Your lungs might not be your only concern if you're trying electronic cigarettes -- your mouth may pay the price, too.
Vaping alters the natural bacteria found in the mouth, leaving you more vulnerable to oral infections and inflammation, a new study reports.
The researchers said this study is the first to show that vaping can alter the natural balance of beneficial bacteria, or microbiome, in the mouth, adding to the list of potential health effects associated with e-cigarette use.
"Cells that are exposed to e-cigarettes are more susceptible to infections," said the study's senior author, Deepak Saxena. He's a professor of basic science and craniofacial biology at NYU College of Dentistry in New York City.
Saxena said that e-cigarettes also lead to increased inflammation, which harms oral health. And once someone develops inflammation, it's possible to develop white patches in the mouth called leukoplakia that sometimes develop into cancer. However, this study doesn't have enough long-term evidence to show whether or not these changes could lead to oral cancers in the future, Saxena said.
"Our study is just one piece of this big puzzle on e-cigarettes, and I would advise people to not use them. If you have not started, don't start. Nicotine is highly addictive," he said.
A U.S. Centers for Disease Control and Prevention report from November suggested that as many as one out of every five U.S. high school students had vaped in the last month. That's especially concerning since more than 2,500 Americans have been hospitalized with lung injuries traced back to e-cigarette use. An additive sometimes used when people vape is suspected as a trigger for these injuries. Fifty-four people have died as a result.
People who smoke traditional tobacco cigarettes are known to have a higher risk of gum disease and oral infections. Tobacco causes changes in the mouth's usual environment that dampen the immune system response and let bad bacteria flourish, the researchers explained.
E-cigarettes have been considered less harmful, but there hasn't been a lot of research, particularly long-term studies on the new devices.
For the new study, the research team recruited 119 participants, including roughly equal numbers of people who didn't smoke or vape, people who smoked tobacco cigarettes, and those who had only used e-cigarettes.
The researchers performed oral exams and collected saliva samples to test for the bacteria living in the participants' mouths.
Almost three-quarters of tobacco smokers showed signs of gum disease or infection. Forty-three percent of e-cigarettes users also showed signs of these problems. Only 28% of the nonsmokers had signs of gum disease or infection.
When they tested for bacteria, the researchers found different types of predominant bacteria in the three groups.
"We found there is a shift in the microbiome of e-cigarette users, making it much closer to that of regular cigarette smokers," Saxena said.
Co-author Xin Li, an associate professor at NYU College of Dentistry, noted that the researchers can't say if e-cigarettes are more dangerous for oral health than traditional tobacco cigarettes.
"We saw a similar trend to inflammation and periodontitis (a serious gum infection), but I don't think we can draw any conclusions about whether e-cigarettes are more harmful," she said.
If you vape and have concerns about these potential changes, Saxena suggested taking greater care with your oral health and perhaps seeing your dentist more frequently. Li said maybe probiotics can help restore the microbiome in the mouth. But both noted these steps haven't been studied yet.
Li said if you are using e-cigarettes to help with quitting traditional tobacco cigarettes, try to use e-cigarettes for the shortest time you can. Plan on how you'll cut back. Don't plan to use e-cigarettes indefinitely, she advised.
Ronald Burakoff is chairman of dental medicine at Long Island Jewish Medical Center and North Shore University Hospital in New York. He said the study's findings make sense.
"This article describes in detail some of the adverse outcomes associated with [e-cigarette] usage. Firstly, it increases the amount of bacteria in the mouth; secondly, it promotes inflammation of the gums," Burakoff said. He added that these changes could lead to an increased risk of infection.
The study was published online Feb. 26 in iScience.
Read more about vaping and your health from Johns Hopkins Medicine.
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