Vapes cause a whole host of damage to the mouth, and a lot of it isn’t reversible, experts warn.
Vapes and e-cigarettes can accelerate oral disease and many of the damaging effects are irreversible, experts warn.
Young people are presenting with damage from vapes that normally occurs in older tobacco smokers, said Melbourne dentist Dr Dilhan Rajasingham.
Dr Rajasingham told Dermatology Republic he was seeing more young people whose gum disease had been accelerated by vaping.
In addition, he said there was a rise in the condition that has become widely known as “vaper’s tongue”, where a patient presents with altered sensation, numbness or tingling of the tongue caused by heat and chemicals from vapes and changes in the bacteria in the mouth. Gums present as swollen, red and painful.
“[Previously], it was more in patients who were medium to long-term smokers in their 30s, 40s, 50s or 60s that you’d see these symptoms. Now we’re seeing patients even in their early 20s with these problems,” said Dr Rajasingham.
He said if patients ceased vaping, it was likely that some of the acute damage would be reversible, however long-standing or chronic effects might still exist such as gum disease or cavities.
Oral medicine specialist Dr Sue-Ching Yeoh said vaping caused oral dryness which could lead to an increased risk of irritation, dental caries, gingivitis and periodontal disease, opportunistic fungal infections such as candidosis, and disturbance of the oral microbiome.
“Vapers are at risk of inflammation and infection around dental implants, which may compromise the prognosis,” said the dental surgeon at Sydney’s Royal Prince Alfred Hospital and president of the Oral Medicine Academy of Australasia.
Dr Yeoh said vapes contained several known carcinogens that were either in the vape juice or formed as the juice was heated into an aerosol, including formaldehyde and acetaldehyde, which could increase the risk of oral cancer or lung cancer.
As with smoking tobacco, the effects of vaping seemed to be cumulative, she told DR.
“The magnitude will depend on the frequency, amount and duration of the habit,” she said.
“It will also depend on whether the patient is using nicotine-containing vapes.”
Dr Yeoh said some of the negative effects such as dry mouth may resolve over time after the patient ceases vaping.
“Other effects such as dental decay are generally irreversible,” she said.
Vapes also increase the risk of changes in the lining of the mouth and the possible development of oral mucosal lesions and oral cancer, she said. More studies were supporting these observations, she added.
“Initially the data was scarce as vaping is a reasonably recent habit,” said Dr Yeoh.
“There is long-term data on the effects of smoking on the oral cavity, and many of the effects are common to both habits.
“There is ongoing research into the risks of developing oral cancer in vapers. The data is difficult to determine as cancer develops over a long period of time. Many patients who vape have either smoked in the past, or are current smokers, and this acts as a confounder.”
Dr Yeoh said patients who used vapes as a smoking cessation method should be reviewed by their GP and have individualised treatment plans, while patients who were recreational vapers needed education about the health risks.
“Many are unaware of the associated health risks, particularly with nicotine and its effect on the developing brain,” she said.
“It is well documented that vaping can act as a gateway to smoking and other habits. Studies have shown that some people who have never smoked but vape recreationally eventually start to smoke and end up being ‘dual users’.”
The warning comes as new data released by the Australian Institute of Health and Welfare last week showed that the number of people regularly using e-cigarettes and vaping almost tripled from 2.5% in 2019 to 7% in 2022-2023.
According to the data, vaping was most common among people aged 18 to 24 years and vape use increased from 5.3% in 2019 to 21% in 2022–2023. Almost half (49%) of people aged 18–24 reported having ever trying an e-cigarette.
