Sunday, November 8, 2020

Dental Office and COVID

 

ADA study finds COVID-19 rate among dentists less than 1%

JADA publishes report from ADA Science & Research Institute, Health Policy Institute

October 15, 2020

By Mary Beth Versaci

JADA study graphic 

Fewer than 1% of dentists nationwide were estimated to be COVID-19 positive as of June, according to an American Dental Association Science & Research Institute and Health Policy Institute study.

"Estimating COVID-19 Prevalence and Infection Control Practices Among US Dentists," published online ahead of print by The Journal of the American Dental Association, is the first large-scale collection and publication of U.S. dentists’ infection rates and infection control practices related to COVID-19, according to the ADA.

In June, ADASRI and HPI researchers invited U.S. dentists practicing primarily in public health and private practice to participate in a web survey covering questions related to COVID-19-associated symptoms, COVID-19 infection, infection control procedures used in their primary dental practice, and mental and physical health conditions.

Of the 2,195 dentists who responded to the survey, 20 had a confirmed or probable COVID-19 infection. Respondents included dentists from every state and Puerto Rico. When the results were weighted according to age and location to approximate all U.S. dentists, 0.9% were estimated to have a confirmed or probable COVID-19 infection, with a margin of error of 0.5%.

"This is very good news for dentists and patients," said Dr. Marcelo Araujo, Ph.D., CEO of the ADASRI, chief science officer of the ADA and senior author of the report. "This means that what dentists are doing — heightened infection control and increased attention to patient and dental team safety — is working."

The results of the study will be shared during the ADA FDC Virtual Connect Conference's opening session, COVID-19 and Beyond: Leading a Profession Through Uncharted Territory, scheduled for 5:30-6:15 p.m. CDT Oct. 15. ADA FDC 2020 registration will remain open at ADA.org/meeting throughout the conference, which ends Oct. 17.

The study found that 82.2% of the responding dentists were asymptomatic for one month before the survey, 16.6% had been tested for COVID-19, and 3.7% and 2.7% had tested positive via respiratory and blood samples, respectively, while none had tested positive with a salivary sample. Among those not tested, 0.3% had received a probable COVID-19 diagnosis from a physician.

"Understanding the risks associated with COVID-19 transmission in the dental setting is critical to improving patient and dental team safety," Dr. Araujo said. "This study brings us another step forward in understanding what works. Dentists are following ADA and U.S. Centers for Disease Control and Prevention guidance, and it’s helping to keep the dental team and their patients as safe as possible."

Interim guidance from both the ADA and CDC calls for dental professionals to use the highest level of personal protective equipment available, including masks, goggles and face shields. To minimize aerosols, the ADA guidance also recommends dental professionals use rubber dams and high-velocity suction whenever possible and hand scaling instead of ultrasonic scaling when cleaning teeth.

The researchers found that 99.7% of the dentists surveyed said they had implemented enhanced infection prevention and control procedures, including disinfecting all equipment and surfaces that are commonly touched, checking staff and patient temperatures, screening patients for COVID-19, encouraging distance between patients while waiting, and providing face masks to staff. While 99.6% of dentists reported using PPE when treating patients, 72.8% used PPE as recommended by interim guidance from the CDC. During the time evaluated by the survey, there were limited supplies of PPE, particularly N95 or equivalent masks.

In the two weeks before the survey, 33.9% of the responding dentists reported experiencing at least mild psychological distress, with 8.6% reporting symptoms of depression and 19.5% reporting symptoms of anxiety. About one-fourth of the respondents had at least one medical condition associated with a higher risk of developing severe illness from COVID-19.

The authors of the study are continuing to collect infection rate data, and they have added dental hygienists to their ongoing survey, in collaboration with the American Dental Hygienists Association.

