Association of e-cigarette use with oral health: a population-based cross-sectional questionnaire study

Huilgol, Priyanka; Bhatt, Surya P.; Biligowda, Niranjan; Wright, Nicole C.; Wells, James M.

doi:10.1093/pubmed/fdy082

Cited by 43 publications

(39 citation statements)

References 25 publications

(21 reference statements)

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“…There have been a few studies that address the direct health effect of e-cigs usage, especially regarding the oral cavity. In a cross-sectional analysis, it is reported that daily e-cig usage was associated with significantly increased odds of permanent loss of any tooth from nontraumatic causes in adults in the USA and it was indicated that vaping may be a risk factor for poor oral health outcomes including periodontal disease and tooth loss [73]. An association between e-cigs usage and higher odds of cracked/broken teeth, pain in the tongue and/or inside-cheek as compared to those who had never used e-cigs, among adolescents was previously shown [74].…”

Section: Studies On Direct Health Effects Of Ends In the Oral Cavitymentioning

confidence: 99%

Electronic Nicotine Delivery Systems (ENDS) and Their Relevance in Oral Health

Farsalinos

Poulas

2019

Toxics

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The number and popularity of electronic nicotine delivery systems (ENDS) and especially e-cigarettes (e-cigs) have been increasing in the last decade. Although ENDS owe their popularity to excluding the harmful chemicals that are present in tobacco smoke, there is a debate whether they are safe, regulated, and as harmless as they are assumed to be and have potential unknown long-term effects. Involvement of cigarette smoking to the progression of periodontal diseases, other adverse oral health outcomes, and its detrimental effects to oral health are well-described. ENDS producer companies claim that these products can improve oral health by providing alternatives to smoking. However, the effect of e-cigs on oral health is not fully understood and is still debated among many scientists and clinicians. The number of studies addressing the potential toxic effect of ENDS or e-cig aerosol on oral cells is limited along with the clinical studies which are still preliminary, and their sample size is limited. The long-term effects of inhaled aerosols and the potential synergistic effect of the e-cigs components are not known. It is essential and of utmost importance to determine whether exposure to ENDS aerosol contributes to the progression of periodontal diseases and how it affects periodontal ligament and gingival cells which are believed to be its first targets. This review briefly summarizes the available evidence about the effects of e-cigs on periodontal health including several pathophysiological events, such as oxidative stress, DNA damage, inflammation, cellular senescence, dysregulated repair, and periodontal diseases.

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Section: Studies On Direct Health Effects Of Ends In the Oral Cavitymentioning

confidence: 99%

Electronic Nicotine Delivery Systems (ENDS) and Their Relevance in Oral Health

Farsalinos

Poulas

2019

Toxics

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“…However, another study showed a statistically significant increase in gingival inflammation in tobacco smokers who switched from smoking to vaping for two weeks [22]. A larger cross-sectional analysis using the 2016 Behavioral Risk Factor Surveillance System survey data showed an increased odds of teeth loss due to decay or gum disease with the use of e-cigarettes [23].…”

Section: Introductionmentioning

confidence: 99%

Association between Regular Electronic Nicotine Product Use and Self-Reported Periodontal Disease Status: Population Assessment of Tobacco and Health Survey

Atuegwu

Perez

Oncken

et al. 2019

IJERPH

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Electronic nicotine product use is increasing in the U.S., but few studies have addressed its effects on oral health. The goal of this work was to determine the association between electronic nicotine product use and periodontal disease. Population Assessment of Tobacco and Health adult survey data from 2013–2016 (waves 1, 2 and 3) was used for the analysis. Longitudinal electronic nicotine product users used electronic nicotine products regularly every day or somedays in all three waves. Participants with new cases of gum disease reported no history of gum disease in wave 1 but reported being diagnosed with gum disease in waves 2 or 3. Odds ratios (OR) were calculated to determine the association between electronic nicotine product use and new cases of gum disease after controlling for potential confounders. Compared to never users, longitudinal electronic nicotine product users had increased odds of being diagnosed with gum disease (OR 1.76, 95% Confidence Interval (CI) 1.12–2.76) and bone loss around teeth (OR 1.67, 95% CI 1.06–2.63). These odds were higher for participants with a history of marijuana and a history of illicit or non-prescribed drug use. Our findings show that e-cigarettes may be harmful to oral health.

