Research Article: The association between electronic-cigarette use and self-reported oral symptoms including cracked or broken teeth and tongue and/or inside-cheek pain among adolescents: A cross-sectional study

Date Published: July 11, 2017

Publisher: Public Library of Science

Author(s): Jun Ho Cho, Yu Ru Kou.

http://doi.org/10.1371/journal.pone.0180506

Abstract

Little is known about oral health related to electronic-cigarette (EC) use, even though EC use is increasing rapidly. The aim of this study is to assess the relationship between EC use and oral health, including ‘gingival pain and/or bleeding’, ‘tongue and/or inside-cheek pain’, and ‘cracked or broken teeth’ among adolescents.

A total of 65,528 students in 2016 were included in this cross-sectional study.

For EC use, 0.5% (n = 297) students were daily users, 1.9% (n = 1259) were ‘1 to 29 days past month users’, and 5.9% (n = 3848) were former users. Overall, 18.5% students reported they had experienced ‘gingival pain and/or bleeding’, 11.0% reported ‘tongue and/or inside-cheek pain’, and 11.4% reported a ‘cracked or broken tooth’ within the past 12 months. When comparing ‘daily EC users’, ‘1 to 29 days past month EC users’, and ‘former EC users’ with ‘never EC users’, the adjusted ORs for ‘cracked or broken tooth’ were 1.65 (95% CI: 1.19–2.27), 1.26 (95% CI: 1.06–1.51), and 1.16 (95% CI: 1.04–1.30), respectively. Comparing ‘daily EC users’ with ‘never EC users’, the adjusted OR for ‘tongue and/or inside-cheek pain’ was 1.54 (1.05–2.26). However, EC use among adolescents was not associated with ‘gingival pain and/or bleeding’ when adjusted for the potential confounders.

Based on the results, the odds of cracked or broken teeth among daily, ‘1 to 29 days past month’, and former EC users were significantly higher than those among never EC users. The odds of tongue and/or inside-cheek pain among daily EC users were significantly higher than those among never EC users. In conclusion, the results suggest that daily EC use among adolescents may be a risk factor for cracked or broken teeth and tongue and/or inside-cheek pain.

Partial Text

Electronic cigarettes (EC) are battery-powered electronic devices, which aerosolize liquid that contains nicotine, humectants, and flavors [1]. EC use has increased rapidly and globally, particularly among smokers and adolescents [2]. During 2010–2013, ever EC use increased among current conventional cigarettes (CC) smokers (9.8%–36.5%) and among former CC smokers (2.5%–9.6%) in a study of US adults. Among Korean adolescents, ever EC use was 0.5% in 2008 and increased to 8.2% in 2014 [3]. In Poland, ever EC use among high school students increased from 16.8% in 2010/11 (n = 1,760) to 62.1% in 2013/14 (n = 1,970) [4]. The North Carolina Youth Tobacco Survey found that prevalence of use in the past 30 days increased from 1.7% in 2011 (n = 4,791) to 7.7% in 2013 (n = 4,092) [5]. The issues regarding their effectiveness as a smoking cessation aid and health risks due to EC use are still controversial [6]. So far, there is no strong evidence in regards to their safety, although there are reports that ECs may be less harmful to users and bystanders, than CCs [7]. It is known that the main reasons for using ECs are to quit CCs, as an alternative to CCs, curiosity, appealing flavors, and peer influences [8, 9].

This study evaluated the association between EC use and oral symptoms among adolescents. It found that EC use was associated with a significantly increased chance of either cracked or broken teeth or tongue and/or inside-cheek pain among adolescents. However, the results did not find an association between EC use and gingival pain and/or bleeding among adolescents.

Based on the results, after adjusting for potential confounders, EC use was associated with a significantly increased chance of either cracked or broken teeth, or tongue and/or inside-cheek pain among adolescents. The odds of cracked or broken teeth among daily, ‘1 to 29 days past month’, and former EC users were significantly higher than those among never EC users. The odds of tongue and/or inside-cheek pain among daily EC users were significantly higher than those among never EC users. In conclusion, the results suggest that EC use among adolescents may be a risk factor for tongue and/or inside-cheek pain and cracked or broken teeth.

 

Source:

http://doi.org/10.1371/journal.pone.0180506

 

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