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It is thought that nicotine May alter the mouth environment making it more hospitable for bacteria involved in periodontal disease to survive Increases plaque formation Alters cell metabolism of plaque bacteria, which may increase the prevalence and quantity of bacterial strains that lead to periodontal disease Smoking also increases the growth of Candida albicans which may promote the adherence of plaque to the tooth surface and the accumulation of calculus and thus periodontal disease and gum recession

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