Dental News - New research outlines vaping’s unique connection to periodontal disease

Anisha Hall Hoppe, Dental Tribune International

Fri. 11. March 2022

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NEW YORK, US: Smoking tobacco has long been known to be detrimental to oral health, but the risks of newer simulations of smoking such as vaping are less well-known though they are often believed to be healthier alternatives. Now, researchers from the New York University (NYU) College of Dentistry have completed the first study on the oral health of users of e-cigarettes. They found that vaping created a unique periodontal microbiome, compared with that of non-smokers and conventional cigarette smokers, and that participants who vaped experienced a worsened state of periodontal disease at the end of the study.

The study compared the bacterial composition and cytokine concentrations of the subgingival plaque in conventional cigarette smokers, e-cigarette users and non-smokers over the course of six months. The participants in all groups exhibited some evidence of periodontal disease at baseline.

In the e-cigarette users, the detected cytokine levels indicated inflammation, but some cytokines were at lower levels than expected. The researchers believe this was possibly due to the strains of bacteria present in those who vaped but not present in those who smoked or who had never smoked. The researchers hypothesised that it was possible that these bacteria were actively supressing the immune reactions that would normally have been expected.

Co-author of the study Fangxi Xu, a junior research scientist at NYU, said in a press release: “Vaping appears to be driving unique patterns in bacteria and influencing the growth of some bacteria in a manner akin to cigarette smoking, but with its own profile and risks to oral health.”

Even worse was the finding that clinical attachment loss after six months was signficantly worse in the e-cigarette smokers. This was measured in the same groups of participants but in a separate, earlier study.

Lead author of the most recent study Dr Scott Thomas, an assistant research scientist at NYU, said of the findings: “E-cigarette use is a relatively new human habit. Unlike smoking, which has been studied extensively for decades, we know little about the health consequences of e-cigarette use and are just starting to understand how the unique microbiome promoted by vaping impacts oral health and disease.”

More long-term research is needed for dentists to feel comfortable offering counsel to their patients regarding e-cigarette use. E-cigarettes and alternative tobacco products fall under the umbrella of what some call tobacco harm reduction.

Dental Tribune International reported that a survey of German dentists by the German subsidiary of Philip Morris International (PMG), a cigarette company moving towards smoke-free products, found that 58% of the respondents did not feel informed on the subject of tobacco harm reduction and that 69% were not aware of the concept.

Dr Charilaos Avrabos, then PMG’s manager of scientific and medical affairs, claimed in a 2018 press briefing regarding the survey that “it is clear that e-cigarettes are not risk-free products; neither are tobacco heating devices. For non-smokers, these are not products that offer any benefits. For smokers, who use the most damaging form of nicotine delivery continually over a period of years, switching to these products can make a huge difference by reducing the amount of harmful substance.”

However, PMG’s claims seem to be contradicted by the findings of the NYU research and the results of a 2020 study on vaping’s effect on periodontal health. Senior author of that study Dr Purnima Kumar, professor of periodontics at Ohio State University, said: “If you stop smoking and start vaping instead, you don’t move back toward a healthy bacterial profile but shift up to the vaping profile. Knowing the vaping profile is pathogen-rich, you’re not doing yourself any favours by using vaping to quit smoking.”

The recent study, titled “Electronic cigarette use promotes a unique periodontal microbiome”, was published in the February 2022 issue of mBio.