In March, The New York Times listed dentistry as one of the professions at highest risk of COVID-19 infection based on data from O*NET, a database maintained by the U.S. Department of Labor. It was presumed that virus transmission could occur because of the close proximity between dental professionals and patients and because many dental procedures generate aerosols that may contain viral particles from infected individuals.

"The fact that dentistry was named one of the most at-risk professions for infection, but has a far lower prevalence of infection compared to other health professions, is not a coincidence," said Marko Vujicic, Ph.D., chief economist and vice president of the ADA Health Policy Institute. "The profession has taken this issue extremely seriously, and it shows. We will continue to track the rate of COVID-19 among dentists and other facets of the pandemic affecting dentistry so it can help inform the dental profession and other industries as well."

Wednesday, October 21, 2020

Link Between Periodontal Disease and Heart Health

 

The surprising link between periodontal disease and heart health: What dental professionals need to know

Researchers have found that people with periodontal disease are almost twice as likely to have heart disease, and that risk may be even greater than for those with high cholesterol. Find out from Dr. Robert H. Gregg II what you can do in your practice to help educate patients about the oral-systemic connection between periodontal disease and cardiovascular disease, and ultimately help save lives.

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Can your mouth tell if you’re at risk for heart disease? It just may! Researchers have found that people with periodontal disease are almost twice as likely to have heart disease. (1) A recent analysis shows that the potential heart disease risk for patients with periodontal disease may be even greater than for those with high cholesterol. (2) For too many Americans, this reality hits close to home in that more than 85 million Americans have some form of cardiovascular disease (CVD) (3), while more than 200 million American adults have some form of periodontal disease. (4)

February is both Heart Health Month and Gum Disease Awareness Month

Given the link between these two systemic diseases, the dental profession can be considered a key assessor of not just oral health, but also heart health. Can we help save the 800,000 Americans who die from CVD annually? (1) Or can we help the 795,000 people who have a stroke in the United States annually? (5) The first step is helping the general population understand how these chronic diseases may be related.

Understanding the link between periodontal disease and heart disease: The suspected role of bacteria and inflammation

Scientists suspect the link between the two diseases is due to the same bacteria. In this scenario, bacteria found in infected gum tissue around teeth break down the barrier between the gums and the underlying connective tissue, causing inflammation. During normal chewing or brushing, bacteria can enter the bloodstream and move to other parts of the circulatory system, contributing to the formation of cardiovascular disease.

Inflammation, or swelling, is the body’s natural response to infection. It is possible that as oral bacteria travel through the body it triggers a similar response, which then leads to the formation of arterial plaque. (6) Oral bacteria have been found in the fatty deposits of people with atherosclerosis. (7) These deposits can narrow arteries or break loose and clog them entirely, leading to heart attack or stroke.

While scientists are still researching whether inflammation is at the root of the problem, one thing is for sure: It is firmly established that a link exists between periodontal disease and heart disease.

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Treating periodontal disease: Helping patients’ total health

Given the link between periodontal disease and heart health—not to mention tooth loss and the multitude of other systemic diseases linked to periodontitis—it is important for patients to accept effective treatment. Treatment itself is not enough; treatment must be successful to have an impact. (8)

The first step in effective treatment is diagnosis. Is your hygiene team actively looking for the disease? Do you have a proper probing protocol in place? Patients often don’t understand, or simply ignore, the warning markers of periodontal disease, so it is imperative that your office has the tools in place to inform patients. Initial symptoms of periodontal disease are often silent—i.e., symptoms do not actually appear until later stages.

