Researchers link vaping to risk of oral disease

US researchers say just a few months of vaping puts healthy people on the brink of oral disease.

The bacteria in the mouths of daily e-cigarette users are teeming with potent infection-causing organisms that put them a risk of ailments ranging from gum disease to cancer, they say in a paper in the journal Science Advances.

In some cases, though the study participants didn’t have an active disease, their bacterial composition resembled that of people with periodontitis, a gum infection that can lead to tooth loss and even be a risk factor for heart and lung disease.

The damaging effects were seen with or without nicotine, leading the researchers to suggest that the heated and pressurised liquids in e-cigarette cartridges create the right environment for a dangerous combination of microbes.

Even current and former long-time cigarette smokers, whose tobacco habit would have given disease-causing microbes easier access to the mouth, had the more damaging oral profiles linked to vaping after only three to 12 months of e-cigarette use.

“If you stop smoking and start vaping instead, you don’t move back toward a healthy bacterial profile but shift up to the vaping profile,” says Purnima Kumar from Ohio State University, the paper’s senior author.

“Knowing the vaping profile is pathogen-rich, you’re not doing yourself any favours by using vaping to quit smoking.”

The researchers collected plaque samples from under the gums of 123 people who showed no current signs of oral disease: 25 smokers, 25 non-smokers, 20 e-cigarette users, 25 former smokers using e-cigarettes and 28 people currently smoking and vaping.

They then conducted DNA deep sequencing of the bacteria genomes to identify not just the types of microbes living in those mouths, but also what their functions were.

Most startling, Kumar and colleagues say, was the profile of the oral microbiome in vapers who had never smoked, were young (age 21-35) and healthy and had used e-cigarettes for just four to 12 months.

Particularly concerning were the levels of stress in the microbial community, which were detected by the activation of genes that contribute to the creation of a mucus-like slime layer surrounding bacterial communities.

The immune system is used to seeing assembled bacteria look like clearly defined communities, but Kumar says that in e-cigarette users, these communities cloaked in slime look like foreign invaders and trigger a destructive inflammatory response.

This change in the microbial landscape, accompanied by higher levels of proteins in vapers’ mouths, signalled that the immune system was on standby to activate and produce inflammation – exponentially increasing the likelihood for disease.

“The reason we’re all healthy is because our immune system has recognised these bacteria and their functions since birth and has established a sense of harmony,” Kumar says.

“The problem is when you throw a curve ball with an environmental shift like this, your immune system doesn’t recognise the bacteria as friends anymore. You have to call the police on them, and that causes a huge inflammatory response.”