When electronic cigarettes arrived on the market over a decade ago, proponents touted the aerosol, battery-powered devices as a safer and healthier alternative to tobacco cigarettes, and even a potential way to help smokers kick their habit.

But over the years, growing evidence against vaping’s supposed safety—and a 2019 outbreak of vaping use-associated lung injury (EVALI) resulting in over 2,800 cases and 68 deaths as of Feb. 2020—is changing the public’s perception of these innocuous devices that come in a dizzying array of shapes and flavors.

And researchers at New York University have discovered just another reason to drop your vape pen: It may give you gum disease.

In a peer-reviewed study published in mBio on Tuesday, the researchers found that individuals who smoked cigarettes or vaped had entirely different oral microbiomes than nonsmokers, which included bacteria implicated in the destruction of gum tissue and tooth and bone loss.

“What we were trying to find out is whether the spectrum [of an e-cigarette user’s oral microbiome] is closer to a smoker’s or closer to a non-smoker’s,” Deepak Saxena, a molecular pathologist at NYU and lead author of the new study, told The Daily Beast.

While nonsmokers and smokers shared 2o percent of all types of bacteria normally found in the mouth, Saxena and his team found both types of smokers were home to colonies of harmful bacteria known to cause serious gum infections. Past studies by Saxena’s group found an indicator of gum disease, called clinical attachment loss, was significantly worse in e-cigarette users compared to cigarette smokers and nonsmokers, likely putting them more at risk of getting infected.

Just as with cigarette smoking, vaping creates a low oxygen environment that’s a perfect breeding ground for highly pathogenic microorganisms like Fusobacterium (which causes gum disease and found to be more in e-cigarette smokers than cigarette smokers) and Treponema (a family of bacteria that include some that cause syphilis).

Though the findings raise some pretty alarming flags, Saxena does emphasize that “we don’t even know what would be the outcome of this microbiome in our overall health.” Gum disease seems to be the obvious consequence, but we need more research into the linkages before we can be sure how much worse vaping might be on oral health.

Still, it’s exceedingly clear these days that vaping is far from the healthier substitute to cigarette smoking people once touted.

The team’s next plan is to study how exactly vaping encourages a unique oral microbiome, how nicotine and our oral bacteria interact with one another and whether bacteria break down nicotine. Saxena and his group want to investigate if this breakdown influences the immune system’s activity in the mouth (that seems to be the case as they found vaping associated with immune proteins called cytokines that can cause inflammation). Since they only looked at vapes delivering nicotine, Saxena and his group are also interested in studying how popular flavoring agents like menthol, vanilla or fruit flavors could change or worsen our oral microbiomes.

One thing’s for sure: Before you pick up a vape, you might want to reconsider and think about what your dentist might say.

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