Side effects of vaping may include cavities, new study finds

Vaping may increase the risk of cavities and tooth decay, according to new preliminary research.

The aerosol e-liquid used in vape pens can coat teeth with a sugary, sticky film that promotes bacteria growth — like going to bed sucking on a lollipop — said Dr. Karina Irusa, author of the study and assistant professor of comprehensive care at Tufts University School of Dentistry.

Adding artificial sweeteners and flavors to sticky spray can create the perfect breeding ground for cavities. “Sugar is what bacteria feed on,” Irusa said.

The new study, published Wednesday in the Journal of the American Dental Association, is considered preliminary and does not prove that vaping causes cavities.

But because e-cigarette use is so prevalent among teens — with 2.5 million teens vaping in the United States alone — the possibility that it could increase the risk of tooth decay in this generation is concerning, said experts who study youth vaping.

The stickiness of the aerosol can be the main culprit.

Dr Karina Irusa, Tufts University School of Dentistry

“We know young people are vaping 24/7,” said Bonnie Halpern-Felsher, professor of pediatrics at Stanford University School of Medicine. “Teenagers told us, anecdotally, that they woke up in the middle of the night and took shots,” said Halpern-Felsher, who did not participate in the new study. “They keep their vape product under their pillow and vape all night.”

Tufts’ research focused primarily on adult patients seeking treatment at the school’s dental clinic. Of 13,216 patients, only 136 reported vaping.

Many patients were already considered at high risk for tooth decay, due to factors such as diet or other oral health issues.

Among these high-risk patients, e-cigarette users, Irusa found, had a “significantly” higher risk of developing cavities, compared to those who did not vape.

Tufts researchers suggested that people who vape might need specific treatments, such as prescription fluoride toothpastes and mouthwashes.

Dark areas on the tips of the upper front teeth are an example of vaping-related tooth decay, the researchers said.2020 Wiley Periodicals, Inc.

Previous research from the Irusa team has suggested that the decay associated with e-cigarette use may be forming in an unusual area: on the tips of the front teeth.

“These areas are usually left untouched because they’re easier to clean. They’re easier to get to,” Irusa said. “I think the stickiness of the aerosol may be the main culprit.”

“This is exactly what we thought was going to happen,” said Dr. Purnima Kumar, chair of the Department of Periodontology and Oral Medicine at the University of Michigan School of Dentistry and spokesperson for the American Dental Association.

Kumar was not involved in the new study, but published separate research in 2020 that found e-cigarette use completely and rapidly alters a person’s oral microbiome.

“Within six months of use, these people had changed their oral health profiles at the molecular level,” Kumar said. “There were changes that we would only see after five years of smoking” regular cigarettes.

E-cigarette users had different types of oral bacteria that grow on heated e-liquid ingredients, such as propylene glycol and vegetable glycerin, which add nicotine and sweet flavors to vapes.

“Bacteria are constantly looking for food. You can vape today, and your bacteria will still be feeding on your vape for the next 10 hours,” she said.

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