To vape, or not to vape? Rachel Pointer

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  Posted by: Dental Design      29th November 2017

According to Action on Smoking and Health (ASH), 2.9 million people now use electronic (e-) cigarettes, or vape, in Great Britain. There are more ex-smokers now using e-cigarettes than current smokers, and the main reason given for taking up vaping was to stop smoking tobacco.

In May 2017, the Tobacco Products Directive 2014/14/EU (TPD) introduced new rules for nicotine-containing e-cigarettes and refill containers. Maximum nicotine strength was set at 20mg (2 per cent). Vape tanks larger than 2ml will no longer be permitted either, while e-liquid bottles must now have a maximum capacity of 10ml. Before this date, the e-cigarette industry was largely operating without regulation in the UK.

From a dental – and healthcare – professional point of view, it is positive that so many vapers have given up smoking ‘regular’ cigarettes and the like. Health bodies in the UK, including the British Medical Association, continue to maintain that vaping is ‘almost certainly better’ than smoking tobacco, although, because it is addictive, it does reinforce habitual behaviour.

So, how should members of the dental team advise patients who vape, either as a way to reduce their daily use of ‘regular’ cigarettes etc., or as a substitute for a tobacco-smoking habit? Not smoking remains one of the central tenets of good, preventive dental care, alongside a healthy diet and an efficient cleaning routine, on a foundation of regular appointments. When asking patients about their lifestyle, you must ask them about their use of e-cigarettes. It is important to be positive – anything that reduces tobacco use must be supported – but you must underline the fact that there are many unknowns about vaping. There simply isn’t enough long-term evidence available yet to give a full picture.

E-cigarettes still give the user access to nicotine. Nicotine can “limit the blood flow in our mouth’s tissues (and therefore) it seems likely that vapers may be more pone to gum disease”. The relationship between periodontal disease and tooth loss is well established, as is the relationship with various systemic diseases, which can be life limiting. Patients who vape may also have a regular, dry cough or complain of xerostomia.

Instead, while we wait for long-term studies, which will enable evidence-based practice and protocols, instructing good, preventive daily dental care is the only approach to take. Teaching the correct brushing technique, using high-quality tools, and enhancing the daily routine with appropriate adjunctive products will allow patients who vape to not only keep their mouth clean, but reduce the risk of future problems developing. Recommend TANDEX products, including brushes and interdental brushes, for an efficient, yet gentle clean.

When they enjoy the benefits of a fresh, healthy mouth and great smile, the prospect of an e-cigarette – containing potentially toxic ingredients and with much still to learn about their long-term impact on health – may become far less appealing. While we wait for more evidence to become available, reinforcing positive, preventive behaviours is the approach to take.

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