E-cigarette aerosol / e-liquid exposure (flavored and unflavored; nicotine and non-nicotine) vs Unexposed controls / unflavored e-liquid / conventional cigarette smoke: Cariogenic and commensal oral bacteria (S. mutans and commensal streptococci growth, adhesion, biofilm)
- Population
- Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few clinical microbiome studies)
- Intervention
- E-cigarette aerosol / e-liquid exposure (flavored and unflavored; nicotine and non-nicotine)
- Comparison
- Unexposed controls / unflavored e-liquid / conventional cigarette smoke
- Outcome
- Cariogenic and commensal oral bacteria (S. mutans and commensal streptococci growth, adhesion, biofilm)
Most in vitro studies indicate e-cigarette aerosol/e-liquid (especially flavored/high-concentration) disrupts normal oral flora and favors cariogenic S. mutans growth and biofilm, plausibly increasing caries risk; not pooled (ungraded, narrative).
What each review found
Include earlier review versions| Finding | Effect | Studies | GRADE certainty |
|---|---|---|---|
E-cigarette aerosol / e-liquid exposure (flavored and unflavored; nicotine and non-nicotine) vs Unexposed controls / unflavored e-liquid / conventional cigarette smoke Cariogenic and commensal oral bacteria (S. mutans and commensal streptococci growth, adhesion, biofilm) · Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few… · Laboratory (in vitro/ex vivo) studies of oral bacteria and dental hard tissue, plus a few clinical oral-microbiome studies Most in vitro studies indicate e-cigarette aerosol/e-liquid (especially flavored/high-concentration) disrupts normal oral flora and favors cariogenic S. mutans growth and biofilm, plausibly increasing caries risk; not pooled (ungraded, narrative). The effects of electronic smoking on dental caries and proinflammatory markers: a systematic review and… (2025) All outcomes | Narrative synthesis of 9 studies (Table 2). E-cigarette aerosol/e-liquid at higher concentrations (>=5%) and flavored liquids inhibited commensal oral streptococci and allowed S. mutans to proliferate, with increased… | 9 studies | GRADE not reported |
Findings are shown side by side, never pooled across reviews.
The reviews
| Review | Searched up to | Included studies | AMSTAR 2 |
|---|---|---|---|
| The effects of electronic smoking on dental caries and proinflammatory markers: a systematic review and meta-analysis. 2025 All outcomes | September 2024 (initial search April 2024, updated September 2024) | 41 | Not applicable |
How reviews are matched to this question
Reviews word the same question differently. Four decision models (TypeSafe's Jev, Liquid AI's d1-ultra, SubQ Snap and Baseten's Elephant) judged each wording of the population, intervention, comparator and outcome against the others; two wordings count as the same when at least three of them agree and none clearly disagrees, and findings count as this question only when all four elements match. Timing, setting and subgroup never split a question: they are shown on each finding.