The Short and Long-term Effects of Vaping

You're listening to The Dr. Phil Klein Dental Podcast from Viva Learning.com. Welcome to the show. I'm Dr. Phil Klein. For decades, lots of studies have shown smoking is harmful to your health, but when it comes to vaping, manufacturers aren't disclosing what they're actually putting in the liquid. So it's anybody's guess what the long-term effects are. Today, we'll be discussing how most vape liquid contains chemicals that can potentially lead to some very serious health issues, including addiction, cancer, and xerostomia. And let's not forget the increased risk for tooth decay as a result of the vaporized liquid entering the mouth. Our guest is Shannon Nanne, a registered dental hygienist whose mission is to help reduce the incidence, morbidity, and mortality of oral cancer through the education of healthcare professionals. She's authored a variety of articles in numerous publications and is a key opinion leader for several companies educating thousands of dental and medical professionals. Shannon, it's a pleasure to have you on Dental Talk. Thanks so much for having me today here, Phil. I appreciate it. Yeah, and first I want to congratulate you on the success of your recent webinar, Real Talk, The Short and Long -Term Effects of Vaping. Apparently you had over 800 people on that, which is really impressive. Even for Viva Learning, that's impressive. So hats off to you for a really successful attendance. I haven't seen the webinar, but I intend to. I want to watch the recorded version. To begin... You know, the horrible effects of vaping is a very serious issue. We all know that. Although many families don't discuss this with their kids, and a recent survey shows that as many as 37% of high school seniors and more than 17% of eighth graders vaped in the previous year. So tell us why this should be concerning to us. I'm so glad that you asked this question, Dr. Klein, especially thinking I have one child entering eighth grade and one child entering seventh grade just this year. You know, I've been sitting on the PTA board for the past eight years as an executive board member, and I hear the stories at our PTA meetings and our school board meetings where our kids are actually vaping in the bathroom during the school day, in fact. Some parents may not be concerned by this statistic. After all, quote, at least they're not smoking, right? Well, wrong. I mean, it's estimated that one in five high school students right now may be using a tobacco product. And the problem is not only kids who vape are at a high risk of smoking traditional cigarettes in this future, they're now causing permanent damage to their gums and risking tooth locks. Wow. That's a really scary statistic. So do you think that parents actually feel that way? Hey, my kid's vaping. At least they're not smoking tobacco, you know, the traditional cigarette, which is proven to cause cancer. Do they have this false feeling of safety and, you know, it's not that bad. It could be worse when it comes to vaping. Yes, absolutely. We've had parents come to the school demanding that they get their vape pen back for their child. And, you know, the liquid that they're putting in this e-cigarette, it's called an e-liquid. It's usually made up of like a propylene glycol, glycerin, flavings, watering and nicotine. Although sometimes some users will actually substitute THC for the nicotine. So I think maybe parents are thinking they're like enjoying a hookah or enjoying just some kind of nice flavoring into their lungs and not realizing. Maybe they're doing a little more than what their vape pen is suggesting to you. So through your experience as a dental hygienist, what are some of the really bad things that can happen to the mouth because of vaping? Well, you know, vaping, it will definitely gradually affect your gums due to the serious extent that your teeth will fall out over time. So that's a pretty serious problem. Therefore, you know, the ingredient that's most harmful in the oral cavity is this PG, again, referring to it as a propylene glycol. It is toxic to enamel and soft tissues. PG is safe to eat. And inhale. But when used orally, it breaks down into acids that can actually damage your enamel and irritate the soft tissues. It causes dry mouth. It takes away essential saliva, leaving to more and more cavities and gum disease. Honestly, I just had a case presentation recently. a 35-year-old who had never had dental decay. He was a smoker, and within the last 12 months, he decided to quit smoking because he was nervous with the COVID. And in the last year, we saw full-blown decay. Many people think just drinking some water can help hydrate his mouth, but he was then drinking juices on top of it because we know clearly that water is not a replacement for the saliva, which contains all the compounds that help. protect the teeth from damage from strep mutants. So he started vaping after he gave up cigarettes? Yes, because he was nervous that he was going to have chest problems and lung problems because of COVID. So he was changed to vaping and ended up full-blown mouth decay. And how long did you say he was vaping before that breakdown started to occur? One year. He was Paris-free for 35 years. When he came to see you, did he account for his oral deprecation, his oral care deprecation to the vaping, or did he think it was related to something else? He thought it was related to something else. I will be honest and tell you that this is a case presentation that I read about. It was not me personally seeing him. Right now, with the vaping or having this dry mouth, so what do these teens do? They drink soda. They drink energy drinks to get rid of the dry mouth from the vaping, which now intensifies damage caused from the propylene glycol because all these drinks contain sugar that feeding the bacteria and the acids have further eroded the tooth enamel. You know, some traditional tobacco products don't contain. This is why the vaping is worse for oral health. The vegetable glycerin, the flavorings in this e-liquid allow more cavity-causing bacteria to stick to the soft tooth and lead to rampant decay is what we saw in this case. We obviously understand the oral side effects when it comes to the breakdown of enamel and decay. What other negative effects occur intra-orally that most people are not familiar with when it comes to vaping? Well, I mean, not only does vaping cause serious health issues such as damage to your heart and lungs, it can cause other physical changes that are very undesirable, such as a negative impact on your skin, your teeth, your hair, and your lungs. These liquids actually coat your lungs as you absorb it through your e-cigarette, which makes your lungs job a lot harder as they attempt to function. So breathing is much more difficult. Also, you can develop a hacking cough. from all the inflammation. The vaping can increase your heart rate, which makes you