Associations of electronic and conventional cigarette use with periodontal disease in South Korean adults

J Periodontol. 2020 Jan;91(1):55-64. doi: 10.1002/JPER.19-0060. Epub 2019 Aug 26.


Background: The aim of this study was to examine the association of conventional cigarette smoking and electronic cigarette vaping with periodontal disease in South Korean adults.

Methods: For this study, data from 13,551 participants, a subset derived from the Korean National Health and Nutrition Examination Survey conducted between 2013 and 2015, were examined. Participants were divided into four categories: electronic cigarettes vapers, conventional cigarettes smokers, ex-users, and non-users. Periodontal status was measured by the Community Periodontal Index. Multiple logistic regression analysis was performed to examine the association of periodontal disease with smoking and vaping individually.

Results: Out of 187 men and 35 women who vape electronic cigarette, 67 (35.8%) men and 10 (28.6%) women had periodontal diseases. Out of 1,957 men and 363 women who smoke conventional cigarettes, 861 (44.0%) men and 121 (35.3%) women had periodontal diseases. Periodontal disease was more prevalent in each vapers and smokers than non-users in men (electronic cigarettes: odds ratio [OR] = 2.34, 95% confidence interval [CI] = 1.52 to 3.59, conventional cigarettes: OR = 2.17, 95% CI = 1.76 to 2.68). Furthermore, both vaping and smoking had significant relation to dental caries, toothache, and dental damages.

Conclusions: Electronic and conventional cigarette use was each significantly associated with increased periodontal disease rates. After adjusting for demographic, socioeconomic, and health-related characteristics, both vaping and smoking each had significant association with periodontal diseases. Therefore, this study suggests that vaping may not be a safe alternative to smoking. Cessation of both types of cigarettes is necessary for maintaining oral health.

Keywords: electronic nicotine delivery systems; periodontal diseases; smoking.

MeSH terms

  • Adult
  • Dental Caries*
  • Electronic Nicotine Delivery Systems*
  • Female
  • Humans
  • Male
  • Nutrition Surveys
  • Periodontal Diseases*
  • Republic of Korea
  • Smoking Cessation*