• Active Smile Healthy Living FAQ's

Diet and my teeth - Why is a healthy diet important for the health of my mouth?

Q    Why is a healthy diet important for the health of my mouth?

A    Every time you eat or drink anything sugary, your teeth are under acid attack for up to one hour. This is because the sugar will react with the bacteria in plaque (the sticky coating on your teeth) and produce harmful acids. So it is important to cut down on how often you have sugary foods, which will limit the amount of time your teeth are at risk.  

Acidic foods and drinks can be just as harmful to your teeth. The acid wears away the enamel, and will leave the dentine uncovered. This is called ‘dental erosion’, and makes your teeth sensitive and less attractive.

A diet that is rich in vitamins, minerals, and fresh fruit and vegetables can help to prevent gum disease. Gum disease can lead to tooth loss and cause bad breath. The diagram below shows you what you should eat as part of a healthy and balanced diet.

Q    What is tooth decay?

A    Tooth decay damages your teeth and leads to fillings or even extractions.  Decay happens when sugar reacts with the bacteria in plaque. This forms the acids that attack the teeth and destroy the enamel. After this happens many times, the tooth enamel may break down forming a hole or ‘cavity’ into the dentine. The tooth can then decay more quickly.

Q    What foods can cause decay?

A    All sugars can cause decay. Sugar can come in many forms, for example: sucrose, fructose, maltose and glucose. These sugars can all damage your teeth.

Many processed foods have sugar in them, and the higher up it appears in the list of ingredients, the more sugar there is in the product. Always read the list of ingredients on the labels when you are food shopping.

When you are reading the labels remember that ‘no added sugar’ does not necessarily mean that the product is sugar free. It simply means that no extra sugar has been added. These products may contain sugars such as those listed above, or the sugars may be listed as ‘carbohydrates’. Ask your dentist if you aren’t sure.

Q    How do acidic foods and drinks affect my teeth?

A    Some foods and drinks are more acidic than others, and some are acidic enough to attack your teeth directly. The acidity of a product is measured by its ‘pH value’.    

    The pH values of some food and drinks are listed below. The lower the pH number; the more acidic the product. Anything with a pH value lower than 5.5 may cause tooth erosion.  ‘Alkalines’ have a high pH number and cancel out the acid effects. A pH value of 7 is the middle figure between acid and alkali.

•    vinegar                         pH 2.0
•    red wine                    pH 2.5
•    cola                        pH 2.5
•    pickles                        pH 3.2
•    grapefruit                    pH 3.3
•    orange juice                    pH 3.8
•    lager                        pH 4.4
•    cheddar cheese                pH 5.9
•    celery                        pH 6.5
•    milk                        pH 6.9
•    breadstick                    pH 7.0
•    mineral water (still)                 pH 7.6
•    walnut                        pH 8.0
•    carrots                        pH 9.5

Q    Can I eat snacks?

A    It is better for your teeth and general health if you eat 3 meals a day plus no more than two snacks, instead of having lots of snack attacks. If you do need to snack between meals, choose foods that do not contain sugar. Fruit does contain acids, which can attack your teeth. However, this is only damaging to your teeth if you eat an unusually large amount. Try to limit dried fruit as it is high in sugar and can stick to your teeth.

If you do eat fruit as a snack, try to eat something alkaline such as cheese afterwards. Savoury snacks are better, such as:

•    raw vegetables
•    nuts    
•    cheese
•    breadsticks

Q    Can I eat sweets?

A    The main point to remember is that it is not the amount of sugar you eat or drink, but how often you do it. Sweet foods are allowed, but it is important to keep them to mealtimes.

To help reduce tooth decay, cut down on how often you have sugary foods and drinks and try to choose sugar-free varieties.  

Sweets and chewing gum containing Xylitol may help reduce tooth decay.  

Sugary foods can also lead to or worsen a range of health problems including heart disease and being overweight.  

Q    What should I drink?

A    Still water and milk are good choices. It is better for your teeth if you drink fruit juices just at meal times. If you are drinking them between meals, try diluting them with water and rinsing your mouth with water after drinking.  Drinking through a straw can help the drink go to the back of your mouth without touching your teeth.

Diluted sugar-free squashes are the safest alternative to water and milk. If you make squash or cordial, be sure to dilute the drink 1 part cordial to 10 parts water. Some soft drinks contain sweeteners, which are not suitable for young children – ask your dentist or health visitor if you aren’t sure.

Fizzy drinks can increase the risk of dental problems. If they contain sugar this can cause decay and the acid in both normal and diet drinks can dissolve the enamel of your teeth. The risk is higher when you have these drinks between meals.

