Evidence Indicates Vaping Wreaks Havoc on the Oral Cavity

Several years ago, exploding smart phones hit the news. But it may not be as widely known that injuries sustained from vaping accidents have been on the rise. In fact, between 2015 and 2017 they accounted for more than 2,000 emergency room visits. But that’s just the tip of the iceburg.¹

E-cigarettes used in vaping produce vapor through a combination of e-liquids and heating elements housed in a variety of battery-operated devices. Vaping liquids include a base of propylene glycol, flavorings, and often nicotine. They all pose health risks. No detonation required.

When propylene glycol is heated, it produces high levels of formaldehyde vapor, which, like nicotine, is a known carcinogen. The content of flavorings isn’t regulated and is an unknown. But aside from dangers posed by the chemical cocktail, the heating elements on vaping devices carry their own risks.

E-cigarettes work via heating elements, which feature tiny metal coils, often composed of chromium and nickel. Once activated, usually through puffing, the heating element aerosolizes the liquids, which then are inhaled. Toxic metals have been found in leftover e-liquid, indicating that they leach into the vapor—and then into the lungs.

Vapers can end up with e-cigarette-caused immunodeficiency in the mouth, which can lead to overgrowth of bacteria and yeast.¹ But that’s just the start. Vapor flavors are intensified when e-liquids are dripped directly onto heating elements. Pleasurable sensations are reportedly caused by throat contraction.

SKIN IN THE GAME

Recent research indicates that the use of e-cigarettes alters the oral microbiome, and sets the stage for the colonization of complex microbial biofilms. This elevates the risk for inflammation and infection.²

In fact, the effect of e-cigarettes on periodontal tissues is reportedly similar to that of conventional cigarettes. Additionally, some vaping formulations, especially sweet ones, may be highly cariogenic.³ Other conditions resulting from vaping can include oral lesions, oral thrush, and what’s known as “black, hairy tongue,” which occurs when discolored dead cells and bacteria build up on the tongue, giving it a black, fuzzy appearance. Oral lichenoid reaction may also develop. This is characterized by white patches on oral soft tissues.¹

A NEW KIND OF HIGH

When marijuana is vaped, it must be heated to a higher temperature to aerosolize tetrahydrocannabinol (THC). But this releases more toxic substances. In addition, vitamin E acetate, often added to THC e-liquids, has been linked to severe lung damage in vapers. In fact, according to the US Centers for Disease Control and Prevention (CDC), by February 18, 2020 (incidentally, just around the time the first COVID-19 cases appeared in the US), there were 2,807 deaths attributed to e-cigarette or vaping product use-associated lung injury (EVALI) in all 50 states, the District of Columbia, Puerto Rico, and the US Virgin Islands.⁴

Investigations into the effects of vaping are ongoing. But experts agree that dental professionals should include questions about vaping activities when gathering medical-dental histories from patients.³

References

1. Thompson D. Is vaping a scourge on your skin? Available at: Click here.
2. Smruti P, Paul B, Li Q, et al. Electronic cigarette aerosol modulates the oral microbiome and increases risk of infection. Available at: Click here.
3. Irusa KF, Vence B, Donovan T. Potential oral health effects of e-cigarettes and vaping: a review and case reports. J Esthet Restor Dent. 2020;32:260–264.
4. US Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated With the Use of E-Cigarette, or Vaping, Products. Available at: Click here.