The effect of electronic cigarettes on dental enamel color

Abstract

Objective: The use of electronic cigarettes (ECIGs) has recently increased as an alternative to conventional smoking tobacco products. The literature is scarce on the effects of ECIGs on dental and oral structures. Therefore, the objective of this study was to observe whether ECIG aerosol could alter the color of dental enamel.Materials and methods: Sixty-three bovine enamel specimens were randomly separated into groups (n = 7) and treated with aerosols with different e-liquid flavors (neutral, menthol, and tobacco) and nicotine content (0, 12, and 18 mg). The initial color assessment was performed using a spectrophotometer (Easy Shade-Vita). Dental enamel was exposed to 20 cycles of ECIG aerosol in a smoking machine, and the final color was measured. The color change was evaluated using ΔEab, ΔE00, and Whiteness Index (WI D ) formulae. Differences in L* a* b* coordinates were calculated, and data were analyzed (two-way ANOVA, uncorrected Fisher's LSD post hoc test, α = 0.05). Results: Luminosity (ΔL) was reduced by aerosols with almost all levels of nicotine content and neutral and menthol flavors. Flavored e-liquids caused more color change (P < .05) according to ΔEab and ΔE00. ΔE values from both formulae exceeded the thresholds for perceptible visual alterations of color. WI D increased after ECIGs exposure for menthol and tobacco and decreased for neutral flavors. Conclusions: ECIG aerosol from e-liquids with different nicotine contents and flavors altered enamel color. Menthol and tobacco e-liquids may alter the enamel color decreasing the yellowness of the enamel compared to neutral e-liquid.

Influence of electronic nicotine delivery systems (ENDS) in comparison to conventional cigarette on color stability of dental restorative materials

“…14 As a result, it has the potential to become an epidemic. 15 A common known side effect of ENDS is the discoloration of teeth, 11 however its effect on oral restorations is not reported. CIELab system was employed for discoloration assessment, as it relates to clinical significance and compares difference in measurements to subjective observations.…”

“…In a recent study by Pintado-Palomino et al, exposure of teeth to ENDS aerosol resulted in ΔE range from 1.9 to 4.6, these findings are similar to the present study in relation to ceramic specimens. 11 Cigarette smoking results in combustion of elements resulting in release of metals like arsenic, lead and cadmium along with dark components of smoke. These elements deposit on the surface, resulting in discoloration.…”

“…The amount of liquid and cigarette consumption for each puff of ENDS and cigarette is not similar, which may influence study outcomes. 11 In addition, the parameters like, number of puffs, their duration and puff intervals among ENDS and conventional cigarette smoking are difficult to standardize in an in-vitro experiment. Furthermore, the amount of aerosol delivered by any ENDS device differs, therefore the outcomes of the present study should be limited to the device used in the present study (SMOK – Alien).…”

E‐Cigarette and palatal ulcer: a possible relationship?

“…Other oral side effects attributed to e‐cigarette use are nicotine stomatitis, black hairy tongue, angular cheilitis and xerostomia with the latter being the most common 8 . E‐cigarette vapour also seems to alter enamel colour and especially, the menthol and tobacco e‐liquids reduce the yellowness of the enamel compared to neutral e‐liquid 13 . On the other hand, e‐cigarette inhalation has also been shown to contribute to periodontal disease and thus has a negative impact on periodontal health and dental implants 15,16,30 .…”

“…Although there is a widespread misconception that ENDS are a harmless substitute for conventional cigarettes, the possible immediate and long‐term risks are yet not fully documented. Recently, several in vivo and in vitro studies have demonstrated a variety of oral and systemic adverse effects after the inhalation of the ENDS aerosol from both nicotine and nicotine‐free devices 13‐18 .…”