E-Cigarettes/Vaping and Oral Health: Effects on Periodontal Tissues, Caries Risk, and the Oral Microbiome

https://doi.org/10.5281/zenodo.18454248

Abstract

The number of users of e-cigarettes and vaping devices has been increasing rapidly, especially in adolescents and young adults, raising increasing concern over both the short-term and long-term effect on oral health. The narrative review is a synthesis of the existing evidence on the impacts of vaping on the periodontal tissues, dental caries risk, and the oral microbiome. Existing clinical and experimental literature indicates that e-cigarette aerosol may induce inflammation of the gingiva, reduce the ability to heal periodontally, and be the cause of dysregulated host immune responses due to oxidative stress and pro-inflammatory pathways. New evidence further suggests that vaping can change saliva composition and flow, which could alter buffering capacity and antimicrobial activity and that some flavored e-liquids and nicotine-containing aerosols can alter enamel demineralization processes and bacterial adhesion and thus is plausibly likely to lead to caries susceptibility. Microbiome-centered studies show that vaping can be linked with quantifiable changes in the structure of oral microbial population such as the enrichment of opportunistic and inflammation-related taxa, which may predispose to the development of periodontal diseases and irritation of oral mucosal tissues. Nevertheless, the evidence base is heterogenous, and the limitations are small samples, imprecise measurement of exposure, short follow-up, and dual use of conventional tobacco confounding. Altogether, existing data confirms that vaping is biologically plausible in its association with unfavorable oral health effects, specifically, disrupted microbiome and inflammatory periodontal reactions. Standardized exposure definitions and outcomes of clinical importance require further longitudinal research to elucidate dose-response relationships, take out nicotine and flavoring agents, and provide guidance on dental public health and chairside counseling.