The Impact of Electronic Cigarettes on Oral Health: Analytic Cross-Sectional Study

Electronic cigarette smoking (ECS) is a rising concern among young people.

This study aimed to compare perception, clinical findings, and cytomorphological changes in buccal mucosa of electronic cigarette smokers and nonsmokers.

A cross-sectional study includes 100 consented university students aged ≥18 years, of both genders.

Tobacco, and alcohol users, those with systemic diseases were excluded. A validated questionnaire was administered, clinical examination, cytomorphological analysis were performed.

The obtained data were analyzed using SPSS version 28 software. The chi-square test and Fisher's exact test, student's t test was used.

A significant change observed in the ECS tongue/buccal mucosa, specifically, white discoloration (20% vs. 6%, P = 0.037). Dry mouth and a feeling stickiness in the mouth were more common among ECS (62% vs. 30%, P = 0.001), and (48% vs. 20%, P = 0.003) respectively. Significant cytological changes found in ECS with P < 0.001 for nuclear size (increase in 48% vs. 0%), nuclear-cytoplasmic ratio (increased in 46% vs. 0%), binucleation (presence 66% vs. 8%), a moderate perinuclear halo (18% vs. 0%), cytoplasmic granules (moderate/severely present in 62% vs. 2%), and moderate/severe inflammation (present in 18% vs. 8%). The average nuclear size (μ) was significantly greater in ECS than in nonsmokers (10.434 vs. 8.480) and presence of micronuclei (20% vs. 4%, P = 0.014).

There is a significant association between ECS and dry mouth signs and symptoms, white discoloration of buccal mucosa, and oral cytomorphological changes suggesting potential malignant transformation.