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Does smoking explain the association between use of e-cigarettes and self-reported periodontal disease?

Research output: Contribution to journalArticlepeer-review

Lina AlQobaly, Hassan Abed, Yaser Alsahafi, Wael Sabbah, Faisal F. Hakeem

Original languageEnglish
Article number104164
Pages (from-to)104164
Number of pages1
JournalJournal of Dentistry
Published1 Jul 2022

Bibliographical note

Funding Information: The authors would like to thank the Deanship of Scientific Research at Umm Al-Qura University ‎for supporting this work by Grant Code: ( 22UQU4350291DSR03 ). Publisher Copyright: © 2022

King's Authors


OBJECTIVE: Many studies have been conducted to understand the association between e-cigarette use and different periodontal parameters, but the effect of conventional smoking in explaining this association remain to be elucidated. This study aimed to assess the association between e-cigarettes and self-reported periodontal disease, and whether smoking status explains this association. METHODS: This cross-sectional study was based on secondary data analysis of 8,129 participants of the National Health and Nutrition Survey (NHANES) 2015 -2018. E-cigarette use and smoking status were collected through questionnaires. Self-reported periodontal diseases and bone loss were derived from the 8-item CDC/AAP questionnaire. The associations between e-cigarette use and self-reported periodontal diseases were tested in logistic regression models adjusting for demographic factors, socioeconomic indicators, smoking status, diabetes and dental visits. Additionally, to test the effect of smoking on the relationship, three fully adjusted logistic regression models stratified by smoking status were constructed. RESULTS: E-cigarettes ever users and current users had higher odds of self-reported periodontal disease (OR = 1.43, 95% CI: 1.18, 1.73) and bone loss (OR = 1.80, 95% CI: 1.30, 2.49) respectively compared to non-users after adjusting for smoking and potential confounders. In the regression models stratified by smoking status, e-cigarette was only significantly associated with self-reported periodontal disease variables among current smokers, but not among previous or never smokers. CONCLUSION: E-cigarette use is associated with self-reported periodontal disease. However, smoking status appears to explain the relationship between e-cigarette use and periodontal disease. CLINICAL SIGNIFICANCE: This population-based cross-sectional study shows that e-cigarette use is associated with self-reported periodontal disease. Smoking status appears to explain the association. Dental professionals should consider the effect of conventional smoking and comprehend the risks of e-cigarette on oral health and its benefits when used as a smoking cessation aid.

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