Individuals who smoke have a higher risk of losing their teeth than non-smokers, found new research published in the Journal of Dental Research.

Researchers at the University of Birmingham and the German Institute of Human Nutrition observed that male smokers were 3.6 times more likely to lose their teeth than non-smokers, while female smokers were 2.6 times more likely.

The association between smoking and tooth loss was higher for younger people. Data also showed that heavy smokers had a higher risk of losing their teeth than those who smoked fewer cigarettes.

Using the long-term longitudinal study, EPIC (European Prospective Investigation into Cancer and Nutrition), researchers assessed data from 23,376 participants.

“Most teeth are lost as a result of either caries (tooth decay) or chronic periodontitis (gum disease),” lead author Thomas Dietrich, a professor at the University of Birmingham, said in a news release. “We know that smoking is a strong risk factor for periodontitis, so that may go a long way towards explaining the higher rate of tooth loss in smokers.”

The gums of a smoker may appear healthier than they actually are because smoking can mask gum bleeding, a key symptom of periodontitis. According to researchers, quitting smoking can reduce the risk of tooth loss. An ex-smoker will eventually have the same risk for tooth loss as someone who never smoked, but it could take more than 10 years, Dietrich said.

“Gum disease and consequential tooth loss may be the first noticeable effect on a smoker’s health,” Kolade Oluwagbemigun, from the German Institute of Human Nutrition, said in the news release. “Therefore, it might give people the motivation to quit before the potential onset of a life-threatening condition such as lung disease or lung cancer.”

According to the U.S. Centers for Disease Control and Prevention (CDC),  13 percent of adults aged 65 to 74 have lost all of their natural teeth.