Vaping: An Attractive Option or a Destructive Alternative for Oral Health?

Guest post by Jack Simon

Here it is my dear readers – the very first guest post on Dental Revelations Blog. Jack Simon is a skilled writer and I am happy that he has offered to write on my blog. Today’s subject is an important one.

Many people are turning to e-cigarettes as the conventional cigarettes are increasingly considered as anti-social. Plus there is this false belief that vaping is safer health wise than conventional cigarettes. Vaping is not safe and there are many health aspects you should consider if you opt for vaping. Jack Simon has comprehensively pointed out those health aspects in this guest post.

Please read it though before the whole vaping business blows up in your face. Literally.


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Are e-cigarettes harmful to your health? Image source: http://www.pixabay.com

The flare of e-cigarettes (ECs) in the recent years has put the health professionals’ in a situation to race against time and discover whether its introduction has been for better or for worse.

ECs, also known as ENDS (Electronic Nicotine Delivery Systems) are the battery operated devices with a metal heating element, which vaporizes a solution comprising a range of chemicals.

These days, more and more individuals are taking it up in preference to or in addition to traditional cigarettes. This hot trend in the market has raised some serious questions for government and public health professionals, as the growth of the products has seriously outpaced the regulations.

People consider e-cigarettes to be a healthier option. A common line that they use to give themselves a false gratification is

“I just vape & don’t smoke and it is not injurious to health”

This fake sense of security in e-cigarettes that they pose no harmful impact, as they use water vapor is actually not true. In reality, the notion that these products are no threat is in fact not 100% verified. If you also have the same approach, then it would be a good time to take a closer look at them and consider the effect they may have on our oral health.

Background

Its introduction in the US led to its extensive use by both smokers and non-smokers. Statistics indicate that about 20.1% of adult smokers tried ECs in 2011 and the rate of its use by school children has doubled during 2011-2012 in the US.

Sales of ECs in 2012 were estimated to be $1.7 billion in the US. If not regulated properly, the economics of ECs are expected to have remarkable growth possibility for the tobacco industry and beat the sales of tobacco smoking cigarettes in the coming decade.

Researchers are conducting a range of experiments to look at them closely. One of such findings showed that e-cigarettes consumers are acquiring much higher levels of chemical toxins – this is in clear-cut contrast to the harm decreasing patter in the ads on offer by ECs companies.

These devices have initially escaped scrutiny for safety standards and rules, but the FDA has latterly begun efforts to form regulations that would control the marketing of these products. In view of their warm acceptance and usage, the National Institutes of Health (NIH) held a workshop in 2013 to find-out the future research concerns relating to the effects of ENDS on health, potential use in cessation of smoking, addictiveness and public well-being. Furthermore, rate of queries from patients to medical practitioners relating to the safety and effectiveness of ECs as smoking cessation devices are increasing with increased acceptance.

In recent study by the U.S. Department of Health and Human Services, it has been clarified that during the process of nicotine vaporization, a variety of chemicals and metal particles are produced by these devices. The chemicals identified in the aerosols of ECs are: propylene glycol, formaldehyde, glycerine, acetaldehyde, toluene, acrolein, nickel, cadmium, nitrosamines, silicon, aluminum, and lead.

While the levels of these identified compounds and metals in ENDS are quite lower than tobacco smoke, some of them have been found to be carcinogenic and genotoxic by many studies. In addition, smoking characteristics and potential for exploitation by consumers of ECs, periodontal and upper aerodigestive tract epithelial cells, nicotine yield and degree of exposure of oral, physical characteristics of vaporized nicotine and other chemical products are tremendously different if compared to conventional cigarettes.

Let’s Unveil Its Effects on Oral Health

Apart from the recognizable health implications, vaping pose severe damage to your oral health (teeth, gums and tongue). Problems like tooth decay, teeth loss, gingivitis, periodontal disease and oral cancer are the most common ill-effects caused by conventional cigarettes and e-cigarettes. The nicotine absorbency is very high in ECs.

The Journal of the Indian Society of Periodontology published a report to disclose that nicotine significantly contributes to the development of gum problems (gingivitis and periodontitis), which can be the leading cause for bad breath and inflammation throughout the body.

The Journal of Cellular Physiology published the result of recent study, showing that a high rate of mouth cell die with the increased exposure to e-cigarette vapor.

Studies have also revealed that the menthol additive in ECs liquids have a destructive effect on the epithelial cells and the fibroblasts within the periodontal ligament. Its longer term use may also increase the risk of oral cancer; however this is still under investigation.

The Role of Nicotine in Destroying Your Oral Health

  • In Gum Recession
    Nicotine is a vasoconstrictor; therefore it has the tendency to contract the muscular wall of the blood vessels and cutting-down the amount of blood that flows through the veins. With restricted blood flow, the gums do not get sufficient oxygen and nutrients that is necessary for them to stay healthy. Moreover, it chokes mouth tissues, thus cause death of the gum tissues.

