Comparative Assessment of Oral Health Findings Among E-Cigarette Users, Conventional Smokers, and Non-Smokers in Makkah City: A Cross-sectional Study

The rising popularity of electronic cigarettes (e-cigarettes) in Saudi Arabia has prompted concerns regarding their impact on oral health. This study compared oral health parameters among e-cigarette users, conventional smokers, and non-smokers.

A cross-sectional study was conducted on 90 participants at Umm Al-Qura University Dental Hospital, divided equally into three groups. Clinical assessments included salivary flow rate (SFR), decayed, missing, filled teeth (DMFT) index, plaque index, salivary potential of hydrogen (pH), gingival pigmentation, and gingivitis. Dry mouth and symptoms were assessed via validated questionnaires. (ANOVA) and Chi-square tests were applied (p < 0.05).

E-cigarette users showed significantly lower SFR compared to non-smokers (p < 0.01; Cohen’s d = 0.784) and a higher prevalence of gingivitis and dry mouth (p < 0.01). No significant differences were found in DMFT, plaque levels, pH, or gingival pigmentation. Most e-cigarette users perceived e-cigarettes as less harmful and more effective for smoking cessation.

E-cigarette use was linked to reduced salivary flow and greater prevalence of gingivitis and dry mouth, likely due to nicotine-induced glandular dysfunction and mucosal dehydration. In contrast, other parameters showed non- significant differences, trends aligned with prior research on vaping-related microbial and inflammatory changes. Misconceptions about e-cigarette safety remain common among users. However, the study’s cross-sectional design, self-reported data, and limited sample size restrict causal interpretation.

E-cigarette use may negatively impact oral health by reducing salivary flow and consequently increasing the risk of gingivitis and dry mouth. These findings highlight the need for public health education and underscore the importance of further longitudinal and biochemical studies to clarify the long-term effects of e-cigarette use on oral health.