Relationship of E-cigarette Smoking (Vaping) with Dental Caries in Adolescents: A Systematic Review

Objective of study was to find association between e-cigarette use and dental caries among adolescents. Inclusion criteria were original articles (in-vivo/in-vitro), studying effects of e-liquids and aerosols on caries/ bacteria causing caries. Exclusion criteria were review articles and articles not showing caries as outcome. Review was registered in INPLASY, with registration number INPLASY202530057. Google Scholar and PubMed were searched till 16th March’25. AMSTAR-2 was used for risk of bias. Review was presented and organized in table form. Out of 15 original articles, four human studies found and three studies could not find significant differences between caries levels of control and e-cigarette groups. In four in-vitro studies, viscous and flavored e-cigarette aerosols were found to suppress growth of oral commensal streptococci and promote caries producing Streptococcus mutans growth. Aerosol form caused greater suppression of commensals compared to bacteria exposed to un-aerosolized e-liquid. In conclusion, e-cigarettes are cariogenic by shifting of oral microbiome in favor of caries, high levels of sugars and flavors in e-liquids and heating of e-liquids. All human studies included adolescent age within young adult groups. Hence, results of this study could not be inferred to adolescents alone. No funding was done for this review.