Vaping harms teeth and oral health in ways you may not be unaware of. Recent research confirms that aerosols produced through vaping coat the teeth surfaces and create a perfect breeding ground for bacteria. The effects can linger long after you vape and often cause irreversible damage to the teeth.
Vaping is often wrongly thought to be a smoking cessation tool. Rather, it causes teeth to decay in a way similar to sticky sugars.
Vaping causes gum inflammation, cavities, dry mouth, and foul odor. It's also linked to oral cancer and lung and heart diseases.
Regular dental visits and proper counseling can create awareness to help you quit the habit.
The Centers for Disease Control and Prevention (CDC) highlights that 2.5 million teens and adolescents vape in America- and the number is rising. Read on to learn how vaping affects oral health.
By 2022, 1 in 10 middle and high school teens in the United States had experimented with e-cigarettes. What may be more startling is that 14.1% of high school pupils (2.14 million) and 3.3% (380,000) of middle school students currently use e-cigarettes regularly. Dentists are alarmed at the rise of vaping habits and the damage they do to youth mouths. Furthermore, research continues to reveal additional oral health hazards.
How vaping affects mouth structures
Effect on oral hard tissues
Propylene glycol, a common base in e-cigarettes, degrades into acetic acid, lactic acid, and propionaldehyde. The most significant issue with this combination of ingredients is that they work together to demineralize enamel — the outermost and hardest layer of teeth. Studies have found up to a 27% decrease in enamel hardness due to chronic vaping. Furthermore, these compounds are also hygroscopic, which means they bind with the water in saliva, causing xerostomia(dry mouth).
Another base compound, glycerin, which is 60% as sweet as sucrose, combines with certain flavors used in vaping juices to increase microbial adherence to teeth structures by four times. This helps Streptococcus mutans — the main culprit for caries — to adhere to enamel, causing rapid demineralization and rampant teeth cavities. Moreover, vaping compositions with sweeteners are akin to ordinary soft drinks and a high-sucrose diet and are highly cariogenic.
Effect on the oral soft tissues
Nicotine, the chief active constituent of tobacco, restricts blood flow to the gums, depriving them of nutrients and oxygen and causing gum recession. Despite popular belief, recent preliminary studies reveal that e-cigarettes have the same effect on the soft tissues supporting the teeth as traditional cigarettes. In addition, a two-week research study on the gingival response when smokers transitioned from smoking to vaping discovered a substantial rise in gingival inflammation-busting the belief that vaping is less dangerous than conventional cigarettes.
Effect on dental esthetics
Though tooth enamel is the body's toughest surface, it is porous. Therefore, nicotine can easily pass through these pores, and as it comes into direct contact with air, it instantly turns brown — causing teeth to turn a yellowish-brown over time. In addition, for a person who has been vaping for years, the stains penetrate deep into the enamel and often reach the dentin's outer layer, making it difficult to remove.
The oral health consequences of vaping
Vaping is commonly marketed as a safer alternative to help with smoking cessation and tobacco consumption habits, but research reveals the contrary. The oral health consequences of vaping are summarized below.
The oral cavity is made up of a balanced microbial flora — consisting of good and bad bacteria. An imbalance can lead to a shift from a healthy to a diseased state, like gingivitis (gum disease) and periodontitis. Glycerol and propylene glycol in vaping devices suppress the good bacteria and produce an environment that thrives the growth of harmful bacteria. Besides, they also increase soft tissue inflammation.
According to one study, people who vape have more bacteria lodged in the pits and fissures of teeth. Vaping also exposes the gums to nicotine and hot, drying vapor. As a result, vapers are more likely to get gum disease. As gum infections worsen, the teeth loosen and eventually fall out.
Vaping often obscures the early indicators of gum disease, like swelling and bleeding when you brush. It may continue to rot your teeth long before you take notice.
Cavities are mainly produced by plaque acid eroding tooth enamel. When plaque bacteria come into touch with sugar, they make this toxic acid. If you use a flavored vape that contains sugar, you increase your chances of acquiring teeth cavities. The combined effect of sticky flavored aerosols and a dry vapor significantly increases the risk of teeth decay.
The presence of numerous well-known carcinogenic substances has been discovered in the ingredients of several brands of e-cigarettes. In addition, researchers have looked at the molecular changes caused by e-cigarettes on the oral mucosa. The findings have been disturbing, with reports ranging from low levels of anti-oxidants to gene deregulation and DNA strand breakage.
