whether they were previously categorized as a light or heavy smoker; the risk of periodontitis-related tooth loss was approximately 5 times higher in a previously heavy smoker than in a previously light smoker.

In short, the sooner our patients succeed at giving up smoking, the better!


  1. Ravidà A, Troiano G, Qazi M, et al. Dose-dependent effect of smoking and smoking cessation on periodontitis-related tooth loss during 10 - 47 years periodontal maintenance—A retrospective study in compliant cohort. J Clin Periodontol. 2020;47:1132–1143.