Vaping involves inhaling aerosol from electronic devices like e-cigarettes, vape pens, and mods. The liquids used in these devices, often called e-liquids or vape juice, contain a mix of chemicals that are heated to create the inhalable aerosol. Vaping is detrimental to oral health, as the ingredients and physiological effects significantly compromise the health of teeth and gums. This practice introduces multiple chemical and biological stressors that actively degrade the oral environment.
How Vaping Ingredients Alter the Mouth’s Environment
The base of most e-liquids is a mixture of Propylene Glycol (PG) and Vegetable Glycerin (VG). Propylene Glycol is hygroscopic, meaning it attracts and binds to water molecules within the mouth. This action leads directly to xerostomia, or chronic dry mouth, by reducing the protective layer of saliva. Saliva is necessary for neutralizing acids, washing away food particles, and protecting against decay-causing bacteria. When PG degrades, it breaks down into compounds like acetic acid, lactic acid, and propionaldehyde. This process significantly lowers the mouth’s pH level, creating an acidic environment that encourages enamel erosion and decay.
Vegetable Glycerin and the added flavorings further compromise the teeth. Their combination causes a substantial increase in microbial adhesion to the tooth enamel. This sticky film promotes biofilm formation and enables cavity-causing bacteria, such as Streptococcus mutans, to adhere more effectively to the tooth surfaces. The flavoring chemicals themselves soften enamel, making the teeth more susceptible to decay.
Nicotine’s Physiological Effects on Gums and Tissue
The nicotine contained in most e-liquids damages the gums and soft tissues, separate from the chemical impact of PG and VG. Nicotine acts as a vasoconstrictor, causing the small blood vessels in the gum tissue to narrow. This constriction severely restricts blood flow and circulation to the gums. Reduced blood flow diminishes the delivery of oxygen and essential nutrients to the gingival cells. This hinders the body’s natural ability to fight infection and repair damaged tissue. Nicotine also impairs the function of fibroblasts, cells that maintain the health and integrity of gum tissues, slowing down the healing process following any oral injury or dental procedure.
A concerning effect of nicotine-induced vasoconstriction is that it can mask the initial, visible signs of gum disease. Restricted circulation prevents the gums from swelling or bleeding, allowing the disease to progress undetected beneath the surface. Nicotine also contributes to gum recession by damaging the connective tissues that anchor the gums to the teeth, which can ultimately lead to tooth loss.
Common Oral Health Consequences of Vaping
The combined effects of chemical alteration and nicotine’s physiological impact result in several specific oral health conditions. Dental caries, commonly known as cavities, are accelerated by reduced saliva, lowered acidic pH, and increased bacterial adhesion from e-liquid ingredients. This decay often follows unusual patterns, sometimes appearing near the gum line where the e-liquid aerosol tends to pool, which is distinct from traditional decay patterns.
Periodontal disease, which includes gingivitis and its more severe form, periodontitis, is worsened by vaping. Nicotine’s reduction of blood flow and suppression of immune response allows the gum infection to advance more rapidly. Vaping creates a unique, less healthy oral microbiome compared to non-users. This is associated with a greater worsening of clinical attachment loss—the separation of gum tissue from the tooth—over time.
Generalized irritation and inflammation are frequent complaints among vapers. Changes in the oral microbiome can lead to opportunistic infections, such as oral candidiasis (oral thrush). Users may also experience “vaper’s tongue,” or generalized oral mucosal irritation, often presenting as a burning or stinging sensation.