Does smoking always lead to gum disease?

No, but it increases your chance of getting it by about six times and increases the severity by the same factor. However, it can hide the signs of periodontal disease which can take years to progress. The condition can be very advanced before a person actually notices the damage. Gum disease is normally coupled with plaque and calculus that collects at the base of the tooth, which leads to bacteria infecting the gums. Smoking reduces the body’s ability to combat this condition.

Slight infections around the edges of the gums are common and easily treated, but smoking allows the condition to progress more deeply and seriously. Plaque and tobacco are a dangerous combination. X-rays taken of the teeth of even young smokers usually show that bone support has begun shrinking away from the tooth roots.

Flossing and careful brushing tends to slow down the deterioration, but smokers often have reduced sensation in their mouths and it is difficult to detect and remove all the plaque at the gum margins. (See Gum Disease)