Compared to nonsmokers, smokers are 10 times more likely to develop oral cancer and diseases from tobacco products, including nicotine.
Of course smoking isn’t the same as vaping; cigarette smoke has toxic chemicals that e-liquid does not and there’s no link (yet) between vaping and a greater risk of mouth cancer. (Although vape liquids can contain substances that are known carcinogens.)
However, the evidence is accumulating that vaping may have a negative impact on your oral health.
In a 2021 study of more than 100 people, researchers found that those who smoked or used e-cigarettes were more likely than non-smokers to have clinical attachment loss, which is a sign of destructive gum disease. (The CAL was 3.5 mm in smokers, 2.8 mm in e-cigarette users, and 2.2 in non-smokers.) During the six-month study, about 44% of smokers, 29% of e-cigarette smokers, and 18% of non-smokers had gum disease progression.
“There is not enough data or studies on the length of time it takes for the changes to occur and there is still much to learn on the effects of vaping,” said Avalene Roberts, a New York–based dental hygienist and a spokesperson for the American Dental Hygienists’ Association. “However, if vaping becomes habitual, your dentist will notice immediately as you may develop dryness of the mouth and tongue and you may develop staining of the teeth if nicotine is used.”
People who use e-cigarettes also might be at greater risk of cavities.
There are more than 10,000 e-liquid formulations, with different basic components including nicotine and flavors that can mimic baked goods, sweets, beverages, and fruits. Flavored vapes are popular, with a 2022 CDC survey suggesting that 85% of students who vape use flavored e-cigarettes, with the most commonly used flavors being fruit (69% of people); candy, desserts, or other sweets (38%); mint (29%); and menthol (17%).
Vapes get their sweet taste because manufacturers sometimes add sucrose (table sugar) and sugar alcohol (sweet-tasting sugar substitutes) to e-liquids, which can affect your teeth.
In fact, vape flavors may have physical and chemical properties similar to sugary food and drinks, according to some research.
In a 2018 study conducted in a lab, cavity-causing bacteria called Streptococcus mutans were four times more likely to stick to tooth enamel when vape aerosols were present, and flavored aerosols resulted in a twofold increase in biofilm formation.
A biofilm is a community of bacteria that can’t be easily rinsed away. Biofilms can form when microorganisms attach and grow on a wet surface, in this case, your teeth. Biofilms are known to cause oral problems like gum disease. The aerosols generated by e-cigarettes may encourage the growth of biofilms made of S. mutans to the detriment of healthier mouth bacteria, the study suggested.
In essence, vaping could alter your microbiome, or the mix of organisms in your body, according to Roberts.
“Dental professionals are trained to spot changes in the mouth and aid patients in smoking cessation,” Roberts said. “Some of the immediate giveaways that a patient has been [vaping] nicotine is dryness of the mouth and tongue, increase in cavities and gum disease, stained teeth, and mouth odor. Nicotine restricts blood flow to the gums, which can speed up the progression of periodontal disease.”
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