The impact of vaping on oral health: what you need to know
In recent months, media reports have raised alarms about the potential dangers of vaping on oral health. Some claim that vaping is as harmful, if not more so, than smoking. However, these claims often lack supporting evidence. Let’s have a look at the evidence.
What experts say about vaping
Professor Sir Chris Whitty, the Chief Medical Officer for England, said last year: “If you smoke, vaping is much safer; if you don’t smoke, don’t vape.”
General health effects of vaping
Extensive reviews, such as the 2018 report by the National Academies of Science, Engineering and Medicine (NASEM), indicate that e-cigarettes are likely far less harmful than traditional cigarettes. However, the long-term health effects, especially for youth, remain uncertain.
The Office for Health Improvement and Disparities (OHID) 2022 report supports this view, stating that “vaping poses only a small fraction of the risk of smoking,” while cautioning that vaping is not risk-free, particularly for non-smokers.
Despite these expert opinions, public perception has shifted. In 2023, 39% of adult smokers believed e-cigarettes were as harmful as cigarettes, a significant increase from 7% in 2013.
Vaping and periodontal health
Smoking is a well-known risk factor for periodontal disease, prompting concerns about the effects of e-cigarettes on gum health. Studies show mixed results. The 2018 NASEM report suggested that switching to e-cigarettes might improve periodontal health for smokers, though this evidence is limited.
A 2020 systematic review indicated that switching to e-cigarettes could alleviate oral symptoms for smokers but might still pose oral health risks. Similarly, a 2021 review in the Journal of Dental Research found that the risk of periodontal disease from vaping was less than smoking but higher than non-smoking.
The 2022 OHID annual review included numerous studies but found no new evidence that would alter these conclusions. A 2022 meta-analysis found periodontal health parameters to be similar between non-users and e-cigarette users, with traditional smokers faring worst.
Recent studies, including a large US cohort, found no significant associations between vaping and serious gum issues, though some indicated an increase in bleeding after brushing or flossing.
E-cigarettes and the oral microbiome
Research on how e-cigarettes affect the oral microbiome suggests that vaping can alter the microbial balance, potentially leading to dysbiosis, a harmful imbalance of microbes. However, these studies often involve former or current smokers, complicating the interpretation of results. Longitudinal studies are needed to understand the clinical impacts of these changes.
Vaping as a smoking cessation aid
A Cochrane systematic review, including 78 studies, found high-certainty evidence that e-cigarettes are more effective than traditional nicotine replacement therapies (NRT) in helping smokers quit. Another review focused on dental settings found limited but promising evidence for e-cigarettes in smoking cessation.
What’s the current guidance on e-cigarettes for smoking cessation?
UK healthcare professionals have comprehensive guidance:
- NHS Information: Provides resources on using e-cigarettes to stop smoking and debunks vaping myths.
- NICE Guidance: Recommends discussing nicotine-containing products, including e-cigarettes, with patients.
- OHID Reviews: Annual, expert, independent evidence reviews commissioned by Public Health England.
Youth vaping and disposable products
Vaping is not recommended for children or young people. There has been a worrying increase in youth vaping, driven by disposable e-cigarettes. The UK government is currently consulting on measures to reduce youth vaping and enforce age restrictions.
The bottom line
E-cigarettes are less harmful than traditional cigarettes but are not risk-free. For non-smokers, especially young people, vaping is not recommended. For smokers, e-cigarettes can be an effective tool for quitting smoking, and dental professionals should support patients who choose this method.
Both smoking and vaping can cause discolouration of the teeth. You may notice — if you vape frequently — that your teeth are starting to turn yellow. A professional dental hygiene treatment can help here, and Well:o also offers teeth whitening.