Q    Should I brush my teeth after every meal?

A    It is important that you brush for two minutes, twice a day with a toothpaste containing fluoride. The best times are before breakfast and last thing at night before you go to bed.  

Eating and drinking naturally weakens the enamel on your teeth, and brushing straight afterwards can cause tiny particles of enamel to be brushed away. It is best not to brush your teeth until at least one hour after eating.  

It is especially important to brush before bed. This is because the flow of saliva, which is your mouth’s own cleaning system, slows down during the night and this leaves your teeth more at risk from decay.

Children up to three years old should use a toothpaste with a fluoride level of at least 1000ppm (parts per million). Three-year-olds to adults should use a toothpaste that contains 1350ppm to 1500ppm of fluoride.
Q    Does chewing gum help?

A    Chewing gum makes your mouth produce more saliva, which helps to cancel out the acid in your mouth after eating or drinking. It has been proven that using sugar-free chewing gum after meals can prevent tooth decay. However, it is important to use only sugar-free gum, as ordinary chewing gum contains sugar and therefore may damage your teeth.

Healthy gums and healthy body - How can the health of my mouth affect my heart?

Q    Could the health of my mouth affect my general health?

A    Yes. There are new findings which support something that dental professionals have suspected for a long time: infections in the mouth can cause problems in other parts of the body.

Q    What problems could my dental health cause?

A    Problems which may be caused or made worse by poor dental health     include:

•    heart disease
•    strokes
•    diabetes
•    giving birth to a premature or low-birth-weight baby
•    respiratory (lung) disease.

Q    How can the health of my mouth affect my heart?

A    People with gum disease are almost twice as likely to have coronary artery disease than people without gum disease. When people have gum disease, bacteria from the mouth can get into their bloodstream. The bacteria produce protein. This can then affect the heart by causing the platelets in the blood to stick together in the blood vessels of the heart. This can make clots more likely to form. Blood clots can reduce normal blood flow, so that the heart does not get all the nutrients and oxygen it needs.  

If the blood flow is badly affected this could lead to a heart attack.  

Q    What is the link between gum disease and strokes?

A    Several studies have looked at the connection between mouth infections and strokes. They have found that people who have had a stroke are more likely to have gum disease than people who have not had one.

When the bacteria that cause gum disease get into the bloodstream, they produce a protein. This can cause inflammation of the blood vessels, and this can block the blood supply to the brain. This can cause a stroke.
Q    How could diabetes affect my dental health?

A    People with diabetes are more likely to have gum disease than people without it. This is probably because diabetics are more likely to get infections in general. People who do not know they have diabetes, or whose diabetes is not under control, are especially at risk.  

If you do have diabetes it is important that any gum disease is diagnosed, because it can increase your blood sugar. This would put you at risk of diabetic complications.

Also, if you are diabetic, you may find that you heal more slowly. If you have a problem with your gums, or have problems after visits to your dentist, discuss this with your dentist before you have any treatment.

New research has also shown that you are more likely to develop diabetes if you have gum disease.  

    If you have diabetes, you have an increased risk of losing teeth.

Q     Could gum disease affect my unborn baby?

A    Pregnant women who have gum disease may be over three times more likely to have a baby that is premature and so has a low birth weight. There is a one-in-four chance that a pregnant woman with gum disease will give birth before 35 weeks.

It seems that gum disease raises the levels of the chemicals that bring on labour. Research also suggests that women whose gum disease gets worse during pregnancy have an even higher risk of having a premature baby.

Having gum disease treated properly during pregnancy can reduce the risk of a premature birth.

Q    How could bacteria in the mouth affect my lungs?

A    Bacterial chest infections are thought to be caused by breathing in fine droplets from the throat and mouth into the lungs. This can cause infections, such as pneumonia, or could make an existing condition worse. People with gum disease have more bacteria in their mouths and may therefore be more likely to get chest infections.

Q    Can tooth loss lead to dementia?

A     A recent study found that people with fewer teeth had a higher risk of     experiencing memory loss or early-stage Alzheimer’s disease.

This may be because the gum infections that can cause tooth loss may release chemicals that increase the brain inflammation which leads to earlier memory loss.

Q    What are the tell-tale signs of gum disease that I should look out for?

A     Visit your dentist or hygienist if you have any of the symptoms of gum disease. These can include:

•    inflammation of the gums, causing them to be red, swollen and to bleed easily, especially when brushing
•    an unpleasant taste in your mouth
•    bad breath
•    loose teeth
•    regular mouth infections.

Q     Do I need to tell my dentist about any changes to my general health?