The American Academy of Periodontology lists the signs of periodontal disease as the following: (9)

  • Red, swollen, or tender gums or other pain in the mouth
  • Bleeding while brushing, flossing, or eating hard food
  • Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
  • Loose or separating teeth
  • Pus between the gums and teeth
  • Sores in the mouth
  • Persistent bad breath
  • A change in the way the teeth fit together when one bites down
  • A change in the fit of partial dentures

A patient-friendly, less-invasive treatment for periodontal disease

Even with a prompt diagnosis, patients often refuse surgical treatment—including flap surgery, soft-tissue grafts, bone grafting, guided tissue regeneration, and the application of enamel matrix derivative—out of fear or misunderstanding. (10) The way to repair damage caused by periodontal disease is to get rid of the infection and close up the pockets. Until recently that meant painful scraping and scalpel-and-suture surgery. How can we reach past inherent fear and help patients understand the importance of treatment that is imperative to total health? Today, many general dentists and periodontists offer a patient-friendly, less-invasive laser procedure—the LANAP protocol—as another option for effective treatment that helps alleviate patient fear.

As a profession, we can help educate patients about the oral-systemic connection by looking for early symptoms of periodontal disease and offering minimally invasive treatment options that patients will accept. Every 40 seconds an American adult has a stroke. (11) Could you help save a life today?


Sunday, August 16, 2020

Denture Care Instructions and Tips

 

DENTURE CARE INSTRUCTIONS AND TIPS

Denture Care Instructions and Tips

  • THREE DENTURE CARE TIPS
  • HOW TO CLEAN DENTURES
  • HOW TO REMOVE DENTURES
  • CAN DENTURES BE REFITTED?

Three Denture Care Tips

Your dentures will last longer and fit better if you take proper care of them. Keep these points in mind to keep your dentures in top shape:

  • Clean dentures daily:  Brush your dentures each day the same way that you would brush your teeth, with one key difference: Skip the toothpaste. Many commercial types of toothpaste can damage dentures. Instead, use a soft-bristle denture brush, designed specifically for cleaning dentures, and water to brush all surfaces of the dentures, but be careful not to bend any attachments. Rinse your dentures with water after each meal. You can buy specialized denture cleaners for soaking dentures, but soaking is not a substitute for brushing—you need to brush the dentures to remove plaque.
  • Treat dentures right:  Fill the sink with water or place a folded towel in it when handling your dentures, so you don’t break them if they should fall into the sink. When you aren’t wearing your dentures, let them soak in cool water or a denture cleaning solution to keep them from drying out. Be careful of cleaning solutions if your dentures have metal attachments—the solutions could cause the metal to tarnish. And don’t soak dentures in hot water—they could warp.
  • Remove your dentures (full or partial) every night:  This allows the gum tissue beneath them a chance to rest.

How to Clean Dentures

Plaque can form on dentures, just like natural teeth. If they’re not removed every day, your dentures may look less white and bright. It is also important to clean your dentures with a denture brush and soak them in a cleanser solution daily to avoid odor.

  1. Clean your dentures over a sink filled with water to avoid damage if you drop them.
  2. Rinse dentures thoroughly in warm water to remove any loose food particles.
  3. Use a denture cleanser. (Conventional toothpaste, bleach, vinegar and soap are not designed for denture cleaning and could, in some cases, cause damage. Scratched dentures will harbor unsightly plaque bacteria, causing denture odor. Harsh products like bleach may even turn the pink parts of your dentures white.)
  4. Moisten a denture brush (not a soft-bristle toothbrush) to clean all surfaces of your denture gently. Brushing too hard can damage any plastic or metal parts. Rinse and brush in clean, warm water.
  5. Brush your gums, tongue and natural teeth with a fluoride toothpaste before reinserting your dentures. This will help remove plaque from your teeth, stimulate circulation in your mouth and help maintain good oral health.
  6. Rinse with a mouthwash after brushing to give your mouth a refreshed feeling.

How to Remove Dentures

  1. Swish your mouth with warm water or a mouthwash.
  2. Fill the sink with warm water to avoid breaking the dentures if they are dropped.
  3. Remove your top denture by placing your thumb against your front teeth and press upward and outward toward your nose.
  4. Remove your lower denture by slowly pulling on it while applying a rocking motion.

