A 32-year-old man who visited the dentist for tooth pain was shocked to learn that nearly all his teeth were loose. After further questioning, doctors discovered the cause: he smoked up to four packs of cigarettes a day. According to Dr. Lin Hong-Da, a periodontist at Cathay General Hospital, more than 80% of Taiwanese adults suffer from periodontal disease—a condition that not only harms oral health but also increases the risk of heart disease, diabetes, and even cancer.
Dr. Lin shared the case in an interview with CTI News’ Health Plus program. He explained that the young man had smoked heavily since high school. By the time he sought treatment, more than 80% of the bone supporting his teeth had already been destroyed, leaving almost his entire dentition unstable. “The more you smoke, the more severe the destruction tends to be,” he said.
Periodontal disease typically begins with poor daily oral hygiene. “When plaque and bacteria accumulate along the gums due to inadequate cleaning, inflammation develops—this is gingivitis, which is reversible,” Dr. Lin explained. “But if inflammation continues and reaches the jawbone, it becomes periodontitis, which is irreversible.”
One study cited by Dr. Lin followed 5,700 women over age 50 and found that those with a history of periodontal disease had a 12% higher mortality rate, while completely toothless patients had a 17% higher mortality rate. The increased risk is linked to inflammation that can lead to blood clots and reduced chewing ability that affects nutrition.
According to Taiwan’s Ministry of Health and Welfare, nearly 90% of Taiwanese men and 80% of women have periodontal disease, with the highest prevalence occurring between ages 50 and 64. Dr. Lin noted that many patients mistake early symptoms—bleeding gums, gum recession, widening gaps between teeth—for signs of aging or “heatiness,” causing them to delay treatment.
He also highlighted emerging evidence linking periodontal bacteria to cancer. “DNA from periodontal pathogens has been detected in tumor samples from pancreatic, oral, colon, and gastric cancers,” he said, suggesting the bacteria may travel through the bloodstream and trigger cellular mutations.
Smoking remains one of the strongest risk factors. “Cigarettes contain more than 1,000 toxins that impair the immune response in the gums,” Dr. Lin warned. He added that e-cigarettes, despite containing less nicotine, still release harmful substances and are not recommended.
Dr. Lin emphasized that dental implants also require proper care. “Implants are not immune to disease. Poor cleaning can lead to peri-implantitis, ultimately causing implant failure.”
To protect oral health, Dr. Lin recommends brushing at least twice daily using the Bass technique, flossing or using interdental brushes, and getting a professional cleaning every six months. Quitting smoking, reducing sugar intake, maintaining a healthy lifestyle, and eating a balanced diet can all help strengthen immunity and slow periodontal damage.
