On top of their other health hazards, electronic cigarettes may help rot your teeth, a new study suggests.
Vaping appears to promote cavities, which can result in tooth loss if not treated quickly, experts say.
"If you are vaping, be aware that there are potentially some detrimental oral health effects," said lead researcher Dr. Karina Irusa, an assistant professor of comprehensive care at Tufts University School of Dental Medicine in Boston.
"If you do vape, make sure to mention this to your dentist because it may be important to make sure we customize your preventive routine to be a bit more aggressive than we would do for the average patient," she said.
In the United States, 9.1 million adults and 2 million teenagers use tobacco-based vaping products, according to the U.S. Centers for Disease Control and Prevention. That's a lot of potential tooth decay.
For the study, Irusa and her colleagues analyzed data from more than 13,000 patients treated at Tufts dental clinics from 2019 to 2022. All were 17 and older.
Although most patients didn't vape, the researchers found that 79% of those who did had a high risk for cavities, compared with about 60% of patients who didn't use e-cigarettes.
E-cigarettes may raise the risk of dental decay because the sugary content and stickiness of vaping liquid adhere to the teeth, Irusa said.
Vaping fluids also change the microbiome in the mouth, making it more friendly to decay-causing bacteria. And vaping seems to encourage decay in areas where it usually doesn't occur, such as the bottom edges of front teeth, she noted.
Some lab studies have found that the vapor from e-cigarette liquid promotes bad bacteria in the mouth.
"The bacteria that actually cause decay when they're exposed to this vapor seem to be more virulent, just more aggressive, and they can survive under more strenuous conditions," Irusa said.
"With e-liquids, we are also seeing similar issues with gum health that we would see in tobacco," she said.
"From the gum perspective as well as the tooth perspective, if you have a big cavity it only gets worse if nothing is done. Then you end up losing your tooth or need extensive dental work to try and save the tooth," Irusa explained.
Dentists should routinely ask about e-cigarette use as part of a patient's medical history, she said. That includes teens, since U.S. health officials have found nearly 8% of middle and high school students admitted using e-cigarettes in 2021, according to a Tufts news release.
Vapers should maintain a rigorous regimen of brushing and flossing, using prescription-strength fluoride toothpaste and fluoride rinse, and fluoride treatments. They also need checkups more often than twice a year, Irusa said.
Patricia Folan is director of clinical programs at the Northwell Health Center for Tobacco Control in Great Neck, N.Y. She said, "Although this study had several limitations, including the small sample size, the association between caries and e-cigarette use is a concern that potential and current e-cigarette users should consider."
Increasingly, research indicates that e-cigarettes are not as safe as advertised, Folan said. "E-cigarettes have been linked to high levels of addiction as well as cardiac and respiratory illness. Additional studies would be helpful to confirm the impact of e-cigarettes on dental health," she added.
"Health care providers, including dentists, should ask all patients about their tobacco use, including e-cigarettes, counsel them to quit, and provide them with resources to do so," Folan said. Those resources should include cessation medications and information about local programs and quitlines, she noted.
The report was published online Nov. 23 in the Journal of the American Dental Association.