Vaping, heated tobacco, and periodontal health: a systematic review of their effects on inflammation, microbiota, and non-surgical therapy response
Abstract
Background: The increasing use of electronic cigarettes and heated tobacco products has raised concerns regarding their potential effects on periodontal health. The objective of this systematic review was to assess the impact of these alternative nicotine delivery systems on periodontal inflammation, oral microbiota, and outcomes of non-surgical periodontal therapy. Methods: A comprehensive literature search was conducted in PubMed, Web of Science, and Scopus, in accordance with PRISMA guidelines. Results: The findings indicate that although electronic cigarettes and heated tobacco products may reduce exposure to certain harmful constituents compared with conventional cigarettes, they are not free of adverse effects. Their use has been associated with increased levels of pro-inflammatory cytokines, reduced anti-inflammatory mediators, delayed periodontal healing, and alterations in oral microbiota composition, which may contribute to the progression of periodontal disease. These biological changes may negatively influence the response to non-surgical periodontal therapy. Discussion: From a clinical perspective, individuals using electronic cigarettes or heated tobacco products tend to exhibit less favorable treatment outcomes, often comparable to those observed in conventional cigarette smokers. Despite being promoted as harm-reduction alternatives, current evidence suggests that electronic cigarettes and heated tobacco products still pose significant risks to periodontal…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Tobacco and COPD: presenting the World Health Organization (WHO) Tobacco Knowledge Summary
- Comparative effects of e-cigarette smoking on periodontal status, salivary pH, and cotinine levels
- Association between exposure to environmental pollutants and increased oral health risks, a comprehensive review
- Influence of gestational window on offspring vascular health in rodents with in utero exposure to electronic cigarettes
- Natural products as kinase inhibitors in lung cancer: molecular mechanisms, therapeutic potential, and clinical trials
- Nicotine in electronic cigarettes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.