Our recently-published meta-analysis of the association between e-cigarette use and disease (now available open access) found that the risks of e-cigarettes were indistinguishable for cardiovascular disease, stroke and metabolic dysfunction, but did find lower risks for respiratory and oral diseases. Specifically, the risk for oral disease in e-cigarette users was about 13% below that of cigarette smokers (OR 0.87, 95% CI 0.76 to 1.00), with similar effects in youth and adults. Priti Charde and colleagues’ new paper Effects of e-cigarette smoking on periodontal health: A scoping review helps explain this finding.
Charde and colleagues systematically reviewed the clinical literature on e-cigarette use and the initiation and progression of periodontal (gum) disease. They found that using e-cigarettes promoted inflammation of the gums, changed the bacteria living in the mouth (microflora) toward more harmful bacteria, and reduced the gums’ healing capacity. (Your mouth is constantly healing itself from the damage inflicted by eating.) They found more clinical periodontal disease as well as as less favorable response to treatment compared to non-smokers. These effects were, however, generally smaller in the e-cigarette users than the smokers, consistent with our results.
Here is the abstract:
Objectives
Use of electronic cigarettes (ECs), also known as vaping, has gained remarkable popularity globally during the last decade especially among young people. Current evidence suggests that vaping may be associated with health risks. The aim of this study is to evaluate whether vaping increases the risk for initiation and progression of periodontal disease; and to appraise the clinical changes seen in patients using e-cigarettes, and how these changes impact the management of periodontal disease.
Study selection, data and sources
A comprehensive electronic search was conducted on the PubMed, Scopus and Embase databases using the following search terms: Electronic Cigarettes OR vaping OR electronic nicotine delivery systems OR e-cigarettes AND Periodontitis. The search was limited to studies published from 1st January 2012 to 31st December 2022.
Results
A total of 23 clinical studies focusing on the effect of e-cigarette smoking on the periodontal clinical parameters, levels of inflammatory mediators, alteration in periodontal microflora, and response to periodontal treatment were found to be eligible for inclusion in the review. Vaping may be associated with greater clinical attachment loss (CAL) compared to non-smokers. Moreover, ECs are also associated with unfavorable effects on periodontal microbial counts, biomarkers of inflammation and oxidative stress.
Conclusions
Vaping may play a role in the initiation and progression of periodontal disease by altering the host response resulting in the release of inflammatory cytokines and periodontal microflora. Clinical studies show deleterious effects of vaping on periodontal health as well as less favourable response to periodontal treatment is observed in e–cigarette users compared to non-smokers. However, compared to cigarette smoking, the effects of vaping are less remarkable.
The full citation is: Charde P, Ali K, Hamdan N (2024) Effects of e-cigarette smoking on periodontal health: A scoping review. PLOS Glob Public Health 4(3): e0002311. https://doi.org/10.1371/journal.pgph.0002311. It is available for free here.
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