The safety and long-term health effects of using e-cigarettes or other vaping products still aren’t well known. In September 2019, federal and state health authorities began investigating an outbreak of a severe lung disease associated with e-cigarettes and other vaping products. We’re closely monitoring the situation and will update our content as soon as more information is available.

Vaping can have a negative effect on your teeth and overall oral health. With that said, vaping does appear to pose fewer oral health risks than smoking cigarettes.

Vaping and e-cigarette devices have become increasingly popular in the past decade, but research hasn’t quite caught up.

Although studies are ongoing, there’s still a lot we don’t know about its long-term effects.

Read on to find out what we do know about potential side effects, e-juice ingredients to avoid, and more.

Current research suggests vaping can have a variety of negative effects on your teeth and gums. Some of these effects include:

Excess bacteria

One 2018 study found that teeth that had been exposed to e-cigarette aerosol had more bacteria than those that hadn’t.

This difference was greater in the pits and crevices of teeth.

Excess bacteria are associated with tooth decay, cavities, and gum diseases.

Dry mouth

Some e-cigarette base liquids, particularly propylene glycol, can cause mouth dryness.

Chronic mouth dryness is associated with bad breath, mouth sores, and tooth decay.

Inflamed gums

One 2016 study suggests e-cig use triggers an inflammatory response in gum tissues.

Ongoing gum inflammation is associated with various periodontal diseases.

Overall irritation

A 2014 review reported that vaping can cause mouth and throat irritation. Gum symptoms may include tenderness, swelling, and redness.

Cell death

According to a 2018 review, studies of live cells from human gums suggest vaping aerosols can increase inflammation and DNA damage. This can lead cells to lose their power to divide and grow, which can speed up cell aging and result in cell death.

This may play a role in oral health issues such as:

  • periodontal diseases
  • bone loss
  • tooth loss
  • dry mouth
  • bad breath
  • tooth decay

Of course, results from in vitro studies aren’t necessarily generalizable to real-life scenarios, as these cells have been removed from their natural environment.

More long-term research is needed to truly understand how vaping-related cell death can affect your overall oral health.

A 2018 review from the National Academy of Sciences concluded that research suggests vaping poses fewer oral health risks than smoking cigarettes.

However, this conclusion was based on the limited research available. Research is ongoing, and this stance may change over time.

Supporting research

One 2016 study involved oral examinations on people who switched from smoking cigarettes to vaping.

Researchers found the switch to vaping was associated with overall improvement in several indicators of oral health, including plaque levels and gum bleeding.

One 2017 study compared three groups of men in Saudi Arabia: a group who smoked cigarettes, a group who vaped, and a group who abstained from both.

Researchers found those who smoked cigarettes were more likely to have higher plaque levels and self-reported gum pain than those who vaped or abstained entirely.

However, it’s worth noting the participants who smoked cigarettes began smoking long before the participants who vaped began vaping.

This means the people who smoked cigarettes were exposed to higher nicotine levels for an extended period of time. This may have skewed the results.

One 2018 prospective study reported similar results with respect to gum inflammation among people who smoke, people who vape, and people who abstain from both.

Researchers found that people who smoked experienced higher levels of inflammation after an ultrasonic cleaning than people who vaped or abstained entirely.

Contradictory research

In contrast, a 2016 pilot study found that gum inflammation actually increased among smokers with mild forms of periodontal disease when they switched to vaping for a two-week period.

These results should be interpreted with caution. The sample size was small, and there was no control group for comparison.

The bottom line

More research needs to be done to understand both the short- and long-term effects of vaping on oral health.

Using a vape juice that contains nicotine may cause additional side effects.

Most research into the oral effects of nicotine focuses on nicotine delivered through cigarette smoke.

More research needs to be done to understand the unique effects of nicotine from vaping devices on oral health.

The following side effects may occur as a result of vaping itself or vaping a fluid that contains nicotine:

Vaping a fluid that contains nicotine may also cause one or more of the following side effects:

The Bottom Line

Vaping is tied to several adverse effects. Nicotine may exacerbate some of them. More research is needed to truly understand and compare the effects of vaping fluid with and without nicotine.

Few studies have compared the effects of different vape flavors on oral health.

One 2014 in vivo study found that most e-juice flavors reduced the amount of healthy cells in the connective tissues in the mouth.

Among the flavors tested, menthol proved the most damaging to oral cells.

However, in vivo studies don’t always indicate how cells behave in real-life environments.

Results from a 2018 study suggest flavored e-cigarette aerosols have similar properties to high-sucrose candy and drinks and might increase the risk of cavities.

Limited research suggests that, in general, vaping flavored e-juice may increase your risk for mouth irritation and inflammation.

For example, one 2016 study found that e-cigarette liquids were associated with gum inflammation. Gum inflammation increased when the e-liquids were flavored.

A 2017 review also suggests e-cigarette flavorings may contribute to the development of periodontal diseases.

It’s difficult to know what’s in your e-cigarette fluid.

Although manufacturers must submit a list of ingredients to the U.S. Food and Drug Administration (FDA), many don’t list ingredients on their packaging or websites.

Currently, the only e-liquid ingredients known to have negative effects on oral health include:

  • nicotine
  • propylene glycol
  • menthol

In addition, flavored e-liquids may cause more gum inflammation than non-flavored e-liquids.

Limiting or eliminating these ingredients may help reduce your overall risk for side effects.

Juuling” refers to the use of a specific vape brand. Juuling e-liquids typically contain nicotine.

The oral health effects mentioned above also apply to juuling.

If you vape, it’s important to look after your teeth. The following may help reduce your risk for side effects:

  • Limit your nicotine intake. Opting for low-nicotine or nicotine-free juices can help limit the negative effects of nicotine on your teeth and gums.
  • Drink water after you vape. Avoid dry mouth and bad breath by rehydrating after you vape.
  • Brush your teeth twice a day. Brushing helps remove plaque, which helps prevent cavities and promotes overall gum health.
  • Floss before bed. Like brushing, flossing helps remove plaque and promotes gum health.
  • Visit a dentist on a regular basis. If you can, see a dentist every six months for a cleaning and consultation. Maintaining a regular cleaning schedule will aid in the early detection and treatment of any underlying conditions.

Certain symptoms may be a sign of an underlying oral health condition.

Make an appointment with a dentist or other oral healthcare provider if you experience any of the following:

  • bleeding or swollen gums
  • changes in sensitivity to temperature
  • frequent dry mouth
  • loose teeth
  • mouth ulcers or sores that don’t seem to heal
  • toothache or mouth pain
  • receding gums

Seek emergency medical treatment if you experience any of the above symptoms alongside a fever or swelling in your face or neck.