Dentists warn vaping dries mouth and fuels tooth decay among teens and adults

Actress Lily James has revealed she just needed her first dental filling at age 36, a development doctors say mirrors a broader trend: vaping is increasingly linked to tooth decay, gum problems and enamel damage among young users. About 5.5 million adults in Britain vape, according to a 2025 YouGov survey for Action on Smoking and Health (ASH). The same survey found that 7 percent of 11- to 17-year-olds vape, and one in five teens has tried vaping. Although some young people use vapes as an alternative to smoking, clinicians warn that the products carry oral health risks that can appear long before adulthood.

Smita Mehra, a principal dentist at The Neem Tree clinics in London and Surrey, says the Lily James anecdote reflects a troubling pattern. She notes that as vaping becomes more common among youths, doctors are treating more patients with multiple cavities, plaque build-up and early-stage gum disease — problems formerly uncommon before age 30. “Vaping is far more addictive than tobacco for many young users, and it’s harming their oral health in worrying ways,” Mehra said.

Dentists say the core issue is dry mouth caused by vaping, driven by ingredients such as propylene glycol, which pulls moisture from oral tissues, and vegetable glycerin, which coats the mouth and helps plaque cling to teeth. Nicotine further reduces saliva flow, and warm vapor accelerates evaporation, leaving less natural cleansing action in the mouth. “Saliva is your natural defense system,” Mehra explained. “It washes away bacteria, neutralizes acid, and protects tooth enamel. When vapor dries the mouth, food sticks to teeth, plaque builds up and decay starts.” Dry mouth is a known risk factor for tooth decay, tooth loss and gum disease, and dentists have observed tartar and staining building up on the side of the mouth where the vape is held, a pattern linked to regular vaping.

Support for these concerns comes from a growing body of evidence. A US study published this year in JDR Clinical & Translational Research found that vapers were about 80 percent more likely to report dry-mouth symptoms than non-vapers. The issue is not limited to adults: clinicians report that toxins and heat in vape aerosols can affect younger mouths as well. James Goolnik, a London-based dentist and founder of Bow Lane Dental, says the front teeth often bear the brunt because smoke impacts these surfaces first and the tongue protects the back teeth. Repeated exposure to heat, chemicals and drying vapor can erode enamel on visible surfaces and contribute to staining, decay and damage that can affect appearance and function.

Goolnik and other practitioners emphasize that the added flavourings in many vape liquids, which mimic cola, candy or fruit, can fuel sugar cravings and disrupt the oral microbiome. “The sweet flavourings and added sugars act as fuel for decay-causing bacteria and shift the mouth’s microbial balance toward gum disease,” he said. A study in the American Society for Microbiology’s mSystems journal linked long-term vaping to oral bacteria associated with bleeding gums, plaque build-up and even bone loss, patterns typically seen in older smokers.

In addition to the immediate dental effects, scientists point to the vapour itself as a potential hazard. Heated vape liquids can produce toxic aldehydes and reactive carbonyls that damage cells in the mouth, promoting inflammation and raising concerns about cancer risk. A 2024 study by University College London and the University of Innsbruck reported pre-cancerous DNA changes in cheek cells of vape users, similar to patterns found in smokers. While researchers caution that the long-term implications remain under study, the findings underscore that vaping is not risk-free for the mouth.

Beyond the direct oral damage, nicotine can influence behavior and diet. Some health professionals note that nicotine’s impact on appetite and reward pathways can lead to cravings for sugary snacks, setting the stage for a cycle of dry mouth, high-sugar intake and plaque formation. A 2022 paper in Frontiers in Oral Health documented that certain vape flavours can alter saliva and sweetness perception, potentially nudging users toward sweeter foods. The result is a “perfect storm” of dryness, sugar cravings and sticky bacteria that accelerates decay, according to Mehra and colleagues.

The growing concern about youth vaping extends beyond dental health. Dentists point to government-funded studies tracking adolescent health as essential to understanding long-term risks to oral, lung and mental health. The Adolescent Health Study, which follows about 100,000 young people aged ten and older, aims to monitor how vaping affects various health outcomes over time. While some experts argue that vaping may be less harmful than smoking for people who switch from cigarettes, clinicians caution that non-smokers, especially youths, should avoid vaping altogether given the potential oral and systemic risks.

For patients who develop tooth decay or gum disease linked to vaping, treatment can be more invasive than typical care for younger people. Enamel loss does not regenerate, meaning damage can lead to heightened sensitivity, more frequent cavities or cracks, and, in severe cases, the need for crowns, root canals or gum surgery. Clinicians urging caution say the best approach is prevention: reducing or stopping vaping and maintaining rigorous oral hygiene, regular dental visits, and mindful dietary choices.

The case highlighted by Lily James—she described having her first filling at 36 due to vaping—serves as a focal point for clinicians who say youth exposure to vapes is producing tangible, earlier-life dental problems. While the broader public health view recognizes that vaping is not as harmful as smoking when used as a cessation tool for established smokers, dentists stress that non-smokers and youths should avoid initiating vaping, given the potential for lasting oral-health consequences and the evolving scientific picture on long-term risks.