Chewing tobacco, also known as smokeless tobacco, is a product placed directly into the mouth, typically between the cheek and gum, rather than being inhaled. The answer to whether this habit causes cavities is a definitive yes, as it significantly contributes to tooth decay and a cascade of other severe oral health problems. The combination of its chemical makeup and the physical act of holding the tobacco against the teeth creates a highly destructive environment for both the hard and soft tissues of the mouth.
How Chewing Tobacco Accelerates Tooth Decay
The primary chemical mechanism by which smokeless tobacco accelerates decay is its high sugar content, which is intentionally added during manufacturing for flavoring and to enhance the curing process. When a wad of chewing tobacco is held in the mouth for extended periods, this sugar is continuously released onto the tooth surface.
This constant sugar exposure provides a readily available food source for oral bacteria, particularly species like Streptococcus mutans. As these bacteria consume the sugars, they produce acid as a metabolic waste product, which rapidly lowers the pH level in the immediate vicinity of the tobacco placement. Enamel begins to demineralize, or dissolve, when the surrounding pH drops below a critical value, typically around 5.5.
The acidic environment strips the enamel of its mineral content, leading to the formation of microscopic lesions that eventually become visible cavities. Users often hold the tobacco wad for several hours a day, which prevents the natural buffering action of saliva from neutralizing the acids. This prolonged exposure maintains the low pH, maximizing the time the enamel spends in a destructive state and increasing the risk of dental caries.
Physical Damage to Enamel and Roots
Beyond the chemical decay caused by sugar and acid, chewing tobacco inflicts direct mechanical damage on the teeth through abrasion. Most smokeless tobacco products contain coarse, gritty material, including fine particles of sand and soil. These abrasive elements are pressed against the teeth for long durations, acting like sandpaper on the tooth structure.
The constant grinding action physically wears away the protective outer layer of enamel. As the enamel thins, it exposes the underlying dentin, which is significantly softer and less mineralized. Once the dentin is exposed, the decay process accelerates rapidly because this layer is far more susceptible to acid attack than the hard enamel.
The worn-down areas of the teeth also become highly sensitive to temperature changes and pressure, as the dentin contains microscopic tubules that lead directly to the tooth’s nerve. This mechanical wear not only makes the teeth more vulnerable to decay but also compromises their structural integrity over time.
The Role of Gum Recession in Oral Disease
The placement of chewing tobacco directly against the gums causes chronic irritation to the soft tissue, which is further exacerbated by the product’s chemical composition. Over time, this constant exposure leads to gingival recession, where the gum tissue pulls away from the tooth surface.
When the gums recede, they expose the tooth root, which is normally protected by the gum tissue and jawbone. Unlike the crown of the tooth, which is covered by durable enamel, the root is covered by a softer material called cementum. Cementum is far less resistant to demineralization and decay than enamel, making the exposed root surface a prime target for root caries.
This exposed root structure decays much more easily and quickly than the enamel-covered crown, leading to a higher likelihood of root caries among chewing tobacco users. The loss of gum tissue also destabilizes the tooth’s support structure, increasing the risk of periodontal disease and eventual tooth loss.