E-Cigs, Heated Tobacco Linked to Whiter Teeth in Study

Key Takeaways

• Current smokers exhibit significantly lower dental whiteness compared to never smokers and former smokers.
• Exclusive use of e-cigarettes (ECs) and heated tobacco products (HTPs) correlates with improved dental color parameters, nearing those of non-smokers.
• Differences in whiteness between EC/HTP users and smokers are visually noticeable (ΔWID >2.9 units).
• Study highlights potential cosmetic benefits for smokers switching to tar-free nicotine products.

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Introduction

A recent study published on ScienceDirect investigates the impact of e-cigarettes (ECs) and heated tobacco products (HTPs) on dental color parameters compared to conventional cigarette smoking. As smoking remains a leading cause of tooth discoloration, the research explores whether transitioning to non-combustible nicotine delivery systems could mitigate this aesthetic concern.

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Study Details

The cross-sectional study evaluated 89 participants across five groups: current smokers, former smokers, never smokers, exclusive EC users, and exclusive HTP users. Dental color was measured using digital spectrophotometry, focusing on the CIE Lab* system and the Whiteness Index for Dentistry (WID). Higher WID values indicate whiter teeth, while ΔE* values assess perceptible color differences.

Participants were matched for age and gender, with strict exclusion criteria to minimize confounding factors. Current smokers showed median exhaled carbon monoxide (eCO) levels of 14.5 ppm, while EC/HTP users and non-smokers had eCO levels <7 ppm.

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Key Findings

Current smokers demonstrated the lowest WID values (13.38 units), reflecting poorer dental whiteness, compared to never smokers (19.96 units) and former smokers (16.79 units). Notably, EC users (16.72 units) and HTP users (17.82 units) exhibited WID values closer to non-smokers.

The ΔWID difference between smokers and EC/HTP users exceeded 2.9 units, surpassing the threshold for visible whiteness variation. ΔE* analysis revealed “clearly visible and clinically disturbing” color differences between smokers and never smokers (ΔE* = 4.102), while comparisons between ex-smokers and EC users showed no perceptible difference (ΔE* = 0.415).

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Clinical Implications

The study underscores potential cosmetic benefits for smokers switching to ECs or HTPs. “Use of alternative nicotine delivery systems may be associated with cosmetic benefits with important implications for those smokers perceiving dental aesthetics as a significant problem,” the authors note.

For younger demographics, aesthetic improvements could serve as a motivator to quit smoking. “An oral-based narrative may be a much more significant reason to refrain from smoking than the fear of developing smoking-related diseases,” the researchers suggest.

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Limitations and Future Research

While the findings are promising, the study acknowledges limitations, including its small sample size and cross-sectional design, which precludes causal conclusions. The authors call for larger, prospective trials to validate results and assess long-term effects.

Additionally, factors like coffee or red wine consumption—known to stain teeth—were not fully accounted for. Future research should incorporate standardized controls for such variables.

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Conclusion

The study provides evidence that ECs and HTPs, which lack combustion-generated tar, may reduce tooth discoloration compared to conventional smoking. While not without limitations, the research highlights a tangible aesthetic incentive for smokers to transition to tar-free alternatives.

This article summarizes findings from a study published on ScienceDirect. Funding was provided by ECLAT Srl. via a grant from the Foundation for a Smoke-Free World. The authors declared no direct conflicts of interest.