If you take care of your dentures, you should be able to use them for five to seven years before you need to replace them. It’s important to see your dentist every six months to check the condition and fit of your dentures and to look for any signs of irritation or gum disease so they can be treated immediately.

Can Dentures Be Refitted?

Visit your dental professional regularly, as recommended by the American College of Prosthodontists (ACP). Rely on him or her for advice and answers to specific questions about your oral care. Even with the best care, natural changes in your mouth may make it necessary to have your dentures remade after a number of years. The bony ridge that your dentures rest on shrinks over time. Dentures should be refitted every few years by relining or rebasing, and new dentures should be made every five to 10 years. Report any change in the way your dentures work or feel to your dentist or prosthodontist. Your oral care professional can tell you whether an adjustment, a relining or new dentures are needed.

Sunday, July 5, 2020

Connection Between Oral Health and Systemic Diseases

The Connection Between Oral Health and Systemic Diseases

It’s not news that there is a significant link between one’s oral health and overall health. Though studies are ongoing, researchers have known for quite some time that the mouth is connected to the rest of the body.
“Your mouth is the entry point of many bacteria,” said Dr. Steven Grater, Pennsylvania Dental Association (PDA) member and general dentist from Harrisburg. “To keep this bacteria from going into your body, cleaning your mouth (brushing, flossing and rinsing) is necessary.”
PDA strives to educate the public about the role oral health plays in some systemic diseases, such as diabetes and heart disease, and oral health complications during pregnancy. PDA wants you to know what you can do to keep your teeth, gums and body healthy.
Diabetics are more prone to several oral health conditions, including tooth decay, periodontal (gum) disease, dry mouth and infection. According to “Oral Health in America: A Report of the Surgeon General,” the relationship between type I and type II diabetes and periodontal disease has often been referred to as the “sixth complication” of the disease.
Periodontal disease is an infection of the tissues that support your teeth, and is caused by plaque-forming bacteria in your mouth. In diabetics, it is often linked to how well a person’s diabetes is under control. Diabetic patients should contact their dentist immediately if they observe any of the symptoms of periodontal disease, including red, swollen or sore gums or gums that bleed easily or are pulling away from the teeth; chronic bad breath; teeth that are loose or separating; pus appearing between the teeth and gums; or changes in the alignment of the teeth.
Diabetic patients often suffer from dry mouth, which greatly increases their risk of developing periodontal disease. If you suffer from dry mouth, talk to your dentist. He or she may recommend chewing sugarless gum or mints, drinking water, sucking on ice chips or the use of an artificial saliva or oral rinse.
Studies also have shown that periodontal disease may be linked to cardiovascular disease, stroke, bacterial pneumonia, preterm births and low-birth weight babies. Research suggests that people with periodontal disease are nearly three times as likely to suffer from heart disease. Oral bacteria can affect the heart when it enters the blood stream, attaching to fatty plaques in the heart’s blood vessels and contributing to the formation of clots.
Due to the increase in hormone levels, particularly estrogen and progesterone, pregnant women are at greater risk to develop inflamed gums, which if left untreated can lead to periodontal disease. A five-year study conducted at the University of North Carolina found that pregnant women with periodontal disease are seven times more likely to deliver a premature, low-birth-weight baby.
Oral health problems can cause more than just pain and suffering. They can lead to difficulty speaking, chewing and swallowing, affecting your ability to consume the nutrition your body needs to stay healthy, participate in daily activities and interact with others. Poor nutrition also can lead to tooth decay and obesity. In a recent study, researchers at the University of Buffalo examined 65 children, ages two through five, who were treated for cavities in their baby teeth. Nearly 28 percent of them had a body-mass index indicating they were either overweight or obese.
To keep your teeth, gums and body healthy, PDA recommends the following:
  • Provide your dentist with a complete health history, including any illnesses and medication use.
  • Brush your teeth twice a day with fluoride toothpaste.
  • Floss daily to help remove plaque, the sticky film of bacteria that gets stuck between your teeth and under your gums.
  • Visit your dentist regularly for a checkup and professional cleaning to help prevent any problems and detect possible problems in their early stages. The mouth is often the location used to diagnose a variety of diseases.
  • Eat a well balanced diet, which will help you maintain a healthier immune system, help prevent heart disease and slow diabetes disease progression.
  • If you smoke, talk to your dentist about options for quitting.
“A clean mouth will lead to a clean body,” Dr. Grater said. “Although you clean your mouth every day at home, regular checkups to the dentist will prevent additional disease that can likely cause you to be sick.”
For more information about the link between oral health and overall health and many other oral health topics, visit PDA's Patient Resource Center.

