Online exclusive to complement October 2019 print issue.
By Megan Allbrooks
With eight deaths and more than 500 cases of severe lung disease currently recorded across the nation, e-cigarettes have quickly become a concern for doctors and civilians.
E-cigarettes, also called vapes or vape pens, work by heating a liquid to produce an aerosol that users inhale into their lungs. This liquid can contain nicotine, tetrahydrocannabinol (THC) and cannabinoid (CBD) oils, as well as other substances and additives.
While some users choose to vape without these products, the majority report regularly consuming e-cigarettes with both THC and nicotine. However, neither of these chemicals—despite having their own particular health impacts—have been conclusively linked to the mysterious lung disease. This is largely due to the fact that most of the vaping industry remains unregulated, resulting in products that the public ultimately knows very little about.
Despite the public’s general lack of knowledge, dental hygienists have been among the nation’s first to recognize how e-cigarettes might be affecting patients’ mouths. According to Dr. Melvin Benson, of Integrated Dental Arts in Greeley, vaping first emerged as a way for adults who were already nicotine addicts to wean themselves off of smoking traditional cigarettes. Marketing, however, chose a different route. Rather than advertise for a demographic of adults, e-cigarettes were sold with a much younger audience in mind—specifically, middle and high school students. To appeal to this audience, vaping companies added various flavorings, some of which now include strawberry, mango and cotton candy.
After nearly a generation of anti-smoking campaigns, suddenly there was an alternative on the market that did not contain any of smoking’s side effects or unpleasantries. Vape juice smelled good, tasted good, and did not have cigarettes’ nasty propensity to burn one’s lungs and stain the teeth. While people of all ages quickly flocked to the new fad, dentists still agreed that the disadvantages of vaping far outweigh any short-term benefits.
Already, the effects of e-cigarettes can be seen right inside patients’ mouths. Most notably, the nicotine found in vapes is known to cause serious dry mouth, due to its tendency to slow blood flow. While dry mouth is certainly unpleasant, saliva actually plays an important role in the mouth’s ecosystem. According to Dr. Michael McDill, of Alpine Dental in Fort Collins, saliva frequently acts as a protective coating on the teeth to fight off plaque and cavities. When that saliva is removed, the mouth’s defense system is disabled.
Additionally, many of the flavorings found in e-cigarettes cannot be metabolized by our bodies’ natural bacteria, resulting in perfect conditions for the growth of plaque and cavities. While some of these adverse effects can be remedied—or at least held at bay—through diligent dental hygiene, a toothbrush and some dental floss are ultimately flimsy solutions to a much larger problem.
Perhaps a more pressing concern is the propensity for vapes to explode. Explosions usually occur when the lithium batteries within a vape pen overheat. These explosions are usually attributed to improper charging of the device or a type of apparatus called a “mechanical mod” that has no internal safety, thereby enabling it to overheat and explode. While rare, exploding batteries have occurred.
Dr. Jacob Dunham, with Integrated Dental Arts, describes one such encounter. “[His] battery exploded. [He] came in with two front teeth broken, [and] pretty bad burns on [his] gums and lips. He came in the next day after receiving emergency care from a hospital. We had to do two crowns to replace what he’d lost of those two front teeth.”
Between 2015 and 2017 alone, more than 2,035 visits to U.S emergency rooms occurred due to e-cigarette burns and explosion-related injuries. The FDA is in charge of regulating all tobacco products—including e-cigarettes. But while the agency has sent warning letters to e-cigarette manufacturers about marketing violations and illegal sales to minors, they haven’t issued any warning letters about the potential for the batteries to overheat and explode. Instead, the FDA suggests that companies should rework their batteries to make them less likely to overheat.
Despite the FDA’s small push for change, e-cigarettes remain one of the most unregulated goods on the market. Many are manufactured abroad, making it difficult to control what is going into the devices and if the various parts are being installed correctly. In addition to the possibility of explosion, some studies have found traces of heavy metals within e-cigarettes. Other research has identified carcinogenic additives within the vape juice itself. Until the market becomes more regulated, however, it remains up to consumers to fend for themselves. The most frightening thing about e-cigarettes may not be what we know about them. Instead, it may be what is unknown. And according to Dr. Benson, “the unknown is very, very scary right now.”
In light of recent events, it has become more and more important for the health community to demand change. Already, dentists throughout Northern Colorado are trying to educate their patients, especially middle and high school students. As of 2018, 3.6 million teenagers in the United States reported vaping within the last 30 days. In regard to the survey, Alex Azar, head of the U.S. Department of Health and Human Services, commented, “These new data show that America faces an epidemic of youth e-cigarette use, which threatens to engulf a new generation in nicotine addiction.”
In an effort to prevent such an epidemic, the American Dental Association is attempting to form campaigns to teach consumers about what they may be ingesting. Other organizations are simply pushing for the industry to be more heavily regulated by the government. Although progress has been slow, one can only hope that the mysterious surge in lung disease will force the government to take, in the words of Dr. Benson, “a more active role in saving lives, as well as many, many teeth.”