The Smoking and Vaping and Dental Health Crisis: Why South Africa's High Smoking Rates Are Destroying More Than Just Lungs

By Dr TCN Buleni

3 min read

A person is standing on a quiet street, exhaling a large cloud of vapor.

South Africa's smoking rate in 2025 remains stubbornly high at more than 25%, while countries like New Zealand have dropped to just 6.8%. But here's what most smokers don't realize: while they're worried about lung cancer, smoking is quietly destroying their mouths in ways that will cost them thousands of rands long before any lung problems appear.

At Smilez Dental Surgery, we see the devastating oral effects of smoking every day. The statistics are sobering: over 39,000 South Africans die from tobacco-related diseases each year, but the dental destruction starts within weeks of lighting that first cigarette.

"I thought dental problems were just cosmetic," says a 35-year-old patient who recently quit smoking. "I had no idea my R15,000 worth of dental emergencies this year were directly caused by my cigarette habit."

The Hidden Dental Costs of Smoking

While lung cancer makes headlines, smoking attacks your mouth immediately and relentlessly. Here's what happens and what it costs:

Gum Disease Progression Smoking reduces blood flow to your gums, making them unable to fight infection. A non-smoker might develop minor gum inflammation treatable with a R1,590 normal cleaning. A smoker with the same initial problem faces advanced periodontitis requiring R12,100 in perio treatment, plus potential tooth loss.

Tooth Loss and Replacement Costs Smokers are twice as likely to lose teeth compared to non-smokers. Each lost tooth costs between R8,170 for a PFM crown and R8,030 for front tooth root canal treatment if salvageable. For complete tooth replacement, implant costs vary significantly. For a typical smoking-related tooth loss scenario involving five teeth, you're looking at R40,000 to R80,000 in replacement costs. Also the risk of losing the implants due to periodontal disease and diminishing healing factors.

Delayed Healing After Dental Procedures Smoking dramatically slows healing after dental surgery. A simple adult extraction (R990) that should heal in one week can take a month in smokers, often leading to complications like dry socket (R1,140). These complications frequently require additional treatments and sutures (R260 each). Also risk losing implants due to lack of proper healing after placement.

Oral Cancer Risk Among youth (ages 13-15), 21.5% are current tobacco users, starting a dangerous pattern early. Oral cancer treatment costs can exceed R100,000, assuming it's caught early. Advanced cases require extensive surgery and reconstruction that can cost hundreds of thousands of rands.

The Vaping Deception: Not the "Safe" Alternative

As of 2024, over a third (36.4%) of high school students in South Africa had tried vaping, and 16.8% were actively vaping. Many parents and teens believe vaping is harmless to teeth, but early evidence suggests otherwise.

Vaping exposes teeth to different chemicals that can cause enamel erosion, leading to sensitivity and increased cavity risk. While long-term dental effects are still being studied, early intervention patients are already showing increased cavity rates and gum irritation. The "harmless" alternative may cost families just as much in dental bills.

The Medical Aid Reality for Smokers

Most medical aid schemes have annual dental limits between R8,000 and R15,000. Here's how smoking destroys these benefits quickly:

A non-smoking family might use R4,770 annually for routine care and consultations (R930 consultation + R1,590 normal cleaning x2), leaving over R10,000 for emergencies. A smoking family often exhausts their entire R15,000 limit by June treating gum disease (R12,100 perio treatment), infections, and complications. Any additional problems mean 100% out-of-pocket costs.

Even worse, many medical aids exclude certain smoking-related complications from coverage, leaving families responsible for massive bills that could have been prevented.

The Financial Timeline of Smoking Damage

Months 1-6: Reduced blood flow begins affecting gum health. Minor bleeding during brushing that could be treated with better hygiene now requires professional intervention.

Year 1-2: Gum disease becomes established. Professional treatment costs R3,070 (perio consult R3,140) to R12,100 (full perio treatment) annually instead of R1,590 for routine cleanings.

Years 3-5: First tooth loss typically occurs. Emergency extractions (R990-R2,360 for wisdom teeth), potential root canal treatments (R8,030 front tooth, R9,350 back tooth), and crowns (R8,170 PFM crown) become necessary.

Years 5+: Multiple tooth loss, extensive gum disease, and potential oral cancer screenings become routine. Annual dental costs can exceed R50,000.

Compare this to a non-smoker who might spend R3,450 annually (consultation R930 + two cleanings R1,590 each) on routine preventive care throughout their lifetime.

Breaking the Cycle: Immediate Benefits of Quitting

The good news? Your mouth begins healing within days of quitting smoking. Blood flow improves within 48 hours, reducing gum inflammation. Within three months, your risk of complications during dental procedures drops significantly.

One patient told us, "I quit smoking in January and my gums stopped bleeding within two weeks. My dentist said my gum health improved more in three months than it had in the previous three years."

Taking Action: Beyond Willpower

If you're ready to protect your oral health and your wallet, here's your action plan:

Immediate Steps: Book a comprehensive dental examination (R930 consultation) to assess current smoking damage. Early intervention can prevent R20,000+ in future emergency treatments.

Quitting Support: Contact your medical aid about smoking cessation programs. Many cover nicotine replacement therapy that can save you thousands in future dental costs.

Damage Control While Quitting: If you're not ready to quit immediately, increase dental cleanings to every three months instead of six. For smokers, we recommend R1,980 smoker cleanings instead of standard R1,590 cleanings. This aggressive prevention approach can slow damage while you work toward quitting.

The Bottom Line

About 10% of male deaths and 5% of female deaths are caused by tobacco, but dental destruction happens first and costs more immediately than most people realize. While you're worried about future lung problems, smoking is quietly stealing your teeth and emptying your bank account today.

At Smilez Dental Surgery, we've seen families spend their children's university funds on smoking-related dental emergencies. We've watched parents choose between groceries and dental treatment because smoking damage exhausted their medical aid benefits.

Your mouth is sending you early warning signals about what smoking is doing to your entire body. The question is: will you listen before it's too late?

Don't let smoking steal your smile and your savings. Contact Smilez Dental Surgery today for a comprehensive assessment of smoking-related dental damage. Together, we can create a plan to protect your oral health and your financial future. The cost of quitting is temporary. The cost of continuing to smoke is permanent.

Ready to break free from smoking's grip on your oral health? Contact Smilez Dental Surgery today for expert guidance on protecting and restoring your smile.