Bleeding Gums


7:00 PM - May 06, 2007 #1

I had a question posed at the AskJoel Board about bleeding gums after quitting. Here is a copy of the response to that question:
From: John (Gold) Sent: 1/18/2004 8:40 AM
You're not alone Kim it finding your gums getting more oxygen while experiencing far less nicotine induced vasoconstriction while also being fed far less carbon monoxide. Although not yet fully explained, there is new study evidence suggesting that the increased incidence of bleeding may actually be independent of gingival health and more associated with gingival epithelial thickness.
Can't seem to put my hands on it now but there is an older study which found that the average smokers has an average of three fewer teeth in older age than their nonsmoking counterpart.
As for the smoking dream, please read Joel's article that Bob linked for you.
Tim, I've never read any study indicating that ex-smokers sustain a greater rate of infections than smokers. Increased circulation is not necessarily a bad thing. Please take care in not feeding the junkie mind too many excuses to get their antiseptic back. Thanks. Also, you might want to read Joel's Dreams of smoking too as horizontal healing lungs loaded with a tremendous suppy of tars reflecting the chemicals consumed drifting up to meet a healing sense of smell and taste pretty much assures the new ex-smoker a vivid dream.
Only one rule, no nicotine today, Never Take Another Puff! John

Gingival bleeding on probing increases after quitting smoking.

Journal of Clinical Periodontology 2003 May; 30(5): 435-7.
Nair P, Sutherland G, Palmer RM, Wilson RF, Scott DA.

Department of Periodontology and Preventive Dentistry, Guy's, King's and St Thomas' School of Dentistry, Kings College, Guy's Campus, London SE1 9RT, UK.

BACKGROUND: Gingival inflammation associated with plaque accumulation is delayed or impaired in smokers. Anecdotal evidence suggests that smokers who quit experience an increase in gingival bleeding.

METHOD: A group of 27 subjects on a Quit-smoking programme were examined for changes in gingival health over a 4-6-week period.

RESULTS: The bleeding on probing with a constant force probe increased from 16% of sites to 32% of sites, despite improvements in the subjects oral hygiene.

CONCLUSION: This provides further evidence that tobacco smoking affects the inflammatory response and that these changes are reversible on quitting.

PMID: 12716336 [PubMed - indexed for MEDLINE]

Tobacco smoking and periodontal hemorrhagic responsiveness.

Journal of Clinical Periodontology 2001 July; 28(7): 680-5.

Bergstrom J, Bostrom L.

Department of Periodontology, Karolinska Institutet, Stockholm, Sweden.

OBJECTIVE: The influence of smoking on the periodontal hemorrhagic responsiveness was investigated in 2 different populations, one exclusively consisting of patients with established periodontal disease, the other of dental hospital admissions in general.

MATERIAL AND METHODS: The hemorrhagic responsiveness of the patient was clinically found from "bleeding on gentle probing" expressed as the relative frequency of bleeding sites (%). In the periodontal patient population, gingival bleeding was assessed by 1 examiner with known probing force, whereas in the dental hospital admissions population assessments were done by a great number of non-calibrated examiners with unknown probing force.

RESULTS: Smokers exhibited a significantly lower hemorrhagic responsiveness than non-smokers. This held principally true for both populations but the effect was much more clearly detectable in periodontal patients than in dental hospital patients in general. A dose-response effect was typically evident in the periodontal patient population. Accounting for the periodontal disease severity, however, the effect of smoking became clearly detectable also in the general patient population.

CONCLUSION: Tobacco smoking is associated with a clinically suppressed hemorrhagic responsiveness of the periodontium.

PMID: 11422590 [PubMed - indexed for MEDLINE]

From: John (Gold) Sent: 3/16/2004 6:19 AM
Smoking cessation increases gingival blood flow
and gingival crevicular fluid.

Journal of Clinical Periodontology 2004 April; 31(4): Pages 267-272.

Morozumi T, Kubota T, Sato T, Okuda K, Yoshie H.

Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Morozumi T, Kubota T, Sato T, Okuda K, Yoshie H: Smoking cessation increases gingival blood flow and gingival crevicular fluid. J Clin Periodontol 2004 doi: 10.1111/j.1600-051X.2004.00476.x. Copyright Blackwell Munksgaard, 2004.
Objectives: The purpose of the present study was to determine the effect of smoking cessation on gingival blood flow (GBF) and gingival crevicular fluid (GCF).

Material and Methods: Sixteen male smokers (aged 22-39 (25.34.0) years), with no clinical signs of periodontal and systemic diseases, were recruited. The experiment was performed before (baseline) and at 1, 3 and 5 days, and at 1, 2, 4 and 8 weeks after smoking cessation. The status of smoking and smoking cessation was verified by exhaled carbon monoxide (CO) concentration, and by serum nicotine and cotinine concentrations. A laser Doppler flowmeter was used to record relative blood flow continuously, on three gingival sites of the left maxillary central incisor (mid-labial aspect of the gingival margin and bilateral interdental papillae). The GCF was collected at the mesio- and disto-labial aspects of the left maxillary central incisor and the volume was calculated by the Periotron 6000(R) system. The same measurements except for the GBF were performed on 11 non-smoking controls (four females and seven males), aged 23-27 (24.41.2) years.