Nicotine is a stimulant that can cause people to grind their teeth, gradually eroding tooth enamel. This increases the likelihood of chipping, cracks, and cavities. It's common knowledge that nicotine stains teeth, but it also plays a pathogenic role in tooth loss due to its propensity to impair the natural process of tooth mineralization via altered genetic signaling and inflammatory system activation.
Vaping dries out the saliva flow in the mouth and can cause a foul odor. People who suffer from chronic dry mouth are more likely to develop oral health issues such as thrush and burning mouth syndrome. Continuous vaping can cause mouth and throat irritation too.
One of your body's natural defenses against plaque bacteria is saliva. Therefore, as saliva dries up, plaque bacteria can grow unhindered, and infection below the gum line can emerge. If left untreated, this infection might progress to severe gingivitis and periodontitis.
Nicotine causes tongue and buccal mucosa pain. Nicotinic stomatitis is a response to the heat produced by vaping.
Symptoms requiring a dental visit
Specific dental symptoms may indicate an underlying oral health problem. For example, ulcers that fail to heal are one of the earliest signs of oral cancer. If you encounter any of the following symptoms, make an appointment with a dentist:
- Swollen gums.
- Increased sensitivity to temperatures.
- Frequent dry mouth.
- Loose teeth.
- Mouth ulcers.
Other vaping health consequences
Vaping seriously affects the lungs. One such condition is E-cigarette or vaping use-associated lung injury (EVALI). It has been reported due to vitamin E acetate found in vaping chemicals. The alveoli — the air sacs in the lungs where oxygen enters the body — are coated with a surfactant. The lung surfactant is a lipid and protein combination produced in the lungs and keeps the alveoli from clumping together. Vaping creates aerosols that inhibit surfactants’ ability to function effectively and, thus, hampers breathing. In addition, the National Institutes of Health (NIH) has recently pointed out that chronic e-cigarette users showed poor blood vessel function, putting them at risk for heart disease. Moreover, poor gum health can increase the risk of a heart attack by 2-3 times.
Why parents should be concerned
The use of e-cigarettes has surpassed combustible cigarettes among middle and high school students in the United States. Many previously tobacco-free people think of vaping as a safe option and opt for it. However, Vaping has turned into a global issue. Concerns about the toxic ingredients in vape devices and e-cigarettes have been rising. The FDA has already restricted the sale of flavored e-cigarettes — and manufacturers now need FDA approval to sell their products in the US market.
With such a rise in vaping levels, you might know a friend or a relative who is unaware of the consequences. Providing them with the right information and persuading them to get help quitting can save a life.
What does the CDC recommend?
The CDC and FDA advise consumers not to use cannabis-containing e-cigarettes or vaping products, especially from unofficial sources such as friends, family, or in-person or internet vendors. Furthermore, E-cigarette or vaping products (including nicotine or THC) should never be used by minors, young adults, or pregnant women.
Adults who use nicotine-containing e-cigarettes, or vaping pens, should consider utilizing FDA-approved smoking cessation drugs.
If they require assistance quitting tobacco products, including e-cigarettes, they should contact their healthcare provider.
Ways to minimize the effects of vaping:
- Try and restrict nicotine intake. Go nicotine-free to avoid the oral health consequences.
- Maintain good oral hygiene. Brush your teeth twice daily — preferably with fluoride toothpaste and floss regularly.
- Stay hydrated. This helps to prevent dry mouth and bad oral odor.
- Visit your dentist every six months. Access the condition of your teeth and gums regularly.
- Quit the habit. Consider using cessation products or seek professional help if you want to quit vaping.
Vaping can take a toll on oral health — quickly and quietly. The extent of harm is yet to be fully explored, and more research is required. However, it is best to avoid vaping altogether. If you're already using, it's best to quit as soon as possible to allow your lungs and body to begin their self-healing process — if it's not too late.
- CDC — Morbidity and Mortality Weekly Report. Notes from the Field: E-cigarette Use Among Middle and High School Students — United States, 2022.
- CDC. E-Cigarette, or Vaping, Products Visual Dictionary.
- PLOS ONE. E-cigarette aerosol exposure of pulmonary surfactant impairs its surface tension reducing function.
- Science Advances. Adverse effects of electronic cigarettes on the disease-naive oral microbiome.
- CDC. Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products.
- PLOS ONE. Cariogenic potential of sweet flavors in electronic-cigarette liquids.