  • In Causing Bad Breath
    Nicotine constrains the body’s ability to produce saliva. Lack of saliva can leave your mouth prone to bacteria buildup, tooth decay and dry mouth. This also affects the mouth’s normal inhibitory function of cleaning and reduces the body’s innate capacity to heal and generate new cells.

  • In Intensifying Grinding
    Nicotine acts as a stimulant that fires-up the muscles, making you grind your teeth more intensely or might prompt you to start grinding even if you aren’t a grinder.

  • In Hiding Tell-Tale Signs of Gum Problem
    Nicotine can mask the initial signs of gum disease and makes it hard for a dentist to diagnose it.

Various researches have clarified that vaping impose many potential ill-effects to our oral health. This should be enough to the most rabid vapers to see the whole picture clearly that it is not safe.

The manufacturers of ECs claim that their product is a healthier therapeutic alternative to conventional smoking, but in the absence of any verified scientific study to back this contention, it would be ideal to avoid it.

Nicotine inhalation puts the person’s dental health at greater risks. Regardless of whether these devices pose less harmful effects than conventional smoking, health specialists concur that they are by no means safe.

Your likelihood of getting gum problem is higher as long as you are using nicotine, so visit your dentist in a frequency of three months to prevent tooth loss, bone loss, gum recession and many oral issues.


Author Biography

Jack Simon is a content strategist at Irresistible Smiles. He has flair of writing engaging articles about oral health care. His keen interest in presenting the dental care issues in a simple and straightforward manner is appealing to the readers.

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Is Xylitol Good for You?

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Xylitol will help you to improve oral health

What Is Xylitol?

Well I was going to write about xylitol but when collecting facts I run into an article that comprehensively and distinctly gives you the relevant information on xylitol. Why produce something somebody else has done so well? So ladies and gentlemen please read through this article:

Xylitol: Everything You Need to Know (Literally) by Kris Gunnars, BSc at www.authoritynutrition.com

What I will add from an experience to this great article is that always choose a product that is sweetened by xylitol only. This will minimise the possibility of having stomach problems. It is not necessarily the xylitol that is culprit for the enhanced bowel movements but the other sweeteners like maltitol syrup. Trust me, I know from my personal experience. All I need to have is 3 or more pastilles sweetened with both xylitol and maltitol syrup and rest of my family will suffer from consequences – if you know what I mean…

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Use chewing gum or pastilles sweetened 100% with xylitol

Here are couple of sites that sell products (chewing gum, pastilles) sweetened 100% by xylitol:

Peppersmith

Sweetlife – Spry brand

Fazer

Word of Warning

Even though the xylitol is absolutely harmless to us human beings (both children and adults), it can be fatal to dogs. So do not leave any xylitol product in the reach of your dog.

Controversy

Like mouthwashes and sparkling water divide us dental professionals, so does the xylitol. Some don’t know enough about it and some dental professionals take guidance from studies that are low of quality.

In 2015 the Cochrane released a review about xylitol which concluded that the xylitol has not been proven to be effective in prevention of decay. Many of us dental professionals most likely only read the abstract of the review, am I right? Very few of us had enough time or attention span long enough to go through the full version of the review. I mean really go through it – all the 10 studies they had included in their review.

Well I am going to make it easier for you now. I have looked into the full review and have simplified it in the next paragraph.

Cochrane Review and It’s Flaws

There are hundreds of studies about xylitol and caries (decay). In PubMed alone has over 500 of these publications. But yet the Cochrane review has been put together by using only ten of them.

In five of these studies the daily dosage of xylitol was lower than what is known and proofed by several clinical studies to be effective – that is 5 g per day.

Three out of these five studies were studies over toothpastes containing fluoride and xylitol. The levels of xylitol in toothpaste are always lower than the recommended, effective daily dosage of xylitol.

Clinical studies have concluded that the daily dosage and the frequency of use are the key factors in the effectiveness of xylitol. The xylitol should be spread throughout the day into small doses – preferably to 3-4 doses per day. As the xylitol is not antimicrobial compound, it needs to be used this 5 g per day to be effective in reducing the level of bacteria in mouth and therefore caries.

Let me repeat – five of out of ten studies included in the Cochrane review did not use sufficient dosage of xylitol. One out of these five studies wasn’t even a study over xylitol but probiotics – the xylitol was merely used as an adhesive (in milligrams – far from the 5 gram recommended daily dosage).

One out of these five studies did not even state the dosage of xylitol used. So why did they choose them for the review? I will try to find the answer in the Conclusion paragraph.

Ok, enough of those five questionable studies. Lets have a look at some of the remaining studies.

One of them the reviewers themselves think it has a “high overall risk of bias”. Well, they said it themselves – why include it?

Another study was conducted on kids with good oral health – how would you see if the xylitol is effective if there is nothing to improve in oral health? The ones executing this kind of study have been silly in the first place but the Cochrane reviewers are even sillier to include it in the review. What was the point?

