Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

22 questions · 30 findings · 2 reviews

No studies found 0 · 0%GRADE not reported 30 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Electronic cigarette use vs Non-smokers

TNF-α level · People who use electronic cigarettes

The review reports no significant e-cigarette effect on salivary TNF-α.

3 findings from 1 review

Electronic cigarette use vs Non-smokers

IL-6 level · People who use electronic cigarettes

The review reports that GCF evidence was limited and may show a potential association.

3 findings from 1 review

Electronic cigarette use vs Non-smokers

IL-1β level · People who use electronic cigarettes

The review reports no significant e-cigarette effect on salivary IL-1β.

3 findings from 1 review

Electronic cigarette use vs Non-smokers

IL-8 level · People who use electronic cigarettes

The review reports that GCF evidence was limited and may show a potential association.

3 findings from 1 review

Electronic cigarette use vs Non-smokers (non-users)

Oral candidiasis prevalence · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette users may have a higher prevalence of oral Candida colonization than non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers (non-users)

Dental caries and cariogenic bacteria (Streptococcus mutans, Lactobacilli) · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette use is associated with more cariogenic bacteria and increased dental caries risk compared with non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers (non-users)

Self-reported gingivitis · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette use is associated with self-reported gingivitis compared with non-smokers (single included review; ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers (non-users)

Oral microbiota composition (dysbiosis; increased periodontal/opportunistic pathogens) · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette use is associated with oral microbiota dysbiosis and increased pathogenic bacteria compared with non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

Electronic cigarette use vs Traditional (conventional) cigarette smokers

Plaque index / periodontal health (relative harm vs conventional smoking) · Adult e-cigarette (ENDS) users (general oral health)

E-cigarette users tend to have a lower plaque index and less periodontal harm than traditional cigarette smokers, although still worse than non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers (non-users)

Plaque index (PI) / oral hygiene · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette users tend to have a higher plaque index (more biofilm accumulation) than non-smokers (narrative synthesis of systematic reviews; ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers (non-users)

Periodontitis / periodontal disease and periodontal parameters · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette users appear more likely to develop periodontal disease and worse periodontal parameters than non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers

Peri-implant clinical and radiographic parameters (plaque index, probing depth, bone loss, pro-inflammatory profile) · Adult e-cigarette (ENDS) users with dental implants (incl. male implant-supported prosthesis patients)

Among dental implant patients, e-cigarette users show worse peri-implant parameters (more plaque, worse clinical and radiographic outcomes) than non-smokers (narrative synthesis; ungraded).

1 finding from 1 review
  • An Umbrella Review of E-Cigarettes' Impact on Oral Microbiota and Biofilm Buildup. 2025 All outcomes
    Dental implant / peri-implant care · Implant/peri-implant populations: Vamos (implant patients), Youssef (male implant patients only), Yang (broad SR incl. peri-implant)
    Narrative synthesis: e-cigarette users with dental implants showed a higher peri-implant plaque index and worse clinico-radiographic and immunological peri-implant parameters than non-smokers (worse than non-smokers…
    3 studies
    GRADE not reported

Electronic cigarette use vs Non-smokers

Interleukin-8 (IL-8) · Humans who use e-cigarettes (mostly adults, often with periodontal disease) assessed for oral proinflammatory markers

Meta-analysis suggests no significant effect of e-cigarette use on the salivary level of Interleukin-8 (IL-8) (6 studies), though heterogeneity was high (I2=84%) and the pooled estimate appears only in Figure 3C (unavailable); GCF data were limited (1 study(ies)) (ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers

DMFT/DMFS index (dental caries experience) · Humans who use e-cigarettes (adolescents to adults) assessed for dental caries

A meta-analysis of 3 studies compared DMFT/DMFS in e-cigarette users vs non-smokers, but the pooled effect appears only in Figure 3A (unavailable) and heterogeneity was very high (I2=98%); the effect of vaping on dental caries remains unclear (ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers

Interleukin-6 (IL-6) · Humans who use e-cigarettes (mostly adults, often with periodontal disease) assessed for oral proinflammatory markers

Meta-analysis suggests no significant effect of e-cigarette use on the salivary level of Interleukin-6 (IL-6) (6 studies), though heterogeneity was high (I2=95%) and the pooled estimate appears only in Figure 3D (unavailable); GCF data were limited (1 study(ies)) (ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers

Dry mouth (xerostomia) · Humans who use e-cigarettes (adolescents to adults) assessed for dental caries

Two studies reported more frequent xerostomia (dry mouth) among e-cigarette users than non-smokers, which may raise caries risk, but results were not pooled (ungraded, narrative).

1 finding from 1 review

Electronic cigarette use vs Non-smokers

Tumour necrosis factor-alpha (TNF-α) · Humans who use e-cigarettes (mostly adults, often with periodontal disease) assessed for oral proinflammatory markers

Meta-analysis suggests no significant effect of e-cigarette use on the salivary level of Tumour necrosis factor-alpha (TNF-α) (7 studies), though heterogeneity was high (I2=95%) and the pooled estimate appears only in Figure 3E (unavailable); GCF data were limited (2 study(ies)) (ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers

Combined salivary IL-1β, IL-6, IL-8, and TNF-α levels · Humans who use e-cigarettes (mostly adults, often with periodontal disease) assessed for oral proinflammatory markers

Combining all four salivary cytokines, the meta-analysis found no effect of e-cigarette use on salivary proinflammatory marker levels (low between-marker heterogeneity, I2=31%); the pooled estimate appears only in Figure 3F (unavailable) and is ungraded.

1 finding from 1 review