Sunday, March 1, 2020

Gum Disease and Overall Health

Gum Disease and Your 

Overall Health

The Impact of Periodontal Disease

Man flossing his teeth
Klaus Vedfelt / Getty Images

Often taken for granted, the monotonous task of brushing and flossing our teeth daily has never been more important in order to avoid periodontal disease known as gum disease and the risk it places on our overall health. It has been estimated that 75 percent of Americans have some form of gum disease, which has been linked to serious health complications and causes various dental problems that like periodontal disease, are often preventable.

What Is Gum Disease?

Periodontal disease, also called gum disease, is mainly caused by bacteria from plaque and tartar buildup. Other factors that have the potential to cause gum disease may include:
  • Tobacco use
  • Clenching or grinding your teeth
  • Certain medications
  • Genetics
Types of periodontal disease (gum disease) include:
  • Gingivitis – The beginning stage of gum disease and is often undetected. This stage of the disease is reversible.
  • Periodontal disease – Untreated gingivitis may lead to this next stage of gum disease. With many levels of periodontal disease, the common outcome is chronic inflammatory response, a condition when the body breaks down the bone and tissue in the infected area of the mouth, ultimately resulting in tooth and bone loss.
Signs of gum disease include:
  • Red, bleeding, and/or swollen gums
  • Bad breath
  • Mobility of the teeth
  • Tooth sensitivity caused by receding gums
  • Abscessed teeth
  • Tooth loss
Recent studies suggest periodontal or gum disease may contribute to or be warning signs of potentially life-threatening conditions such as:
  • Heart disease and stroke – Studies suggest gingivitis may increase the risk of heart disease and stroke because of the high levels of bacteria found in infected areas of the mouth. As the level of periodontal disease increases, the risk of cardiovascular disease may increase with it. Other studies have suggested that the inflammation in the gums may create a chronic inflammation response in other parts of the body which has also been implicated in increasing the risk of heart disease and stroke.
  • Diabetes – People with diabetes often have some form of gum disease, likely caused by high blood glucose, according to the U.S. Centers Disease Control and Prevention. People with diabetes need to take extra care to ensure proper brushing and flossing techniques are used to prevent the advancement of the gum disease. Regular check-ups and cleanings with your dental hygienist should be followed.
  • Chronic kidney disease – A study, conducted by Case Western Reserve University, suggests that people without any natural teeth, known as edentulous, are more likely to have chronic kidney disease (CDK), than people with natural teeth. CDK affects blood pressure potentially causing heart disease, contributed to kidney failure, and affects bone health.
  • Preterm birth – Babies that are born premature (before 37 weeks of gestation), may face numerous health complications. Research indicates that women with periodontal disease are three to five times more likely to have a baby born preterm compared to women without any form of gum disease. Women are more susceptible to gingivitis when pregnant and should follow their regular brushing habits, and continue with dental cleanings and examinations.

Treatments for Gum Disease

Depending on the type of periodontal disease, some of the available treatment options are:
  • Removal of plaque and calculus by way of scaling done by your dental hygienist or dentist.
  • Medications such as chlorhexidine gluconate, a mouth rinse prescribed by your dentist or hygienist to help kill the bacteria in your mouth, along with frequent cleanings.
  • Surgery may be necessary in certain cases to stop, halt, or minimize the progression of periodontal disease. Surgery is also used to replace bone that was lost in advanced stages of the disease.

