The mouth is the first point of contact for the aerosol produced by electronic cigarettes (vapes), making the oral cavity highly susceptible to chemical and physical effects. Changes in a vaper’s mouth stem from ingredients like base liquids, flavorings, and nicotine. These effects manifest as changes in the oral environment, damage to the hard tissues of the teeth, and impacts on the soft tissues of the gums and mucosal lining.
How Vaping Ingredients Alter the Mouth Environment
The liquid in e-cigarettes is primarily composed of Propylene Glycol (PG) and Vegetable Glycerin (VG), which act as carriers for nicotine and flavorings. Both PG and VG are humectants, meaning they actively draw moisture from their surroundings. When the vapor is inhaled, these compounds pull water from oral tissues, leading to xerostomia, or chronic dry mouth.
This dryness severely reduces the natural flow and quality of saliva. Saliva is a natural defense mechanism that helps neutralize acids, wash away food particles and bacteria, and protect soft tissues. Studies indicate that vaping reduces resting saliva and lowers buffering capacity, severely compromising the mouth’s ability to recover from acidic attacks.
With less saliva, the mouth’s pH level becomes more acidic. This creates an environment where harmful bacteria can thrive and adhere easily to the teeth and gums. The resulting dry, sticky sensation is a precursor to severe dental problems like accelerated tooth decay and gum disease.
Damage to Teeth and Enamel
The hard tissues of the teeth are directly exposed to the chemical cocktail in the aerosol, leading to wear and decay. The Vegetable Glycerin component is highly viscous and sticky. This property helps Streptococcus mutans, the primary bacteria responsible for cavities, adhere to the enamel surface, particularly in the pits and fissures of the molars.
Sweetened e-liquid flavorings pose an additional threat to tooth structure. Many common flavorings are acidic, and exposure to these aerosols can decrease enamel hardness by as much as 27% compared to unflavored controls. This erosive effect, similar to highly acidic beverages, softens the enamel, making the teeth more vulnerable to decay.
Beyond chemical effects, nicotine in the e-liquid is a stimulant that contributes to physical damage to the teeth. Nicotine is associated with an increased risk of bruxism (involuntary clenching and grinding of the teeth). This heightened muscle activity can lead to fractures, excessive wear of chewing surfaces, and sensitivity, compounding the erosive damage caused by the vapor residue.
Vaping’s Role in Gum Disease and Oral Inflammation
The soft tissues of the mouth, including the gums and mucosal lining, suffer from chemical and vascular changes induced by vaping. Nicotine acts as a potent vasoconstrictor, narrowing the blood vessels. This reduces blood flow to the gingival tissues, limiting the delivery of oxygen and nutrients necessary for fighting infection and healing.
Vasoconstriction can mask the early warning signs of gingivitis. The classic symptoms of gum inflammation—redness, swelling, and bleeding—are caused by increased blood flow. Because nicotine restricts this flow, a person with underlying gum infection may not exhibit typical signs of bleeding upon brushing, giving a false appearance of healthy gums.
Furthermore, heating elements and flavorings in the vapor can cause direct irritation and morphological changes to the oral mucosal cells. Studies show that e-cigarette aerosol exposure can induce pro-inflammatory responses and oxidative stress in oral epithelial cells. This sustained irritation, combined with the compromised immune response from reduced blood flow, increases susceptibility to severe periodontal disease and slows the body’s wound-healing capacity.