First-ever study shows e-cigarettes cause damage to gum tissue

A University of Rochester Medical Center study suggests that electronic cigarettes are as equally damaging to gums and teeth as conventional cigarettes.

The study, published in Oncotarget, was led by Irfan Rahman, Ph.D. professor of Environmental Medicine at the UR School of Medicine and Dentistry, and is the first scientific study to address e-cigarettes and their detrimental effect on oral health on cellular and molecular levels.

Electronic cigarettes continue to grow in popularity among younger adults and current and former smokers because they are often perceived as a healthier alternative to conventional cigarettes. Previously, scientists thought that the chemicals found in cigarette smoke were the culprits behind adverse health effects, but a growing body of scientific data, including this study, suggests otherwise.

"We showed that when the vapors from an e-cigarette are burned, it causes cells to release inflammatory proteins, which in turn aggravate stress within cells, resulting in damage that could lead to various oral diseases," explained Rahman, who last year published a study about the damaging effects of e-cigarette vapors and flavorings on lung cells and an earlier study on the pollution effects. "How much and how often someone is smoking e-cigarettes will determine the extent of damage to the gums and oral cavity."

The study, which exposed 3-D human, non-smoker gum tissue to the vapors of e-cigarettes, also found that the flavoring chemicals play a role in damaging cells in the mouth.

"We learned that the flavorings-some more than others--made the damage to the cells even worse," added Fawad Javed, a post-doctoral resident at Eastman Institute for Oral Health, part of the UR Medical Center, who contributed to the study. "It's important to remember that e-cigarettes contain nicotine, which is known to contribute to gum disease."

Most e-cigarettes contain a battery, a heating device, and a cartridge to hold liquid, which typically contains nicotine, flavorings, and other chemicals. The battery-powered device heats the liquid in the cartridge into an aerosol that the user inhales.

"More research, including long term and comparative studies, are needed to better understand the health effects of e-cigarettes," added Rahman, who would like to see manufacturers disclose all the materials and chemicals used, so consumers can become more educated about potential dangers.

Cognitive Behavioral Therapy Resource for Children's Dental Anxiety

The International and American Associations for Dental Research (IADR/AADR) have published an article titled "Development and Testing of a Cognitive Behavioral Therapy Resource for Children's Dental Anxiety" in the OnlineFirst portion of JDR Clinical & Translational Research. In this study, Jenny Porritt, Department of Psychology, Sociology, and Politics, Sheffield Hallam University, UK, et al describe the development of a guided self-help cognitive behavioral therapy (CBT) resource for the management of children's dental anxiety and provide preliminary evidence for the feasibility and acceptability of this approach with children aged between nine and 16 years.

CBT is an evidence-based treatment for dental anxiety; however, access to therapy is limited. This study employed a mixed methods design where within phase one, a qualitative "person-based" approach informed the development of the self-help CBT resource. Guidelines for the development and evaluation of complex interventions were also used. Within phase two, children aged between nine and 16 years who had elevated self-reported dental anxiety and were attending a community dental service or dental hospital were invited to use the CBT resource. Children completed questionnaires, which assessed their dental anxiety and health-related quality of life prior to and following their use of the resource. Recruitment and completion rates were also recorded.

Acceptability of the CBT resource was explored using interviews and focus groups with children, parents/caregivers and dental professionals. A total of 85 children were invited to participate in the feasibility study and trial the CBT resource. The recruitment rate (proportion of children invited to take part in the study who agreed to participate) and completion rate (proportion of children who agreed to participate who completed the study) was 66 percent and 86 percent, respectively. A total of 48 patients completed the study.

At the conclusion of the study, the authors ascertained that there was a significant reduction in dental anxiety and an increase in health-related quality of life following the use of the guided self-help cognitive behavioral therapy resource. The results of this study will inform the design of a definitive trial to examine the treatment and cost-effectiveness of the resource for the reduction of children's dental anxiety.

"Having launched this year, JDR Clinical & Translational Research provides a unique opportunity for oral health research leaders to publish their research and effectively translate their findings to those who need the information to deliver evidence-based prevention and care. On behalf of the International Association for Dental Research, I am pleased that the authors of this study contributed their research to this publication," said IADR President Jukka Meurman.