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Sir, electronic cigarettes (e-cigarettes) have been a popular topic of discussion recently. Their relationship with periodontal disease has been a particular area of interest within the dental field.1 However, they may also pose a risk for another major oral health problem, dental caries.
An electronic cigarette is a device which utilises the heating of a solution or 'e-liquid' to release a vapour. Initially devised as a means to deliver nicotine to a smoker in a familiar method to which they are accustomed, the concept was developed with the introduction of a plethora of flavoured 'e-liquids'.
The e-liquids contain a mixture of various chemicals including sucrose,2 aqueous glycerine and artificial flavourings.3 This cariogenic substrate is delivered to the oral cavity as an aerosolised vapour.
Furthermore, the introduction of flavoured e-liquids, as well as zero-nicotine levels, has now also attracted non-smokers to the use of e-cigarettes as a recreational activity. 'Vaping' has become especially popular with teenagers and young adults, often involving prolonged sessions of continuous use lasting numerous hours.
I would propose that the cariogenicity of flavoured e-liquids could be an area of further research. Furthermore, it could be particularly beneficial to work together with manufacturers to develop less cariogenic 'e-liquids', using alternative ingredients.
Wadia R, Booth V, Yap H F, Moyes D L . A pilot study of the gingival response when smokers switch from smoking to vaping. Br Dent J 2016; 221: 722–726.
Kubica P, Wasik A, Kot-Wasik J, Namie-nik J . An evaluation of sucrose as a possible contaminant in e-liquids for electronic cigarettes by hydrophilic interaction liquid chromatography-tandem mass spectrometry. Anal Bioanal Chem 2014; 406: 3013–3018.
Callahan-Lyon P . Electronic cigarettes: human health effects. Tob Control 2014; 23 (Suppl 2): ii36–ii40.