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Supporting Your Practice

Potential Effects of E-cigarette Aerosols on Oral Tissue

Dr. Diana Messadi spoke with Dr. John O’Keefe about an article she published with her colleagues recently in PLOS One. The article is titled: Characterization of Electronic Cigarette Aerosol and Its Induction of Oxidative Stress Response in Oral Keratinocytes

Read the article here (PDF)

Dr. Diana Messadi is Chair of the Section of Oral Medicine & Orofacial Pain and Associate Dean for Education and Faculty Development at the UCLA School of Dentistry.


Dr. Messadi and her colleague recently published an article which studied the in vitro effect of e-cigarettes on oral tissues. Some of the key findings are noted below.

  • Vapour and liquid byproducts of the e-cigarettes, when introduced to tissue cultures, led to a substantial reduction of the enzyme glutathione involved in redox balance reactions
  • This reduction induces oxidative stress and a marker for cytotoxicity and carcinogenicity
  • This, also, increases inflammation in lung disease and has implications for periodontal disease and oral cancer

Now, in vivo effects must be researched but, given the introduction of e-cigarettes only a few years back, there is still limited information available about the clinical effects of e-cigarettes and vaping.  A small study carried out at UCLA revealed that dental students feel that they are lacking credible information about vaping and e-cigarettes. As such, it is difficult for practitioners to advise our patients accordingly on the safety of e-cigarettes and their effects on the oral cavity and overall health.

Main Messages

  1. Adolescents are among the highest percentage of first-time users of tobacco products via e-cigarettes. Therefore, it is important to discourage them from starting to use these products as it can be a gateway to using other tobacco products or even, future substance abuse.
  1. Nowadays, adults are using e-cigarettes as a tobacco cessation method. However, this is not an approved form of tobacco cessation. As a practitioner, we should advise them to use them only for a pre-defined period of time.
  1. Patients should be advised that e-cigarette vapour contains the same chemical carcinogens including formaldehyde, acetaldehyde, lead, hydrocarbons which are found in traditional cigarettes and tobacco products.

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