A      Always tell your dentist about any changes to your general health. It is especially important to tell them if you are pregnant or have heart disease, diabetes, lung disease or have ever had a stroke. You also need to tell them about any medicines you are taking as these can affect both your treatment and the health of your mouth.

Q     Does gum disease run in families?

A     Although there is some evidence that gum disease runs in families, the main cause is the plaque that forms on the surface of your teeth. To prevent gum disease, you need to make sure you remove all the plaque from your teeth every day by brushing and cleaning in between your teeth.
Q     How can I help to stop my gum disease getting worse?

A     If you have gum disease, your dentist or hygienist will usually give your teeth a thorough clean to remove any scale or tartar. This may take a number of sessions with the dentist or hygienist.

They will also show you how to remove the soft plaque yourself, by cleaning all the surfaces of your teeth thoroughly at home. Plaque is a sticky film of bacteria which forms on the teeth every day. For more information see our ‘Tell me about’ leaflet Gum Disease.

Gum disease is never cured. But as long as you keep up the home-care you have been taught you can slow down its progress and even stop it altogether. You must make sure you remove plaque every day, and go for regular check-ups with the dentist and hygienist, as often as they recommend.

Q     Can exercise help to prevent gum disease?

A     A recent study has shown that people who stay fit and healthy are 40% less likely to develop tooth-threatening gum infections that could lead to gum disease. It also found that not exercising, not keeping to a normal body weight and unhealthy eating habits made a person much more likely to get advanced gum disease.

If you are serious about your health – and your teeth – you will need to exercise, eat a healthy, balanced diet and keep to a normal body weight.  

Q     Can smoking affect my teeth and gums?

A     Smoking can make gum disease much worse.  People who smoke are more likely to produce bacterial plaque that leads to gum disease. The gums are affected because smoking means you have less oxygen in your bloodstream, so the infected gums do not heal. Smoking can also lead to tooth staining, tooth loss because of gum disease, bad breath, and in more severe cases mouth cancer. For more information see our ‘Tell me about’ leaflets Smoking and oral health and Mouth Cancer.


American Academy of Periodontology.
British Dental Health Foundation Leaflet – Gum disease.
Journal of Periodontology
British Dental Health Foundation Press Releases – 09/03/2009

Oral care products - What are the best products to care for my gums and teeth?

Q     How often should I clean my teeth?

A     It is important to clean your teeth for two minutes, twice a day – in the morning and especially last thing at night. Usually two minutes is enough to remove plaque and to clean properly. Some people find using a stop-watch or timer useful as two minutes is often longer than you think. If you eat or drink certain foods you may need to clean more often.

Q    What do I need to clean my teeth properly?

A    There are many different oral care products you can get today. Your dentist or hygienist will be able to recommend the best toothbrush and toothpaste for you to use, as well as the best way to clean between your teeth.

Q    Which is the best toothbrush to use?

A    It is usually recommended that adults use a toothbrush with a small- to medium-sized head with multi-tufted, ultra soft to soft filaments (bristles). These filaments should be round ended and made from nylon.

Q     Are electric toothbrushes a good idea?

A    Some people prefer to use an electric toothbrush. They are especially useful if you have limited movement or find cleaning particularly difficult. These toothbrushes usually have heads which either vibrate or oscillate and pulsate. Some electric toothbrushes are meant to be thrown away when the battery runs down, and some are rechargeable. You can buy electric toothbrushes from your local chemist, electrical retailer or dentist.
    Electric toothbrushes with oscillating and pulsating heads have been proven to be the most effective. Many electric toothbrushes have two-minute timers built in to help you brush for the correct amount of time.

Q    What about children’s toothbrushes?
A    It is just as important for children to use the correct toothbrush. Look for a small-headed toothbrush with soft nylon bristles, suitable for the age of your child. There are many novelty toothbrushes for children that help encourage them to brush for the correct length of time. There are also electric toothbrushes that have been specially designed for children to use. Children under the age of 7 should be supervised while brushing.

Q    What toothpastes are there?

A    There are many toothpastes, and some are designed for different needs. There are toothpastes for gum health, sensitive teeth and for smokers, ones with anti-bacterial agents, and others which help to restore the natural whiteness of your teeth. Your dentist can recommend the most suitable toothpaste for your needs.

Q    What about fluoride toothpastes?

A    Most toothpastes contain a certain amount of fluoride, which has been proven to reduce tooth decay considerably. Most dentists recommend using fluoride toothpaste to prevent decay.

Q    Should I use a fluoride toothpaste?

