Association between electronic nicotine delivery systems and dental caries: A systematic review with meta-analysis

Abstract

Objective

To explore the association between the electronic nicotine-delivery systems (ENDS) use and dental caries in adolescents and adults.

Material and methods

Two researchers independently conducted the search across six databases, study selection, data extraction, and assessment of risk of bias and certainty of evidence. Included studies involved participants ≥ 16 years old, assessed ENDS use, and employed clinical and/or radiographic methods for caries diagnosis. Risk of bias was evaluated using the Joanna Briggs Institute Checklist and the Newcastle–Ottawa Scale. A meta-analysis was performed to calculate the mean difference (MD) in caries severity between ENDS users and non-users. The GRADE approach was used to assess the certainty of the evidence.

Results

Of the 559 eligible studies, four were included (three cross-sectional and one was a prospective cohort). Three studies identified a potential association between the ENDS use and either the experience or risk of dental caries, as well as the prevalence of untreated teeth. Three studies were classified as having a high risk of bias. The quantitative analysis of the pooled effects (2 studies) showed no significant MD between the history of dental caries among those who did or did not use ENDS (MD: 0.72, 95 % confidence interval: −1.70–3.15).

Conclusion

It was showed a potential association between ENDS use and increased severity and risk of dental caries in both population groups. However, quantitative analysis showed disease severity is not associated with the use of these devices among adults. The certainty of evidence for qualitative and quantitative analyses was very low.