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 in 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 European Federation of Periodontology (EFP) 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 vapour (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.

Andreas Stavropoulos, chair of the EFP’s scientific affairs committee and EFP immediate past president, explains, “Damage on the gums and the tissues supporting the teeth, often to an irreversible state, is a likely adverse effect of vaping.

“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 not to suggest vaping as a transition strategy of tobacco cessation, but rather to prioritise 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.”

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 discolouration, caries, tooth sensitivity and loss, increased cariogenic, reduced enamel hardness, and increased risk for cancer.

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