Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
Emory University Midtown Hospital, Emory University, Atlanta, GA, USA.
Crit Rev Toxicol. 2020 Feb;50(2):97-127. doi: 10.1080/10408444.2020.1713726. Epub 2020 Feb 11.
Electronic cigarette (e-cigarette) use is becoming more prevalent and is particularly popular among adolescents and conventional smokers. While the oral health sequelae of conventional smoking are well-established, the impact of e-cigarettes on oral health is still unknown. This study aims to systematically review the available research evidence on the oral health impact of e-cigarette use. This systematic review was conducted according to PRISMA guidelines and used the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence. Three electronic databases (PubMed, Web of Science, and Embase) were systematically searched for studies including case reports. Two independent reviewers extracted data and synthesized the findings. Ninety-nine articles were included in this systematic review. Analyses of the articles yielded seven categories based on symptom similarity and/or focus: mouth effects, throat effects, periodontal effects, dental effects, cytotoxic/genotoxic/oncologic effects, oral microbiome effects, and traumatic/accidental injury. The majority of mouth and throat symptoms experienced by e-cigarette users were relatively minor and temporary, with some evidence that conventional smokers who switched to e-cigarettes experienced mitigation of these symptoms. E-cigarette exposure increased the risk for deteriorating periodontal, dental and gingival health as well as changes to the oral microbiome. Extensive dental damage as a result of e-cigarette explosions were described in case reports. Components of e-cigarette vapor have known cytotoxic, genotoxic, and carcinogenic properties. Although switching to e-cigarettes may mitigate oral symptomatology for conventional smokers, findings from this review suggest that a wide range of oral health sequelae may be associated with e-cigarette use. Well-designed studies to investigate oral health outcomes of e-cigarette use are needed.
电子烟（e-cigarette）的使用越来越普遍，尤其在青少年和传统吸烟者中很流行。虽然传统吸烟对口腔健康的影响已得到充分证实，但电子烟对口腔健康的影响尚不清楚。本研究旨在系统综述电子烟使用对口腔健康影响的现有研究证据。本系统评价按照 PRISMA 指南进行，并使用有效公共卫生实践项目质量评估工具对证据进行评估。系统检索了三个电子数据库（PubMed、Web of Science 和 Embase）中包括病例报告的研究。两名独立审查员提取数据并综合研究结果。本系统评价共纳入 99 篇文章。对这些文章的分析基于症状相似性和/或重点分为七个类别：口腔影响、咽喉影响、牙周影响、牙齿影响、细胞毒性/遗传毒性/肿瘤学影响、口腔微生物组影响和创伤/意外损伤。电子烟使用者经历的大多数口腔和咽喉症状相对较轻且短暂，有证据表明，改用电子烟的传统吸烟者这些症状有所减轻。电子烟暴露增加了牙周、牙齿和牙龈健康恶化以及口腔微生物组改变的风险。病例报告中描述了由于电子烟爆炸导致的广泛牙齿损伤。电子烟蒸汽的成分具有已知的细胞毒性、遗传毒性和致癌性。虽然改用电子烟可能会减轻传统吸烟者的口腔症状，但本综述的研究结果表明，电子烟的使用可能与一系列广泛的口腔健康后果有关。需要进行设计良好的研究来调查电子烟使用对口腔健康的影响。
