Study: Vaping leads to dental decay

A new study, published in the Journal of the American Dental Association, found patients who said they used vaping devices were more likely to have a higher risk of developing caries. 

Likening the use of e-cigarettes to going to bed sucking on a lollipop, Dr Karina Irusa, author and assistant professor of comprehensive care at Tufts University School of Dental Medicine, said the aerosolized e-liquid used in vape pens may cover teeth in a sugary, sticky film that promotes bacteria growth.

Dr Irusa and her colleagues analyzed data from more than 13,000 patients older than 16 who were treated at Tufts dental clinics from 2019-2022.

Too little emphasis on link between vaping and oral health

While there has been increased public awareness about the dangers of vaping to systemic health – for example, dental research has shown ties between e-cigarette use and gum disease, and damaged tooth enamel – Dr Irusa noted that relatively little emphasis has been focused on the association between vaping and oral health.

The researchers observed a statistically significant difference in dental caries risk levels between the e-cigarette/vaping group and the control group. 

About 79 per cent of the vaping patients were categorized as having high-caries risk, compared to just about 60 per cent of the control group. 

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

Adding artificial sweeteners and flavorings to the sticky aerosol may increase the caries risk factor.. “The sugar is what the bacteria feeds on,” Irusa said.

Vaping takes an “aesthetic toll”

While vaping aerosols have been shown to change the oral microbiome – making the mouth a breeding ground for decay-causing bacteria – it has been observed that the use of e-cigarettes encourages decay in areas where it usually doesn’t occur, including the bottom edges of front teeth. 

“It takes an aesthetic toll,” Irusa says.

The researchers recommend that dentists should routinely ask about e-cigarette use as part of a patient’s medical history. This advice also applies to dentists who see adolescents, including middle- and high-school students.

The researchers also suggest patients who use e-cigarettes should be considered for a “more rigorous caries management protocol,” which 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 said. “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.”

Read the full article: A comparison of the caries risk between patients who use vapes or electronic cigarettes and those who do not – a cross-sectional study.