Smoking stains and tartar on teeth: how are they cleaned, and what happens next?

Tooth discolouration falls into two groups. Cleveland Clinic defines outer (extrinsic) stains as staining that affects the outer surface of the enamel and usually comes from food and drink, and inner (intrinsic) stains as colour changes that start inside the tooth and affect the dentine layer under the enamel. According to Cleveland Clinic, cigarettes and other tobacco products are one of the reasons discolouration is seen more often than in non-smokers. Tobacco stain largely sits on the outer surface; that is why it usually decreases markedly with cleaning.

Tartar is something separate. If the soft layer of bacteria that forms on the tooth every day (plaque) is not cleaned off, it hardens with the minerals in saliva and turns into tartar. The surface of tartar is rough; new plaque and stain cling to this rough surface more easily than to smooth enamel. The dark brown band you see in someone who smokes is usually these two things layered on top of each other: hardened tartar underneath, and the colour left by tobacco on top of it and within it.

Where the stain is gives a clue. The tongue side of the lower front teeth is where tartar builds up most, because it is close to where the salivary glands open. The cheek side of the upper molars is a similar area. If you see a dark band running along the gum line and thickening towards the gaps between the teeth, this is most likely a build-up mixed with tartar. A grey or yellow colour spread evenly over the whole surface of the tooth fits more with an inner colour change and may not change with cleaning.

The visible part is half the problem. Tartar can also build up below the gum line, and this tartar cannot be seen from outside. Because the build-up below the gum sits right against the gum, it constantly feeds the inflammation. The NHS lists the gums bleeding when you brush, floss or eat something hard, and the gums becoming swollen and red, as the first signs of gum disease. In people who smoke, one of these signs, bleeding, may be seen less than expected.

Why does smoking reduce bleeding in the gums? The blood-vessel-narrowing effect of nicotine and tobacco smoke is the explanation most often put forward. In a case-control study published in the Journal of Periodontology in 2025, the proportion of sites bleeding on probing was 45 per cent in smokers with gum disease and 78 per cent in non-smokers without gum disease; the authors interpreted this as nicotine's effect of masking gum inflammation. This study was carried out at a single hospital in Kabul, with only 122 men aged 15 to 50; the case group included only smokers with gum disease and the control group only healthy non-smokers, and why bleeding decreased was not measured directly; the nicotine explanation is the authors' interpretation. Keep these limits in mind; even so, the practical conclusion is this: if you smoke, the fact that your gums do not bleed may not mean they are healthy.

The risk is not only hidden. The US Centers for Disease Control and Prevention (CDC) writes that people who smoke have twice the risk of gum disease compared with non-smokers, that the more and the longer someone smokes the more the risk increases, and that gum disease treatments may work less well in people who smoke. According to the CDC, stopping helps the gums heal after treatment.

On the implant side, the picture is similar. In a 2015 meta-analysis combining 107 studies, 6.35 per cent of the 19,836 implants placed in people who smoked had failed, compared with 3.18 per cent of the 60,464 implants placed in non-smokers; smoking also increased the risk of infection after surgery and bone loss around the implant. The authors add that the results should be interpreted with caution because of uncontrolled factors in the studies. So it is not right to say that someone who smokes cannot have implants, but it is clear that the risk rises measurably. The details are on our smoking and implants page.

This is where the link between staining and health comes in. A brown stain is not a disease in itself; it is an aesthetic problem. But the conditions that create it, namely tartar build-up and smoking, are two strong drivers of gum disease. That is why you need to go for a clean not only to have your teeth brightened, but also to have your gum pockets measured.

The first list gives signs suggesting that the stain is most likely on the surface and will decrease with cleaning. If a sign in the second list applies to you, there may be a problem other than the stain as well, and you should mention it specifically at the examination.

The order is first to understand the state of the gums, then to remove the build-up, and last of all to assess the colour. The decision on whitening is made after the clean, not before.

1. 1

   Examination and gum measurement

   The dentist examines the teeth, old fillings and crowns and, if needed, measures the gum pockets with a fine probe. Say that you smoke and how much you smoke a day; little bleeding is interpreted together with this information.

2. 2

   Ultrasonic cleaning (scaling)

   An instrument with a vibrating tip, together with a water spray, separates hard tartar from the tooth surface. Tartar just below the gum line is also removed at this stage. The vibration and the sound of the water can be unpleasant, but the procedure does not wear away the tooth itself.

3. 3

   Fine cleaning with hand instruments

   Tartar left between the teeth and in narrow areas is removed with small hand instruments. If there is deep build-up below the gum, the dentist may leave this for a separate deep cleaning session; the NHS writes that in advanced cases deep cleaning below the gums may be needed.

4. 4

   Polishing with air (air-flow) or with a polishing paste

   Air-flow removes surface stain by spraying water, air and a fine powder onto the tooth. The type of powder matters: a 2025 review combining laboratory studies found that sodium bicarbonate and calcium carbonate powders roughened the surfaces of fillings and crowns, and that glycine and erythritol powders were the least abrasive. The same review found that ultrasonic instruments can also roughen surfaces, especially composite fillings and glass ionomer, and that zirconia and lithium disilicate crowns were less affected; these are laboratory findings. If you have fillings or crowns, you can ask which powder will be used.

5. 5

   Reassessing the colour

   The colour left after cleaning is the tooth's own colour. Cleveland Clinic writes that whitening works best on outer surface stains, and that bonding or veneers may be needed for deep stains. If whitening is wanted, it is planned at this point, on healthy gums and teeth.

6. 6

   Setting the check-up interval

   How often you will need a clean is set according to how fast tartar builds up for you, the state of your gums and whether you keep smoking. If there is gum disease, the interval becomes shorter.

A clean removes most of the stain. Depending on the colour that remains and the state of the teeth, the options below are discussed.

The following are the methods most often recommended online and the wrong decisions most often made. Each of them has a cost.

Timings vary with the amount of tartar and the state of the gums. The sequence below describes the usual course; the advice of the dentist following you takes priority.

1. The day of the clean

   The gums may bleed a little and be tender. Where tartar has been removed, the gaps between the teeth may feel empty for the first time; this space is the area the tartar used to fill.

2. The first few days

   There may be sensitivity to cold at the necks of the teeth, especially where the gums have receded. Using a toothpaste for sensitive teeth and continuing to brush with a soft brush is usually enough.

3. The first weeks

   As the inflammation decreases after the tartar has been removed, the redness and swelling of the gums go down. In people who smoke, this healing may be slower.

4. The following months

   If smoking continues, the stain builds up again. How quickly the stain comes back is a good measure for setting your check-up interval.

We do not give a figure here; the scope of a clean varies a great deal from mouth to mouth. The main factors that determine the scope:

The amount and location of the tartar

Tartar only above the gum can be removed in one session; deep build-up below the gum may need separate sessions.

Whether there is gum disease

If pocket depth has increased, gum treatment and more frequent check-ups are needed instead of a simple clean.

The method used

Whether air-flow or polishing is applied in addition to ultrasonic cleaning changes the scope.

Whitening and restorations

Whitening after the clean, or replacing old fillings and crowns, are separate procedures.