Cariogenicity of e-cigarettes

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Send your letters to the Editor, British Dental Journal, 64 Wimpole Street, London, W1G 8YS. Priority will be given to letters less than 500 words long. Authors must sign the letter, which may be edited for reasons of space.

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.


  1. 1

    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.

  2. 2

    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.

  3. 3

    Callahan-Lyon P . Electronic cigarettes: human health effects. Tob Control 2014; 23 (Suppl 2): ii36–ii40.

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