A new study has been released which reports that smoking can kill the oral bacteria in your mouth that is healthy and helps you fight oral infections and diseases, leaving smokers more vulnerable to oral health diseases. Simultaneously it also seems that the smoking can increase the number of harmful oral bacteria that will cause these diseases and infections.

In a normal and healthy mouth, patients can enjoy a stable ecosystem of helpful bacteria. Even though the ecosystem is disrupted every day for brushing and flossing routines, the helpful bacteria still manage to thrive. But the new research here is showing that the smoker does not have this stable and balanced ecosystem. Instead, the smoker has a diverse and chaotic ecosystem full of harmful bacteria.

Most people already know that smoker suffer from higher rates of oral diseases, such as gum disease and oral cancer, than others who do not smoke. But this new study is showing us exactly how that happens, and apparently the answer is that the smoker’s mouth is a breeding ground for harmful bacteria. The study was conducted by Purnima Kumar, an assistant professor of periodontology at Ohio State University.

“The smoker’s mouth kicks out the good bacteria, and the pathogens are called in,” said Kumar. “So they’re allowed to proliferate much more quickly than they would in a non-smoking environment.”

And though most dentists are already aware of the benefits that quitting smoking will have on their patients, dentists will now be able to fully explain to their patients exactly why their gum disease is caused by their smoking. This will also help dentists to develop new, more aggressive dentistry tactics when handling patients who smoke. Dentists can use this information to develop preventative treatment specifically designed for those who smoke.

“A few hours after you’re born, bacteria start forming communities called biofilms in your mouth,” said Kumar. “Your body learns to live with them, because for most people, healthy biofilms keep the bad bacteria away.”

Kumar even compared the biofilm to a lush and green lawn of grass. “When you change the dynamics of what goes into the lawn, like too much water or too little fertilizer,” she said, “you get some of the grass dying, and weeds moving in.” For smokers, the “weeds” are problem bacteria known to cause disease.

The study also looked into how the bacterial ecosystems are affected after being completely removed from the mouth. The researchers took oral bacteria cultures one, two, four, and seven days after a professional cleaning of the mouths of both smokers and non-smokers.

“When you compare a smoker and nonsmoker, there’s a distinct difference,” said Kumar. “The first thing you notice is that the basic ‘lawn,’ which would normally contain thriving populations made of a just few types of helpful bacteria, is absent in smokers.”

They found that nonsmokers tend to regain an ecosystem of healthy bacteria that is similar to the one they had before the professional cleaning. The bacteria associated with disease are generally absent. Lab results also show that the body contains low levels of cytokines, a sign that the body is embracing the helpful biofilms instead of rejecting them as a potential threat.

“By contrast,” said Kumar, “smokers start getting colonized by pathogens – bacteria that we know are harmful – within 24 hours. It takes longer for smokers to form a stable microbial community, and when they do, it’s a pathogen-rich community.”

The smokers’ mouths also show signs of fighting off the helpful biofilm, mistaking this helpful bacteria as being a harmful threat. The body contains higher levels of cytokines than those of non-smokers, showing that the body is releasing defense mechanisms against the oral bacteria. The effects of this defense against biofilm can also been seen in a physical reaction in the gums. Typically this immune response results in gingivitis, causing red and swollen gums, and can even eventually lead to periodontitis and tooth loss.

“It has to drive how we treat the smoking population,” she said. “They need a more aggressive form of treatment, because even after a professional cleaning, they’re still at a very high risk for getting these pathogens back in their mouths right away.

Dentists don’t often talk to their patients about smoking cessation,” she continued. “These results show that dentists should take a really active role in helping patients to get the support they need to quit.”

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