Vape pens heighten risk of periodontal disease

Interview: Dr. Prachi Neogi, Consultant Dentist, Bhailal Amin General Hospital


On this World Oral Health Day, March 20, the focus shifts to the alarming impact of vape pens on oral health.

Developed in 2003, e-cigarettes or vape pens were initially touted as devices that could help give up smoking. There is however mounting research that not only can vape pens be as addictive as normal cigarettes, they contain nicotine and other harmful chemicals such as marijuana. Long term effects include lung damage, asthma and cardio-vascular diseases:

Why are e-cigarettes (vape pens) a cause of concern?

Their rise has sparked concerns among healthcare professionals worldwide. Initially marketed as a safer alternative to traditional tobacco smoking, vape pens have gained popularity, particularly among young adolescents and adults. However, recent studies suggest that the perceived lower risk associated with vaping compared to smoking may not hold true. A study published in 2019 that reviewed trends in risk perception of vaping versus smoking cigarettes from 2012 to 2017 revealed shifting attitudes towards the safety of e-cigarettes. While many users believe vaping poses fewer health risks than traditional smoking, emerging evidence points to potential harm, particularly concerning periodontal (gum) health.

How do vape pens harm the mouth?

Vape pens alter the biofilm (microorganisms growing on the surface) in the oral cavity, leading to an increase in certain inflammatory biomarkers (signs of normal or abnormal change/progress) such as interleukin (IL-β) and IL-8. These alterations contribute to inflammation of the gum (gingival inflammation), bleeding on probing, and deterioration of periodontal health. Additionally, the use of e-cigarettes has been linked to a decrease in saliva's antioxidant capacity, comparable to the effects of smoking traditional cigarettes. Use of e-cigarettes can also lead to dry mouth or reduced salivary secretions, also known as xerostomia which increases , the risk of dental caries.

What are the inherent risks in vape pen composition?

One of the significant complications is the risk of malfunction, including spontaneous failures and explosions within the oral cavity, resulting in severe injuries to both hard and soft tissues. Moreover, the presence of metals and metalloids in vape aerosols raises concerns due to their serious health effects, including cancer and cardiovascular disease.

What about the liquid used in these pens?

These liquids, commonly referred to as vaping juice, contain solvents such as propylene glycol (PG) and vegetable glycerin (VG), which are known airway irritants. High concentrations of nicotine in e-liquids pose toxicity risks, especially to children and adults upon exposure through inhalation, dermal (skin) contact, or ingestion. The addition of various flavors to e-liquids may also contribute to tooth discoloration, highlighting additional concerns for oral health.

Some tips for maintaining oral health in light of growing e-cigarette use?

Dental professionals play a crucial role in educating patients about the detrimental effects of vaping on oral health. Through regular dental check-ups dentists can raise awareness about the risks associated with e-cigarette use, particularly regarding periodontal disease. Teaching patients about the impact of vaping on gingival inflammation, dental caries (chronic infection), and other oral health issues should be integrated into preventive care strategies for patients of all age groups. Dental health professionals must incorporate discussions about e-cigarette use into routine patient assessments to gather valuable information to tailor preventive strategies and educate patients effectively.

How do vape pens compare with traditional cigarettes?

Recent investigations have highlighted the adverse effects of vaping on periodontal health. Studies have shown that smokers who switched to vaping experienced a significant increase in gingival inflammation within a short period. While vape pen users may exhibit fewer oral symptoms compared to traditional cigarette smokers, they are still prone to oral mucosal lesions (damage of tissue), black tongue, burns, nicotine stomatitis (inflammation of salivary glands), and hairy tongue.

Long-term use of vape pens has been associated with deteriorating periodontal health, gingival diseases, and marginal alveolar (part of jaws from where teeth arise) bone loss. Although vape pen users may experience relatively less destruction of periodontal tissues compared to smokers, the overall impact on oral health warrants further investigation through comprehensive, long-term studies.

(Dr. Prachi Neogi is Consultant Dentist at Bhailal Amin General Hospital in Vadodara)

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