Association of e-cigarette use with oral health: a population-based cross-sectional questionnaire study.

BACKGROUND: The impact of daily or intermittent electronic cigarette (e-cigarette) use on oral health is unknown. METHODS: We performed a cross-sectional analysis using the 2016 Behavioral Risk Factor Surveillance System data. Poor oral health was determined by the number of permanent teeth removed due to non-traumatic causes, and e-cigarette use determined by daily or intermittent use within 30 days prior to survey administration. We performed logistic regression analysis to test associations between e-cigarette use and oral health with adjustment for factors associated with poor oral health, survey clustering, strata and weight. RESULTS: We included survey responses from 456 343 adults. Over half of respondents (51.5%) reported having at least one permanent tooth removed because of tooth decay or gum disease in their lifetime. Daily e-cigarette use was reported by 4957 (1.1%) of respondents. In multivariable analysis, daily e-cigarette use, was independently associated with a 78% higher odds of poor oral health (adjusted OR = 1.78, 95% CI: 1.39-2.30; P < 0.001). CONCLUSIONS: In a population-based health survey of US adults, self-reported health behavior and outcomes, daily use, but not intermittent use of e-cigarettes was independently associated with poor oral health. Care must be exercised in seeking 'healthier' cigarette alternatives.