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There are 36 million smokers in the United States, according to the Centers for Disease Control, amounting to about 15 percent of the population. While this number has declined over the years, it’s still a large number of people who are at risk for dental issues that come with smoking.

What does smoking do to your teeth? Tobacco hurts your teeth in many ways. Cigarettes limit your mouth’s ability to fight off infection, which leaves you defenseless against the bacteria produced by smoking. When your mouth can’t fight back, plaque and bacteria fester.

Increased plaque and bacteria cause a wide range of oral health issues:

Tooth Discoloration

Yellowed or stained teeth is one of the most obvious signs that someone is a smoker. The chemicals in tobacco cling to the enamel in your teeth, causing them to stain over time. Teeth whitening treatments can help slow down this process, but if you continue smoking it’s impossible to stop or reverse it entirely.

Bad Breath

The old saying “your breath smells like an ashtray” definitely holds true with smokers today. Cigarette particles remain in the mouth long after a cigarette is finished, which cause the breath to take on the characteristics of a cigarette.

Beyond that, the longer-term effects of smoking also contribute to bad breath. The overgrowth of bacteria in the smoker’s mouth leads to horrible breath. Unfortunately, amount of brushing or gargling with mouthwash will get rid of the smell because it is coming from gum disease, oral sores, and decay. The only real way to turn things around is to stop smoking entirely and work with a dentist to address the underlying issues it caused.

Prolonged smoking can also lead to inflammation of the salivary glands, which results in painful swelling in the face and could require surgery if salivary gland stones develop.

Gum Disease

According to the CDC, smokers are twice as prone to gum disease as nonsmokers. The risk increases with every cigarette you smoke, and gum disease treatments do not work as well on smokers.

Why is this? Smoking decreases your mouth’s ability to fight off bacteria, which allows it to build up on teeth and eventually make its way to the gums. If left untreated, gums can pull away from teeth and cause the underlying bone structures to weaken. The most severe form of this is periodontitis, where the bone and tissue holding teeth in place break down, causing teeth to fall out or be extracted.

Losing teeth is an outcome for heavy smokers because their mouths don’t get a break long enough to heal. Smoking also counteracts the effects of gum disease treatments like brushing, flossing, prescription mouth rinses, and tartar removal treatments.

Delayed Healing

Unfortunately, the bad news does not end there for smokers.

Not only does smoking increase your risk of things like tooth extraction and oral surgery, it also slows down your body’s ability to recover from these procedures. It also lowers the rate of successful dental implant procedures.

The more time your mouth spends in a vulnerable state, the more prone you are to developing further complications. A dentist can help mitigate this as much as possible, but treatment plans are only so effective if the patient continues to smoke.

Oral Cancer

The most severe form of smoking-related mouth issues is oral cancer. According to the Oral Cancer Foundation, about 50,000 people in the U.S. are diagnosed with oral cancer each year and an estimated 80 percent of them are smokers. The risk of developing oral cancer increases when smoking is combined with heavy drinking.

Oral cancer begins as a white or red patch in the mouth accompanied by difficulty chewing or swallowing, numbness in the jaw, and even pain in the ear. While there are certainly other causes for these symptoms, the National Institutes of Health recommends that anyone who has these symptoms for more than two weeks should see a doctor. The earlier cancer is detected, the more effective treatment will be.

The Best Solution

Again, a dentist can put together a treatment plan to help mitigate the issues associated with smoking, but the only way to make them go away completely is to stop smoking. Dental issues are just one of the many parts of your body that can be affected by smoking; quitting will ensure a healthier life for years to come.

Millennials—loosely defined as the group of people who are reaching adulthood in the early 21st Century—have a lot going for them. Soon to surpass baby boomers as the largest living adult generation, they're poised to have an immense effect on our economy…and a big hand in shaping our future. But there's one thing that's not so great about this generation: their oral hygiene habits.

A recent survey of 2,000 millennials found that three in ten brush their teeth only once a day. Not only that, but many go without brushing for over two days at a time. And despite that fact that 56 % are concerned about losing their teeth, the survey showed that over half were afraid of going to see the dentist.

What's wrong with this picture? First of all, let's point out that the American Dental Association (ADA) recommends brushing twice a day with fluoride toothpaste, and flossing once a day, to keep your oral health in good shape. Proper brushing and flossing is the most effective way to rid your teeth of plaque: the buildup of food particles and harmful bacteria that cause tooth decay and gum disease. Brushing and flossing are the two most important things you can do at home to maintain good oral hygiene—and having good oral hygiene is the best way you can help keep your natural teeth healthy and sound for your whole life.

But even if you're careful to brush and floss as recommended, you still need to see your dentist for regular checkups. That's because it's almost impossible to completely remove harmful plaque from all tooth surfaces—especially in between teeth and under the gums. Left alone, sticky plaque hardens into tartar, a mineralized deposit that can't be removed at home. A dental professional, however, can effectively remove stubborn plaque during a routine office visit.

What's more, at a regular dental checkup you'll get a full teeth cleaning and a complete evaluation of your oral health, including screening for oral cancer and other potentially serious diseases. These conditions are uncommon…but untreated tooth decay is prevalent among millennials, affecting one in three people ages 18 to 34. When decay bacteria are left alone they can cause further problems in teeth and gums, and eventually lead to tooth loss.

Missing teeth and other dental issues can cause problems that aren't just "skin deep." A 2017 survey by the ADA found that 28% of young adults say the appearance of their teeth and mouth hurts their job prospects, and 38% find their lives are "less satisfying" due to oral problems. That's two more reasons not to put off a routine visit to your dentist!

This month we're spreading the word to remind both children and adults: as you suit up for outdoor activities this spring, don't forget to protect your face and head. Spring often brings a flood of patients suffering with head, mouth and facial injuries resulting from sports-related accidents to doctors' offices and emergency rooms. Many oral and facial injuries can be easily prevented with the use of sports safety equipment like helmets and mouth guards.

National Facial Protection Month is sponsored by the Academy for Sports Dentistry, the American Academy of Pediatric Dentistry, the American Dental Association, the American Association of Oral and Maxillofacial Surgeons, and the American Association of Orthodontists. Together we encourage children and adults to enjoy the pleasures of the season by using common sense and taking the necessary precautions to prevent sports injuries.

For more information about the prevention and treatment of facial injury, visit MyOMS.org.

April is #OralCancerAwarenessMonth. Early detection is critical, and dental hygienists are the prevention experts who have the ability to have a positive impact in their patients lives. Raise awareness!