If you are a smoker, for sure, your dentist had to direct your attention to problems in oral cavity associated with such a bad habit. If however you do not smoke, this information will also be important for you.
When your dentist insists on ceasing such a bad habit as smoking, this does not deal only with tooth plaque (which has from gray to brown and black color) and bad breath (photos 1, 2). Unfortunately, all medical restoration works in smoking patients fade and tarnish quickly becoming dull and gray. However, the significantly more serious problem consists in the development of nicotinic stomatitis (smokers patch).
Nicotinic stomatitis manifests a protective response of oral mucosa on the longstanding poisonous effect of tobacco combustion product when smoking or chewing it. Such stomatitis develops in oral mucosa in the form of singular or multiple patches of excess epidermidalization (the off-white films) against the chronic irritated mucosa (photo 3).
Generally, no patients with nicotinic stomatitis put in complaints. Sometimes, a moderate cosmetic effect can be visible in the shape of white lines or circles on the buccal and tongue mucosa; patients can note roughness and dryness of oral mucosa, ageustia. Rarely, the complaints can be made of mucosa burning sensation when eating spicy or hot food.
During examination of oral cavity doctor-stomatologist detects the off-white films of different forms which cannot be removed after stripping with an instrument. The most favorite places of films location are mucosa areas permanently exposed to irritation with smoke, namely: hard palate, anterior soft palate, angles of mouth, tongue dorsum (photos 4, 5). The affected areas can be often detected in the form of white lines along the line of teeth joining. These lines slightly rise above mucosa level and commonly appear irregular due to steady biting off the dominant areas. Patient, however, feels no pain; biting of buccal mucosa grows simply into the habit and can be observed in the majority of patients (photo 6). Against the white films one can frequently see soft reddish prominences with the pinholes of excretory canals of salivary glands (photo 7).
The diagnostics of nicotinic stomatitis comes easy for a professional, but success of treatment depends on a patient in many instances. After elimination of smoking as a leading cause of the disease development, oral cavity alterations become easily reversible during treatment. However, if a longstanding irritative agent would not be eliminated, then disease can possess malignant form. Tobacco smoke comprises nicotine, great numbers of tar precipitations, cyanhyndric acid, hydrogen sulphide, ammonium, carbonous, phenols. Nicotine itself hardly has a significant effect on oral or breathing ways mucosa; however, purine which arises during its destruction is a very dangerous substance possessing pronounced carcinogenicity. Nicotinic stomatitis belongs to accidental precancer and occurs in 13% of patients with various dental disorders.
When treating nicotinic stomatitis, only elimination of a bad habit — smoking, adequate treatment, oral cavity sanation in a whole, regular preventive control of doctor-stomatologist may ensure good result.
