Shisha, commonly known as “hookah” or “waterpipe smoking” has been a part of cultural and social traditions for centuries, particularly in the Middle East, North Africa and Southeast Asia but in recent years it has gained popularity amongst young adults in the UK.
Shisha involves smoking flavoured tobacco through a water pipe, creating a relaxing and communal experience. However, despite its allure, the effects of shisha on oral health are a growing concern that demands the attention of dental professionals.
Shisha smoking involves the combustion of a mixture of tobacco, molasses, glycerine, and various flavourings that are heated using hot charcoal. The smoke passes throughwater in the pipe's base before being inhaled through a hose. There is a common misconception that shisha smoking is a safer alternative to cigarettes. Research carried out by The British Heart Foundation highlighted that during a single shish session lasting between 20-80 minutes a shisha smoker can inhale the same amount of smoke as a cigarette smoker consuming over 100 cigarettes.
It can also impact oral health in many ways
Caries and periodontal disease One of the most significant threats shisha poses to oral health is an increased risk of periodontal disease. The smoke produced during shishamsessions contains a high concentration of harmful substances, including tar, carbon monoxide, heavy metals and carcinogens. When inhaled, these toxic components irritate the soft tissues and prolonged exposure of the oral cavity to shisha smoke can exacerbate existing gum problems, leading to periodontitis and eventually tooth loss.
Despite the perception of milder smoke, the sugar and fruit extracts used to flavour the tobacco contribute to bacterial growth, increasing the risk of caries and enamel erosion.
Staining
Shisha smoking is notorious for causing discolouration of teeth caused by the combination of tar and nicotine. These stains can be difficult to remove through regular brushing and can significantly impact a patient’s dental aesthetics and may even affect their self-confidence.
Halitosis
The chemicals present in shisha smoke can cause a pungent odour in the mouth that can be challenging to mask or eliminate and can be a major social concern for patients who smoke shisha regularly.
Xerostomia
Shisha smoking can cause xerostomia, thus diminishing the crucial role saliva plays in maintaining oral hygiene by neutralising acids, washing away food particles and inhibiting bacterial growth. A dry mouth environment can lead to an increased risk of caries and other oral infections, such as candida and herpes simplex virus infections.
Oral cancer risk
Perhaps the most alarming consequence of shisha smoking is its association with an elevated risk of oral cancer. Shisha smoke contains polycyclic aromatic hydrocarbons and heavy metals that damage the delicate tissues in the mouth and throat. Long-term and frequent shishasmoking increases the likelihood of developing oral cancer, which can be life-threatening if not diagnosed and treated early on.
Non-oral effects of shisha smoking Shisha smoking not only affects the oral cavity, but it can also have profound effects on overall health as outlined by The American Thoracic Society, resulting in:
- Increased risk of lung and gastric carcinoma
- Reduced lung function
- Decreased fertility for both men and women
- Increased risk of stroke and cardiovascular disease
- Increased risk of transmitting tuberculosis and herpes due to sharing of mouth pieces
Preventive measures
As dental professionals, we have a duty to educate patients and raise awareness about the risks of smoking shisha as it will prevent young patients from adopting this habit. Furthermore, we must dispel misconceptions about shisha being a safe alternative to cigarettes.
The following dental advice can help reduce the damaging effects of shisha:
- Reducing the frequency and duration of shisha sessions to help minimise the harmful effects on oral health
- Practising good oral hygiene is essential for shisha smokers. Regularly brushing and flossing can help remove plaque, reduce the risk of gum problems, caries and combat halitosis
- Drinking plenty of water during and after shisha sessions can help counteract the drying effect of the smoke and promote saliva production
- Frequent dental check-ups are crucial for early detection and intervention of oral health issues related to shisha smoking
Conclusion
In light of recent scientific evidence presented, it is clear that shisha smoking is not the harmless activity it is often perceived to be. Although it may be an alluring and sociable activity,its impact on oral health cannot be overlooked. The hazardous substances present in shisha smoke pose serious risks to oral tissues, ranging from periodontal disease and stained teeth to an increased risk of oral cancer. It is important to educate patients about these risks so they can take the appropriate preventive measures and make informed choices about their oral health and overall well-being.