Electronic Cigarettes and Oral Health

R. Holliday (Lead / Corresponding author), B. W. Chaffee, N. S. Jakubovics, R. Kist, P. M. Preshaw

    Research output: Contribution to journalReview articlepeer-review

    36 Citations (Scopus)
    190 Downloads (Pure)


    Novel nicotine products, particularly electronic cigarettes (e-cigarettes), have become increasingly popular over the past decade. E-cigarettes are sometimes regarded as a less harmful alternative to tobacco smoking, and there is some evidence of their potential role as a smoking cessation aid. However, there are concerns about their health consequences, particularly in users who are not tobacco smokers, and also when used long term. Given the mode of delivery of these products, there is potential for oral health consequences. Over the past few years, there have been an increasing number of studies conducted to explore their oral health effects. In vitro studies have reported a range of cellular effects, but these are much less pronounced than those resulting from exposure to tobacco smoke. Microbiological studies have indicated that e-cigarette users have a distinct microbiome, and there is some indication this may be more pathogenic compared to nonusers. Evidence of oral health effects from clinical trials is still limited, and most studies to date have been small in scale and usually cross-sectional in design. Epidemiological studies highlight concerns over oral dryness, irritation, and gingival diseases. Interpreting data from e-cigarette studies is challenging, given the different populations that have been investigated and the continual emergence of new products. Overall, studies reveal potential oral health harms, underscoring the importance of efforts to reduce use in nonsmokers. However, in smokers who are using e-cigarettes as an aid to help them quit, the benefits of quitting tobacco smoking may outweigh any negative oral health impacts of e-cigarette use, particularly in the short term. Future research is needed to understand the clinical significance of some of the biological changes observed by following different cohorts of users longitudinally in carefully designed clinical studies and pragmatic trials supported by high-quality in vitro studies.

    Original languageEnglish
    Pages (from-to)906-913
    Number of pages8
    JournalJournal of Dental Research
    Issue number9
    Early online date25 Mar 2021
    Publication statusPublished - Aug 2021


    • electronic nicotine delivery systems
    • tobacco
    • dental research
    • periodontal diseases
    • nicotine
    • oral health

    ASJC Scopus subject areas

    • General Dentistry


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