Study shows link between vaping and risk of tooth decay

A vaping habit could lead to a dull smile and more frequent visits to the dentist.

Research by faculty from the Tufts University School of Dental Medicine found that patients who reported using a vaping device were more likely to have a higher risk of cavities. With CDC surveys reporting that 9.1 million American adults and 2 million teenagers use tobacco-based vaping products, that means a lot of vulnerable teeth.

This study’s finding of an association between vaping and the risk of tooth decay — the dental term for cavities — serves as a warning that this once-seemingly harmless habit can be very harmful, says Karina Irusa, assistant professor of comprehensive care and lead author. on paper. The study was published on November 23 Journal of the American Dental Association.

Over the past few years, public awareness of the systemic health risks of vaping has increased, especially after the use of vaping devices was linked to lung disease. Some dental research has shown a connection between the use of electronic cigarettes and increased markers of gum disease and especially damage to tooth enamel, its outer shell. But relatively little attention has been paid to the intersection between e-cigarette use and oral health, even by dentists, Irusa says.

Irusa says the recent Tufts finding may be just an indication of the damage to the mouth that vaping causes. “The extent of the effects on dental health, specifically tooth decay, is still relatively unknown,” he says. “At this point, I’m just trying to raise awareness,” both among dentists and patients.

This study, Irusa says, is the first known to specifically examine the association of vaping and e-cigarettes with an increased risk of cavities. She and her colleagues analyzed data from more than 13,000 patients over the age of 16 who were treated at Tufts dental clinics from 2019-2022.

While the vast majority of patients reported not using vaping, there was a statistically significant difference in the level of tooth decay risk between the e-cigarette/vaping group and the control group, Irusa found. About 79% of vaping patients were categorized as being at high risk of dental caries, compared to just 60% of the control group. Vaping patients were not asked whether they used devices containing nicotine or THC, although nicotine is more common.

It is important to understand that this is preliminary data. It’s not 100% conclusive, but people need to be aware of what we’re seeing.”

Karina Irusa, assistant professor of comprehensive care and lead author of the post

More studies need to be done, and Irusa wants to take a closer look at how vaping affects the microbiology of saliva.

One of the reasons why e-cigarette use could contribute to a high risk of tooth decay is the sugar content and viscosity of the vaping liquid, which sticks to the teeth after being aerosolized and inhaled through the mouth. (A 2018 study published in the journal PLOS One compared the properties of sweet-flavored e-cigarettes to gummy candies and fizzy drinks.) Oral aerosols have been shown to alter the oral microbiome, making it more hospitable to decay-causing bacteria. It has also been observed that vaping appears to promote decay in areas where it does not normally occur – such as the bottom edges of the front teeth. “It takes an aesthetic toll,” says Irusa.

Tufts researchers recommend that dentists routinely ask about e-cigarette use as part of a patient’s medical history. This includes pediatric dentists who see adolescents – 7.6% of high school and college students report using e-cigarettes in 2021, according to the FDA/CDC.

The researchers also suggest that patients who use e-cigarettes should consider a “more rigorous caries management protocol,” which could include prescription fluoride toothpaste and fluoride rinses, in-office fluoride applications, and checkups more often than twice a year.

“Managing tooth decay takes a lot of time and money, depending on how bad it gets,” says Irusa. “Once you start the habit, even if you get fillings, if you continue, you’re still at risk of secondary decay. It’s a vicious cycle that won’t stop.”

Steven Eisen of Tufts University School of Dental Medicine is the lead author of this article. Full information on authors and conflicts of interest is available in the published article.


Link to journal:

Irusa, KF, et al. (2022) Comparison of dental caries risk between patients who use vapes or electronic cigarettes and those who do not. Journal of the American Dental Association.

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