by Rana Baroudi
Dr. Baroudi is a Board Certified Periodontist. She has successfully passed the American Board of Periodontology oral and written examinations covering all phases of periodontal disease, its treatment and dental implants. She is also an Associate Clinical Professor of Periodontology at UCSF where she enjoys teaching and lecturing on a bi-monthly basis.
Learn MoreOver the past decade, vaping has been promoted as a “safer alternative” to smoking—but when it comes to your gums, teeth, and dental implants, the reality is far more complex. Both vaping and traditional cigarette use can harm the delicate tissues that support your smile, and neither is risk-free. At Cambrian Periodontics & Dental Implants in San Jose, Dr. Rana Baroudi and Dr. Trung H. Nguyen regularly see how nicotine—no matter the source—can undermine gum health, slow healing, and threaten the long-term success of dental implants. Understanding how these habits affect your mouth can help you make informed choices and protect your investment in your oral health.
Nicotine, whether inhaled through smoke or vapor, constricts blood vessels throughout the body. In the mouth, this reduction in blood flow limits oxygen and nutrient delivery to the gums. Over time, this creates an environment where bacteria thrive, tissues become inflamed, and healing slows dramatically.
Healthy gums rely on proper circulation to fight infection, repair minor damage, and maintain bone density. Nicotine essentially “chokes” this system, depriving the gums of what they need to stay strong and resilient. Even worse, because nicotine reduces bleeding and visible signs of inflammation, smokers and vapers may not realize their gum disease is worsening until it becomes severe.
Cigarette smoke contains thousands of toxic chemicals, including carbon monoxide, tar, and hydrogen cyanide—all of which irritate gum tissue and damage the cells responsible for healing. These toxins disrupt the natural balance of bacteria in the mouth, allowing harmful pathogens to multiply and cause chronic inflammation.
Smokers are more likely to experience:
In many cases, even aggressive treatment such as scaling and root planing or gum grafting may have limited success if smoking continues, because the body’s healing response remains compromised.
Vaping may eliminate many of the combustion byproducts found in cigarettes, but it still delivers nicotine—and introduces other potential irritants. E-liquids often contain propylene glycol, glycerin, and flavoring chemicals that, when heated, can irritate the delicate lining of your mouth.
While vaping typically causes less visible staining and odor than smoking, studies increasingly show that it can still contribute to:
Although vaping may feel “cleaner,” it’s not harmless—especially for patients with dental implants or a history of gum disease.
Successful dental implants depend on the process of osseointegration—the biological bonding of the implant to the surrounding bone. This process requires a healthy blood supply and strong immune response. Nicotine, whether from cigarettes or vape pens, compromises both.
Smokers and vapers face a significantly higher risk of:
Even after successful implant placement, ongoing nicotine exposure can shorten the implant’s lifespan. Studies show that implant failure rates among smokers and vapers are two to three times higher than those of non-users.
One of the most deceptive aspects of nicotine use is how it masks the visible signs of gum disease. Because nicotine constricts blood vessels, smokers and vapers often don’t experience typical symptoms like bleeding gums or swelling, even when infection is present. This can give a false sense of security and delay treatment until the condition becomes advanced.
Dr. Baroudi and Dr. Nguyen emphasize that regular periodontal maintenance appointments are crucial for nicotine users. These visits allow for detailed evaluation of gum pockets, bone levels, and early indicators of inflammation that might not be visible at home.
Patients who smoke or vape face greater challenges during recovery from periodontal or implant procedures. Reduced oxygen supply and slower blood clot formation delay healing and increase the likelihood of infection or wound breakdown. In some cases, nicotine use can even interfere with the success of regenerative procedures like bone grafting or laser periodontal therapy.
At Cambrian Periodontics, patients undergoing surgery are strongly encouraged to stop nicotine use at least two weeks before and after treatment. This short period of abstinence can dramatically improve healing outcomes and reduce complications.
While vaping is often marketed as a safer alternative, the oral tissues respond similarly to both forms of nicotine exposure. Both smoking and vaping reduce saliva, increase bacterial load, and interfere with the body’s immune defenses. Over time, these effects can compromise not just gum health but overall systemic wellness.
The key difference lies in perception: smokers often expect oral damage, while vapers may be unaware that their “smokeless” habit is quietly harming their gums and implants. The long-term effects of vaping are still being studied, but current evidence clearly shows measurable tissue damage, inflammation, and delayed wound healing—even in young, otherwise healthy patients.
If you smoke or vape, there are still steps you can take to minimize the damage and begin restoring your gum health:
Your gums and dental implants represent a long-term investment in your oral health. Protecting them means understanding the real impact of nicotine—whether it comes from cigarettes or e-cigarettes. The sooner you take action to reduce or quit, the better your chances of preserving your natural tissue, bone support, and implant stability.
At Cambrian Periodontics & Dental Implants, Dr. Rana Baroudi and Dr. Trung H. Nguyen provide personalized periodontal care for patients who smoke or vape, offering advanced diagnostic tools and treatment options to help reverse early damage and prevent further deterioration.
