A recent article published by a team of periodontologists at the Dental Institute of the Kings College of London in the British Dental Journal studied the consequence of a switch to vaping in smokers. The authors insist that their study is a pilot study and requires more research on this topic.
- Increased sites of gingival bleeding,
- Increased volume of gingival crevicular fluid (GCF),
- Increased levels of inflammatory markers in the blood and in the GCF.Findings of this study
The study was the first of its kind and the effects of vaping on oral health were completely unknown. Vapers often report on canker sores, dry mouth and dry, burning lips when vaping on commercial e-liquids, all signs that could be the result of an inflammation. By studying the signs of inflammation and the levels of selected pro-inflammatory cytokines in GCF, saliva and serum, the authors conclude that vaping is a probable cause of gingival inflammation.
The material the participants were given for this 2-week test was the Blu Pro and its Tobacco e-liquid (nicotine strength 18 mg/ml). The researchers compared their results with smokers who quitted smoking without using e-cigarettes but couldn’t make sure that their visual check, bleeding on probing (BOP), was increased due to vaping and not because of smoking cessation.
No servere harms compared to smoking deseases
Inflammation has also been reported in other types of epithelia exposed to e-vapor. However, it remains unclear what component(s) of e-vapor including nicotine, PG and VG, is playing such role, or if it is in response of a change in the microbial flora of the dental plaque. The authors did not mention any comparison with nicotine gum users to confirm or overturn a direct effect of nicotine.
The authors point out a risk of periodontitis, the alteration of the bones that host the teeth, because of persistant gingivitis. The phenomenon was well described in the case of smokers but it comes as a surprise for these specialists when examining vapers. Vaping is promoted by PHE and the Royal College of Physicians as an overall safer alternative to smoking, even though the risk persists and is estimated 5% compared to smoking. Gingivitis or periodontitis are not considered as severe harms compared to lung cancer or heart diseases. However, an oral health degradation may have severe consequences on general health.
Researchers surprised that almost all participants quit smoking during the study
Finally the authors, who did not design the study as a smoking cessation experiment, were surprised to see that 14 out of 18 participants reported complete smoking abstinence over the two weeks they used an e-cigarette. The clinical change they observed and the underlying biological changes remain to be explored on a larger sample of participants. Other types of analysis are suggested by the authors for further studies and could include the macrophage migration inhibitory factor, another pro-inflammatory response, and samples of dental plaque to investigate potential changes in their microbial flora.
Wadia R., Booth V., Yap HF., Moyes DL., 2016. A pilot study of the gingival response when smokers switch from smoking to vaping. British Dental Journal 221, 722 – 726 (2016) Published online: 9 December 2016 | doi:10.1038/sj.bdj.2016.914