Projected increase in oral cancer due to rise in use of electronic-cigarettes

Abstract

The main risks of developing oral cancer are tobacco smoking and alcohol consumption in excess, infection with human papillomavirus, and a family history of oral cancer. Tobacco smoking is a significant health risk because of the many negative effects it has on the body. It can induce epigenetic alteration of oral epithelial cells, damage the functioning of the immune system, and induce oxidative oral stress. A result of these stressors is the induction of mutagenicity, potentially leading to the development of oral squamous cell carcinoma. The popularity of E-cigarettes is ever-increasing, especially among young adults. E-cigarettes are often marketed as a safer alternative to conventional cigarettes, however, this is not factual. E-cigarettes contain high amounts of nicotine making them highly addictive, and the more than 7,000 flavors, the majority of which have not been evaluated for their genotoxicity, are appealing to teenagers. Many of these flavors cause DNA damage, inflammation, and oxidative stress. In addition, heating the liquid in E-cigarette pods generates carbonyls such as the carcinogenic formaldehyde and acetaldehyde, and the cytotoxic acrolein. These findings indicate a high risk of developing cancer for chronic users of E-cigarettes. Klawinski et al. (2021) reported a case of a previously healthy 19-year-old male who vaped daily for 4 years and developed oral squamous cell carcinoma. When comparing the dental health issues of smokers and vapers it was found that smoking cigarettes is a significant risk factor for developing peri-implant disease, dental implant failure and bone loss, gum disease, and periodontitis. There is little research on the effects of vaping on the oral cavity of vapers, but the research that is available has shown vapers have an excessively increased risk of developing gum disease, dental implant failure, bone loss, and periodontitis. Further research needs to determine a cause-and-effect relationship between vaping and the development of oral cancer.