In 2007, vaping was first introduced as an effective way to help smokers wean themselves off of nicotine. But it quickly became an attractive option for teens and young children, many of whom preferred the fruity and candy-like flavors that e-cigarette manufacturers offered.
Since the main ingredient in vape juice is water, it's easy to think that vaping is a harmless habit. Unfortunately, this isn't the case—experts have concluded that the chemicals, aerosols, and nicotine in vape juice are just as damaging to your health as their tobacco-based counterparts.
If you know five people, at least one of them vapes. So its health implications (while minimally researched) stand to affect millions as they age.
8 Reasons Vaping Impacts Your Oral Health
The most frequently cited hazards of vaping deal with the lungs and heart. Oral health issues associated with vaping often take the back seat to the obvious respiratory and cardiac risks.
But that in no way means your mouth is safe from harm. Vaping puts your mouth at serious risk—and your oral health has a direct relationship with your overall well-being.
Here are the eight most common ways vaping can affect your oral health:
1. Increased Bacteria Growth
When a smoker sucks on their vape, the heating coils in their device heat up and release a cloud of aerosolized particles, including nicotine, flavorings (including diacetyl), volatile organic compounds (VOCs), and heavy metals.
To achieve the desired effect, the user inhales the cloud and this mixture into their lungs. But first, it passes through the mouth, where some of these aerosolized particles can stick to the teeth and soft tissues in the mouth.
This build-up has the same impact other habits that ruin your teeth do—it encourages bacteria to grow and increases the risk of cavities, gum disease, and other common oral health issues.
A 2020 study published in Science was the first to make this connection. Using rRNA sequencing—a bacterial analysis method—researchers discovered that out of 119 participants, e-cigarette users had an increased risk of infection or gum disease at a rate of 42.5%.
This rate is nearly double that of non-smokers, underscoring the impact vaping has on how well bacteria can survive in the oral microbiome.
2. Mouth Burns
To turn the liquid inside the vape pen into vapor, it has to be heated to incredibly high temperatures. Unfortunately, this heat can lead to mouth and tongue burns when you inhale with too much force.
Some vapes are adjustable—that is, they allow users to increase the voltage for larger clouds or bigger hits. A study by the American Dental Association Science and Research Institute shows that when e-cigarette users activate a high-heat setting, the properties of the inhaled aerosol change.
The article, titled "Effect of Heating on Physicochemical Property of Aerosols During Vaping," was published by the International Journal of Environmental Research and Public Health. It focused on the impact of four different power settings on e-cigarettes and how they affected the aerosol's mass, pH, viscosity, color, and metal contents.
The authors discovered that hot aerosols produced by e-cigarettes can heat up the mouthpiece to a temperature that burns the skin inside the mouth little by little with the risk of burning the tongue and lips.
3. Tooth Discoloration
Another risk cited in the above study is the yellowing of the outer layer of tooth enamel. This process—called extrinsic discoloration—occurs when the nicotine in vape juice reacts with other substances (such as oxygen and water) to form tar-like particles that stick to the enamel of your teeth.
Although the potential for discoloration isn't as serious in vape users, they face the same implications smokers do. Costly restorative procedures like in-office teeth whitening require time and money—and if you're a frequent vaper, those costs can add up.
4. Tooth Decay And Gum Disease
When your teeth start to yellow, tooth decay has either already happened or is close behind. Vaping decreases saliva production—which plays a huge role in regulating your mouth's microbiome.
When there's less saliva in the mouth, plaque builds up. Plaque hardens into tartar, then causes serious issues like tooth decay or gum disease.
As the teeth decay and gums recede, people begin to see black dots on their teeth and a metallic taste in their mouth, often accompanied by bad breath.
In a systemic review of 8 case-controlled studies on the effects of e-cigarette and smoking on periodontitis, every single result pointed to the severe risk vaping poses to gum tissue. Recession, discoloration, and inflammation of the gums were all reported in participants who vaped.
For diabetics, the problem is worse. Since diabetes also affects the mouth's ability to produce saliva, the combination of vaping and diabetes increases the risk of gum disease dramatically.
While tooth decay is relatively easy to treat in its early stages, gum disease can be difficult to recover from. When ignored, it causes gum inflammation and bone loss.
5. Mouth Cancer
While e-cigarettes have fewer toxins than regular cigarettes, even lower levels show potentially increased oral cancer risks. The evidence indicates that e-cigarettes have the potential to cause cancer.