A    Yes. Fluoride has been proven to reduce dental decay by at least 40%, so everyone should be encouraged to use fluoride toothpaste. There may already be fluoride in your drinking water. Research has shown that children living in areas that don’t have fluoride in the drinking water have more dental decay than children living in areas that do have fluoride in the drinking water.
It is important to use only a small, pea-sized amount of toothpaste for children, as they are likely to swallow some of it. All children up to three years old should use a toothpaste with a fluoride level of at least 1000ppm (parts per million). After three years old, everyone should use a family toothpaste that has 1350ppm to 1500ppm of fluoride. After brushing you should spit out the toothpaste rather than rinsing, to prevent the fluoride being washed away.
If your dentist feels that you have a high risk of dental decay, they may recommend and prescribe toothpaste with a higher fluoride content. This high level of fluoride can offer more protection to people more at risk of decay.

Q    My teeth are stained, what toothpaste should I use?

A    There are toothpastes which can help to remove staining. These are often called ‘whitening’ toothpastes. It is important to realise that these toothpastes can only help you to restore the original shade of your teeth and will not change their natural colour. If you feel you need something stronger to whiten your teeth, talk to your dentist about how this could be done. If you are a smoker, there are special smokers’ toothpastes that will remove the staining that can build up over time.

Q    My teeth are sensitive, what can I use?

A    There are several toothpastes that contain ‘desensitising agents’ to help reduce the pain of sensitive teeth. Some people find that rubbing this toothpaste along the affected area and leaving it on overnight helps ease the discomfort.

Q    Are there natural toothpastes?

A    Yes, there are several toothpastes that contain special mineral salts and plant extracts. They are made of only natural ingredients and flavouring. Some products are produced without animal testing, and some are suitable for vegetarians and vegans. However, sometimes these toothpastes do not contain fluoride.

Q    What are ‘total care’ toothpastes?

A    Total care toothpastes contain a number of ingredients to make them an effective ‘all-round’ toothpaste. They contain anti-bacterial agents, ingredients which help control plaque and prevent gum disease, fluoride to help prevent tooth decay and flavours which help to freshen the breath. They may also contain whitening or tartar-control ingredients.

Q    What about cleaning between my teeth?

A    Brushing alone only cleans three of the five surfaces of your teeth, so it is important that you also clean between your teeth every day. Your dentist or hygienist will be able to show you how.     

    Interdental brushes
    To clean the small gaps between your teeth you can use special ‘interdental’ brushes. These can be on long or short handles for easier use and are generally colour coded for the different-sized gaps between your teeth. Ask your dentist or hygienist for advice on how to use these products correctly and safely.

    Dental floss and tape
    There are several different types of dental floss or tape, including mint-flavoured, wax-coated and ones containing fluoride. Many people prefer tape to floss, as it is wider and can be gentler on the gums. You can also get floss ‘harps’, and these have the floss attached to a handle which may make the floss easier to use.
    Water jets
    These are another way of cleaning in between the teeth using a high-pressure jet of water. Some people with bridges and implants find them particularly useful.

Q    What are disclosing tablets and solutions?

A    These contain a dye. After brushing and cleaning interdentally, you can use a disclosing tablet or solution to dye any plaque that hasn’t been removed. This can help to show any places you are missing when brushing. You can easily remove the dye afterwards by brushing.

Q    Should I use a mouthwash?

A    Many people use a mouthwash as part of their daily oral health routine. Some mouthwashes contain an anti-bacterial ingredient to help reduce plaque and prevent gum disease. Mouthwashes may contain fluoride to help prevent decay and all will help to freshen your breath and wash away particles of food.

Q    Why do some mouthwashes contain alcohol?

A    Some mouthwashes contain alcohol because it helps to enhance the taste, helps in the cleansing action and adds to the antibacterial effect. However, some people find alcohol mouthwashes too strong and prefer a milder alternative that is alcohol free. Mouthwashes containing alcohol should be kept away from children.

Q    Are there any mouthwashes for gum problems?

A    Some mouthwashes, especially ones containing Chlorhexidine, are particularly effective at treating gum infections. They are also very effective at treating other mouth problems, such as those following a tooth extraction or when a wisdom tooth is coming through. You must not overuse these mouthwashes and not use them over a long period. This is because they can cause staining, although this can be easily removed by the dental hygienist. Make sure you always follow your dentist’s and the manufacturer’s instructions.

Q    What about ‘total care’ mouthwashes?

A    Some mouthwashes contain anti-bacterial ingredients which work against the bacteria responsible for causing bad breath and plaque.
Q    What should I use to clean my denture?

A    You should clean all the surfaces of your denture with a small- to medium-headed     toothbrush using a denture-cleaning paste. If you choose an effervescent (fizzy)     tablet for stubborn stains, you should thoroughly brush the denture before soaking.     Products specifically designed to clean dentures are less abrasive than regular     toothpastes. Therefore they are less likely to roughen the surface of your dentures     which would make them more likely to become stained.

