A new study shows that vaping can be harmful for people’s mouths, triggering gum disease and the production of bad bacteria.

Smoking has never been associated with positive oral health, but a new study, examining the relationship between vapes, cigarettes, and oral health, found that the habit can contribute to gum disease.

Published in the journal mBio, and conducted by researchers from New York University, the study found that people who vape have a unique oral microbiome that is different from nonsmokers and traditional cigarette smokers.

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The study was conducted on a group of 87 people who smoked, vaped, or smoked regular cigarettes. Participants went to the lab to have their mouths analyzed twice, with their sessions occurring six months apart. Researchers took saliva samples and looked into the possibility of gum disease.

Researchers found that most people showed symptoms of gum disease, as everyone does after the age of 30, but that people who vaped showed evidence of “clinical attachment loss.” This is a symptom of gum disease where there is a separation between the gum and the tooth, creating pockets where bacteria can hide and thrive. In terms of microbiomes, vapers had a more similar environment to smokers, but also had bacteria like TNFα, known for causing inflammation and being linked with diseases like Alzheimer’s, depression, and more.

Deepak Saxena, one of the lead researchers, spoke with Interesting Engineering and discussed the findings. “Our thinking was that the microbiome [of e-cigarette users] will be similar [either] to the combustible cigarette users or to the non-smokers,” he said. This wasn’t the case. The study shows vaping creates a unique environment for bacteria, one that could affect people’s health in the future in ways that are not yet known.

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While vaping and smoking are harmful to our health, the problem with vaping is that it’s an activity limited to mostly young people. Vaping has been marketed as a healthier alternative to cigarettes, touting the fact that it’s vapor and not smoke. But the truth is that these devices haven’t been around all that long, and there’s no way of knowing their long-term effects.