Vaping 101 for Dentists: Vaporizers, How They Work, and Protecting Patient Health

The long-term health effects of e-cigarettes and vaporizers used to consume tobacco are not yet known. The Canadian Dental Association advises against smoking of tobacco due to risks that smoking poses to individual oral and general health.

Dental health professionals play an important role in educating patients about the physical and oral health risks of vaping. This page provides general information about vaping to help inform discussions between dentists and their patients. 

HOW VAPING WORKS

Most vaping devices use electrical power from a battery to heat a liquid solution. The heat causes the solution to become vaporized. The vapour then condenses into an aerosol, which is breathed in by the user through a mouthpiece in the vaping device.

VAPING DEVICES

There are two kinds of vaping devices:

• • • Open, which means they can be refilled.
    • Closed, which means either the whole product, or the part that holds the vaping substances, can’t be refilled.

Vaping devices are available in many shapes and sizes and can sometimes look like USB drives or pens. The amount of substance exposure (including nicotine) when a person vapes can be affected by:

• • • Device battery power
    • Type of vaping device
    • Device settings
    • Combination of internal components
    • Type of vaping liquid and amount of nicotine
    • User behaviour patterns and experience with vaping

VAPING SUBSTANCES

Most vaping substances are liquids, but wax and herbs are also available.

Vaping liquids contain nicotine and/or flavouring compounds all dissolved into one mixture, typically propylene glycol and/or glycerol. Nicotine content can be very low but can also exceed nicotine levels in a typical tobacco cigarette.

When heated up, vaping liquids produce an aerosol that may contain dozens of chemicals. The ingredients typically found in vaping liquids and resulting aerosol are:

• • • Glycerol
    • Propylene glycol
    • Nicotine
    • Flavours (menthol, popcorn, cinnamon, vanilla, fruity flavours etc.)

CHEMICALS PRESENT IN VAPING LIQUIDS

• • • Compounds consisting of chemicals and blends of chemicals are used to simulate various flavours.
    • Using vaping devices with higher power and temperature settings can result in a higher level of chemicals being released into the vapour.
    • Chemicals used to create discernable flavours in vaping products are the same chemicals used by food manufacturers to flavour foods and may not be safe to breathe into the lungs.

HEALTH CONSIDERATIONS AND EFFECTS

The long-term health effects of vaping tobacco and liquids are currently unknown but continue to be assessed and researched. However, at this time, we do know that: 

• • • The amount of chemicals and contaminants in vapour is normally at much lower levels than in cigarette smoke.
    • When vaping oils and liquids are heated, the reaction can create formaldehydes like nickel, tin, aluminum that can be carried within the vapour.
    • Vaping can create nicotine dependence in persons not previously using nicotine.
    • Vaping increases exposure to harmful chemicals like the main liquids in vaping products: glycerine and propylene glycol. 
    • Using vaping products with higher power and temperature settings can produce more chemicals.
    • While there have been no reported cases, there is concern that inhaling heated diacetyl, a flavouring chemical used in vaping products, could cause popcorn lung.

ADDRESSING HEALTH CONCERNS

In 2017, Health Canada and the Canadian Institutes of Health Research established the Scientific Advisory Board on Vaping Products. The 10-member board includes scientists, researchers, academics, and health professionals, with expertise in a range of disciplines, including clinical medicine, population and public health, and basic and biomedical science who:

1. 1. 1. Review the scientific literature on the potential health benefits and harms of vaping products.
      2. Provide recommendations on the federal legislative framework for vaping products.

HELPFUL LINKS

Canadian Dental Association

• • • CDA Position on Smoking and Vaping
    • Smoking Tobacco
    • Smokeless Tobacco
    • Quit Supports

Health Canada

• • • Smoking, vaping and tobacco
    • INFOGRAPHIC: The Mechanics of Vaping (Health Canada)

Original post: February 11, 2019. Last updated: January 17, 2022