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Smokers often exhibit higher levels of calculus (tartar) accumulation, which is a hardened form of plaque that provides a rough, ideal surface for bacterial colonization and a potent mechanical irritant to the gum line

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But when you add e-cigarettes, you see a slight increase in the youth who are using tobacco and part of that is marketing, said Brittany Huffman, program coordinator for Tobacco Free Allegheny, a tobacco-use prevention nonprofit