Research Shows Link Between Vaping and Periodontal Diseases

According to the United States Centers for Disease Control and Prevention, nearly half of adults in the US ages 30 and older have some degree of periodontal disease.¹ Smoking has long been recognized as a contributor. But vaping—which produces toxic byproducts such as formaldehyde, aluminum, manganese, lead, cobalt, and chromium—and its effects on periodontal health are not yet well understood.

A series of longitudinal studies conducted by the New York University College of Dentistry (NYUCD) reveal increasing evidence of a relationship between e-cigarette use, otherwise known as vaping, and periodontal diseases.²

MOUNTING EVIDENCE

To learn more about the impact of vaping on the development of periodontal diseases, the NYUCD researchers conducted a study that compared the oral health of 119 subjects who were divided into the three groups: cigarette smokers, e-cigarette smokers, and nonsmokers. The study showed that the aerosols used in vaping altered the users’ levels of proinflammatory cytokines. This modified their oral microbiomes, accelerating the rate of oral microbial infection.³

In a subsequent study, also using 119 subjects divided into the three cohorts, researchers discovered another e-cigarette effect. A signature characteristic of periodontal disease is attachment loss, which leads to tissue and ligament separation from tooth surfaces, resulting in deep pockets where harmful bacteria can proliferate. After 6 months, not only were vapers found to be more vulnerable to infection, but clinical attachment loss was significantly worse—an effect found only in the e-cigarette smokers.⁴

ALTERED MICROBIOME

A third study compared the bacterial community structure in the saliva of 101 patients with periodontitis divided into the three groups. At the 6-month interval, they found

that e-cigarette use altered the periodontal microbiome, leading to an increase in the numbers of pathogens implicated in periodontal diseases.⁵

The most recent study examined the oral health of 84 adults under the same parameters. Bacteria in plaque samples revealed the vaper microbiome to be unique. For instance, the study showed a subgingival microbial community enriched in Fusobacterium and Bacteroidales (G-2), both known associates of periodontitis, to be especially dominant among vapers.⁶

VARIOUS CYTOKINE LEVELS

The latest study also showed significantly elevated levels of a proinflammatory cytokine in vapers, leaving them more prone to inflammation. In contrast, other cytokines exhibited lower levels in these patients, increasing after treatment. This suggests that some oral bacteria in vapers may suppress immune response.⁶

Researchers concluded that while periodontal microbiome similarities between the groups exist, each is unique. That of vapers, however, shares more in common with that of smokers—including the risks.

REFERENCES

1. United States Centers for Disease Control and Prevention. Periodontal Disease. Available here.
2. New York University. Evidence grows for vaping’s role in gum disease. Available here.
3. Pushalkar S, Paul B, Li Q, et al. Electronic cigarette aerosol modulates the microbiome and increases risk of infection. iScience. 2020;23:100884.
4. Xu F, Aboseria E, Janal MN, et al. Comparative effects of e-cigarette aerosol on periodontium of periodontitis patients. Front Oral Health. 2021;2:729144.
5. Xu F, Pushalkar S, Lin Z, et al. Electronic cigarette use enriches periodontal pathogens. Mol Oral Microbiol. 2022;37:63–76.
6. Thomas SC, Xu F, Pushalkar S, et al. Electronic cigarette use promotes a unique periodontal microbiome. mBio. 2022;13:e0007522.