The association between self-reported vaping and the human oral microbiome: a systematic review

Vapes, with or without nicotine, have experienced a rise in their popularity, and our understanding of how vapes affect our oral microbiome remains to be reviewed. This systematic review explores whether the use of vapes is associated with measurable alterations in the diversity and taxonomic composition of the oral microbiome compared to non-vapers or conventional cigarette smokers.

A comprehensive and systematic search of 6 databases was meticulously conducted, covering published literature up to the end of August 2024. The data was then extracted and underwent a qualitative analysis. Studies' risk of bias was assessed using Newcastle Ottawa Scale. Eligible studies needed to have a comparison group of either non-smokers or tobacco users or both and a group of sole e-cigarette users.

The search yielded 18 articles, with sixteen being cross-sectional and the remaining two were cohort studies. There were 1418 participants across the studies, ranging from 30-125 participants in each study. Majority of the included literature indicated e-cigarettes can alter the taxonomic composition and diversity of their user's oral microbiome.

Vaping was found to be associated with changes in oral microbiome. Since, the majority of the existing literature relied on self-reporting to see if participants were sole vapers, and mainly focused on bacterial genera, the exact impact of these changes are difficult to ascertain. However, the existing literature demonstrates a relationship in a few bacterial genera associated with periodontal disease among e-cigarette users, highlighting the need for further comprehensive studies with sound methodological approach to recruit sole e-cigarette users.

This study concludes that vapes do have a demonstratable impact on the oral microbiome that is unique to vapes. E-cigarette use may be associated with an increase periodontal pathogens which may predispose e-cigarette users to worse periodontal disease, however, further research is required.