The association between electronic-cigarette use and self-reported oral symptoms including cracked or broken teeth and tongue and/or inside-cheek pain among adolescents: A cross-sectional study

BACKGROUND Little is known about oral health related to electronic-cigarette (EC) use, even though EC use is increasing rapidly. The aim of this study is to assess the relationship between EC use and oral health, including 'gingival pain and/or bleeding', 'tongue and/or inside-cheek pain', and 'cracked or broken teeth' among adolescents. METHODS A total of 65,528 students in 2016 were included in this cross-sectional study. RESULTS For EC use, 0.5% (n = 297) students were daily users, 1.9% (n = 1259) were '1 to 29 days past month users', and 5.9% (n = 3848) were former users. Overall, 18.5% students reported they had experienced 'gingival pain and/or bleeding', 11.0% reported 'tongue and/or inside-cheek pain', and 11.4% reported a 'cracked or broken tooth' within the past 12 months. When comparing 'daily EC users', '1 to 29 days past month EC users', and 'former EC users' with 'never EC users', the adjusted ORs for 'cracked or broken tooth' were 1.65 (95% CI: 1.19-2.27), 1.26 (95% CI: 1.06-1.51), and 1.16 (95% CI: 1.04-1.30), respectively. Comparing 'daily EC users' with 'never EC users', the adjusted OR for 'tongue and/or inside-cheek pain' was 1.54 (1.05-2.26). However, EC use among adolescents was not associated with 'gingival pain and/or bleeding' when adjusted for the potential confounders. CONCLUSIONS Based on the results, the odds of cracked or broken teeth among daily, '1 to 29 days past month', and former EC users were significantly higher than those among never EC users. The odds of tongue and/or inside-cheek pain among daily EC users were significantly higher than those among never EC users. In conclusion, the results suggest that daily EC use among adolescents may be a risk factor for cracked or broken teeth and tongue and/or inside-cheek pain.