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22 A 2018 report from the National Academies of Health found a lack of rigorously designed studies examining the effects of e-cigarettes on oral health, as well as no epidemiological studies examining the associations between e-cigarette use and incidence or progression of periodontal disease. 23 The report also found that human studies and in vitro studies suggest that e-cigarette aerosols can cause harm to oral health by inducing gingival inflammation in the oral cavity, but that other studies suggest that e-cigarette use may be less harmful to oral health than continued smoking of combustible tobacco cigarettes. There is a need to better understand the health effects of vaping, and especially the impact of vaping on the oral cavity

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