Dentists have long known about the impact of cigarette smoking and the use of nicotine products on the teeth and gums. The foremost impact is to the total health of the patient who smokes or uses products containing nicotine by increasing their risk of developing oral cancer. Additional risks of using these products include tooth decay, periodontal infections, and gum tissue loss. Many patients have made the switch from smoking to electronic cigarettes in order to reduce the risks to their health. While many patients have been lulled into thinking e-cigarettes is a safer option, new research has found that these alternatives still post a significant risk to users’ health and are not as safe as once thought.
E-cigarettes are handheld, battery-powered devices in which users place a cartridge of flavored liquid. The liquid is made up of water, nicotine, and usually, has a flavoring component. This liquid turns into a vapor when warmed by the e-cigarettes heating device. The vapor is then inhaled into the lungs much like smoke from a conventional cigarette.
In a 2016 study published in the journal, Oncotarget, researchers reported their findings regarding e-cigarettes. Researchers on the project exposed gum tissue of nonsmokers to flavored e-cigarette vapor. One flavoring they used was tobacco flavoring, which contained 16 milligrams of nicotine, the other type was menthol flavoring, and this contained 13 to 16 milligrams or no nicotine at all. In some cases, the vapor actually showed to be more harmful to these cells than tobacco cigarette smoke, with 40 to 53 percent of mouth cells dying within three days. Results showed that e-cigarette vapor was as dangerous as cigarette smoke and in some cases more, to the epithelial cells of the mouth.
The epithelial cells of the mouth are the body’s first line of defense against disease-causing bacteria and viruses. They also aid in digestion, helping to break down food. These cells provide moisture to the tissues of the mouth and help to facilitate swallowing.
"The epithelial cells of the mouth are important in the protection of the health of the mouth and the body," says Dr. James Erpenbach, D.D.S. Erpenbach is a Knoxville, Tennessee, dentist who cautions his patients about the danger of using tobacco products – including e-cigarettes. "The research regarding these devices has been extremely limited. There is no official Food and Drug Administration ruling that says they are safe to use," he explains.
Despite no FDA ruling confirming their safety, electronic cigarette use is on the rise. This is because many people believe them to be a safer option, or use them as a step-down device from cigarettes. One group that is using them at an alarming rate is teenagers. The Centers for Disease Control reported in 2015 that 16 percent of high school students were using e-cigarettes, up from 1.5 percent in 2011. "It is concerning that teens are using these devices," says Erpenbach.
Not only did researchers find that e-cigarette vapors kill off mouth cells, but they also found that before the cells die, they produce proteins that cause inflammation in the mouth. This inflammation is damaging to oral tissues and becomes a gateway for infections and illness.
Nicotine is already a known cause of periodontal diseases, but when combined with e-cigarette’s dangerous vapors, more harm occurs. "The irony of the situation is that users of e-cigarettes think they are using a much safer option when the reality is they’re just causing another kind of damage," says Erpenbach.
Erpenbach urges patients using nicotine products and e-cigarettes to quit in order protect their oral and total health. Patients using these products should also ask their dental providers about oral cancer screenings at their regular dental checkups.