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First-ever study finds link between vaping and dental caries incidence

New research has reported that the use of e-cigarettes and vaping devices is associated with a higher risk of dental caries. (Image: art_of_galaxy/Shutterstock)

BOSTON, US: Adding to existing evidence on the link between vaping and a deterioration in oral health, researchers from Tufts University School of Dental Medicine have recently assessed the association between e-cigarette and vaping device use and caries risk level. They found that vaping increased the risk of developing caries in patients. Given the findings, they recommended that the use of e-cigarettes and vaping devices should not only be included in routine dental and medical history questionnaires but should also be regarded as being among the risk factors that increase a patient’s caries risk level.

According to the Centers for Disease Control and Prevention (CDC), approximately 9.1 million American adults and two million teenagers use tobacco-based vaping products. However, despite growing evidence linking vaping to a deterioration in systemic health, there is little public awareness of this issue. Previous research has reported that using electronic vaping devices may increase the risk of developing periodontal disease and damage tooth enamel. However, more research was needed to understand the link between e-cigarette use and oral health, and the present study was the first one to investigate the association between vaping and an increased risk for dental caries.

In the study, the researchers analysed data from over 13,000 patients older than 16 who were treated at Tufts dental clinics from 2019 to 2022. They found that approximately 79% of the patients who vaped or used e-cigarettes had a higher risk of developing caries compared with only 60% of the control group. The researchers noted that it was not inquired whether the devices used contained nicotine or tetrahydrocannabinol, the main psychoactive compound found in cannabis.

“It’s important to understand this is preliminary data,” lead author Dr Karina Irusa, assistant professor of comprehensive care at the university, said in a press release. “This is not 100% conclusive, but people do need to be aware of what we’re seeing,” she added.

According to the researchers, e-cigarette use could contribute to the development of caries owing to the high sugar content and viscosity of the vaping liquid. When aerosolised and inhaled, the liquid sticks to the teeth, and the vaping aerosols alter the oral microbiome, allowing bacteria responsible for dental caries to enter the oral cavity. It has also been shown that vaping may encourage dental caries in areas where it usually does not occur, such as on the bottom edges of anterior teeth.

In light of the findings, the researchers recommended that dentists ask patients about e-cigarette use as part of medical history taking. This also includes paediatric dentists since the number of middle- and high-school students who use e-cigarettes is high in the US and reached 7.6% in 2021, the CDC reported.

Additionally, the researchers believe that patients who use e-cigarettes should follow a more rigorous caries management protocol, which could include prescription-strength fluoride toothpaste and fluoride rinse, in-office fluoride applications and a higher number of dental check-ups.

“It takes a lot of investment of time and money to manage dental caries, depending on how bad it gets,” Dr Irusa commented. “It’s a vicious cycle that will not stop,” she concluded.

The study, titled “A comparison of the caries risk between patients who use vapes or electronic cigarettes and those who do not: A cross-sectional study”, was published in the December 2022 issue of the Journal of the American Dental Association.

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