Vaping and oral health: Are e-cigarettes more or less harmful than traditional smoking? Original paper

This meta-analysis of 18 observational studies found that e-cigarette users had worse oral health and gum health than nonsmokers but better outcomes than traditional tobacco smokers.

This Study Summary was published on April 4, 2025.

The study

E-cigarette use varied across the studies, from occasional to daily vaping over months to years, though exact usage data were inconsistent.

Compared to nonsmokers and former smokers, e-cigarette users had higher plaque levels but a lower gingival index (less gum inflammation). However, there were no differences in pocket probing depth (space between tooth and gum) and alveolar bone health (the bone structure surrounding the teeth).

Compared to smokers, e-cigarette users had lower plaque levels, less bleeding on probing, improved alveolar bone health, and shallower pocket probing depth. However, e-cigarette users had a higher gingival index (more gum inflammation) than smokers.

The quality of evidence was low to moderate, with many studies showing a high risk of bias, mainly due to confounders like former smoking history.

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The results

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    This Study Summary was published on April 4, 2025.