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Vaping or the use of electronic cigarettes is experiencing increasing adoption due to alleged advantages over conventional smoking. However, its potential health implications have recently been the subject of debate. Recent studies have, for example, revealed major modifications of the oral microbiota, which could contribute to the establishment of a flora enriched in pathogenic strains capable of triggering specific immune responses.
Electronic cigarettes, or e-cigarettes, were initially developed to support smoking cessation strategies. The benefits would be obtained by the absence or reduction of harmful combustion products from conventional cigarettes. However, the liquids contain not only some of the toxic compounds of conventional cigarettes, but also unique chemical compounds for vaping.
Aerosols released by e-cigarettes contain nicotine at highly variable concentrations, but also other substances such as acetaldehyde, acrolein, formaldehyde, propylene glycol, glycerin, ethanol, acetol, and propylene oxide. While the effects of nicotine on health are well established, much less is known about the other compounds.
Despite the unknowns, vaping is a practice that is increasingly common, especially among young people. Surveys, for example, have revealed that in the United States, the use of e-cigarettes is now more common among adolescents than that of traditional cigarettes. The reasons for this growth are likely associated with a fashion effect, as well as the design of a wide range of attractive e-cigarettes for young people (in the shape of a pen, USB key, etc.), or the availability of a wide variety of flavors suitable for all genders and ages. Their use could also partially mitigate the stigma associated with conventional smoking.
The few studies exploring the effects of e-cigarettes on health have shown that the components of their aerosols adhere to the walls of the upper digestive tract and respiratory tract structures. These structures include the oral cavity, nasal cavity, and lungs, with the oral and periodontal microbial community being the first to be exposed.
However, to what extent can e-cigarettes affect the oral microbial flora? What would be the implications for our health? It is important to know that the oral cavity is the main entry point for many microbial species colonizing the respiratory and gastrointestinal tracts. Alteration of the oral microbial complex could thus have potentially deleterious consequences both locally and systemically.
A practice favoring the growth of pathogenic microbial strains
Comprising more than 700 species of bacteria, the oral microbiota is the second largest microbial population in our body after that of the intestine. It has both unique characteristics and commonalities with the microbiota of the respiratory, gastrointestinal, and genitourinary systems. On the other hand, the oral cavity forms an incredibly complex habitat, at which microbial communities colonize both the soft tissues of the oral mucosa and the hard tissues of the dental surfaces.
The microbial profile of the oral cavity can dynamically change throughout life, influenced by many factors such as diet, exposure to medication, immune health, oral hygiene, and exposure to nicotine products.
A longitudinal study evaluating the effects of e-cigarettes on the human subgingival plaque (SGP) microbial community suggested that their use promotes the growth of unique periodontal microbiota. The characteristics of this microbiota would be between those of conventional smokers and those of non-smokers.
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This suggests a major change with health impacts on oral and dental health that would be fundamentally different from those of conventional smoking. Periodontitis, in particular, is caused by disruption of the microbiota lining the space between the teeth and the gingival tissues. This triggers inflammatory and immune responses that could potentially lead to tooth loss, deterioration of the maxillary bones, and systemic diseases. The periodontal microbiota of e-cigarette users would have specific immune signatures.
These results are consistent with those of another series of studies suggesting that the modifications induced by e-cigarettes on the oral microbiota could promote the growth of pathogenic strains. One study recently uncovered biofilm deposits that favor the growth of bacteria such as Streptococcus mutans primarily involved in dental caries. An over-representation of the Porphyromonas and Veillonella strains was also observed in saliva samples from vapers. As part of the natural oral microbiota, these strains can cause inflammation of the gums by becoming dominant over other strains. In addition, a high presence of inflammatory cytokines was also detected in these e-cigarette users.
Overall, most studies suggest that the use of e-cigarettes increases the risks of oral microbial dysbiosis, potentially leading to oral and periodontal diseases. Although more research is needed to further explore this association, doctors call for caution in the use of these devices, especially among young people.
Sources: BMC Microbiology , ASM Journals
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2023-12-29 15:00:05
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