Vaping may increase a person’s risk of tooth decay and tooth decay, initial new research suggests.
The aerosolized e-liquid used in vape pens can cover teeth with a sugary, sticky film that promotes bacterial growth—like sucking on a lollipop going to bed—said Dr. Karina Irusa, study author and assistant professor of comprehensive care at Tufts University School of Dental Medicine.
Adding artificial sweeteners and flavorings to the sticky aerosol can create the perfect breeding ground for tooth decay. “The sugar is what the bacteria feed on,” said Irusa.
The new study, published Wednesday in the Journal of the American Dental Association, is considered preliminary and does not prove that vaping causes tooth decay.
But because e-cigarette use among teens is so prevalent — 2.5 million teens vape in the United States alone — the possibility that it could increase the risk of tooth decay in this generation is worrying, said experts looking at vaping among young people.
The stickiness of the aerosol could be the main culprit.”
“We know that young people vape 24/7,” said Bonnie Halpern-Felsher, professor of pediatrics at Stanford University School of Medicine. “Teens told us anecdotally that they’ll wake up in the middle of the night and take blows,” said Halpern-Felsher, who was not involved in the new study. “They keep their vaping product under their pillow and vape all night.”
Tufts research focused primarily on adult patients who wanted to be treated at the school’s dental clinic. Of 13,216 patients, only 136 said they had vaped.
Many patients have already been considered to be at high risk of tooth decay due to factors such as diet or other oral health issues.
Among these high-risk patients, according to Irusa, e-cigarette users had a “significantly” higher risk of developing tooth decay than those who did not vape.
The Tufts researchers suggested that people who vape may need specialized treatments, such as prescription fluoride toothpaste and mouthwash.
Previous research by Irusa’s team suggested that tooth decay associated with e-cigarette use can develop in an unusual area: on the tips of the front teeth.
“These areas are generally not affected because they are easier to clean. They’re more accessible,” said Irusa. “I think the stickiness of the aerosol could be the main culprit.”
“We thought that was exactly what would happen,” said Dr. Purnima Kumar, chair of the Department of Periodontics and Oral Medicine at the University of Michigan School of Dentistry and spokeswoman for the American Dental Association.
Kumar wasn’t involved in the new study, but published separate research in 2020 that found that e-cigarette use completely and rapidly changed a person’s oral microbiome.
“Within six months of use, these people had changed their oral health profile on a molecular level,” said Kumar. “There were changes that we would only see after five years of smoking normal cigarettes.”
E-cigarette users had different types of oral bacteria that thrive on heated e-liquid ingredients such as propylene glycol and vegetable glycerin, which give vapes nicotine and sweet flavors.