Q    What is a denture fixative?

A    Denture fixatives are products which help to stick or hold a denture in place and to     stop it moving around and causing irritation and sores. Fixatives can come in     different forms, including creams, powders and strips.

Q    Should I use a fixative?

A    Dentures are custom made to fit your mouth and you shouldn’t need to use a     denture fixative. However, over time as your mouth shrinks, the denture may     become loose and may not fit as well. If this happens some people may prefer to     use a fixative in the short term before they have the denture replaced with a new     and better-fitting one.

Q    What is dental erosion?

A    Dental erosion is the loss of tooth enamel caused by acid attack. Eventually the     enamel can be worn away, exposing the dentine underneath which may lead to pain     and sensitivity.

Q    Should I use any special products to help prevent erosion?

A    The use of a good fluoride toothpaste (1350 to 1500ppm fluoride) will help to put back the minerals lost from your teeth and to strengthen the enamel. There are specialist ‘enamel formula’ toothpastes you can use if you feel that your diet is high in acid and you think that you may be at risk of acid erosion.

    You should also try to cut down as much as possible on the amount of acidic foods     and drinks that you have . These foods and drinks include wine, fruit juices,     smoothies, fruit teas, fruit and fizzy drinks.

Q    What about products for bad breath?

A    Often bad breath is a short-term problem caused by smoking, or eating or drinking     something that has a strong smell. The use of products designed to fight bad breath     will help to stop this.

    Long-term bad breath could be a symptom of a dental problem such as gum disease.     So if the bad breath continues you should ask your dentist for advice. Bad-breath     products will only mask the smell and will not remove any underlying problem.

Q    What products could I use to help get rid of bad breath?

A    Good brushing and cleaning in between the teeth is the most important way of     controlling bad breath. In the short term you can use mouth rinses, sugar-free gum     and sugar-free mints. Many of the bacteria causing bad breath live on your tongue,     so brushing your tongue or using a tongue scraper will also help.

Q     What is dry mouth?

A    Dry mouth or ‘xerostomia’ is a condition which affects the flow of saliva, causing     your mouth to feel dry. For more information see our ‘Tell me about’ leaflet Dry     Mouth.

Q     Are there any products I can use to ease this?

A    There are a number of products designed to provide moisture and comfort. These     include rinses, toothpastes, gels and sprays. If you prefer, you can also get lozenges     and chewing gums for when you are out and about. Some people also find chewing     sugar-free gum helps to increase the flow of saliva and reduce the problems.

Q    What is the advantage of chewing sugar-free gum?

A    If you chew sugar-free gum for 10 minutes after eating or drinking anything, this can     help your saliva to cancel out the acid more quickly. The acid is produced when     we eat or drink, and it can cause tooth decay and dental erosion. By chewing sugar-    free gum, you can shorten the time it takes for your saliva to cancel out the acid.

Q    What are probiotics?

A    Probiotics are living micro-organisms − usually ‘friendly’ bacteria − and are most     often used to promote healthy digestion.

Q    How could a probiotic help my oral health?

A    Using an oral probiotic may help to keep up the balance between the ‘friendly’ bacteria in your mouth and the harmful bacteria which can cause plaque build-up, gum disease and bad breath.

    These oral probiotics are often sold as lozenges and you dissolve them slowly in your     mouth after brushing and flossing.

Q       How do I know the claims a product is making are true?

A    The British Dental Health Foundation has an accreditation scheme which checks the     claims made by manufacturers. Look out for the British Dental Health Foundation     approved logo on packaging, which shows that the claims on the packaging have     been clinically proven and the product does what it says.

Smokeless tobacco - if you use smokeless tobacco are you more likely to have gum disease?

Q     What is smokeless tobacco?

A    There are two main types of smokeless tobacco: chewing tobacco and snus.

Chewing tobacco usually comes as leaves or plugs which you put on the inside of your cheek and chew. Chewing the tobacco releases the flavours and nicotine, and causes your mouth to make a lot of saliva. Users generally end up spitting this out. Snus is tobacco that comes as a moist powder, or is packed in small bags, and you put it under the inside of your bottom lip.

 Both types of smokeless tobacco are very addictive and can cause serious health problems.

 The ingredients in smokeless tobacco are a mixture of tobacco-nicotine, sugar, salt, slaked lime, spices and flavourings. They may release hundreds of chemicals and poisons when you use them.   Among these chemicals are many dangerous cancer-causing agents (called ‘carcinogens’).  

