“Once you’ve started the habit [Vaping E-cigarettes], even if you get fillings, as long as you continue, you’re still at risk of secondary caries. It’s a vicious cycle that will not stop,” warns the author.

A vaping habit could lead to a ruined smile and more dental visits.

Researchers at Tufts University School of Dental Medicine showed that patients who reported using vaping devices had a much-increased chance of getting cavities. According to studies conducted by the CDC, 9.1 million American adults and 2 million American teenagers already use tobacco-based vaping products. This translates to a significant number of teeth that are at risk.

The results of this study on the association between vaping and the risk of caries — the dental term for cavities — serve as a warning that this once-appealingly harmless habit may be extremely harmful, according to Karina Irusa, assistant professor of comprehensive care and the paper’s lead author. The work was published in The Journal of the American Dental Association today.

The public’s knowledge of the dangers of vaping to systemic health has increased in recent years, particularly since the use of vaping devices was linked to lung disease. The dental literature suggests that e-cigarette usage is associated with an increased risk of gum disease and, separately, with enamel damage. However, Irusa notes, the connection between e-cigarette usage and oral health has received little attention, even from dentists.

According to the author, the recent Tufts finding is just a hint of the damage vaping causes to the mouth.

“The extent of the effects on dental health, specifically on dental decay, are still relatively unknown,” she adds. “At this point, I’m just trying to raise awareness,” among both dentists and patients.

According to Irusa, this investigation is the first known study that precisely investigates the relationship between vaping and e-cigs with the higher risk of having cavities. Together with her fellow researchers, she evaluated data from almost 13,000 patients older than 16 who were seen at dental clinics run by Tufts University between 2019 and 2022.

Irusa discovered a statistically significant difference in dental caries risk between the e-cigarette/vaping group and the control group, despite the fact that the great majority of patients reported not using vapes. In comparison to roughly 60% of the control group, about 79% of the vaping patients were classified as high-caries risk. Vaping patients weren’t asked if they utilized nicotine or THC devices, albeit nicotine is more common.

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

Irusa plans to examine in further detail how vaping impacts the microbiology of saliva in future research.

The sweet substance and viscosity of vaping liquid, which when aerosolized and subsequently breathed through the mouth, clings to the teeth, is one factor why using e-cigarettes could increase the risk of cavities. (According to a 2018 study published in the journal PLOS One, the qualities of sweet-flavored e-cigarettes are similar to gummy candies and acidic drinks.) It has been demonstrated that vaping aerosols alter the oral microbiota, making it more conducive to decay-causing bacteria. It has also been noticed that vaping appears to promote decay in regions where it does not normally occur, such as the bottom edges of front teeth. 

“It takes an esthetic toll,” Irusa adds.

The Tufts researchers say that dentists should always ask their patients about their use of e-cigarettes as part of their medical history. That includes pediatric dentists who treat teenagers; in 2021, 7.6% of middle- and high-school students reported using e-cigarettes, according to the FDA/CDC.

The researchers also say that people who use e-cigarettes should be considered for a “more rigorous caries management protocol.” This could include prescription-strength fluoride toothpaste and fluoride rinse, in-office fluoride applications, and checkups more often than twice a year.

“It takes a lot of investment of time and money to manage dental caries, depending on how bad it gets,” Irusa points out. “Once you’ve started the habit, even if you get fillings, as long as you continue, you’re still at risk of secondary caries. It’s a vicious cycle that will not stop.”

Source: 10.1016/j.adaj.2022.09.013

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