Vaping may raise oral infection risks by altering microbiome in mouth

Vaping may raise the risk of oral infections and inflammation by altering the microbiome in the mouth, study suggests

  • Oral exams and saliva samples showed 42% of e-cigarette users had gum disease or infection compared to 28% of non-smokers
  • Vapers had more of a bacteria called Porphyromonas gingivalis in their saliva, implicated in gum diseases like gingivitis and periodontitis
  • They also had higher levels of a biomarker in the blood that indicates inflammation

Vaping could alter the mouth’s microbiome and raise the risk of oral infections, a new study suggests.

Researchers found e-cigarette users were at 1.5 times greater risks of gum disease or infection that non-smokers.

What’s more, vapers had higher levels of bacteria implicated in oral diseases as well as biomarkers in their blood that indicate inflammation, which, in turn, can damage all manner of tissues and raise risks for chronic diseases. 

‘The technical message [of our study] is just don’t vape,’ co-senior author Dr Xin Li, an associate professor of basic science and craniofacial biology at New York University College of Dentistry, told

‘From the data, we can clearly see e-cigarettes change the microbiome and this is associated with bad oral health, periodontal disease and inflammation, which can affect the whole body.’ 

A new study from NYU College of Dentistry has found that more than 42 percent of e-cigarette users had gum infection or disease compared to 28 percent of non-smokers (file image)

Proponents of e-cigarettes have touted them as less-harmful alternatives to traditional cigarettes, but no research exists to back these claims.

Rates of vaping have increased in recent years, particularly among high schoolers, with 27.5 percent of teens saying they vaped in 2019, up from 20.8 percent in 2018.

Dr Lin and her co-senior author Dr Deepak Saxena, also a professor of basic science and craniofacial biology, both had sons in middle school in the early 2010s and were worried they could become hooked on vaping.

‘We were concerned and [e-cigarettes] were very close to our school,’ said Dr Lin.

‘You can easily get e-cigarettes at the corner store. They were advertising without any information [about the risks].’ 

While it is well established that smoking traditional cigarettes raises the risk of gum disease and infection by changing the oral microbiome, few studies have examined whether or not e-cigarettes cause similar changes.  

For the new study, published in iScience, a Cell Press journal, the team performed oral exams on – and got saliva samples from – 119 participants.

The adults were split into three groups: e-cigarette users, regular cigarette smokers, and people who had never smoked.

Results showed that gum disease and infection was highest among cigarette smokers at 72.5 percent.

However, e-cigarette users were 1.5 times more likely to suffer from diseases like gingivitis and periodontitis than non-smokers.

More than 42 percent of vapers had gum infection or disease compared to 28 percent of people who had never smoked. 

‘It indicates [vapers are] compromising their oral health, which will soon be similar to that of smokers,’ Dr Saxena told

‘We know smoking is a bigger health concern, but this indicates e-cigarettes could be just as serious.’

Researchers found that the saliva of cigarette smokers, vapers and non-smokers contained different microorganisms.

For example, e-cigarette users had high levels of a bacteria called Porphyromonas gingivalis in their saliva, which is implicated in gum disease and is even resistant to some antibiotics.  

Additionally, vapers has high levels of two substances – interleukin 6 (IL-6) and Interleukin 1 beta (IL1β) – which are produced when inflammation occurs.

Previous studies have shown higher production of IL-6 after cells are exposed to e-cigarette aerosols.

‘[Inflammation] can trigger metabolic diseases such as diabetes, cardiovascular disease and even in the brain – neuroinflammation and dementia,’ said Dr Li.

For future research, the team plans to see if e-cigarettes are causing similar effects in the respiratory and gastrointestinal tracts. 

In the meantime, the authors say the take-home message is to not vape, 

‘Especially to the younger generation, these e-cigarettes are increasing oral infection in the mouth,’ said Dr Saxena.

‘The best thing is If you haven’t started, don’t start anything. If you’re using disposable cigarette and want to quit, do it under the supervision of a doctor. Don’t become a Juul user.’


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