British Dental Journal Paper Dismissed by Experts for Lack of Evidence
A research paper published in the British Dental Journal about the “erosive potential” of vaping on teeth has been called out by dental experts for “several basic errors and misrepresentations.”
A paper published in the British Dental Journal by Dr Ruth Fairchild and Dr Anita Setarehnejad from Cardiff School of Sport and Health Sciences at Cardiff Metropolitan University questioned whether the “erosive potential” of vaping is “cause for concern.”
The objective of their paper states: “Relatively little is known about the erosive potential of vape products, an important consideration for dental health.” However, their paper did not add any new evidence or data to the current field of knowledge.
Furthermore, the paper laid out a series of unfounded claims and misrepresentations of data, more evocative of an American publication than a British one (in the UK, vaping is embraced by the government as a harm reduction method).
In a response to the paper, written by dental experts, the authors state that they are “disappointed to see several basic errors and misrepresentations.” The authors continue by pointing out major errors in the paper.
What did the British Dental Journal paper get wrong?
Among the five most egregious errors in the paper’s findings, the experts who authored the response—R. Holliday, E. McColl, A. Weke, and Z. Sayeed—state that the foremost issue is that the British Dental Journal paper categorises vaping as a form of tobacco. E-cigarettes do not contain tobacco—only nicotine. Any claims the authors make about the harms of tobacco on teeth are unrelated to the topic of vaping.
Second, the authors incorrectly claim that nicotine leads to a “high risk of oral and whole-body health complications,” which is unfounded. The authors of the paper cite a WHO poster depicting the harms of smoking cigarettes on health—not nicotine. As we know, nicotine has been used safely on its own in the form of NRT for decades, even by pregnant women. Nicotine and NRT are regarded as extremely safe, even for long-term use.
Next, the British Dental Journal paper’s authors claim that vaping is associated with cancer, citing a reference which does not support this claim—in fact, their source states the opposite: “no long-term evidence related to oral and systemic health effects exist.”
The authors also claim that “diacetyl is found in most flavoured vapes”—and, again, the supporting reference does not back up this claim. In fact, anyone with a foot in the vaping industry can attest that diacetyl is one of the substances which is banned from all E-Liquids sold in the UK, making this point entirely unfounded.
Lastly, the authors of the misguided paper “grossly misrepresent,” according to experts, the public health guidance on the use of e-cigarettes as a smoking cessation aid. The authors cite a 12 year-old WHO document—which, of course, was created before vaping was popularised. Furthermore, the authors don’t discuss the relative safety of vaping compared to smoking in their paper.
In their response to the British Dental Journal paper, the experts write that while the experiment conducted by the paper’s authors is technically sound, it’s not representative of real-life scenarios, and its sources are unbalanced.
The experts say that more clinical research is needed, and follow up by stating: “Our research group has previously explored this subject […]. Preliminary data showed minimal changes in pH even after prolonged vaping sessions.” The data from this experiment was not published.
How does vaping affect teeth?
As evidenced by the kerfuffle surrounding the paper in the British Dental Journal, experts are still unsure how vaping affects teeth, especially in the long-term.
There are a select few things we do know, however.
When it comes to vaping’s effects on dental health, we’re aware that E-Liquids are made using a mixture of Propylene Glycol (PG), Vegetable Glycerin (VG), nicotine, and flavourings. Interestingly, it’s not likely to be the nicotine that makes an impact on your teeth.
Both PG and VG are known to have a dehydrating effect—which is why your mouth might feel dry after vaping for a while. Dry mouth, caused by anything from not drinking enough water to vaping to the side effects of some medications, can damage your teeth.
When your mouth becomes dehydrated, it’s unable to make enough saliva, which is the substance that protects your teeth and gums from excess food debris and bacteria. Saliva keeps this nastiness from clinging to your teeth and gums, and can neutralise the bacterial acids that cause dental decay.
The best way to combat dry mouth from vaping is to consume plenty of water, which will give your body the hydration it needs to produce more saliva to combat dry mouth.
When it comes to your full body health, vaping is decidedly safer than smoking—up to 95% safer, in fact. If you’re trying to quit smoking, vaping can be an excellent help, especially when used alongside other smoking cessation aids like nicotine patches or gum.
In fact, vaping has a very high success rate as a smoking cessation aid—the highest of all methods according to the NHS, with success rates between 59.7% and 74% in 2019 and 2020.
Conclusion
This piece of health & science news isn’t quite news—just another unfounded medical paper attacking the most successful smoking cessation aid available in the world right now, with no new evidence and poor, unrepresentative references to back up their arguments.
The British Dental Journal paper goes against everything the UK government and the NHS stand for, making claims similar to the ones made in the US about vaping and nicotine’s non-existent associations with cancer and bodily harm.
It’s understandable that the experts in their response state that they are disappointed, as members of the vaping community like us continue to see claims like these which don’t add anything to our current body of knowledge on the subject.
We’d love to see more studies and trials exploring the effects of vaping on dental and oral health. Until then, let’s just keep chugging water.
