Vaping is just as harmful to oral health as smoking

Sept. 7, 2023
Vaping e-cigarettes threatens gum and oral health as much as smoking traditional cigarettes. Here's what you need to know.

According to Dr. Scott Froum, editorial director of Perio-Implant Advisory: Vaping has traditionally have been thought to be the lesser of two evils when compared with smoking for oral heath. Substituting vaping for heavily active smokers may be an alternative for them to quit smoking. What we realized early on is that vaping is worse than you think. Vaping targeted nonsmokers or those who normally wouldn't have smoked. This change in exposure to nicotine, propylene glycol, and other carriers found in the vaping mist predisposes patients to cavities and gum disease. We now recognize vaping as an official concern that elicits a similar inflammatory and oral microbiome change leading to oral pathology. 

From the European Federation of Periodontology

For years, it has been known that smoking can contribute to serious damage on gum and oral health, with smokers having more gum diseases, more tooth loss, and increased levels of oral cancer. It has also been known that gum disease can play a negative role on systemic health; e.g., it is implicated in diabetes, cardiovascular diseases, chronic respiratory diseases, inflammatory bowel disease, and others.

In parallel, regular warnings against vaping usually only highlight its damage to the heart and lungs, but do not refer to oral health.

The European Federation of Periodontology (EFP) warns that vaping electronic cigarettes can be as harmful to gum and oral health as smoking traditional tobacco cigarettes. Despite the fact that the vaping phenomenon is relatively new compared to smoking, meaning research details are still incomplete, evidence does show a clear link between e-cigarettes and poor gum and oral health.

Unlike tobacco smokers, who are more aware of smoking as a risk factor for general health problems and for gum diseases, vaping users are often misled to think of e-cigs as somehow less harmful or even safe. Vaping may not be less detrimental to gum and oral health than smoking.

One of the reasons behind vaping’s unhealthy impact is nicotine, whether smoked or vaped, which restricts blood flow to the gums. Other chemicals contained in the e-cig vapor (including formaldehyde, propylene glycol, and benzene) may aggressively increase damage to the mouth, starting with a progressive destruction of the periodontium, the tissues supporting the teeth.

Unfortunately, the number of vapers is growing globally at a fast rate. This uptake appears to be higher among teenagers, young adults, and people who have never smoked taking up this potentially damaging habit. “Damage on the gums and the tissues supporting the teeth, often to an irreversible state, is a likely adverse effect of vaping,” highlights Andreas Stavropoulos, chair of the EFP’s scientific affairs committee and EFP immediate past president. “This damage includes permanent resorption of the gums and the bone that keep the teeth in function and in the mouth. Treatment of these problems, depending on the extent, is often cumbersome, and expensive.”

“For these reasons, at the EFP we urge oral health-care professionals to not suggest vaping as a transition strategy of tobacco cessation, but rather to prioritize smoking cessation advice for both cigarettes and e-cigarettes alike, and to provide patients with information about the likely detrimental impact of vaping on gum and oral health,” recommends Prof Stavropoulos.

Besides, vaping can harm oral health in a variety of additional ways, including bad breath, mouth and throat irritation, para-tracheal edema, laryngitis, black tongue, nicotine stomatitis, hairy tongue, toothache, tooth discolouration, caries, tooth sensitivity and loss, increased cariogenic, reduced enamel hardness, and increased risk for cancer.

Source: Press release from the European Federation of Periodontology dated September 7, 2023. For more information, visit the EFP website.