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Dental Health

A Hookah Habit is Detrimental to Oral Health
Nov 14, 2018

smoke Dental Care Center

Smoking a water pipe, also called a hookah or shisha, is dangerous for your oral health. Many people have the misconception that smoking a waterpipe is somehow less harmful than smoking cigarettes, but that’s simply untrue. Smoking hookah regularly can lead to gum disease, oral cancer, and other serious health conditions.

History and Use

Smoking communally from a water pipe began over 400 years ago in India, but its popularity is currently on the rise around the world including here in the United States, especially among young people. A hookah or waterpipe heats up flavored tobacco (produced specifically for this use), which is then pulled through the pot of water and into the rubber hose that’s attached to a mouthpiece. Depending on where you are smoking and who you are with, you may use disposable plastic tips so each smoker only uses their own or you may share the mouthpiece communally.

The sweet smell of the tobacco and interactive way of smoking seems less harmful than cigarettes, but the level of nicotine in the tobacco is not currently regulated and there are no age restrictions on who can buy and smoke hookahs.  One study found that among high school seniors, about 1 in 5 boys and 1 in 6 girls had tried hookah in the past year. The millions of waterpipe smokers may be surprised to hear that the risks of smoking hookah are similar, if not worse than, those of smoking cigarettes.


Hookahs are wrongly perceived as a healthier alternative, but this is simply not true. While a cigarette takes typically 5-7 minutes or 40-75 puffs to smoke, a hookah may last an hour and a half or about 50-200 puffs. According to the American Journal of Health Behavior, the amount of smoke inhaled during a typical hookah session is about 90,000 milliliters, compared to that of 600 milliliters inhaled while smoking a cigarette. The tobacco in water pipes is also exposed to high heat from burning charcoal, and the smoke is found to be at least as toxic as cigarette smoke.

Health Risks Associated with Smoking Hookah

  • Dry Mouth – Any tobacco consumption, including smoking hookah, decreases your production of saliva, which is the mouth’s natural cleanser. A dry mouth makes you more susceptible to cavities and at higher risk for tooth decay.
  • Bad Breath – Smoking of any kind causes bad breath. Although the smell of the tobacco is sweet, once it is processed through the water and into your mouth, it stinks just the same. The more tobacco you consume, the worse off your breath will be.
  • Disease – Research suggests that cigarette smokers are nearly four times more likely than non-smokers to develop periodontal disease and hookah smokers are up to 5 times more likely. Hookah tobacco and smoke also contain many toxic agents that can cause clogged arteries and heart disease. Beyond that, if groups are sharing the same mouthpiece, there is always the risk of contracting herpes, hepatitis, tuberculosis, meningitis, and other diseases.
  • Cancer – Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder, and oral cancers. The charcoal used to heat the tobacco can also raise health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals. Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents. Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.

While smoking hookah occasionally is not the worst activity for your overall health, smoking consistently is undoubtedly terrible for your oral health. If you smoke, we advise you to stop to reduce your risk of oral cancer and disease.  

If you have questions about your smoking habit in relation to dental health, call The Dental Care Center.