Q    Can smokeless tobacco be part of other chewing products?

A    Yes. Smokeless tobacco goes by many different names, such as:
•    Paan Masala (Gutkha)                            
•    Snuff
•    Nass, Naswat or Niswar                                          
•    Snus
•    Zarda                                                                      
•    Chaw
•    Supari
•    lq'mik
•    Khaini                                                                     
•    Ariva
•    Mawa                                                                      
•    Shammah
•    Mishri, Mosheri or Misheri                                         
•    Toombak
•    Qiwam or Kima
•    Chimo.

Areca nut, ash and lime are some of the main ingredients used in these mixtures.        

Smokeless tobacco is used mainly by people from South Asia, South East Asia, the Middle East and East Africa.

People who use it don’t always know or use the term 'smokeless tobacco', so they often don’t realise that the products contain tobacco. If you aren’t sure, look on the packaging for names or ingredients we’ve mentioned above.

Q    Is smokeless tobacco linked with mouth cancer?

A    Yes. Mouth cancer is the most serious health risk linked with smokeless tobacco. This is because of the large amount of cancer-causing chemicals it has in it. Over time, having these poisons released in your mouth could make you four times as likely to get mouth cancer. 

One of the most dangerous and popular ingredients used in smokeless tobacco is the areca (or betel) nut. This is used in ‘betel quid’ which is made up of betel leaf, areca nut and slaked lime. Research shows that people who regularly chew areca nut have a bigger risk of cancer of the mouth, pharynx, oesophagus, stomach and pancreas.

Smokeless tobacco users are especially likely to get throat cancer, as they regularly swallow tobacco juice. Cancers of the lip and cheek are also common, as the tobacco is pressed against the lining of the mouth.

Mouth cancer can appear as:
•    a painless mouth ulcer that does not heal properly
•    a white or red patch in the mouth
•    unusual lumps or swellings.
    It is important that you visit your dentist regularly if you are a smokeless tobacco user. This is because part of your check-up will involve a full mouth examination when the dentist will look out for any of these signs.

Q     How can smokeless tobacco affect my teeth and gums?

A    Smokeless tobacco is linked to a variety of oral health conditions. Because it is held in one area of the mouth for a long time, the risk is very high.

Like people who smoke, if you use smokeless tobacco you are more likely to have gum disease. Using tobacco causes more bacteria to grow in your mouth and can also cause your gums to become swollen. Smokeless tobacco also causes your gums to shrink (‘recede’), uncovering the roots of your teeth.
    Smokeless tobacco users may also be more likely to have tooth decay. This is because the amount of sugars, acids and other ingredients in some chewing tobacco products harms the tooth enamel, and causes holes (‘cavities’). Tooth staining and bad breath are other common problems linked to smokeless tobacco.

Q     How can smokeless tobacco affect my overall health?

A    Smokeless tobacco also harms your overall health. The nicotine causes your body to make more cholesterol and, as a result, you are more likely to get heart disease and have strokes.
    Because tobacco users are more likely to have gum disease, they are also likely to have other health problems such as:
•    type-2 diabetes
•    premature births  
•    dementia
•    respiratory (lung) disease.  
    As well as causing mouth cancer, smokeless tobacco may also increase the risk of cancer of the pancreas.

Q     Is smokeless tobacco safer than cigarettes?

A     No, it isn’t. Although many users still believe that smokeless tobacco is not as harmful as regular cigarettes, this is simply not true.
    Like cigarettes, smokeless tobacco is a serious risk to the health of your mouth and to your overall health. Both contain nicotine, which is a very addictive drug. In fact, there is twice as much nicotine in smokeless tobacco than in an average cigarette. This causes problems for the heart by tightening blood vessels and raising blood pressure.
    One can of chewing tobacco can release as much nicotine into your body as 60 cigarettes.

Q     What are the health benefits of giving up smokeless tobacco?

A     Giving up smokeless tobacco can bring many health benefits. Short-term benefits include a better appetite and good digestion, as well as better teeth and gums. Long-term benefits include less chance of developing a serious disease, such as heart disease or mouth cancer. The risk of dying from a heart attack is also lessened by giving up smokeless tobacco.

Q     How can I give up smokeless tobacco?

A    There are many ways you can give up smokeless tobacco. The important thing is to work out why you use it in the first place.
•    You may use smokeless tobacco to help deal with stress and boredom. Dealing  with stress in other ways can help you cut down. For example, you could try taking a walk, listening to music, doing deep-breathing exercises, talking with other people or joining social groups at local community centres.
•    You may use smokeless tobacco to help with tooth and gum pain. If you have tooth or gum problems it is important to see your dentist for proper treatment instead of trying to deal with the pain yourself.
•    Some people use smokeless tobacco because they think it helps with digestion after eating. If you do have stomach problems after eating, then drinking more water instead can help. Or your doctor will be able to offer counselling and treatment.

