Smoking and Gum Disease: Is Nicotine to Blame?
For vapers, learning about the connection between smoking and gum disease invites one question: is it the nicotine or the tar in tobacco that causes the problems? Of course, as vapers we’d be inclined to blame the smoke and tar rather than the nicotine, but would be right to?
There are several theories relating to the link between smoking and gum disease:
The toxins in smoke could directly damage gum tissue.
Smoke could change the specific microbes found in plaque or change how the immune system responds to it.
Nicotine causes blood vessels to constrict, and this could make the early warning signs (like bleeding from the gums) harder to spot.
Nicotine’s effect on blood vessels could lead to “hypoxia” – low levels of oxygen in the tissues – and this could predispose your gums to infections, as well as reducing the ability of your gums to heal themselves.
Unfortunately, it’s not really clear which explanation or combination of them is causing the problems for smokers. For vaping, though, there are clearly some potential benefits. There are far fewer toxins in vapour, so any issues caused as a result of them will be less severe in vapers than smokers.
The last two potential explanations relate directly to nicotine, but there are a couple of things worth noting.
For the idea that nicotine reduces blood flow and that causes the issues, there are some problems. Studies looking directly for the impact of this on the gums (here and here) have found either no change in blood flow or slight increases.
Although nicotine does make your blood vessels constrict, the impact smoking has on blood pressure tends to overcome this and blood flow to the gums increases overall. This is the opposite of what you’d expect if the explanation were true, and at least suggests that it isn’t the major factor at play. Vaping has less of an impact on blood pressure, though, so the result for vapers could be different.
The other idea is that the gum tissues are getting less oxygen, and this is causing the problem. Although studies have shown that the hypoxia caused by smoking parallels how nicotine acts in the body, nicotine isn’t the only thing in smoke that could have this effect. Carbon monoxide in particular is a component of smoke (but not vapour) that has exactly that effect, and hydrogen cyanide is another.
It’s not completely clear which is to blame, but since wound healing (which is a closely-related issue) is affected in smokers but not in NRT users, it’s unlikely that nicotine alone is doing all the damage or even most of it.
Unsurprisingly, a lot of the discussion of this topic conflates nicotine with smoke, and this makes it hard to work out how much of a role nicotine really has. There isn’t much evidence looking at this relating to vaping specifically, as you’d expect, but there isn’t much relating to nicotine out of smoke at all.
