A recent study adds new information to the limited, but growing, body of research examining e-cigarettes. While past research has found changes in the oral microbiome lead to multiple health problems, this study is the first to examine the effects of vaping and smoking on the oral microbiome, including an increased risk of infection.

Published February 2020 in iScience, the study authors point out that cigarette smoking increases gum disease risk and infection by creating an oral environment that supports bacteria, causing infection and contributing to an altered immune response. The researchers set out to determine if e-cigarettes, often thought to be safer than cigarettes, also had significant negative impacts on the human oral microbiome.  

The study’s co-senior authors, Zin Li, PhD, associate professor of basic science and craniofacial biology at New York University (NYU) College of Dentistry and Deepak Saxena, PhD, professor of basic science and craniofacial biology at NYU College of Dentistry, spoke to the need to study the effects of vaping on health and focusing on the oral microbiome. Dr. Li pointed out that the popularity of vaping made it critical to study its impact on health, and Dr. Saxena indicated that since it is known changes in the microbial community of the oral microbiome contribute to health problems, this was of particular interest to the team.

There were 119 subjects in the study, divided into three groups: e-cigarette smokers (n = 40), regular cigarette smokers (n = 40), and never smokers (n = 39). The study looked at the in vivo effects of vaping and its impact on the salivary microbiome and immune health. Using an “e-cigarette aerosol-generating machine and pro-inflammatory immune mediators,” the team examined in vitro how, in pre-cancerous and cancer cell lines, e-cigarette aerosols impact the efficiency of oral pathogens.

Employing 16S rRNA high-throughput sequencing, the team found that compared with e-cigarette users, regular cigarette smokers and never-smokers had significantly altered beta-diversity (P = .006) in their saliva. They found a significantly higher rate of periodontal disease among regular cigarette smokers (72.5%) versus 42.5% for e-cigarette smokers and 28.2% for never-smokers. Other findings included that an elevated inflammatory response resulted when in the in vitro infection model of premalignant Leuk-1 and malignant cell lines were exposed to e-cigarette aerosol and then challenged by Porphyromonas gingivalis and Fusobacterium nucleatum.

In a recent interview, Dr. Saxena said, “Our study suggests that vaping electronic cigarettes causes shifts in the oral environment and highly influences the colonization of complex microbial biofilms, which raises the risk for oral inflammation and infection.”

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