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“…The interaction between the viscous aerosol and oral cavity is of particular interest for several reasons: (i) dental professionals have long been aware of the danger of tobacco products and nicotine on oral health, (ii) the oral cavity which includes lips, gingiva, teeth, palate and tongue is the first organ to directly interact with the e-cigarette aerosol, (iii) changes in tissue surface characteristics from eating glutinous food (e.g., caramels, licorices, or sour candies) and high sucrose intake (e.g., sodas) can lead to negative health consequences in oral cavity. Many e-liquids share similar physical and chemical properties to sugary and gelatinous foods that have been proven to be major risks for dental caries [ 30 , 31 ], and recently (iv) a population-based cross-sectional study revealed that daily use of e-cigarettes is independently associated with poor oral health [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

Cariogenic potential of sweet flavors in electronic-cigarette liquids

et al. 2018

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BackgroundMost electronic-cigarette liquids contain propylene glycol, glycerin, nicotine and a wide variety of flavors of which many are sweet. Sweet flavors are classified as saccharides, esters, acids or aldehydes. This study investigates changes in cariogenic potential when tooth surfaces are exposed to e-cigarette aerosols generated from well-characterized reference e-liquids with sweet flavors.MethodsReference e-liquids were prepared by combining 20/80 propylene glycol/glycerin (by volume fraction), 10 mg/mL nicotine, and flavors. Aerosols were generated by a Universal Electronic-Cigarette Testing Device (49.2 W, 0.2 Ω). Streptococcus mutans (UA159) were exposed to aerosols on tooth enamel and the biological and physiochemical parameters were measured.ResultsE-cigarette aerosols produced four-fold increase in microbial adhesion to enamel. Exposure to flavored aerosols led to two-fold increase in biofilm formation and up to a 27% decrease in enamel hardness compared to unflavored controls. Esters (ethyl butyrate, hexyl acetate, and triacetin) in e-liquids were associated with consistent bacteria-initiated enamel demineralization, whereas sugar alcohol (ethyl maltol) inhibited S. mutans growth and adhesion. The viscosity of the e-liquid allowed S. mutans to adhere to pits and fissures. Aerosols contained five metals (mean ± standard deviation): calcium (0.409 ± 0.002) mg/L, copper (0.011 ± 0.001) mg/L, iron (0.0051 ± 0.0003) mg/L, magnesium (0.017 ± 0.002) mg/L, and silicon (0.166 ± 0.005) mg/L.ConclusionsThis study systematically evaluated e-cigarette aerosols and found that the aerosols have similar physio-chemical properties as high-sucrose, gelatinous candies and acidic drinks. Our data suggest that the combination of the viscosity of e-liquids and some classes of chemicals in sweet flavors may increase the risk of cariogenic potential. Clinical investigation is warranted to confirm the data shown here.

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Association of e-cigarette use with oral health: a population-based cross-sectional questionnaire study

Abstract: In a population-based health survey of US adults, self-reported health behavior and outcomes, daily use, but not intermittent use of e-cigarettes was independently associated with poor oral health. Care must be exercised in seeking 'healthier' cigarette alternatives.

Cited by 43 publications

References 25 publications

Electronic Nicotine Delivery Systems (ENDS) and Their Relevance in Oral Health

Electronic Nicotine Delivery Systems (ENDS) and Their Relevance in Oral Health

Association between Regular Electronic Nicotine Product Use and Self-Reported Periodontal Disease Status: Population Assessment of Tobacco and Health Survey

Cariogenic potential of sweet flavors in electronic-cigarette liquids

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