Vaping e-cigarettes can be as harmful to gum and oral health as smoking traditional cigarettes

Reviewed by Lily Ramsey, LLMSep 7 2023

For years, it has been known that smoking can contribute to serious damage on gum and oral health, with smokers having more gum diseases, more tooth loss, and increased levels of oral cancer. It has also been known that gum disease can play a negative role on systemic health, e.g., it is implicated in diabetes, cardiovascular diseases, chronic respiratory diseases, inflammatory bowel disease, and others.

In parallel, regular warnings against vaping usually only highlight its damage to the heart and lungs, but do not refer to oral health.

The EFP (European Federation of Periodontology) warns that vaping electronic cigarettes can be as harmful to gum and oral health as smoking traditional tobacco cigarettes. Despite the fact that the vaping phenomenon is relatively new compared to smoking, meaning research details are still incomplete, evidence does show a clear link between e-cigarettes and poor gum and oral health.

Unlike tobacco smokers, who are more aware of smoking as a risk factor for general health problems and for gum diseases, vaping users are often misled to think of e-cigs as somehow less harmful or even safe. Vaping may not be less detrimental to gum and oral health than smoking.

One of the reasons behind vaping's unhealthy impact is nicotine, whether smoked or vaped, which restricts the blood flow to the gums. Other chemicals contained in the e-cig vapor (including formaldehyde, propylene glycol, and benzene) may aggressively increase the damage to the mouth, starting with a progressive destruction of the periodontium, the tissues supporting the teeth.

Unfortunately, the number of vapers is growing globally at a fast rate. This uptake appears to be higher amongst teenagers, young adults, and people who have never smoked taking up this potentially damaging habit. "Damage on the gums and the tissues supporting the teeth, often to an irreversible state, is a likely adverse effect of vaping," highlights Andreas Stavropoulos, chair of the EFP's scientific affairs committee and EFP immediate past president. "This damage includes permanent resorption of the gums and the bone that keep the teeth in function and in the mouth. Treatment of these problems, depending on the extent, is often cumbersome, and expensive."

"For these reasons, at the EFP we urge oral healthcare professionals to not suggest vaping as a transition strategy of tobacco cessation, but rather to prioritize smoking cessation advice for both cigarettes and e-cigarettes alike, and to provide patients with information about the likely detrimental impact of vaping on gum and oral health," recommends Prof Stavropoulos.

Besides, vaping can harm oral health in a variety of additional ways, including bad breath, mouth and throat irritation, para-tracheal edema, laryngitis, black tongue, nicotine stomatitis, hairy tongue, toothache, tooth discoloration, caries, tooth sensitivity and loss, increased cariogenic, reduced enamel hardness, and increased risk for cancer.

EFP, global benchmark in periodontology

The EFP (European Federation of Periodontology, www.efp.org) is a non-profit organization dedicated to promoting awareness of periodontal science and the importance of gum health for oral-health professionals and the public. Its guiding vision is "Periodontal health for a better life".

Founded in 1991, the EFP is a federation of 38 national periodontal societies representing more than 16,000 periodontists, dentists, researchers, and oral-health professionals in Europe and around the world. It organizes events and campaigns grounded in evidence-based science in periodontal and oral health, including EuroPerio (the world's leading congress in periodontology and implant dentistry), Perio Master Clinic, and Perio Workshop. Gum Health Day, its awareness campaign for the public celebrated annually on 12 May, brings key messages on gum health to millions of people across the world.

The EFP also organizes workshops and outreach campaigns with its partners: past projects have covered the relationship between periodontal disease and diabetes, cardiovascular disease, and caries, as well as women's oral health during pregnancy.

The extensive list of EFP publications include the Journal of Clinical Periodontology, the research summary JCP Digest, and the online magazine Perio Insight, which offers expert views on periodontal science and clinical practice. The federation's work in education is also highly significant, notably its accredited university-based programs for postgraduate education in periodontology and implant dentistry.

The EFP has no professional or commercial agenda.