Vaping from a Dental Perspective

By Dr. David Miller DDS

We all are aware of the dangerous effects of traditional tobacco methods, use among middle and high school students has been steadily decreasing since 2014. However, since the introduction of the e-cigarette, that number is now increasing, and it is estimated that one in five high school students may now be using tobacco products.  E-cigarette use from 2017 to 2018 increased 78% among high school students and 48% among middle school students.

Vaping (using e-cigarettes) works by heating a liquid to generate an aerosol that is inhaled by a user. The e-liquid in the e-cigarette, is usually made up of propylene glycol, glycerin, flavorings, water, and variable levels of nicotine.

The main ingredient in the e-liquid in e-cigarettes, is propylene glycol (PG), and can be found in various edible items, and are considered safe for consumption by the FDA. PG can also act as a carrier for various inhalant pharmaceutical products, including nicotine. Recent studies indicate when used orally, the byproducts of PG include acetic acid, lactic acid, and propionaldehyde, which are all toxic to enamel and soft tissue. In addition, PG causes dry mouth which has been shown to lead to an increase in cavities, gum disease, and other oral health issues.

Other additives include vegetable glycerin. Although vegetable glycerin and propylene glycol are both FDA approved, together their byproducts like formaldehyde, and heavy metals like lead, nickel and mercury) are potential carcinogens, when inhaled. 

Studies have shown that a 27% decrease in enamel hardness was demonstrated when flavorings were added to e-liquid as compared to unflavored. E-liquid allows more cavity-causing bacteria to stick to a softer tooth and can lead to rampant decay.

Although the percentage of nicotine is much lower than traditional tobacco products, one electronic cartridge (200–400 puffs) can equal the smoking of two to three packs of regular cigarettes.

The dangerous effects of nicotine on gum tissue are well known and users have a much higher chance of developing gum disease and tooth loss.

If you’re fond of your smile and want to keep it intact, the best thing you can do is kick vaping to the curb