Two studies had excellent results in the effectiveness of xylitol (see the other study here). Both of these studies used high enough dosage of xylitol.

Conclusion

It remains to be seen what magnitude of damage on public health one badly executed review has had. There are signs already that it has done great deal of damage. I did just a quick browse through the blogs and the internet and found several articles that were already declaring that the xylitol is useless referring to this Cochrane review. Some even state xylitol is harmful to us.

One must question the motives behind the Cochrane review on xylitol.

Has there been an involvement of the huge sugar industry that feels easily threatened by any alternative (and healthier) option for sugar as a sweetener? It is perhaps one reason why it is difficult to find xylitol products from many countries, especially the further west you go from Europe the more difficult it becomes.

Or was the review put together too hastily and with personal prejudices?

There are several food safety authorities worldwide that have accepted xylitol as food additive. The Joint (WHO/FAO) Expert Committee on Food Additives (JECFA) allocated xylitol’s ADI (acceptable daily intake) already in 1983 to “not specified” which is the most favourable ADI possible. Also the European Food Safety Authority concluded in 2006:

sugarfree chewing gum sweetened with xylitol is sufficiently characterised in relation to the claimed effects

(See the link for the full article at the bottom of this post)

Why produce a review that undermines the effectiveness of the xylitol when clearly there is no harm using it? Quite contrary, it most likely is beneficial to dental health when used appropriately and can have a positive impact on children suffering from middle ear infections.

The Cochrane reviewers are only emphasising their own self-importance and pettiness by this trivial review which will be in the world wide web forever and ever, with their names on it. It is an achievement I do not envy at all.

The Cochrane Library: Riley P, Moore D, Ahmed F, Sharif MO, Worthington HV. Xylitol-containing products for preventing dental caries in children and adults.

European Food Safety Authority (EFSA) on xylitol

Years of Malpractice – How Is It Possible?

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Where there is smoke, there is fire. Dentists negligent behaviour should be act upon.

Ever wondered how it is possible that the dentists who are not practicing dentistry up to the standards get caught only after years of practicing the profession? Well you have come to the right place to find out.

Is It the Patients’ Fault?

Nope. Absolutely not.

The patients cannot tell the difference between a good and bad dentist when it comes to the skills of a dentist. Or if the procedures have been done as they should and if they are necessary in the first place. Or if the instruments entering their mouth have been properly cleaned (take a look at my previous post about this).

An average patient can only judge the dentist by the looks of him and the practice, and by the dentist’s chair-side manners. The rest is build on a trust of receiving good and adequate care. But every once in a while this trust is broken and the dentist ends up in the headlines.

But please remember that not all the dentists ending up to the headlines are rogue dentists as I have written previously.

Collegiality Gone Bad

Collegiality between the dentists means respect to one another’s abilities to work towards the same purpose. Helping patients. But collegiality has an ugly side as well. It is an unwritten code between the dentists which means one should not interfere or especially under any circumstances criticise a fellow dentist’s work. It is a code one should not break. The hygienists are expected to play by the same rules.

Now, this creates a problem. When a dentist is underperforming, the colleagues hear this from the hygienists and nurses. They see see it from the teeth of the patients who come too see them instead of their regular dentist (e.g. for emergency visit or whilst the regular dentist is on a holiday). They know there is a problem but very rarely they raise questions.

Instead the patient is kept under an illusion that the regular dentist has made the right decisions by distorting the truth.

Distorted truth:

“This decay is in such a difficult area to notice.”

The truth:

“This massive decay is so big that even my half-blind grandmother would find it.”

Distorted truth:

“Your dentist has marked it as an early decay, something to be kept an eye on… it has now grown bigger and needs a filling.”

The truth:

“Your dentist needs to have his eyes checked. This decay should have been filled ages ago. If you are lucky enough, you avoid the root canal treatment.”

Conclusion

It should be every dentist’s duty to report problems in colleague’s way of practicing dentistry. The Code of Ethics by ADA state the following:

Dentists should be aware that jurisdictional laws vary in their definitions of abuse and neglect, in their reporting requirements and the extent to which immunity is granted to good faith reporters. The variances may raise potential legal and other risks that should be considered, while keeping in mind the duty to put the welfare of the patient first. Therefore a dentist’s ethical obligation to identify and report suspected cases of abuse and neglect can vary from one jurisdiction to another

In my opinion, you don’t pull out the biggest guns if you suspect negligent behaviour from your colleague. The dentist in question should be given adequate time to correct the problem e.g. by revising.

The privilege of dentists to be accorded professional status rests primarily in the knowledge, skill and experience with which they serve their patients and society. All dentists, therefore, have the obligation of keeping their knowledge and skill current.

If nothing changes, more severe means should take place. This includes giving warnings and as a last resort filing a complaint to the relevant authorities.

Naturally, if the negligence is severe, one should not hesitate to contact authorities urgently.

The bible of dentistry aka ADA’s Code of Ethics 2018 in full.

 

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