Preventing Gum Disease

Proper brushing and flossing is the easiest way to reduce and prevent gum disease, but regular cleanings with your dental hygienist or dentist are necessary to remove calculus and treat advanced gum disease. If you are concerned that you may have gum disease, contact your dentist
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Saturday, February 1, 2020

Vaping & Oral Health

Vaping and oral health: It's worse than you think

Drs. Scott Froum and Alisa Neymark examine the effects of e-cigarette ingredients and their notable deterioration on oral health. They offer insight into how explosions while vaping and e-cig burn injuries can disfigure oral soft tissue.
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THE USE OF ELECTRONIC CIGARETTES (E-CIGARETTES) represents a significant and increasing proportion of tobacco consumption, posing a tremendous threat to oral health. This article will look at the following aspects of e-cigarettes:
  • Overview of e-cigarette usage
  • Statistics on the current prevalence of e-cigarettes
  • Three chemicals contained in e-cigarettes and their effects on oral health
When compared to traditional tobacco use, an argument that e-cigarette use may be as dangerous to oral health—if not more dangerous—can be made.

Overview

Using e-cigarettes, referred to as vaping, works by heating a liquid to generate an aerosol that the user inhales. The liquid in the e-cigarette, called e-liquid, is usually made up of propylene glycol, glycerin, flavorings, water, and nicotine, although some users will substitute THC for nicotine. In practice, e-cigarette users tend to reach lower blood nicotine concentrations than tobacco smokers, although it is difficult to make a direct comparison because nicotine concentrations in e-cigarettes vary widely.
Reasons individuals vape include the following:
  • Smoking cessation
  • The thought that vaping is less harmful than cigarettes
  • Circumvention of smoke-free areas
  • Recreational enjoyment (1)

Prevalence

Researchers and antitobacco advocates are especially concerned that irresponsible marketing has made e-cigarettes appeal to the segment of the young population that had no history of tobacco usage and never intended to start smoking. Because of the known dangerous effects of traditional tobacco methods, use among middle and high school students has been steadily decreasing since 2014. However, since the introduction of the e-cigarette, that number is now increasing, and it is estimated that one in five high school students may now be using tobacco products. (2) E-cigarette use from 2017 to 2018 increased 78% among high school students and 48% among middle school students. (3)

Propylene glycol

The first danger of e-cigarettes is associated with the carrier product known as propylene glycol (PG). PG is primarily used in the production of polymers and in food processing. It can be found in various edible items, such as liquid sweeteners, ice cream, and whipped dairy products. It can also act as a carrier for various inhalant pharmaceutical products, including nicotine. PG is a viscous, colorless liquid that possesses a faintly sweet taste and is one of the major ingredients of the e-liquid used in e-cigarettes. When used orally, the breakdown products of PG include acetic acid, lactic acid, and propionaldehyde, which are all toxic to enamel and soft tissue. (4) In addition, PG is a hygroscopic product, which means water molecules in saliva and oral tissue will bond to the PG molecules, leading to tissue desiccation. (5) The result of this is xerostomia, or "dry mouth," which has been shown to lead to an increase in cavities, gum disease, and other oral health issues.

Vegetable glycerin and flavorings

The second danger of e-cigarettes is due to other major component of e-liquid: glycerin and flavorings. Vegetable glycerin (VG) is a colorless, odorless, viscous, and sweet-tasting liquid. It has a myriad of applications, including medical, pharmaceutical, and personal care. In the food industry, it serves as a humectant, solvent, and sweetener. It is 60% as sweet as sucrose and is not metabolized by cariogenic bacteria, and is therefore thought not to cause cavities. However, studies have shown that the combination of VG with flavorings produces a fourfold increase in microbial adhesion to enamel and a twofold increase in biofilm formation. (6) In addition, a 27% decrease in enamel hardness was demonstrated when flavorings were added to e-liquid as compared to unflavored controls. The viscosity of the e-liquid also allowed Streptococcus mutans to adhere to pits and fissures. In other words, e-liquid allows more cavity-causing bacteria to stick to a softer tooth and can lead to rampant decay.

