Electronic Cigarettes and Periodontal Diseases

Author: Gum Specialist Dr Chandni

Electronic cigarette usage (vaping), has been a hot topic in oral health over the last few years, but so many of us are confused on what we should be advising our patients. So, let’s break it down to what know. E-cigarettes (vapes) heat a liquid to generate vapour that the user inhales. The liquid can come in various flavours but is usually made of vegetable glycerine, propylene glycol and nicotine.

Is vaping just as harmful as using cigarettes?
Cigarettes have many poisonous and carcinogenic substances. Although, vapes may contain harmful substances, the levels are generally much lower than in cigarettes. This makes vapes less harmful in comparison. However, it is important to note that they are not completely risk free.

What risks do vapes have?
The short-term effects can include throat/mouth irritation, headaches, coughing and nausea. The long-term effects are not fully understood. EVALI (e-cigarette or vaping product use-associated lung injury) was thought to be linked to vapes containing THC or vitamin E acetate. These are both banned from the legal products that are regulated in the UK.

Are we just swapping one bad habit to another?
Out of the two, not only is vaping is less harmful than smoking, but it also contains less nicotine. Therefore, switching from cigarettes to vaping immediately reduces the exposure to these toxins. Studies have shown vapes are an effective method for smoking cessation. Although it is not uncommon to find smokers using a vape more often than they would a cigarette, the health risks are still lower in the vape. Generally, vapes are also cheaper than cigarettes. Therefore, vapes may provide a more successful transition to cessation for cigarette users.

Should former smokers stay on vapes forever?
Although vapes are less harmful than cigarettes, they are not completely risk-free. When the user feels ready and sure that they will not relapse back to cigarettes, they can gradually reduce the nicotine strength in their vape and reduce the amount they use the vape until they are fully nicotine-free and have stopped completely. This should only be done when there is no risk that they may relapse back onto cigarettes.

There are so many different vapes, so how do we know what is in them?
Providing the vapes are bought legally from a reputable supplier, they would have had to pass MHRA regulations.

How does this affect the gums?
This has been controversial in the studies. Some have shown that the risk of periodontal disease was less in vaping than in cigarette use, whereas others have shown that vaping can have the same risk as cigarettes. Other studies have also shown that vaping had a similar response to periodontal treatment outcomes to cigarette users. More research is required to fully understand these effects further.

So, where does this leave us? From what we know, vaping may not be as harmful as cigarettes, but this does not mean they are completely risk-free, and their long-term effects are still not fully understood. Therefore, vapes can be recommended to help support adults to stop smoking, but they should not be recommended to young children or to those who have never smoked cigarettes.