Smoking e-cigarettes, also known as vaping, is becoming increasingly popular among the youth as an alternative to regular cigarettes.1 That’s because vaping is commonly believed to be less harmful to their health. However, published research says otherwise, especially when it comes to your oral health.
The chemicals in e-cigarette aerosols — including nicotine, volatile organic compounds and various flavoring agents — alter the oral microbiome, reducing your body’s ability to fight off infection.2 The result? A slow but steady progression toward gum disease that often goes unnoticed until serious damage has occurred, which leads to the same results as smoking regular cigarettes.
How Does Vaping Affect Your Gums and Your Ability to Fight Infections?
A study published in Medicina investigated how e-cigarettes impact gum health, with a particular focus on how vaping affects the body’s natural defenses against oral infections.
• Your oral health is affected — The researchers examined the inflammatory responses in the gums of vapers compared to non-smokers and traditional cigarette smokers. Their findings highlighted that while vaping caused less damage than cigarette smoking, it still significantly weakened the immune system’s ability to fight off bacterial infections, leading to a greater risk of gum disease.3
• Reduced antioxidant capability — One of the key findings of the study was that “vaping is associated with an increased risk of gingivitis and periodontal disease as well as reduced antioxidant capacity of saliva.”4 Healthy saliva contains proteins that help keep the mouth free of dangerous bacteria, preventing infections before they start. In a different study, vapers had a reduction in key salivary antimicrobial proteins, such as lysozyme and lactoferrin.5
• Periodontitis develops — The study concluded that vaping increases the risk of periodontitis compared to non-smokers. However, conventional cigarettes carried a higher oral disease risk compared to vaping.6
Vaping Compromises Your Oral Immune System
Another striking finding of the study was the increased prevalence of gingival inflammation (gum swelling) among vapers. The researchers, compiling data from their selected studies, found that e-cigarettes increase your risk of gingivitis, the earliest stage of gum disease, which, if untreated, progresses to periodontitis and eventual tooth loss.7
• The link between vaping and gum disease — According to the researchers, “There is ample evidence establishing a connection between vaping smoke and an increased risk of developing gingivitis and periodontal disease. The use of the vape pen can introduce certain bacteria that contribute to the development of oral diseases in our body.”8
• Vaping affects your oral immune function — The researchers noted that vaping decreases the antioxidant capacity of your oral microbiome, decreasing the defensive capability that results in an increased risk for oral disease.
Note again, that while vapers are at an increased risk, cigarette smokers have an even greater risk.9 For more information on how cigarette smoking severely harms your health, read “How Cigarette Smoke Weakens Lung Immunity and Fuels Chronic Inflammation.”
Flavoring Agents Contribute to Gum Damage
Another interesting aspect that the study touched upon was how flavored e-cigarettes affect gum health differently than unflavored options.
• The hidden dangers of flavored pods — Many flavored e-liquids contain artificial chemicals that increase their appeal. However, the researchers found that certain flavoring agents were linked to an increased risk on bacterial growth.10
• Flavored pods are more harmful than unflavored varieties — According to the researchers, “Flavored vaping liquids have a more detrimental effect on biofilm formation and the growth of oral commensal bacteria compared to unflavored liquids. This suggests that additives used to flavor vaping liquids may exacerbate oral health problems.”11
Vaping Reduces Gum Bleeding but Worsens Underlying Inflammation
A systematic review published in Clinical Oral Investigations analyzed the impact of vaping on gum health by comparing vapers, cigarette smokers and non-smokers across multiple periodontal health indicators. Similar to the Medicina study discussed earlier, these researchers aimed to determine whether vaping posed a significant risk to gum health and whether vapers experienced periodontal disease at similar rates to smokers and non-smokers.12
• Gums become inflamed and bleed — While traditional smoking consistently showed the worst outcomes across all periodontal health measures, vaping exhibited a unique mix of negative and seemingly deceptive effects.
Specifically, e-cigarette users had less gum bleeding than smokers but significantly higher levels of inflammation than non-smokers, showing that vaping suppresses early warning signs of gum disease while still accelerating its progression.13
• The overall risk of vaping vs. traditional smoking — Going deeper into the bleeding topic, the researchers noted that overall, vapers had a 0.33-fold lower chance of experiencing bleeding gums than cigarette smokers. This may sound like a positive result, but in reality, it’s not. Healthy gums react to irritation by bleeding — a natural response that indicates an underlying problem.
