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?”
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!
- 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