The review notes that while e-cigarettes are often perceived as a safer alternative to conventional smoking, their impact on periodontal tissues is still not fully understood. Some studies indicate that individuals using e-cigarettes may experience worsened periodontal health and a less favorable response to periodontal treatments compared with non-smokers. However, the authors caution that the evidence is mixed and limited, with relatively few high-quality, long-term studies available to draw definitive conclusions.
Current research suggests that e-cigarettes may be less harmful to periodontal tissues than traditional tobacco products, but the absence of large cohort studies and randomized trials makes it difficult to assess the long-term risks reliably.
A major challenge in interpreting existing studies is the lack of distinction between “naive” e-cigarette users—those who have never smoked—and former or current smokers. Many studies do not account for previous smoking history, which can confound results since prior tobacco use may have already caused periodontal damage. This limitation may skew findings and obscure the specific effects of e-cigarette use on gum health.
Another factor complicating research is the rapid evolution of e-cigarette devices. Differences in nicotine delivery, aerosol composition, and usage patterns across products make it difficult to generalize findings. The authors emphasize the need for well-designed longitudinal studies and randomized controlled trials to better understand how e-cigarettes affect periodontal tissues over time.
In the meantime, the review advises clinicians to provide balanced guidance. Dental professionals should recognize the potential harms of e-cigarette use while also acknowledging that it may be a less damaging alternative to smoking, especially within the context of NHS smoking cessation efforts. Current guidelines from the British Society of Periodontology and Implant Dentistry and the National Institute for Health and Care Excellence support informing patients about the limited evidence available and using e-cigarettes primarily as a tool to quit conventional smoking. As England’s former Chief Medical Officer, Chris Whitty, summarized: “If you smoke, vaping is much safer. If you don’t smoke, don’t vape.”
Overall, the review highlights the importance of patient education regarding e-cigarettes and periodontal health. While the long-term consequences remain unclear, dental practitioners are encouraged to discuss potential risks and benefits, support harm reduction strategies, and discourage unnecessary e-cigarette use among non-smokers, ensuring that decisions are informed by the best available evidence.
Reference:
Robson, G., Lim, X. C., Chaudhari, I., Hurley, J., Khalil, S., Amin, V., & Nibali, L. (2025). Trying to clear the air: E-cigarette use and periodontal disease. British Dental Journal, 239(10), 687-692. https://doi.org/10.1038/s41415-025-8919-5
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.