Comparative Effects of E-cigarette Aerosol on Periodontium

Introduction: Tobacco use is one of the main causes of periodontitis. E-cigarettes are gaining in popularity, and studies are needed to better understand the impact of e-cigarettes on oral health. Objective: To perform a longitudinal study to evaluate the adverse effects of e-cigarettes on periodontal health. Methods: Naive e-cigarette users, cigarette smokers, and non-smokers were recruited using newspaper and social media. Demographics, age, gender, and ethnicity, were recorded. Participants were scheduled for two visits 6 months apart. At each visit, we collected data on the daily frequency puffs of an e-cigarette, the number of cigarettes smokes, and other parameters, such as alcohol consumption. Carbon monoxide levels, cotinine levels, salivary flow rate, probing depth, and bleeding on probing were determined at both baseline and follow-up visits. P-values less than 0.05 were considered statistically significant. Results: We screened 159 subjects and recruited 140 subjects. One-hundred-one subjects (31 cigarette smokers, 32 e-cigarette smokers, and 38 non-smokers) completed every assessment in both visits. The retention and compliance rate of subjects was 84.1%. The use of social media and craigslist was significant in recruiting e-cigarette subjects. Ethnicity and race differed between cohorts, as did average age in the male subjects. Carbon monoxide and salivary cotinine levels were highest among cigarette smokers. Bleeding on probing and average probing depths similarly increased over time in all three cohorts. Increase in the rates of severe periodontal disease were significantly higher in cigarette smokers and e-cigarette users than non-smokers. Confounding factors were subjects9 age as most of the e-cigarette group were much younger than cigarette smokers. Conclusion: Among the recruited participants, periodontal severity status after 6 month was significantly worse in cigarette smokers and e-cigarette smokers than non-smokers. This study design and protocol will assist in future larger studies on e-cigarette and oral health.