The youth have stopped smoking. Well, a sizeable portion have ceased the habit; the Office for National Statistics has found that between 2011 and 2023, those aged 18 to 24 in the UK saw a reduction in smoking prevalence of 15.9 per cent, now sitting at 9.8 per cent of the demographic.
Such a decrease can be multifactorial. Smoking prevention schemes, led in many schools, may have been successful – however, some of this drop should be attributed to the rise in e-cigarette use. The 16 to 24-year-old population of Great Britain engages with this the most, with 15.8 per cent using an e-cigarette on a daily or occasional basis.
It's important that patients realise the concerns surrounding smoking and e-cigarette use, or vaping. Clinicians also have the responsibility to communicate the need for an effective oral hygiene routine in an attempt to mitigate the effects on the dentition.
The current situation
Smoking tobacco cigarettes is well known amongst clinicians to be dangerous to a patient’s oral health. From increased risks of periodontal disease to discolouring of teeth, and a far greater threat of various cancers, it’s a habit that is as damaging as it is addictive. Patients understand these risks too; around 94 per cent of UK adults recognise smoking as a risk factor for cancer, which shows that awareness campaigns have been effective.
There is also backing for Britain to have future no-smoking generations, with 71 per cent of adults supporting legislation that works towards this goal.
Still, people smoke. Those that try to quit the habit may find it difficult to abandon tobacco or nicotine intake altogether, and so the use of alternative solutions is sometimes preferred. It is currently understood that vaping is less harmful than smoking, and reduces the exposure to toxins linked to adverse health outcomes. It is a recommended alternative in some circumstances because, whilst patients are still exposed to addictive nicotine, they may be at a lesser risk of poor health, including with their oral health.
A suitable substitute?
Vaping is a common term for the use of an e-cigarette. Despite its advantages over traditional smoking, patients that vape experience increased rates of periodontitis as well as caries development – this is still lower than those that use conventional cigarettes, however. The literature has observed increased oxidative stress, inflammation and alterations in healing, with flavoured vaping liquids having a more detrimental effect on biofilm formation.
It's important to consider that patients who do vape are likely to be previous smokers, and so there is a chance that poor oral health indicators are a result of previous tobacco use; clinicians who have treated a patient for years may be able to assess this progression over time.
Further information on e-cigarette use will only come with time and the public’s exposure to such devices. Part of the reason we know so much about the dangers of smoking, after all, is due to the prevalence of tobacco use in everyday life for centuries. For now, clinicians can recommend what they see: vaping is a healthier alternative to conventional smoking and can be useful as a solution for quitting tobacco products. Patients who do not smoke should not be encouraged to pick up a vaping habit, but those that are looking to break the cycle may see it as a lesser of two evils.
Keep it clean
Clinicians must make patients aware of the risks surrounding tobacco products, and the potential benefits of switching to tobacco-free alternatives such as vaping or nicotine pouches. There is also a significant need to remind patients of the benefits of an effective oral hygiene routine. This includes twice daily brushing, and cleaning interdentally and around the gingival margins to maximise periodontal health – especially for those with a history of smoking.
Professional quality oral hygiene routines are now more accessible than ever with the Waterpik Cordless Pulse water flosser, approved by the Oral Health Foundation. The affordable solution is ideal for every patient and supports smokers and e-cigarette users by being 2x as effective at removing bacterial plaque and improving gum health when compared to traditional dental floss. Patients can remove up to 99.9 per cent of bacterial plaque from treated areas in as little as three seconds, and enjoy a high-quality clean every day.
The shift away from smoking should be encouraged in patients, and, with time, clinicians will learn more about the effect of vaping on the dentition. For now, it is something to be considered and recommended in many cases as an alternative habit which minimises negative oral and general health outcomes.
References available on request.
For more information visit www.waterpik.co.uk