The study confirmed that vapers, like cigarette smokers, had reduced blood flow to their gums, which masked the early symptoms of gum disease. As noted by the researchers, “Nicotine-dependent oral effects are local vasoconstriction and a reduced blood flow that will reduce gingival oxygen and blood supply.”14
Other Effects of Vaping on Gum Health
While e-cigarette users bled less, they still showed increased plaque levels and deeper gum pockets compared to non-smokers, defined as probing depth (PD) in the study.15 For context, periodontal pockets form when gums are healthy and situate closely to your teeth. However, as smoking becomes chronic, the space between the teeth and gums widens, allowing bacteria to form.16
• Compromised oral health — The researchers found that vapers had slightly deeper PDs than non-smokers, but smokers had the highest PDs overall. This means that a regular smoker’s gum tissue is at higher risk from detaching from their teeth and allowing bacteria to invade deeper into the mouth.
Plaque buildup was another major concern. The study revealed that vapers had higher plaque index scores than non-smokers, though slightly lower than cigarette smokers.17
• Increased oral inflammation — The researchers also analyzed molecular markers in the gum tissue of vapers and found that vaping significantly increased levels of proinflammatory cytokines due to nornicotine. According to the researchers, “A specific metabolite of nicotine, the alkaloid nornicotine, is assumed to trigger a higher concentration of cytokines.”18
• Broken down gum tissue — The study found elevated levels of interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α), both of which are heavily involved in the breakdown of gum tissue, as well as matrix metalloproteinases (MMPs) — a group of enzymes that break down collagen and connective tissue.19
While MMPs play a normal role in tissue remodeling, excess levels contribute to gum recession and periodontal disease. This means that vaping not only slows the healing process but actively contributes to the breakdown of gum tissue.20
Vaping Alters the Oral Microbiome
A systematic review published in Evidence-Based Dentistry analyzed 40 studies to determine how e-cigarette use impacts gum health. The researchers aimed to clarify whether vaping causes periodontal destruction similar to smoking cigarettes and how it affects the oral microbiome — the delicate balance of bacteria in your mouth.21
• Harmful bacteria spread in your mouth — Their findings revealed that while vapers did not experience the same level of bone loss as smokers, they did have significantly higher levels of harmful bacteria and inflammatory markers compared to non-smokers.
• Increased risk of gingivitis — The study included a mix of e-cigarette users, traditional smokers and non-smokers. Across all groups, cigarette smokers exhibited the worst periodontal health, but vapers were not far behind.
The researchers found that vaping led to microbial shifts similar to those seen in gum disease patients. These bacterial changes triggered a rise in inflammation, which increases the risk of developing gingivitis and, over time, periodontitis.22
Harmful Bacteria Thrive Due to Vaping
One of the most alarming discoveries in the study was that vapers had significantly higher levels of disease-causing bacteria compared to non-smokers.
• Oral pathogenic bacteria thrive — The bacteria most commonly associated with periodontal disease — Porphyromonas gingivalis and Fusobacterium nucleatum — were found in much higher concentrations in the mouths of e-cigarette users.23
• Increased cytokines — Inflammatory cytokines in the oral area were higher, which contributed to microbiome dysbiosis. Specifically, vapers had significantly higher levels of interleukin-1 beta (IL-6) and tumor necrosis factor-alpha (TNF-α), both of which are heavily involved in the breakdown of gum tissue and bone.24
• Higher incidence of plaque — The study also found that vapers had higher plaque scores than non-smokers, a sign that vaping makes it easier for bacteria to stick to the teeth and gums. Over time, this plaque hardens into tartar, a rough surface that provides even more room for bacteria to grow. The more plaque buildup, the harder it is to remove without professional cleaning, increasing the likelihood of developing gum disease.25
Your Bone Health Also Suffers from Vaping
The review also confirmed that traditional cigarette smokers suffered from marginal bone loss (MBL) — a measurement of bone degradation around the teeth.
• Vaping affects bone health — Those who used e-cigarettes are also at higher risk of bone loss compared to non-smokers.26
• The mechanism behind bone loss — As noted in a study published in Bone & Joint Research, “Nicotine-rich E-cigarette vapor has been demonstrated to induce apoptosis and cause a reduction in both mineralization and alkaline phosphatase activity of Saos-2 osteoblasts (a human osteoblast‐like cell line, the main cell type responsible for bone formation).”27
How to Protect Your Oral Health
If you’re vaping because you think it’s a safer alternative to smoking, it’s time to rethink that decision. I recommend quitting smoking altogether and implement a healthy lifestyle. To get you started on the right path, here are strategies to help you:
• Stop vaping and smoking — Every puff of an e-cigarette or cigarette feeds inflammation and destroys your gum tissue. The nicotine, artificial flavorings and chemical aerosols in vapes alter the balance of your oral microbiome, making it easier for disease-causing bacteria to take over. Quitting completely is the best way to stop the damage.
