E-cigarette exposure increases caries risk and modifies dental surface in an in vitro model

Objective

Electronic cigarettes have become increasingly popular and can deliver nicotine at levels comparable to traditional tobacco cigarettes. However, the potential adverse effects of these alternative smoking devices on dental health remain uncertain. This study investigates changes in the cariogenic potential of tooth surfaces and analyzes alterations in the chemical composition of aerosols generated from sweet-flavored e-liquids used in electronic cigarettes.

Design

Smoking was simulated using an electronic-cigarette testing machine. Eighty specimens of enamel, dentin and root dentin were divided in two groups according smoking: pre-smoke and post-smoke. The response variables were Microhardness (n=10), SEM (n=5) and FTIR (n=5). E-liquid was analyzed pre-smoke and post-smoke by HPLC-UV/Vis. Data were analyzed by one-way ANOVA and Tukey's tests, with a significance level of 5 %. SEM, FTIR and HPLC-UV/Vis data were qualitatively analyzed.

Results

Enamel exhibited higher microhardness values before and after smoking, with all substrates showing significant microhardness reduction after smoking. All dentin specimens presented standard dentinal tubules, and post-smoke enamel prisms appeared disorganized with various orientations. The specimens’ chemical constituents remained stable. Dentin and root dentin post-smoke, carbonate band intensity decreased. There was a thermal degradation of e-liquid products and the formation of new compounds post-vaporization.

Conclusions

E-cigarette smoking reduces the microhardness of enamel, dentin, and root dentin, alters enamel morphology, induces chemical interactions between e-liquid and tooth tissues, and may increase the risk of cariogenic potential.