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E-Cigarettes Linked to Increased Risk of Periodontal Disease

MedicalResearch.com Interview with:

Scott Thomas, PhD
Assistant Research Scientist, Department of Molecular Pathobiology
Fangxi Xu, Junior Research Scientist & Clinical Research Coordinator
Department of Molecular Pathobiology
NYU College of Dentistry 

MedicalResearch.com:  What is the background for this study?  What are the main findings? 

vaping-e-cig-smoking-tobaccoResponse: Cigarette smoking is one of the well-established causes of periodontitis, but the effect of using electronic cigarettes (e-cig), especially its long-term impact on periodontal health, is not yet clearly understood. Considering the increased popularity of e-cig use, especially among teenagers and young adults, and the known effect of high nicotine concentration in e-cigarette products, we conducted this clinical research to see if there were differences in periodontal health between e-cig users, traditional smokers, and nonsmokers. The study consisted of two visits, 6 months apart, where measures of oral and periodontal health were obtained.

Our data showed significantly greater clinical attachment loss in the e-cigarette users and cigarette smokers than in the non-smokers at both study visits. In only e-cigarette users, we observed an over 0.2 mm average increase in the clinical attachment loss after 6 months. 

MedicalResearch.com: What should readers take away from your report?

Response: The rates of severe periodontal disease were greater in cigarette smokers and e-cigarette users than non-smokers at both study visits. Clinical parameters of periodontal disease such as probing depth and clinical attachment loss are also worse in cigarette smokers and e-cigarette users compared to non-smokers. These results demonstrate that there are potential risks associated with e-cigarette use, and there is not enough evidence to claim e-cigarettes are a less harmful alternative to combustible cigarettes when it comes to periodontal health.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Our findings demonstrated that there are potential risks associated with e-cigarette use in periodontal disease, and further study on e-cigarette use is necessary to help comprehensively understand its impact on periodontal health. Our study design can be used to guide larger studies and that could benefit from gaining more precise information on the subject’s social practices, including their dental hygiene routine, to help control for confounding factors. Social and education status can also be evaluated to check whether there is a relationship between higher education, better oral health, and e-cigarette use. Different types and brands of e-cigarette can also be considered as the variation in e-liquid components, flavoring agents, and voltages may contribute to the nicotine yield and chemical constituents in the e-cigarette aerosol. Further investigations on microbiome profile in the e-cig users, cytokine and metabolite analysis can also provide important insights on the effect of e-cig use.

MedicalResearch.com: Is there anything else you would like to add? 

Response: In additional research by our lab, recently published in the journal mBio, we found that the subgingival plaque microbial community of e-cig users was distinct from that of smokers and nonsmokers. Taken together, our research suggests that e-cig use promotes a unique periodontal microbiome, existing as a stable heterogeneous state between those of conventional smokers and nonsmokers and presenting unique oral health challenges. 


Xu Fangxi, Aboseria Eman, Janal Malvin N., Pushalkar Smruti, Bederoff Maria V., Vasconcelos Rebeca, Sapru Sakshi, Paul Bidisha, Queiroz Erica, Makwana Shreya, Solarewicz Julia, Guo Yuqi, Aguallo Deanna, Gomez Claudia, Shelly Donna, Aphinyanaphongs Yindalon, Gordon Terry, Corby Patricia M., Kamer Angela R., Li Xin, Saxena Deepak
Comparative Effects of E-Cigarette Aerosol on Periodontium of Periodontitis Patients
Frontiers in Oral Health     VOLUME=2      YEAR=2021
DOI=10.3389/froh.2021.729144     ISSN=2673-4842 

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Last Updated on March 10, 2022 by Marie Benz