For years my mother smoked cigarettes, from as early as I can remember until she finally quit. Come to think of it, she apparently smoked some while pregnant. This was not entirely uncommon. It’s a well-known fact that smoking causes lung cancer among other health concerns, but it is also known that smoking is an addictive habit not easily stopped by most people who start. Fast forward several decades and e-cigarettes, or vaping as it is also referred to, came along as perhaps a less harmful, possibly less addictive alternative for people trying to move away from traditional (combustible) cigarettes. I think the idea was that these are less damaging than cigarettes and may be used as a transition for those wishing to quit smoking cigarettes because they contain little or no nicotine, but let me tell you, more and more studies are showing that vaping/e-cigarettes are detrimental in their own right. I asked my grandchildren if they were familiar and learned that it is an unfortunate and all too common practice among some high schoolers. Kids congregate in the school bathrooms and inhale. The media has brought forth a host of stories on this alarming trend to be called an epidemic among youth. These have been dubbed the most commonly used tobacco product among teens in the US. As a result, the FDA is pushing hard to restrict access of e-cigarettes to youth and enforcing legal action and fines on retailers that have and continue to sell to underage users. It seems blatantly obvious that the marketing is directed at teens, with the colors and flavors resembling candy and other sweets. E-cigs are often designed to appear like ordinary objects like pens or flash drives. I have recently learned that e-cigarettes can also be used for delivery of marijuana or other drugs as well. I am not even going to address that at this time. I find this particularly concerning because the yet undeveloped adolescent brain is especially vulnerable to nicotine addiction.

Flavored liquid is vaporized and inhaled through a handheld electronic vaping device. A given liquid may or may not contain nicotine, although this trend is still new enough that the long term effects on oral health and overall health are unclear. The liquid also contains propylene glycol, a petroleum byproduct used in antifreeze, paint, liquid detergent and thousands of commercial food products. When heated, studies have shown these e-liquids to contain toxins such as diethylene glycol (also used in antifreeze), lead and chromium. I have seen patients with dry cough or chemical burns on the palate as a result of inhaling the e-liquid, but more often they are unaware because they perceive them as harmless. It makes me wonder how it affects their lungs. Xerostomia, or dry mouth, is another effect that can lead to increased tooth decay. I believe it’s important to educate patients and make them aware that e-cigarettes are not a healthy alternative to smoking. By explaining the negative effects and showing them the oral health issues with the  use of the intraoral camera it becomes more real.