School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
School of Dentistry, University of California, San Francisco, CA, USA.
J Dent Res. 2021 Aug;100(9):906-913. doi: 10.1177/00220345211002116. Epub 2021 Mar 25.
Novel nicotine products, particularly electronic cigarettes (e-cigarettes), have become increasingly popular over the past decade. E-cigarettes are sometimes regarded as a less harmful alternative to tobacco smoking, and there is some evidence of their potential role as a smoking cessation aid. However, there are concerns about their health consequences, particularly in users who are not tobacco smokers, and also when used long term. Given the mode of delivery of these products, there is potential for oral health consequences. Over the past few years, there have been an increasing number of studies conducted to explore their oral health effects. In vitro studies have reported a range of cellular effects, but these are much less pronounced than those resulting from exposure to tobacco smoke. Microbiological studies have indicated that e-cigarette users have a distinct microbiome, and there is some indication this may be more pathogenic compared to nonusers. Evidence of oral health effects from clinical trials is still limited, and most studies to date have been small in scale and usually cross-sectional in design. Epidemiological studies highlight concerns over oral dryness, irritation, and gingival diseases. Interpreting data from e-cigarette studies is challenging, given the different populations that have been investigated and the continual emergence of new products. Overall, studies reveal potential oral health harms, underscoring the importance of efforts to reduce use in nonsmokers. However, in smokers who are using e-cigarettes as an aid to help them quit, the benefits of quitting tobacco smoking may outweigh any negative oral health impacts of e-cigarette use, particularly in the short term. Future research is needed to understand the clinical significance of some of the biological changes observed by following different cohorts of users longitudinally in carefully designed clinical studies and pragmatic trials supported by high-quality in vitro studies.
在过去的十年中，新型尼古丁产品，特别是电子烟（e-cigarettes），越来越受欢迎。电子烟有时被认为是比吸烟危害更小的替代品，并且有一些证据表明它们可能有助于戒烟。然而，人们对它们的健康后果存在担忧，特别是在非吸烟者和长期使用者中。鉴于这些产品的输送方式，可能会对口腔健康产生影响。在过去的几年中，已经进行了越来越多的研究来探索它们对口腔健康的影响。体外研究报告了一系列细胞效应，但与暴露于烟草烟雾相比，这些效应要小得多。微生物学研究表明，电子烟使用者的微生物组有明显的差异，并且有一些迹象表明，与非使用者相比，这可能更具致病性。临床试验中有关口腔健康影响的证据仍然有限，迄今为止，大多数研究规模较小，通常设计为横断面研究。流行病学研究强调了口腔干燥、刺激和牙龈疾病的担忧。由于研究的人群不同，并且不断出现新产品，因此从电子烟研究中解释数据具有挑战性。总体而言，研究揭示了潜在的口腔健康危害，强调了减少非吸烟者使用电子烟的重要性。然而，对于那些使用电子烟作为戒烟辅助工具的吸烟者来说，戒烟带来的好处可能超过电子烟使用对口腔健康的任何负面影响，尤其是在短期内。未来的研究需要了解通过在精心设计的临床研究和由高质量体外研究支持的实用试验中，对不同用户队列进行纵向随访，观察到的一些生物学变化的临床意义。