Of course, the lack of extensive and long-term studies on large populations is a major setback in specifying the link between e-cigarettes and oral cancer. And comparing the toxicity of e-cigarettes to traditional cigarettes creates an unrealistic idea that e-cigarettes are a "safer alternative" to smoking.
But the facts remain the same: 90% of cancers originate from epithelial cells, meaning they stem from the external tissues and organs of the body. When carcinogens like formaldehyde, heavy metals, toluene, and particulate matter deposit onto your gum layer, they rest directly on top of those epithelial cells. Since these cells are the first ones exposed to carcinogens, any risk of oral cancer is heightened.
6. Increased Susceptibility To Infections.
Vaping (and nicotine independently) increase users' risk of numerous oral infections, including oral thrush, a fungal infection caused by an overgrowth of the Candida yeast.
The effects of nicotine on your oral microbiome are multi-faceted:
- Nicotine restricts blood flow which prevents oxygen and nutrients from reaching the mouth tissues, limiting their ability to ward off bacterial infections.
- Blood flow restriction has inflammatory effects, which are especially damaging to the gums—the part of your mouth that's already vulnerable to infection.
- Nicotine also reduces saliva production which makes it harder for our mouths to flush out bacteria.
- Byproducts of the vapor itself rest on the outer layer of gum tissue, where bacteria follow shortly behind.
- Most users don't clean their vaping devices properly, leaving a residue of bacteria and germs on them. In some cases, this can lead to acute stomatitis, a condition where your gums swell up and become painful.
7. Non-oral Health Complications
Like we mentioned earlier, good oral health is important for overall well-being. At the American Stroke Association's International Stroke Conference, two preliminary studies underscored a connection between gum disease and a higher risk of strokes caused when large arteries in the brain harden, causing severe artery blockages.
An additional 2018 study published in the American Heart Association journal suggests that gum disease can cause (or worsen) high blood pressure and interfere with medications used to treat hypertension.
8. Unknown Long-Term Side Effects
Perhaps the biggest risk vaping poses to users' oral health is the fact that it hasn't existed for enough time for researchers, medical and dental professionals, and the public to understand its long-term effects on oral health.
Unlike cigarette use, which has been researched for decades and culturally accepted for centuries longer, vaping has only existed for around 20 years.
Over 2.5 million middle and high school students and about 20% of those between the ages of 18 and 29 use e-cigarettes. A true understanding of how their bodies develop while using vape products is still decades away.
That said, there is absolutely no chance inhaling toxic chemicals deep into your lungs is safe in any way. And the lack of concrete knowledge on the subject makes their use even more dangerous.
While there isn't an explicit and concrete connection between oral health and vaping, the risks are real—and they should not be taken lightly.
As a dental professional, it's essential to educate yourself on the current research, then inform your patients of the potential risks associated with vaping.
And as someone protecting your body, remember to prioritize your oral hygiene routine, get regular teeth cleanings, and avoid habits that compromise your oral health (which include vaping).
The bottom line: Vaping is not safe—its effects on oral health are still being explored, but they have already shown to be extremely harmful.
Want to learn more? These are the questions our customers ask us the most.
What Does Vaping Do To Your Teeth?
When you inhale vape smoke, some of its byproducts (i.e., particles and toxins) settle onto your teeth, gums, and tongue. Over time, this adversely affects the microbiome in your mouth, which includes bacteria, fungi, and viruses. Over time, this can lead to an array of oral issues, including gingivitis, gum tissue recession, cavities, tooth discoloration, and even tooth loss.
The immediate impacts of vaping aren't serious. But repeated vape use (1 in 20 Americans routinely use an e-cigarette or vape product) can increase the risk of these sorts of oral health issues.
Can Vaping Irritate Your Mouth?
Vaping can irritate your mouth by weakening the protective layers of your teeth and gums. Vaping also has an acidic pH which can erode enamel and promote tooth decay. As well, it exposes your mouth to toxins like nicotine, propylene glycol, and vegetable glycerin, which damages both your teeth and gum tissue.
Aside from direct negative effects, vaping decreases saliva production. Dry mouth causes several issues for those who vape, including bad breath, discomfort, a bad taste in their mouth, and more.
Nicotine is also an inflammatory substance—over the past 20 years, an extensive body of research shows that it restricts blood flow to your gums, causing them to be more prone to infection. Coupled with the other substances in vape liquid, this makes the mouth even more susceptible to gum disease and other adverse effects.
Does Vaping Cause Gum Disease?
A growing body of research, including studies published by the Center for Disease Control, American Dental Association, and the National Institute of Health, show that vaping increases the risk of periodontal diseases like gingivitis and periodontitis.
