Smoking is harmful for many reasons; it causes cancer, it is highly addictive and it smells bad. Alongside these grievances, the practice of smoking also has a well-documented and detrimental effect on oral health, being a major carcinogen exacerbating mouth cancer and contributing heavily to teeth yellowing. The effects of tobaccos’ sister industry, that of e-cigarettes and vaping, on oral health remains understudied and largely unknown due to the newness of the practice. While cigarette smoking entails the combustion of tobacco to inhale nicotine laded smoke, e-cigarettes vaporize nicotine and other chemicals in an aerosol or water-based cloud. With a consumption method so different from traditional smoking, researchers remain uncertain as to its long-term health effects.
To combat this lack of knowledge, researchers at NYU conducted a study where the microbial content of dental plaque was analyzed between three groups: cigarette smokers, vapers and non-smokers. Gum disease progression was also assessed among the three groups. Most interestingly, the group of vapers displayed a unique oral microbiome when compared to smokers and non-smokers. Though more closely mirroring smokers due to the increased progression of gum disease causing bacteria, like Fusobacterium and Bacteroidales, the differing concentrations suggest that vaping causes distinctly detrimental effects on oral health. E-cigarette smokers also displayed the highest presence of clinical attachment loss, which is another key indicator of gum disease’s development. Clinical attachment loss measures the degree to which the gum ligaments and tissue have disconnected from the tooth’s surface, with farther distances resulting in bacteria-breeding-ground pockets and receding gums.
Tufts University completed a contemporaneous study that discovered patients who vape were more likely to develop cavities. The researchers analyzed data from more than 13,000 patients over 16 who were seen between 2019-2022. 79% of patients who vape were categorized as having a high risk for cavities, while the control group sat at a 60% risk. One hypothesis for this increased cavity risk points to the viscous sugary content of e-cigarette liquid. When inhaled and aerosolized in the mouth, the mixture sticks to the teeth, resulting in more opportunity for decay. Oral decay and cavities were also seen to occur in places uncommon to the control group, showcasing the comprehensive coating capabilities of the vape.
While these risks of vaping are beginning to be known and understood, equally present is the threat of the unknown with vaping and oral health. A study from the American Journal of Preventative Medicine analyzed the data from the 2021, 2022, and 2023 National Youth Tobacco Survey. The most glaring result from aggregating and analyzing the survey data was the overwhelming amount of uncertainty among young vapers as to the content of their e-cigarettes. Those who are unsure of what they smoke have tripled over those three years. Without knowing what is in these devices, patients and healthcare providers alike cannot make accurate assertions to their short- and long-term effects.
Works Cited
Elsevier. “Synthetic storm: What’s really in your teen’s vape ? and why scientists are alarmed.” ScienceDaily. ScienceDaily, 1 July 2025. <www.sciencedaily.com/releases/2025/07/250701020649.htm>.
New York University. “Evidence grows for vaping’s role in gum disease.” ScienceDaily. ScienceDaily, 22 February 2022. <www.sciencedaily.com/releases/2022/02/220222151907.htm>.
Tufts University. “Using vapes may set the stage for dental decay.” ScienceDaily. ScienceDaily, 23 November 2022. <www.sciencedaily.com/releases/2022/11/221123125126.htm>.