January 7, 2020
by David R. Farkouh, BSc, DMD, MSc(Pedo), FRCDC
It is difficult these days to walk down the street and not have a cloud of smoke engulf your face from a nearby electronic vaping device. My first response to this occurrence is to hold my breath or attempt to dodge the cloud altogether. When I am unable to do so, I am always shocked at how odourless and non-toxic the vapor appears to be. The fact is, smoking e-cigarettes or vaping is anything but non-toxic to one’s body. Electronic vaping devices contain many harmful chemicals, one of which is nicotine. For years the dental profession has supported public policies to prevent nicotine use and to educate the public on the ill-effects smoking cigarettes has on oral health. Vaping gives individuals the perception that they can enjoy the effects of nicotine while not being harmed or imposing harm to one’s neighbour.
This is most concerning in the adolescent population where vaping has become extremely popular.
Similar to cigarette smoking, the nicotine present in electronic vaping devices puts the user at an increased risk of acquiring oral cancer, developing periodontal disease, and tooth staining. Where vaping differs from cigarette smoking is that these electronic vaping devices also contain many chemicals with unknown risks to the oral cavity and the body as a whole. Two key ingredients that are added to many electronic vaping devices are vegetable glycerin and sugar flavorings. Vaping an electronic device that contains a fermentable carbohydrate such as sugar increases the risk of dental caries. Similarly, the vegetable glycerin creates a viscous e-liquid which appears to allow more Streptococcus mutans to stick and adhere to the tooth surface increasing the risk of tooth decay. Although the effects of vaping are still unclear and largely unknown, it is not a far cry to assume that the sugars inhaled in e-cigarettes provide the fuel for the disease we treat every day in our offices.
As a pediatric dentist, I take care of the dental needs of the most vulnerable population to the effects of vaping. Given its popularity, I knew it was only a matter of time before I saw the effects of vaping on teeth. Last month, an adolescent who has been seeing me since childhood presented in my office for their recall appointment. This was the one patient that we all have who has never had a cavity. Upon entering my office, the patient’s mother asked to see me to discuss her concern about his year-old habit of using e-cigarettes. Given his past dental history, I was surprised to hear of his new habit and reassured mom that I would have “the talk” with him and examine his mouth for effects. Needless to say, I was shocked when I examined his mouth and read his radiographs. He had decay and a lot of it! It was at that point that the potential effects of vaping hit me. Although this story may be anecdotal, I do believe the correlation to be true. As healthcare providers we have a responsibility to advocate for our patients and to warn them of the potential and mostly unknown effects that are possible when using electronic vaping devices. Due to insufficient evidence and the lack of research to date we cannot prove all that is bad about e-cigarettes. But you have to think, how can any of it be good!
About the Editor
David Farkouh, is a pediatric dentist working in private practice in Toronto, Ontario. He is also a staff pediatric dentist in the Department of Dentistry at The Hospital for Sick Children in Toronto, Ontario. Dr. Farkouh is the Pediatric Dentistry Editor for Oral Health
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