Studies also find that those who vape are more likely to develop oral inflammation and experience tissue damage (a precondition for gum disease). Even more concerning is the fact that nicotine restricts blood flow to gums and inhibits the body’s ability to fight infection, which makes gum disease even more likely.
Does Vaping Cause Dry Mouth?
Dry mouth (medically referred to as xerostomia) is a common side effect of a wide variety of oral health issues. As mentioned above, dry mouth causes many issues for those who vape—including bad breath, discomfort, and a bad taste in their mouths.
The acidic pH of e-cigarette vapor also contributes to the problem by eroding enamel and promoting tooth decay. Coupled with nicotine's effects on saliva production and the body’s ability to fight infection, this can make dry mouth extremely uncomfortable.
What Can Vaping Do To Your Throat?
Especially at high temperatures, the vaporized particles in vape smoke can have an adverse effect on the throat, resulting in inflammation and irritation. A sore throat is the most common symptom of vaping. It is especially typical when users take a "dry hit"—a deep inhale of vapor when the cartridge is empty—which burns and irritates the throat.
Can Your Dentist Tell If You Vape?
Your dentist probably won't be able to tell if you vape. But he will be able to spot many of the signs associated with vaping, including dry mouth and gum disease. If your teeth are discolored—a direct result of the toxins in vape juice—they will also notice that. Your dentist will almost certainly comment on these issues, especially if they look severe. As they try to determine the root cause, they will likely figure out you vape (likely from you telling them).
Does Nicotine Cause Gum Disease?
Whether or not nicotine itself causes gum disease is still inconclusive. What is proven is nicotine's tendency to restrict blood flow to various parts of the body, including the gums and surrounding oral tissue.
What Does Vaping Do To Your Tongue?
Vaping can cause tongue burns if users aren't careful. Especially when users set their vapes to higher voltages, the excessive heat from the coil can cause tongue burns that take weeks to heal. Vape juice ingredients like propylene glycol and vegetable glycerin (which are often combined with nicotine) are known to irritate the tongue, causing redness, dryness, and sometimes a burning sensation. Carcinogens like formaldehyde and nitrosamines—which are also found in plenty of vape products—rest atop the tongue (and may increase cancer risk).
Can Vaping Cause Oral Thrush?
Vaping induces harmful free radicals—unstable molecules that damage cells in your mouth—and gum inflammation. According to research from the University of Rochester, this consistently results in an increased risk for infections.
The effect of vaping on the growth of Candida albicans—the fungal species that causes oral thrush—isn't clear. What is clear is that dry mouth, inflammation, and a weakened immune response to infectious bacteria can cause oral thrush. And vaping (as well as smoking) can cause all three.
Can Vaping Cause Oral Cancer?
Vaping is carcinogenic, containing significant levels of formaldehyde, nicotine, nitrosamines, heavily metals like cadmium and arsenic, diacetyl, and numerous other chemicals that are known to cause cancer in humans. Since long-term research on such a new habit isn't possible, it's unclear what the exact risk of cancer from vaping is. When putting two and two together, allowing chemicals to repeatedly permeate your mouth's soft tissues will almost certainly increase the of oral cancer—it's only a matter of time before research proves it.
Is Smoking Or Vaping Worse For Oral Health?
Whether smoking or vaping is worse for your oral health is unknown. In terms of carcinogen levels and harshness of inhalation, combustible cigarettes are the worst. But judging the safety of vaping solely on the same criteria as smoking when they are two completely different substances is an oversimplification.
The truth is, vaping has its own adverse effects on oral health that are still being explored. Researchers don't have much conclusive evidence because vaping is still a new issue. But what we do know suggests that vaping is extremely hazardous and should be at all costs.
Can Your Mouth Recover From Vaping?
After quitting vaping, the mouth will begin to heal itself over time. Some patients can take restorative measures at home (e.g., at-home teeth whitening products) to improve their smile. But these procedures only fix one or two symptoms of the actual problem. Many patients find that they need a costly procedure like professional teeth whitening, veneers, or dentures to restore their teeth and gums.
What Happens With Your Mouth When You Quit Smoking And Start Vaping?
When you quit vaping, you will notice a significant improvement (over time) in your oral health. Your mouth will be cleaner and fresher, and your tongue and teeth may return to their original color. However, the long-term effects of vaping on your oral health are still unknown. Experts suggest that quitting smoking and avoiding vaping altogether is the best way to protect your oral health.