The Adverse Effects of Electronic Cigarettes on Oral Health: Where Do We Stand?

Abstract

Background/Objectives. Electronic cigarettes allow smokers to consume nicotine, a highly addictive substance, without burning tobacco. Since their commercialization in early 2004, electronic cigarettes have become popular in the Asian market and then worldwide. Initially conceived as an alternative to combustible smoking, they have gradually established themselves as a mass consumption product, raising both hopes for the reduction of the risks caused by burned cigarettes and concerns about their use among non-smokers, especially young people. Currently, because of their availability, accessibility to non-smokers, including young people, and their manageability, electronic cigarettes are causing more concern than hope among health professionals. This narrative review aimed to synthesize current evidence on the different chemical components generated by electronic cigarette devices and their effects on oral health. We specifically sought to (i) compile and discuss the available evidence regarding the effects of each chemical component in the e-cigarette aerosols on oral health outcomes, and (ii) feature the risks associated with e-cigarette use and how to ovoid/prevent them. Methods: We reviewed relevant English-language literature on electronic cigarette design, use, chemical generation, and adverse effects on oral health through targeted searches of PubMed, Elsevier, Oxford Academic, BioMed Central, MDPI, Scopus, and Google Scholar from 2008 to 2026. Evidence was narratively synthesized to shed light on different oral health concerns reported following electronic cigarette use. Results: This narrative review highlights several adverse effects of electronic cigarettes on oral health, including functional deregulation of the soft (tongue, gums, salivary glands) tissues, hard tissues (teeth, dental restorative materials), and the oral microbiota. These effects were attributed to the different chemicals generated when electronic cigarettes heat-vape e-liquids. These chemicals damage oral tissues/cells, leading to apoptosis, oxidative stress, and DNA damage that may lead to oral cancer. These effects may reduce oral cell growth and increase tissue inflammation, which may delay wound healing. The reviewed studies identified several limitations, including the need for additional investigations involving electronic cigarette use and long-term follow-up. Conclusions: The available in vitro and in vivo studies clearly show the potential harm of vaping on oral health. This review offers a good overview to electronic cigarette users, oral health professionals, and scientists about the potential oral harm effects of electronic cigarettes. The available studies suggest the need for oral health professionals’ support in providing information and awareness about the harmful effects of electronic cigarettes. Thus, the health system and professional orders should develop information and awareness tools to help oral health professionals in their interventions with e-cigarette users.