Q    What will I feel like if I give up smokeless tobacco?

A      You may find that giving up is even harder than giving up cigarettes. This is because of the higher levels of nicotine, which is very addictive.
    When you try to stop using tobacco, your body still wants the nicotine so you might get ‘withdrawal symptoms’. These can include headaches, tiredness, changes in mood, getting angry quickly and finding it hard to concentrate.
    If you find it hard to give up smokeless tobacco, you can get specialist help. This can be nicotine replacement therapy, such as nicotine patches or gum, and support to help you cope with how you feel. A local stop-smoking centre can also give you support.      

Q     Can my dentist help?

A    Your dentist will carry out a regular check-up to make sure that your teeth, gums and mouth are healthy. The dentist will also check your cheeks, tongue and throat for any signs of other conditions that may need looking into. Using smokeless tobacco may cause white, red or white-and-red patches that can be found at a dental examination. Your dentist may also be able to put you in touch with organisations and self-help groups who will have the latest information to help you stop using smokeless tobacco.

It is important that you visit your dentist regularly both for a normal check-up and a full mouth examination so that any other problems can be spotted early.

Smoking and oral health - How will smoking affect my gums and teeth?

Q    How can smoking affect the health of my mouth?

A    Most people now know that smoking is bad for their health.  
It can cause many different health problems and, in some cases, fatal diseases.  However, many people don’t realise the damage that smoking does to their mouth, gums and teeth.

Smoking can lead to tooth staining, gum disease, tooth loss and – more seriously – mouth cancer.

Q    Why are my teeth stained?

A    One of the effects of smoking is staining on the teeth due to the nicotine and tar in tobacco. It can make the teeth yellow in a very short time, and heavy smokers often complain that their teeth are almost brown after years of smoking.

Q    How will smoking affect my gums and teeth?

A    People who smoke are more likely to have gum disease. Smoking may change the type of bacteria in dental plaque, increasing the number of bacteria that are more harmful. It also reduces the blood flow in the gums and supporting tissues of the tooth and makes them more likely to become inflamed. Smokers’ gum disease will get worse more quickly than in people who do not smoke.   Because of the reduced blood flow smokers may not get the warning symptoms of bleeding gums as much as non-smokers. Gum disease is still the most common cause of tooth loss in adults.
Q    How is smoking linked with cancer?

A    Most people know that smoking can cause lung and throat cancer, but many people still don’t realise that it is one of the main causes of mouth cancer too. There are more and more new cases of mouth cancer each year, and thousands die every year from the disease. (See our ‘Tell Me About leaflet Mouth Cancer’).

Q    Are there special dental products I can use?

A    There are special toothpastes for people who smoke. They are sometimes a little more abrasive than ordinary pastes and you need to use them with care. Your dentist may recommend that you use these toothpastes alternately with your usual toothpaste, for example by using a special toothpaste in the morning and your ordinary one at night.

    There are several whitening toothpastes on the market. Although they do not affect the natural colour of your teeth, they may be effective at removing staining. Therefore they may improve the overall appearance of your teeth.

Q    What about mouthwashes?

A    People who smoke may find they are more likely to have bad breath than non-smokers. Fresh-breath products such as mouthwashes may help to disguise the problem in the short term, but that is all they will do.

Q    How often should I visit my dentist?

A    It is important that you visit your dentist regularly, both for a normal check up and a full mouth examination so that any other conditions can be spotted early.  

You should visit your dentist regularly, as often as they recommend. People who smoke are more likely to have stained teeth and gum disease, and therefore may need appointments more often with the dental hygienist.

Q    What can my dentist do for me?

A    Your dentist will carry out a regular examination to make sure that your teeth and gums and whole mouth are healthy.  

Your dentist will also examine your cheeks, tongue and throat for any signs of other conditions that may need more investigation.

They may also be able to put you in touch with organisations and self- help groups who will have the latest information to help you stop smoking.

Q    Will I need any extra treatment?

A    Your dentist may also refer you to a dental hygienist for further treatment, thorough cleaning and to keep a closer check on your oral hygiene.

     Your dental hygienist will be able to advise you on how often you should visit them, although this should usually be every three to six months.

Sugar-free chewing gum - Why is chewing sugar-free gum good for my teeth and gums?

Q What is sugar-free gum?

Sugar-free gum does not have any sugar in it. The taste is added using sweeteners, and therefore the gum does not cause tooth decay. The gum releases its flavours over a period of time, just like ordinary gum.

