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The Brush Up

    What Dentists Need to Know About the Teen Vaping Epidemic

    It’s no secret that the biggest public health concern in the US right now is the teen vaping epidemic. What was originally supposed to be a substitute for adult smokers trying to quit has rapidly become a serious threat among adolescents, as well as adults.  


    Nationally, 20% of high school students reported using e-cigarettes in the past month – up from 1.5% in 2011. In Massachusetts, that number is 40%. Even scarier, 5% of middle school students across the country reported using e-cigarettes in the past 30 days - and that number is 10% in Massachusetts.

    There are a lot of reasons why dental providers should be informed on the issue and should try to talk about it with their patients. Not only can vaping cause serious respiratory illness and damage a teen’s brain development, it also has a direct affect on oral health. 

    Here are some FAQs about oral health and vaping.

    A lot of people assume that vaping is “healthier” than smoking tobacco cigarettes. Are there specific oral health concerns related to vaping that dentists should be aware of when discussing oral health care with patients?

    Due to the spike in vaping use in recent years, scientists are just now beginning to study the health implications of e-cigarettes more seriously. While many still consider vaping as not quite as harmful to oral health as smoking cigarettes, vaping can have a negative effect on teeth and overall oral health. e-cigarettes release formaldehyde when heated with batteries set at high voltages. The aerosol or vapor, which users inhale, can contain nicotine, ultrafine particles that can be inhaled deep into the lungs, flavoring such as diacetyl, a chemical linked to lung disease, volatile organic compounds, cancer-causing chemicals, and heavy metals such as nickel, tin, and lead. Exposure to e-cigarette aerosol can lead to more bacteria in the mouth, which is associated with tooth decay, cavities, and gum diseases. It can also cause dry mouth, inflamed gums, and other issues. The flavoring capsules in e-cigarettes can lead to cavities and increase the risk of developing chronic lung diseases. 

    Still, vaping is a new phenomenon, so there is little scientific research on the long term effects.

    What are the broader dangers surrounding vaping, particularly among adolescents?

    Many teens and adults don’t realize that there actually is nicotine in vaping products, which we know is addictive. Nicotine has very serious effects, especially on the teen brain. It can harm brain development, which occurs into mid-20s. It affects parts of the brain that control attention, learning, mood and impulse control. Nicotine causes that “pleasure center” activation and the feeling becomes highly addictive - more so than alcohol and cannabis, and similar to cocaine. Vaping in particular causes faster absorption of nicotine and thus gives users that “high” quicker than cigarettes, leading to even greater addiction.

    Are there any specific tips on how to approach and discuss these important issues with young patients who may be sensitive or defensive around these subjects?

    Arming  dental care teams, parents and young patients with the information they need is the best way to start the conversation. While there is no singular, proven way to assist adolescents who want to quit vaping, we have to be proactive now, or this will continue to get worse. Ask your patients if they are using e-cigarettes. Giving them access to resources and  creating n opportunity for an open conversation about the effects of vaping and e-cigarettes are the first steps to reversing the epidemic. 

    What resources are available to help dentists, parents and young patients tackle vaping and it’s health concerns?

    Massachusetts Dental Society has a helpful fact sheet about tobacco and vaping.

    Get Outraged is a guide from the Massachusetts Department of Public Health for talking to kids about the dangers of vaping.

    The 84 is a statewide movement of youth fighting tobacco in Massachusetts. Ask your patient if there is an 84 Chapter at their school. The 84 represents the 84% of Massachusetts youth who did NOT smoke when the movement began. 

    The Massachusetts Health Council offers facts about teen vaping.

    The Office of the Surgeon General has great resources for parents.

    The Center for Disease Control also has information for providers on its website, including an informational page all about tobacco use in adolescents.

    Boston Children’s Hospital Adolescent Substance Use and Addiction Center is a great place to refer people who need help with teen addiction. 

    Read some of the latest vaping headlines in the news:

    Washington Post – Everyone Should Be Alarmed by the Vaping Crisis, 9/9/19

    Boston Globe - More Middle and High Schoolers Exposed to Secondhand Vape Aerosols, Study Indicates, 8/28/19

    Wall Street Journal - The FDA's Challenge on E-Cigs, 6/24/19

    CNET - How Vaping Could Ruin Your Teeth, 7/11/19

    DentistryIQ - E-Cig Flavorings May Cause Damage All By Themselves, 1/24/19

    Click here to watch our latest Pearls of Wisdom video on the topic, featuring Dr. Nicholas Chadi, a teen addiction specialist at Boston Children’s Hospital who focuses on vaping.