Think “E-Cigs” Are A Safe Alternative? Read On…

Posted on Jan 16, 2019 by William J. Claiborne, DDS MS

Smokeless cigarettes, or “e-cigs,” first appeared on the market in 2004. Since then, their popularity has exploded.

Dr. William Claiborne,
Biltmore Periodontics

Unlike tobacco cigarettes, where nicotine is inhaled through smoke, e-cigarettes are electronic devices that often mimic the shape of a small cigarette. They are designed to heat a liquid and produce an aerosol, or mix of small particles in the air. The inhalation process is known as vaping.

Because these battery-operated devices deliver nicotine without some of the toxic chemicals in tobacco cigarettes, they are deemed as safer alternatives. Although both cigarettes and e-cigs are vehicles that deliver addictive nicotine, vaping wins when it comes to being the lesser of the two evils.

However, the vapor from e-cigarettes does contain toxic compounds, just at much lower levels than cigarette smoke. This is good news for people who are quitting smoking and vaping instead.

That doesn’t mean e-cigs are SAFE, however. They’re just safer than traditional cigarettes.

A particular concern is the appeal, and hence rapid growth, among teen users.

E-cig vapor, once inhaled, is absorbed by the body. For teens, it may be particularly harmful to developing brains and bodies. The vapor contains a chemical mix of nicotine, formaldehyde and other chemicals. A recent study that examined urine and saliva specimens from teen participants showed e-cig users had elevated levels of harmful compounds such as acrylonitrile, acrolein, propylene oxide, and crotonaldehyde.

For those who both smoked cigarettes and vaped, they had the highest levels of toxins and carcinogens (when compared to e-cig only users and non-smokers). (

Flavorings such as diacetyl, a chemical linked to lung disease, are also a concern. (

And nicotine is nothing to take lightly as far as adolescent development goes. The Centers For Disease Control & Prevention warns that nicotine can harm the developing adolescent brain, which continues to develop until about age 25. Adolescence nicotine use can also harm the parts of the brain that control attention, learning, mood, and impulse control.

Using nicotine in adolescence may also increase risk for future addiction to other drugs.

With limited scientific evidence to develop public health policies, researchers are urging priority status be given to studying the effects of e-cigs aerosol mixtures on cells, tissues and the oral cavity (interior of the mouth). The problem has become such a concern that the National Institute of Dental & Craniofacial Research is studying the biological and physiological effects of their chemical components.

Rather than focusing on the effects of nicotine (those findings are well-known), this will examine how the high concentrations of aerosol mixes affect oral tissues. They will also monitor the tissues in the mouth, airway structures and lungs that absorb the vaporized chemicals in e-cigs. Hopefully, the findings will show the true effects of long-term exposure to these chemical mixtures.

Your smile is particularly vulnerable to e-cigs, just as it is to traditional cigarettes. Since oral tissues are moist by nature, the water vapor inhaled into the mouth is absorbed readily by gum tissues. Nicotine, consumed by any method, is known to have a drying effect on oral tissues. This decreases saliva that helps wash food particles and bacteria from the mouth.

Without sufficient saliva, bacteria rapidly reproduce, increasing the potential for tooth decay and gum disease. A dry mouth also leaves you fighting bad breath on a frequent basis.

Having a dry mouth can lead to a higher risk of periodontal (gum) disease. Initially, the condition causes the gums to become swollen, tender, red, and bleed easily when brushing. If not treated promptly, this early-stage of gum disease (known as gingivitis) can progress to periodontal disease.

In addition to attacking gum tissues and the bone that support teeth, gum disease can weaken gum tissues and allow entry of infectious bacteria into the bloodstream. Once bloodborne, the bacteria can cause inflammatory reactions elsewhere in the body. Research has shown it can increase one’s risk for heart disease, stroke, diabetes, arthritis, preterm births, impotency, and some cancers.

Additionally, nicotine from any source has been shown to constrict blood vessels in the mouth so much that it compromises the ability of oral tissues to heal. This is why we caution patients to stop (or greatly decrease) smoking after an extraction or dental implant placement.

Don’t allow misconceptions of e-cigs being “a safe alternative to smoking” to put the health of your smile at risk. Smoking, in any form, places your oral – and overall – health at a disadvantage. If you do smoke, be especially committed to your regular check-ups and cleanings so we can help you maintain a healthy mouth.

If you’ve noticed signs of gum disease, please know this will not go away on its own. Gum disease will progress and can lead to tooth loss when not treated sufficiently. A periodontist is a specialist and your wisest choice in overcoming all levels of gum disease, and getting your smile back on track! Call 828-274-9440 for an examination appointment in our Asheville periodontal office.

Recent Posts