Q Why is chewing sugar-free gum good for my teeth and gums?

Chewing sugar-free gum helps protect your teeth and gums in between meals when it may not be possible to brush with a toothbrush and fluoride toothpaste.

Your teeth are more at risk of acid attack after you have eaten. The acid is produced by plaque bacteria, and the sugars in our food and drink, and it slowly dissolves away the enamel and dentine of the tooth, to produce a hole or ‘cavity’. (Plaque is the thin, sticky film that keeps forming on your teeth. It contains many types of bacteria which can cause tooth decay and gum disease.)

You can reduce this acid attack by chewing sugar-free gum, as it helps the mouth to produce more saliva –  the mouth’s natural defence against acid.

Q Can sugar-free gum help to protect against dental erosion?

Dental erosion is caused by the acids in the things we eat and drink, such as citrus fruit, fruit juices and fizzy drinks. These start to eat into the enamel covering the teeth, and remove some of the minerals making up the enamel. By helping us make more saliva, chewing sugar-free gum can also help to reduce this type of acid attack. It takes the saliva about an hour to replace the minerals that the enamel has lost. Chewing sugar-free gum for 20 minutes after eating or drinking can increase the flow of saliva, and help replace the minerals more quickly.

See the diagram below. It shows how your tooth enamel is at risk from acid attack after food and drink, and how long it takes the acid level in the mouth to return to the safe zone. pH is the measure of acidity, with levels below 5.5 being acid enough to soften tooth enamel. Chewing sugar-free gum after eating can quickly lower the amount of acid that attacks the teeth.

Q Can chewing sugar-free gum help with dry mouth and bad breath?

Dry mouth and bad breath are often caused by a reduced saliva flow. When you chew sugar-free gum your mouth makes more saliva and the symptoms of dry mouth and bad breath may be reduced.

Q What is Xylitol and where does it come from?
Xylitol is a natural sweetener and is found in some berries, fruit, vegetables and mushrooms. It has a sweetness equal to that of sugar. Xylitol is usually made from birch bark.

Q Why is Xylitol especially good for my teeth?

Xylitol helps to prevent plaque bacteria sticking to the teeth. Studies have shown that xylitol can help reduce tooth decay and even help reverse the decay itself by helping to replace the minerals in tooth enamel.

Q When should I chew sugar-free gum?

It is best to chew soon after eating.

Chewing for up to twenty minutes increases the flow of saliva, speeding up the time that it takes for saliva to cancel out the acid. Remember that plaque starts to form again within half an hour of cleaning your teeth.

Q How many times a day can you chew?

It is recommended to chew sugar free gum after eating and drinking on the go.

Q Is sugar-free gum safe to use for children?

We do not recommend that children under the age of seven chew gum. But this is something for parents to decide.

Q Is sugar-free chewing gum suitable for vegetarians?

Some chewing gums can contain animal glycerine and are not suitable for vegetarians. However, most sugar-free gums now only contain a type of non-animal glycerine and are suitable for vegetarians.

Q Can I chew sugar-free gum if I have dentures or braces?

People with certain types of dentures may find that sugar-free gum sticks to the teeth and palate of the denture.

Sugar-free gum is not recommended if you have a brace.

Q Is there a difference between the gum sticks and gum pellets?

The main difference between sticks and pellets is the size. Pellets tend to be smaller than sticks so they may be better for children and people with smaller mouths.

Q What happens if I swallow the gum?

There is no evidence that swallowing gum is harmful. Swallowed gum will pass through your system like any other food, although it may take a little longer.

Q How should I get rid of my used sugar-free gum?

Sugar-free gum can make a mess just like ordinary gum if you drop it on the floor or stick it to a surface. Wrap it and then put it in a bin.

Q Can sugar-free gum whiten my teeth?

Some sugar-free chewing gums have a ‘whitening’ claim. Although these products cannot lighten the natural colour of your teeth, they may help to lessen any staining which could build-up on your teeth due to smoking, or drinking red wine or coffee.

Q Do I still need to brush my teeth if I've used chewing gum?

Yes. You will still need to brush twice a day with a fluoride toothpaste, and clean in between your teeth with interdental brushes or floss at least once a day to keep your teeth and gums healthy.

Emergency Contact

If you require treatment during Bank Holidays or outside or our normal opening hours, please contact our out of hours service on 03001 232 211

Alternatively for any emergency conditions you may attend the A&E department or Contact NHS 111 from any landline

Contact Us

Call Us: 01386 446 040
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Oral Health Information Centre

Active Smile, 10 Vine Street
Evesham, Worcestershire WR11 4RE