e-cigarette use.1 “As well, the devices, the liquids and the flavouring vary a great deal. On top of that, people tend to vape differently. Some vape all day long, while others only vape occasionally.” The systematic review included 99 studies; among them, there were eight randomized control trials, 11 quasiexperimental studies, 46 correlational or descriptive studies, 15 case reports, and 19 in vitro studies. “Unfortunately, we found that the strength of most of the studies was weak to moderate in terms of evidence for oral health impact,” says Dr.Yang. “But we did identify a few trends that might help guide future research.” The review’s overarching finding is that the impacts of vaping on oral health seem to be less harmful than traditional smoking (for which the oral health sequelae is well understood) but more than not smoking at all. “It seems to fall somewhere in-between. Still, evidence suggests that vaping is associated with periodontal disease, cellular damage, and changes in the oral microbiome,” Dr. Yang says. Toxicology studies have identified components in vaping products that negatively impact human health, including nicotine, diacetyl, ultrafine particulate matter, volatile organic compounds like benzene, and heavy metals like nickel, tin, and lead. Descriptive findings from Dr. Yang’s review suggest that vaping may have dental consequences: e-liquid flavour constituents may play a role in demineralization of enamel and encouraging the growth of cariogenic bacteria. “Sweet and fruity flavours seem to have more significant dental impacts,” says Dr. Yang. “And those flavours also tend to be more popular with young people.” Dr. Yang says that many of the studies in the review were designed to see if the overall health effects of vaping were better than traditional cigarette use, and information about oral health was gathered incidentally. “It’s been hard to filter out vaping from other confounding variables that influence oral health, such as age, general health, and traditional cigarette or cannabis smoking, among others,” says Dr. Yang. “In the next few years, I expect that betterdesigned and larger studies will give us a clearer idea of what vaping does to our mouths and teeth.” Reference 1. Yang I, Sandeep S, Rodriguez J. The oral health impact of electronic cigarette use: a systematic review. Crit Rev Toxicol. 2020 Feb;50(2):97-127. Main Findings of Systematic Review E-cigarette exposure increased the risk for deteriorating periodontal, dental and gingival health as well as changes to the oral microbiome. The majority of mouth and throat symptoms experienced by e-cigarette users were relatively minor and temporary, with some evidence that conventional smokers who switched to e-cigarettes experienced mitigation of these symptoms. Extensive dental damage as a result of e-cigarette explosions were described in case reports. Components of e-cigarette vapor have known cytotoxic, genotoxic, and carcinogenic properties. 31 Issue 4 | 2023 | SupportingYour Practice
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