Dental care: The effects of smoking and vaping on oral health |25 May 2022

In the following interview with Dr Shuchi Singh, we learn about the differences between smoking and vaping, their effects on oral and overall health, and how teeth and gum problems can be prevented in smokers. She also shares her advice on how to quit smoking and vaping.

Dr Singh is registered to the Seychelles Medical and Dental Council as a dental practitioner. She completed her Bachelor of Dental Surgery from Ghaziabad, India in 2013 and has diverse experience in general dentistry for more than nine years.

Dr Singh worked in multiple hospitals and private clinics in India before moving to Seychelles. She is passionate about educating and spreading awareness about oral health among the masses to curb oral cancer and other oral diseases.

Seychelles NATION: What is the difference between smoking and vaping?

Dr Singh: Using an e-cigarette is often called ‘vaping’. E-cigarettes are devices designed to deliver an aerosol (vapour) by heating up a solution that users breathe in. These products were formed to be a safer alternative to smoking cigarette, but vaping still has harmful effects. Users are still inhaling substances other than oxygen into their lungs. Lung injury is more and more common in users of the vaping product.

Overall there is not much difference between smoking and vaping. Commonly, smoking was thought to be more harmful because the product is being burnt and smoke inhaled into the lungs. Recent studies now suggest that similar damage and decreased ability to fight infections can be seen from heating up vaping solutions and inhaling that vapour into the lungs.

Seychelles NATION: Tell us more about vaping. Does it help people to quit smoking?

Dr Singh: In recent times, the number of teenagers and adults vaping on e-cigarette has risen sharply. They are often seen as a ‘healthier’ version of smoking cigarette. But recent studies show that vaping can be detrimental to overall health. Vaping during teenage years has been shown to increase the risk of traditional cigarette or tobacco addiction and uptake in the future.

The liquid or ‘vaping juice’ used may contain toxic chemicals as well as added flavourings. Some may contain nicotine even when they are labelled as ‘nicotine free’. It contains harmful substances such as:

• Nicotine: Just as with traditional cigarettes, e-cigarettes are addictive because of the nicotine content. Nicotine itself brings a whole host of oral health concerns, one being the effect it has on gums. Studies show that nicotine reduces blood flow to the teeth and gums, depriving them of oxygen and nutrients they need to stay healthy. This leads to the development of gum disease, gum recession and it increases the risk of developing cavities.
• Vegetable Glycerin: Alsoknown as glycerol or glycerine, this is a clear, odourless, sweet-flavoured base fluid used in vape pens or e-cigarettes. Studies suggest a prolonged use of vegetable glycerine can lead to inflammation of the lungs. It doesn’t contribute in developing cavities in the mouth directly but it’s believed that long term use of this sweet flavoured liquid causes bad bacteria to stick to the teeth and can result in decay.
• Propylene Glycol: This is one of the primary ingredients in the majority of e-liquids and e-cigarette cartridges today. When broken down in the mouth, this liquid creates various by-products which are toxic to tooth enamel and the soft tissues in the mouth. It can wear down the enamel, weaken the tooth and make them prone to developing cavities. It also dries out the mouth and limits saliva production which eventually leads to dry mouth, bad breath and an increased risk for gum disease and cavities.
• Batteries: E-cigarettes rely on a battery to power the heating coil. This heating coil heats up the e-liquid which becomes the aerosol (vapor) that e-cigarette users inhale. Vape pens typically use lithium-ion batteries. Thousands of cases have been reported of battery explosion because it overheats. The highly flammable liquid inside the battery reacts with oxygen and causes it to combust. Exploding vape batteries can cause serious injuries like:

-           Deep cuts and bleeding

-           Loss of teeth, eyes and fingers

-           Severe burns

-           Permanent scarring

-           Permanent disfigurement on lips and facial region

-           Broken bones

Seychelles NATION: How does smoking and vaping affect oral health, teeth and gums?

Dr Singh: Smoking can impact your oral health. If a person smokes tobacco, it’s important to look after their oral health to prevent dental problems and gum disease.

People who smoke have a higher risk of gum problem, tooth loss, complication after tooth removal and surgery in the mouth, and developing oral cancer. They are more likely to get infections and don’t heal as well as non-smokers.

The effects of smoking include:

• Bad taste in the mouth and bad breath (Halitosis)
• Temporary loss of taste (vape tongue)
• Gum (Periodontitis) disease
• Inflammation in the mouth
• Poor healing after tooth removal (known as dry socket)
• Tooth decay
• Tooth loss
• Poor healing after mouth and gum surgery
• Whitening of the soft tissue in the mouth (called smoker’s keratosis)
• Tobacco stains on teeth
• Mouth cancer

Seychelles NATION: What are the effects of vaping and smoking on overall health?

Dr Singh: According to reports, cigarettes cause health risks. These cigarettes contain and emit a number of potentially toxic substances. Youth who use vape pens are at high risk for cough, wheezing and increase in asthma exacerbations. They sometimes experience heaviness and tightness in the chest. Smoking and vaping have been linked to:

• Lung disease as well as cardiovascular (heart) disease
• Pneumonia
• Rapid heart rate
• Congestive heart failure
• The by-products such as acrolein can cause Chronic Obstructive Pulmonary Disease (COPD), lung injury and lung cancer

Seychelles NATION: How can teeth and gum problems be prevented in smokers?

Dr Singh:●First try to quit smoking ‒ speak to your dentist or call quit lines for guidance and support. If it’s hard to quit then start with reducing the number of smoke/vape.

• Drink water after you smoke ‒ avoid dry mouth and bad breath by rehydrating after vaping.
• Clean your teeth and gums twice a day with fluoride toothpaste.
• Use interdental brushes and dental floss.
• Chew sugar-free gums to stimulate saliva flow because after certain medications, one can experience dry mouth.
• Limit alcohol and avoid recreational drugs.
• Visit your dentist regularly - an early detection and treatment can subsequently reduce the chances of developing any underlying dental problems.

Seychelles NATION: Do you have any advice on how to quit smoking and vaping?

Dr Singh: Teenagers need a lot of care to quit using these products. The brains of young people are very susceptible to nicotine; this makes nicotine highly addictive to them unlike their older counterparts. It’s never too late to quit traditional cigarettes or e-cigarettes.

• ‘Cold turkey’ ‒ stop smoking or vaping all at once on your quit day; this method works the best in many.
• Cut down the number of cigarettes you smoke each day.
• Smoke only part of each cigarette and reduce the number until you stop smoking completely.
• Count how many puffs you take normally and try to reduce the number of puffs each passing day.
• Meet with a doctor who is skilled, who helps youth to stop smoking and who can provide nicotine replacement items such as patches or potentially medication.

F. P.