What is the situation with e-cigarettes and periodontal health?
PD Dr. Kristina Bertl, PhD MSc MBA
Dental health professionals are all too familiar with the negative impact of tobacco consumption on periodontal and peri-implant health, and we have also reported on the subject here several times in the past. However, patients often ask, “What is the situation with e-cigarettes? Are they better for my gums than normal cigarettes?”
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Unfortunately, there is no easy answer to this question and there is limited literature available on the subject. There was therefore considerable interest in a systematic review with a network meta-analysis that was published recently by an Italian research group (Pesce et al. 2022). This review summarized all the available studies on this topic. It analysed the results from 5 studies and 512 patients (170 non-smokers, 176 cigarette smokers and 166 e-cigarette smokers) and compared the three probing depths, plaque values and bleeding scores for the three groups.
This analysis yielded the following interesting results:
- Compared to non-smokers and e-cigarette smokers, cigarette smokers had significantly higher probing depths. However, the comparison between non-smokers and e-cigarette smokers found no significant differences.
- Compared to non-smokers and e-cigarette smokers, cigarette smokers had significantly higher plaque values. However, the comparison between non-smokers and e-cigarette smokers found no significant differences.
- Compared to cigarette smokers and e-cigarette smokers, non-smokers had significantly higher bleeding scores. However, the comparison between smokers and e-cigarette smokers found no significant differences.
In summary, even though this finding is still based on a very limited number of original studies, it would appear that the smoking of e-cigarettes is at least less harmful for the periodontium than smoking traditional cigarettes. However, a negative effect (even though it may be a smaller one) should not be ruled out, and we should be alert as the lower bleeding scores for e-cigarette smokers (and also for cigarette smokers) could potentially mask an underlying problem!
References
- Paolo Pesce, Maria Menini, Giovanni Ugo, Francesco Bagnasco, Mario Dioguardi, Giuseppe Troiano. (2022) Evaluation of periodontal indices among non‐smokers, tobacco, and e‐cigarette smokers: a systematic review and network meta‐analysis. Clinical Oral Investigations (2022) 26:4701–4714
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