| Summary: | Use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes
(e-cigs), is increasing across the US population and is particularly troubling due to
their adoption by adolescents, teens, and young adults. The industry’s marketing
approach for these instruments of addiction has been to promote them as a safer
alternative to tobacco, a behavioral choice supporting smoking cessation, and as
the ‘cool’ appearance of vaping with flavored products (e.g. tutti frutti, bubble
gum, and buttered popcorn etc.). Thus, there is a clear need to better document
the health outcomes of e-cig use in the oral cavity of the addicted chronic user.
There appears to be an array of environmental toxins in the vapors, including
reactive aldehydes and carbonyls resulting from the heating elements action on
fluid components, as well as from the composition of chemical flavoring agents.
The chemistry of these systems shows that the released vapors from the e-cigs
frequently contain levels of environmental toxins that considerably exceed federal
occupational exposure limits. Additionally, the toxicants in the vapors appear to be
retained in the host fluids/tissues at levels often approximating 90% of the levels
in the e-cig vapors. These water-soluble reactive toxins can challenge the oral
cavity constituents, potentially contributing to alterations in the autochthonous
microbiome and host cells critical for maintaining oral homeostasis. This review
updates the existing chemistry/environmental aspects of e-cigs, as well as
providing an overview of the somewhat limited data on potential oral health
effects that could occur across the lifetime of daily e-cig users.
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