E-cigarettes: why are they a risk to oral health?

You have certainly seen someone smoking an e-cigarette – or perhaps you do it yourself. In the Western world, e-cigarettes continue to grow in popularity among young people, smokers and ex-smokers, as they are seen as a healthier alternative to conventional cigarettes.

However, recent studies by scientists in the USA and Italy have concluded that regular exposure to e-cigarette vapour damages gum tissue, which can lead to infections, inflammation and periodontal disease.

Small and easy to carry, these devices usually run on a battery. When you take a puff, the internal battery switches on and heats a liquid that usually contains nicotine, flavourings and other chemicals.

When heated, e-cigarettes release a nicotine-containing vapour that comes in a wide variety of flavours. This vapour is produced from solutions containing solvents, varying concentrations of nicotine, water, flavourings and other additives. The most commonly used solvents are vegetable glycerine and propylene glycol.

Studies have shown that the vaporisation temperature of the device’s heating coil can reach up to 350º. This temperature is enough to trigger chemical reactions and physical changes in the compounds, forming other toxic substances. Glycerine and propylene glycol, for example, generate compounds such as formaldehyde, acetaldehyde, acrolein and acetone when exposed to high temperatures. These substances are classified as cytotoxic, carcinogenic and irritant, and cause pulmonary emphysema and dermatitis.

As vaping has spread, there has been much discussion about the harm it does to health. The debate often focuses on its possible carcinogenic effects, but researchers have continued to highlight its harmful effects on oral health:

They destroy the normal oral microbiota (in favour of disease-causing germs), exposing users to the risk of infection and inflammation, and therefore to tooth decay and even periodontitis – the disease that affects the gums and which, if left untreated, leads to tooth loss.

This was first revealed by a study published in the journal iScience and carried out at New York University. The study was based on an examination of the oral health and oral microbiota of 119 individuals, smokers and non-smokers, and for the first time also included people who use only e-cigarettes, alongside traditional smokers.

By examining oral and saliva samples, the researchers studied the oral microbiota of the 119 participants. Periodontitis and infections of the oral cavity were very common among smokers (in 72.5% of the smokers sampled) and among e-cigarette users (42.5%), whereas they were present in only 28.2% of non-smokers. What is more, bacterial strains such as Porphyromonas and Veillonella were abundant in the mouths of e-cigarette users: both strains are on the periodontitis “blacklist”.

• Bad breath: e-cigarettes do not actually involve inhaling smoke, but the presence of nicotine causes an unpleasant smell in the mouth. When vaping goes hand in hand with poor oral hygiene habits, the problem tends to get worse.
• Gum recession: this occurs because of the nicotine in e-cigarettes, which reduces blood flow. As a result, the gums are deprived of nutrients, which damages the tissue and causes the gums to recede.
• Xerostomia (dry mouth): another oral condition that e-cigarettes can cause is xerostomia – commonly known as dry mouth. This is because nicotine can reduce the production of saliva, which in turn is responsible for keeping the mouth naturally clean and maintaining the bacterial balance in the oral cavity. When this protection is reduced, the risk of tooth decay increases and the lining of the mouth becomes more sensitive, leading to mouth sores, difficulty chewing and bad breath.
• Yellowing of the teeth: of the many oral problems that nicotine can cause, one of the most bothersome for patients is yellowing of the teeth. As it builds up on the tooth surfaces, the substance sticks to the enamel and causes staining that is difficult to remove by brushing.
• Inflammation in the mouth: the chemicals that enter the mouth cause inflammation of the gums and throat, leading to redness, pain and swelling.
• Periodontal disease: the main cause of periodontal disease is the build-up of dental plaque on the tooth surfaces. What few people know is that smokers are at greater risk of developing these problems. This is because e-cigarettes can disrupt the oral microbiota and cause swelling and inflammation of the gums. If left untreated, periodontitis can lead to tooth loss and other complications.
• Gum damage and bleeding: an important study carried out in 2016 by researcher Fawad Javed of the Eastman Institute in Rome highlighted various links between e-cigarette use and damage to gum cells, caused by combustion which, although much lower than with traditional cigarettes, can still inflame the cells of the mouth and gums.

When oral health problems start to appear as a result of using e-cigarettes, it is important to have someone you can rely on. At Dental Studio Dr. Leuștean you will find the best dental professionals to look after your smile! We have modern equipment and technology to carry out every type of treatment you need.