If you are vaping to avoid cigarettes, understand that you’re trading one set of problems for another. The sooner you quit, the faster your gums regain their blood flow, reduce inflammation and start healing.
If quitting cold turkey isn’t an option, gradually reduce your vaping frequency while replacing it with healthier habits or taking up new hobbies. Practicing the Emotional Freedom Techniques (EFT) will also help if you’re feeling overwhelmed throughout the quitting process.
• Repair your oral microbiome — Your mouth depends on a healthy balance of bacteria to fight off disease, but vaping shifts this balance in favor of harmful microbes. To rebuild your oral microbiome, eat more fermented foods like yogurt and kefir, which contain probiotics that support good bacteria in your mouth.
Avoid sugary drinks and processed foods high in linoleic acid, all of which fuel the overgrowth of harmful bacteria. Brush with a homemade toothpaste using natural ingredients — coconut oil, baking soda and a pinch of Himalayan salt. To add a minty aroma, add a small amount of peppermint essential oil. Lastly, I recommend you try oil pulling, which is a better alternative to using mouthwashes.
• Hydrate and support saliva production — Vaping dries out your mouth, reducing your saliva’s ability to wash away bacteria and neutralize acids that cause gum disease. Saliva is your body’s natural defense system for oral health, so keeping it flowing is critical.
Drink enough water daily to adequately hydrate your body. A good rule of thumb to follow is when you see your urine having a pale straw yellow color. In addition, avoid alcohol, which dehydrates your body and impacts your overall metabolic health. For more tips on how to hydrate properly, read my article “Current Hydration Guidelines Are Outdated.”
• Strengthen your gums with proper nutrition — Your gums need the right nutrients to rebuild and fight off infection. Focus on a diet rich in vitamins and minerals that promote healing and strengthen connective tissue.
Eat foods high in vitamin C, such as bell peppers and oranges to boost collagen production and help gums heal faster. Making your own beef bone broth is also recommended, as it is rich in collagen.
Get enough vitamin D from sunlight to support bone density and gum health. According to a study published in Nutrients, vitamin D deficiency has been linked to an increased risk of periodontitis and gingival inflammation.28 For instructions on how to safely optimize your vitamin D levels, read my article “How Vitamin D3 Helps Fight Cavities.”
• Get professional dental cleanings and assessments — If you’ve been vaping or smoking for any length of time, you likely have plaque buildup, gum inflammation or hidden damage that you can’t see. A professional cleaning can help remove hardened tartar and identify areas that need immediate attention.
But don’t just visit any dentist — I recommend you look for an expert in biological dentistry, as this takes a holistic approach to optimizing your oral health. To help you look for a biological, refer to these links:
◦Dental Amalgam Mercury Solutions (DAMS) — Email them here or call 651-644-4572 for an information packet
◦International Academy of Biological Dentistry & Medicine (IABDM)
Frequently Asked Questions About Vaping’s Effects on Gum Health
Q: Is vaping bad for my gums even if I don’t smoke cigarettes?
A: Yes, vaping harms gum health even if you’ve never smoked cigarettes. Research shows that e-cigarettes increase plaque buildup, disrupt the oral microbiome and trigger inflammation that leads to gum disease. While vaping is found to be less damaging than smoking, it still causes long-term harm to your gums and teeth compared to not smoking at all.
Q: Why do my gums look fine if vaping is damaging them?
A: Vaping reduces blood flow to the gums, making inflammation less visible. This means that even if your gums aren’t bleeding or swollen, damage is still happening beneath the surface. By the time symptoms appear, gum disease will already be progressing.
Q: Can quitting vaping improve my gum health?
A: Yes, quitting vaping allows your gums to regain proper blood flow, reduce inflammation, and begin healing. The earlier you stop, the better your chances of reversing early gum disease and preventing permanent damage like gum recession or bone loss.
Q: How does vaping affect the bacteria in my mouth?
A: Vaping alters the balance of bacteria, increasing the number of harmful microbes that contribute to gum disease. These bacteria thrive in the plaque buildup caused by e-cigarettes, leading to infections, bad breath and tissue breakdown.
Q: What steps can I take to protect my gums from vaping damage?
A: The best way to protect your gums is to quit vaping altogether. If you’re still using e-cigarettes, prioritize hydration, add oil pulling into your oral care regimen, maintain a strict oral hygiene routine and schedule regular dental checkups with a biological dentist to catch any early signs of gum disease before they worsen.