Results: Eleven of 16 smokers successfully completed smoking cessation for 8 weeks. At 1 day after smoking cessation, there was a significantly lower CO concentration than at baseline (p<0.01). Also, nicotine and cotinine concentrations markedly decreased at the second measurement. The GBF rate of smokers was significantly higher at 3 days after smoking cessation compared to the baseline (p<0.01). While the GCF volume was significantly increased at 5 days after smoking cessation compared to the baseline (p<0.01), it was significantly lower than that of non-smokers until 2 weeks after smoking cessation (p<0.01).

Conclusion: The results show that the gingival microcirculation recovers to normal in the early stages of smoking cessation, which could activate the gingival tissues metabolism/remodeling, and contribute to periodontal health.

PMID: 15016254 [PubMed - in process]

Life Goes On Without Smoking
It is important for all people who quit smoking to recognize that life goes on without smoking. Over time after a person quits smoking there will be changes: medical, psychological, professional, economic, life roles, relationships, etc. What is important to recognize though is that most of these changes would have occurred whether you had quit smoking or not or even whether or not you ever smoked. As many of my friends are now in their mid-forties and fifties, it is amazing how we share stories of new ailments and new medications being introduced into our lives. Some of these people had quit smoking decades ago, some of them never smoked. None of the ex-smokers bring up a new disorder and say or think to themselves that it must be happening now because they quit smoking ten or twenty years ago. It would be like a person who never smoked who finds out they now have high blood pressure and then thinks to him or herself that it must be because he or she stopped using some product twenty years ago. As we age things happen-it is just the way things go.

If a person gets diagnosed with a smoking related ailment like emphysema or lung cancer years or decades after quitting it is likely that their mind is shifted to think about their past smoking. But medical and psychological conditions that are experienced by smokers and non-smokers alike, the concept of smoking or quitting should not be considered a primary focus anymore.

Smoking did not cause everything. It causes a whole lot of things though and many things that it does not cause, it makes worse. On the same token, quitting does not cause everything. Quitting is usually accompanied with many repairs, but there are also some adjustments (see Medication adjustments) that go on that may need a partnership with your physicians to get worked out.

My general rule of advice is whatever happens the first few days of a quit, whether it is physical or psychological reactions, blame it on not smoking. It is probably the cause of most early quit reactions. If it is a symptom to a condition that could be life threatening, such as severe chest pains or signs or symptoms of a stroke-contact your doctor immediately. While it is probably nothing and just a side effect of quitting, in the long shot that it is something else coincidentally happening the week you are quitting, you need to get it checked out.

Things happening weeks, months, years or decades after your quits though should not ever be assumed to be a quit smoking reaction. It is life going on without smoking. Some of these things may trigger smoking thoughts-especially if they are similar to conditions you did have in the past when you were a smoker. The situation now is a first time experience with a prior feeling where smoking was integrates thus creating smoking thoughts. But even in this case, the condition is creating a smoking thought, it is not that your smoking memories or your smoking past is creating the condition.

Life goes on without smoking. It is likely to go on longer and it is likely that you will be healthier at each and every stage than you would have been if you had continued smoking. Your life will continue to stay better and likely last long longer as long as you always remember to never take another puff!


From the string "Is anyone else experiencing the symptom of...?"

Every now and then a person will experience a specific symptom and put up a post asking whether or not the symptom is one that is normally experienced by people who have quit smoking and if others here had experienced the same symptom when they had quit. As far as if a specific symptom is one that "can" occur after cessation, we have put together a pretty inclusive string titled Possible Withdrawal Symptoms.

As far as whether or not another member or numerous members experienced the same symptom, it does not really make a difference if they had or had not. It is like someone writing and saying that he or she is having a tingling sensation in his or her arm and wondering if anyone else experienced the same symptom when they quit. Then a person who had slept on his or her arm one night when quitting smoking and woke up with that particular arm tingling writes back and says that sure enough, he or she had a tingling arm the week he or she had quit. Now the recent quitter feels a sense of relief because he or she has seen that one other person had the same symptom. So the person does nothing.

The problem was that the person who wrote the question was not having tingling from having slept on his or her arm, but rather, was experiencing a symptom of a heart attack that he was now ignoring. This action could result in a fatal mistake of not seeking what was immediately needed medical attention.

Read the posts Giving and getting medical advice online., Possible Withdrawal Symptoms, and Life goes on without smoking. If you have a concern of a symptom that you are experiencing consult your personal doctor. We say it often here, that the only medical advice that we can give is that to reduce your risk of a host of illnesses and conditions is to stick to your commitment to never take another puff!