The impact of electronic cigarette smoking on periodontal status and proinflammatory cytokine levels: a cross-sectional study

Background: E-cigs(E-cigs) use is increasing worldwide. Recent studies suggest that E-cigs contain harmful elements that could lead to adverse oral health outcomes. Therefore, the aim of this study was to evaluate the impact of E-cigs smoking on periodontal health among current male smokers in Al-Kharj city in Saudi Arabia by assessing periodontal parameters and proinflammatory cytokine levels. Methods: Fifty-three male individuals (25 E-smokers and 28 non-smokers) participated in the study. This study compared periodontal parameters, including the plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment loss (CAL), and marginal bone loss (MBL), as well as levels of unstimulated whole saliva (UWS), interleukin IL-1B, and IL-6, between E-smokers and non-smokers. Results: The E-cigs users consumed approximately 432.6 ± 425.22 puffs on average daily, with a nicotine content of approximately 45.2 ± 11.23 mg on average. There was no statistically significant difference between the groups in terms of BOP and PI. A statistically significant difference was detected in PPD and CAL (p < 0.05) between the two groups, in which the PPD (4.10 ± 1.87) and CAL (2.72 ± 0.89) were greater in E-smokers. The mean MBL was also higher among E-smokers, which was statistically significant (p < 0.05). The mean cytokine IL-1B level was found to be (640.75 ± 138.78) among non-smokers and (889.05 ± 540.56) among E-smokers, and this difference was statistically significant (p < 0.05). However, while IL-1B had shown a significant difference between groups in the bivariate analysis (t-test), its association with E-cigs use became non-significant in the multivariate model (OR = 1.01, 95% CI: 1.00–1.02, p = 0.194). The mean IL-6 level among non-smokers was (19.49 ± 11.90) and among E-smokers, it was (17.07 ± 8.21). And, this difference was not statistically significant (p > 0.05). Conclusions: This study revealed that E-cigs smoking had a negative effect on periodontal status (especially PPD, CAL and MBL). These results may contribute to the pathogenesis of periodontal diseases and tissue destruction. Efforts must be made to educate and create awareness among patients and the general community regarding the risks associated with E-cigs usage especially in young populations.