Nicotine

Another danger associated with e-cigarettes has to do with nicotine. Although the percentage of nicotine is much lower (0.3%–1.8%) than traditional tobacco products, one electronic cartridge (200–400 puffs) can equal the smoking of two to three packs of regular cigarettes. The dangerous effects of nicotine on gum tissue are well known. The literature suggests that nicotine affects gingival blood flow as it is a vasoconstrictor. It also affects cytokine production, neutrophil function, and other immune cell function. (7) In addition, nicotine decreases connective tissue turnover. All of this results a much higher chance of developing gum disease and tooth loss.

Lithium batteries

Recently, a 24-year-old man from Texas was killed when his vape pen exploded, and part of the device wound up severing his jugular vein. (8) Although these types of sensationalized deaths are rare with e-cigarettes and vaping pens (only two reported to date), the explosions of these pens are not. The problem lies within the vape pen and the lithium batteries overheating and exploding. These explosions are usually attributed to improper charging of the device or have been linked to a type of device called a mechanical mod that has no internal safety and can overheat and explode.
One report found that 195 of these adverse events occurred between the years of 2009 and 2016. (9) However, Dennis Thombs, dean of the School of Public Health at UNT Health Science Center, published a study that concluded the number of vape explosions in the US were most likely underestimated. Thombs estimated that there were 2,035 e-cigarette explosions and burn injuries in the US between 2015 and 2017—more than 40 times the initial estimate by the US government. (8) These injuries are serious and often lead to disfigurement of oral soft tissue (figure 1).
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Figure 1: Oral soft-tissue injuries due to e-cigarette explosion (photo courtesy of Nicole Angemi)

Bottom line

The bottom line is vaping can be just as dangerous, if not more dangerous, when compared with smoking. The problem is that vaping is thought to be a safer alternative to traditional tobacco products, and companies are adding flavoring products to attract younger generations. According to a 2013–2014 survey, 81% of current youth e-cigarette users cited the availability of appealing flavors as the primary reason for use. (10)
For example, one patient of a general dental practice had a caries-free history for 35 years. He ceased smoking traditional cigarettes and decided to vape as he thought this was a healthier alternative. Within a year, cervical enamel demineralization and interproximal lesions were present on the mandibular anterior sextant, consistent with the primary point of contact of the e-liquid aerosol (figure 2).
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Figure 2: Effects of e-cigarette usage
In another example, a young patient had been using e-cigarettes for five years. He started vaping as a method to quit smoking traditional tobacco products thinking vaping was a healthy alternative. Because of its ease of use, he smoked a cartridge of one of the more popular vaping products a day. Admittedly, he also drank energy drinks (high sugar content), stating that his mouth was often dry after vaping. This combination led to rampant decay with smooth-surface lesions and future tooth loss (figure 3).
Figure 1 Vaping Oral Health Dentistry
Figure 3: Effects of e-cigarettes
Many advocates of vaping claim that e-cigarette use and vaping poses 5% the health risks of traditional tobacco smoking and claim its use to be helpful in getting people to quit. (11) This particular use does have merit and has helped many individuals quit smoking. Unfortunately, these studies have only analyzed e-cigarette use in former smokers using vaping as a way to stop smoking. The studies have not looked at the health effects of nonsmokers who start vaping because of the perceived innocuous health effects and because it "tastes yummy." In addition, these studies have not looked at vaping in middle school and high school individuals, the group where e-cigarette use is increasing the most in percentage of use. Because of this, a tidal wave of oral health problems is heading our way.