The market for e-cigarettes and vapes has boomed. First developed in China in 2003, e-cigarettes made their way to Europe and North America in 2006. They gained popularity by being branded as a safer alternative to regular cigarettes and even a way for smoking cessation. By introducing different designs and flavors, young people became the market’s prime targets – with a 78% increase in high school users between 2017 and 2018 alone.

There are over 10,000 different formulations of e-cigarettes or vapes. Some with nicotine, and some with THC (the psychoactive ingredient in marijuana). However, the formulas have three constant components: a base, nicotine/ THC, and flavoring. All of these components have negative effects on the user’s general and oral health.


What is a vape made of?


First, the base is made up of propylene glycol and glycerin mixed with water. Propylene glycol is colorless and has a slight sweet taste. When heated by the filament of the device, it aerosolizes to make acetic acid, lactic acid and propionaldehyde. All these by-products break down enamel and cause xerostomia.

Glycerin gives a sweet taste to the vapes and e-cigarettes. Manufacturers can produce any flavor from a bakery to bubble gum. Glycerin itself is not cariogenic, but increases the microbial adhesion to teeth by 4 times and doubles the biofilm formation.

Now for the nicotine/THC part. If the e-cigarette or vape is nicotine containing, yes, the concentration of nicotine is usually lower than a typical cigarette. But consider the fact that the typical vaping session consists of on average 10 puffs, and a vape cartilage holds 150-200 puffs. That’s the same as smoking 2-3 packs of conventional cigarettes. So yes, the user does ingest less nicotine per puff. But throughout the day, the user ends up ingesting a dangerous amount of nicotine.

What are the oral health consequences?


A cross sectional study recently found that any use of a vape or e-cigarette decreases periodontal health, as compared to non-smokers. Moreover as shown in a short-term study, when regular cigarette smokers switched to vaping, gingival inflammation scores significantly increased in 2 weeks.

Not surprisingly, vaping also worsened radiographic peri-implant conditions as a result of an increased inflammatory response.

Going back to the glycerin component of the vape/ e-cigarette – the aerosol that’ is created is extremely thick and viscous. As this thick vapor contains high amounts of sucrose and increases microbial/ biofilm production, it decreases enamel hardness by 27%.

The heat produced by the devices has also shown to release toxic trace metals during use from soldered joints that make up these devices.

Let’s not skim over the fact that these devices also have a tendency to explode. There have been over 2000 explosions reported in the United States between 2015 and 2017, with 2 deaths, all because of the overheating of the lithium batteries.


Trends always make a comeback

Unfortunately the same marketing tactics that we have seen over and over again with cigarettes are being used with vapes and e-cigarettes. Praying on the young and impressionable seems to be the common denominator.

Even the notion that these devices can be used as a smoking cessation method is debunked. One study showed that the chances of smoking cessation were 28% lower with e-cigarettes than quitting “cold turkey.” Rather than helping someone to stop smoking, these devices trigger smoking, especially in children.

Today’s Morning Huddle was brought to you by Dr. Kasra Eghbaldar – Toronto, Ontario