E-cigarette use may cause tooth decay

The habit of vaping may lead to a dim smile and more frequent visits to the dentist
.

Researchers at Tufts University School of Dental Medicine found that patients who used e-cigarettes were more likely to develop tooth
decay.
The Centers for Disease Control and Prevention investigation reported that 9.
1 million U.
S.
adults and 2 million teens use tobacco e-cigarette products, which means a lot of fragile teeth
.

Karina Irusa, assistant professor of integrative care and first author of the paper, said the study's findings on the relationship between e-cigarettes and the risk of dental caries, the dental term for dental caries, serve as a warning that this once-seemingly harmless habit can be very harmful
.
The study was published Nov.
23 in
the Journal of the American Dental Association.

Over the past few years, public awareness of the dangers of e-cigarettes to whole-body health has increased, especially after the use of
e-cigarette devices has been linked to lung disease.
Several dental studies have shown a link
between e-cigarette use and increased markers of gum disease, as well as enamel damage to tooth shells, respectively.
But Irusha says that even dentists pay little attention to the intersection
between e-cigarette use and oral health.

Irusha said Tufts' recent findings may just be a hint
of the damage e-cigarettes are causing to the mouth.
"The extent of the impact on dental health, particularly tooth decay, is still relatively unknown
," she said.
"At this point, I just want to raise awareness
among dentists and patients.
"

Irusha said the study is the first to specifically investigate the relationship between e-cigarettes and e-cigarettes and an increased risk of tooth decay
.
She and her colleagues analyzed data from more than 13,000 patients over the age of 16 who were treated
at Tufts Dental Clinic from 2019 to 2022.

Irusha found that while the vast majority of patients said they did not use e-cigarettes, there was a statistically significant difference in the level of caries risk between the e-cigarette/vaping group and the control group
.
About 79% of vaping patients were classified as patients at high risk of dental caries, compared with only about
60% in the control group.
The researchers did not ask e-cigarette smokers whether they used e-cigarettes containing nicotine or THC, although nicotine is more common
.

"It's important to understand that this is only preliminary data," Irusa said
.
"It's not 100% certain, but people do need to be aware of what we're seeing
.
" Further research is needed, and Irusa wants to take a deeper look at how e-cigarettes affect saliva microbes
.

One reason e-cigarette use may lead to a high risk of tooth decay is the sugar content and viscosity of e-cigarette liquids, which stick to teeth when inhaled through the mouth after atomization
.
(A 2018 study published in the journal PLoS Comprehensive compared the properties of sweetened e-cigarettes to gummies and acidic beverages
.
) E-cigarette aerosols have been shown to alter the oral microbiome, making it more suitable for decay-causing bacteria
.
It has also been observed that vaping appears to promote decay in areas where tooth decay does not normally occur
, such as the bottom edge of the incisors.
"It's aesthetically detrimental
," Irusa said.

Researchers at Tufts University suggest that dentists should periodically ask patients about their e-cigarette use as part of
their patients' medical history.
This includes pediatric dentists who see teens — 7.
6 percent of middle and high school students said they used e-cigarettes
in 2021, according to the FDA/CDC.

The researchers also recommend that patients who use e-cigarettes should consider a "stricter caries management regimen," which may include prescribed doses of fluoride toothpaste and fluoride mouthwash, use of fluoride drugs in the office, and more than two check-ups
per year.

"Managing caries requires a significant investment of time and money, depending on how severe
the caries is," Irusa said.
"Once you get into this habit, even if you fill your teeth, as long as you continue, you are still at risk
of developing secondary caries.
It's a vicious circle
that won't stop.
”

Steven Eisen of Tufts University School of Dental Medicine is the senior author
of the paper.
Full information about authors and conflicts of interest can be found
in published papers.

Journal Reference:

1. Karina F.
   Irusa, Matthew Finkelman, Britta Magnuson, Terence Donovan, Steven E.
   Eisen.
   A comparison of the caries risk between patients who use vapes or electronic cigarettes and those who do not.
   The Journal of the American Dental Association, 2022; 153 (12): 1179 DOI: 10.
   1016/j.
   adaj.
   2022.
   09.
   013