Adverse effects of E‐cigarettes on head, neck, and oral cells: A systematic review

Abstract

Background: E-cigarette sales in the United States (US) are projected to reach 16.5 billion by 2024 according to market analysis. Six deaths and 450 lung illnesses have been linked to e-cigarette use. To our knowledge, a systematic review of the adverse effects of e-cigarettes on head, neck, and oral cells does not exist. This review aimed to conduct a systematic review of current literature to determine whether e-cigarettes caused adverse effects on cells of the head, neck, and oral cavity. Methods: Five databases including Medline, Dentistry and Oral Sciences, CINAHL, CAPLUS, Web of Science, and gray literature were searched for articles any time up to December 2020. Using Rayyan software, two-independent researchers screened 233 articles and extracted 41 for further investigation. Based on the inclusion criteria, 18 articles were eligible for this review.Results: Aberrant morphology, cytotoxicity, oxidative stress, reduced viability, delayed fibroblast migration, and genotoxicity were statistically significant when the head, neck, and oral cells were exposed to e-cigarettes. Of note, most articles in this systematic review found cigarette smoke to be significantly more toxic to head, neck, and oral cells than e-cigarettes.Conclusions: E-cigarettes are implicated in adverse effects on head, neck, and oral cells, yet very few have been tested against these cells. More longitudinal studies using a wider variety of e-cigarettes are necessary before we can determine their total adverse effects. Future research must also investigate chronic e-cigarette use and if it leads to periodontal disease and/or head, neck, or oral cancer.

Considerações atuais sobre o uso dos cigarros eletrônicos relacionados às doenças periodontais: revisão da literatura

“…Embora o tabagismo tenha se mostrado um fator de risco para periodontite 8 , apesar de poucos estudos os cigarros eletrônicos também estão implicados em efeitos adversos na cabeça, pescoço e células bucais 18 . Os problemas psicossociais como a depressão e ansiedade, podem ser precursores ao uso constante do tabagismo e a constância do vício 19 .…”

DNA damage in human oral cells induced by use of e‐cigarettes

“…They did not find enough evidence to support the proposal that e‐cigarettes are carcinogenic to the head, neck, and oral cavity, but further studies are required 14 . Longitudinal studies are also warranted for future research 11 …”

“…e‐Cigarette exposure can induce several oral health effects, including dysbiosis, inflammation, periodontal diseases, deterioration of dental and gingival health, and changes to the oral microbiome 1,10 . e‐Cigarette exposure was also implicated in adverse effects on head and neck, and oral cells in terms of aberrant morphology, cytotoxicity, oxidative stress, reduced viability, delayed fibroblast migration, and genotoxicity 1,11 . e‐Cigarette users have elevated levels of biomarkers of certain volatile organic compounds (VOCs; e.g., acrylamide, acrolein, and acrylonitrile), metals (e.g., cadmium and selenium), and propylene glycol compared with non‐users and may also be exposed to other carcinogenic chemicals (e.g., benzene and chromium) 12 .…”

“…1,10 e-Cigarette exposure was also implicated in adverse effects on head and neck, and oral cells in terms of aberrant morphology, cytotoxicity, oxidative stress, reduced viability, delayed fibroblast migration, and genotoxicity. 1,11 e-Cigarette users have elevated levels of biomarkers of certain volatile organic compounds (VOCs; e.g., acrylamide, acrolein, and acrylonitrile), metals (e.g., cadmium and selenium), and propylene glycol compared with non-users and may also be exposed to other carcinogenic chemicals (e.g., benzene and chromium). 12 There are also studies to investigate the association between e-cigarette exposure and head and neck cancer.…”

“…14 Longitudinal studies are also warranted for future research. 11 According to the above reviews, e-cigarettes are toxic to oral cells, contain carcinogenic agents, and may have the potential to induce oral cancer. The aim of this review is to present an updated summary of studies reporting DNA adducts or other DNA damage in oral cells in vitro or in vivo exposed to e-cigarette vapor, primarily focusing on clinical studies of e-cigarette users.…”