stress, very, very jittery. These people shake a lot. The nicotine, the vaping liquids dehydrate your skin. So now you're ending up with premature wrinkles and very, very dry skin. Sadly, this will also delay wound healing. And the nicotine is also linked to chronic skin conditions like pimples and psoriasis. So now you add that to a teenager's life when they're already having issues in high school with problems. To top it all, the worst of it will include skin cancers, such as squamous cell carcinoma and melanoma, as well as oral cancer. This sounds like it's as bad or worse than cigarettes. it is vaping can even damage your hair follicles causing possibility of hair loss you know reachers is now showing that this kind of hair loss can be super hard to treat so your hair loss can be permanent and this is why truly phil that i walk into schools i'm i'm in the seventh and eighth grade schools talking to these students because this is what they're doing in the bathrooms they're vaping and these children are in there, and I'm still referring them as children because they're my children ages. My son got off the school bus and told me, mommy, there's a fifth grade little girl, she's vaping in a bus. And it made me really disappointed. Where would a fifth grader get a vape pen? When you start looking at all these other issues that it causes, not just the oral cavity, but skin cancers and pimples and psoriasis and hair loss, just when they're starting puberty, you know, this is detrimental to their health. How do you suggest a dental hygienist or a dentist or any dental team member to handle a patient or communicate with a patient who's young, who you suspect is vaping, and you realize that there's been a change in their dentition, they're starting to get breakdown at a faster rate? What's the best strategy to communicate the dangers of this when you're not even sure if they're actually vaping? So what do you suggest a dental team member does? Well, I'll be honest. I like to scare them a little bit. I really do. I really think a picture or a story is worth a thousand words. You know, as an educator, I always show disastrous photos to patients, not only of their own mouth, but their own cell phone, but photos that I've seen from studies and things that I have read. Unfortunately, 24-year-old man. recently in Texas was killed when his vape pen exploded. Part of the device wound up severing his jugular vein. All of these types of issues and deaths are rare, right, with e-cigarettes and vaping pens. But if it happens to you or a family member or a friend, this is where the problems occur. Only two reported to date of explosions of these pens have happened. However, the problem lies with the vape pen and the lithium batteries overheating and explosions. These explosions are usually attributed to improper charging of the device, which can happen. And these kids are actually, you know, putting THC in them. They've been linked to a type of a dice called a mechanical mod, M-O-D, that has no internal safety and can overheat and explode. I do have a photo of this. I show this in the vaping webinar. If you do take it, feel free to take a picture of it and share it. with your patients. You know, back when I first became a hygienist in 1994, I had a picture of our oral systemic diseases in a small, beautiful little pamphlet. And we had a picture of black, hairy tongue. And I would always show that to my patients, 12 years old and up, if I knew they were smoking cigarettes, because you could smell it on them. You know, they're smoking. And I would show them and I would say, are you smoking? And they would say, no, we're not. I'm not smoking. I said, well, I just want to share a picture with you of what can happen. Who's going to want to? kiss you with that. That's really what I think, you know, the first thing as dental professionals will notice is a dry mouth or the patient will have erosion of enamel or they're starting to cough or they're starting to shake a little bit. And we know really when a mouth is in an acidic state, it can cause demineralization of teeth. So, you know, once as dental professionals, we have an opportunity to explain any kind of negative effects of vaping. We seriously need to focus on what's going to be coming next and so far as treatment. Yeah, and it wasn't that long ago that all the public announcement efforts were, especially in schools, was anti-smoking cigarettes. Now we have to deal with vaping, which has really picked up. It was just kind of a trendy thing to do, and now you're seeing large-scale usage of these types of vaping devices, right? It's an epidemic. It is. And when I'm sitting at a school board meeting and a senior from high school stands up and talks to the board and said, please do something because we're afraid to walk into a bathroom because of all these kids vaping. It's very unfortunate. And speaking to the principals after the fact, they said, it's always going to be something, Shannon. It's always going to be something. And they're right. I said, there's no such thing as smoking in the boys' room back in the day from the song that we used to hear. the radio. You know, there's always going to be something. However, there's just so many more negative health effects associated with vaping. And what we see in the oral cavity post vaping, we need to really get on top of these patients and make sure we're helping them as much as we can to quit. So when you see this demineralization occur, what is your treatment strategy as a dental hygienist? Well, I think most importantly is to dispense. And if you don't have it, then possibly recommend a calcium phosphate paste. You know, we want to allow the uptake of all these minerals into tooth structure to penetrate it to help save teeth that are being exposed to all these chemicals in their vape pen. I personally love the Remin Pro. It's got 1,450 parts per million. It is dispensed in the office. The patient can benefit it from saving money on future tooth restorations. And most of all, let's talk about the pain associated. comes with demuralization caused from all this propylene glycol. I recommend they use Remin Pro at night. They can apply it with a toothbrush. They can place in a tray or a fingertip over the teeth. I personally like the fingertip over the teeth because it saves a lot of product. It's not going into a toothbrush that they're throwing away or a tray that they have to rinse out. But it's imperative that we tell these patients not to rinse their mouth after. And some patients will say, well, I don't like the way it feels on my tongue. And I tell them, dip their fingers in water, touch their tongue with their wet finger. cream has a triple protection of fluoride, the nano-hydroxyapatite, of course, which is calcium phosphate and xylitol. Remember that the hydroxyapatite restores the mineral balance, contains 61% more fluoride than any brand, and of course, sweetened with xylitol, which has that karyostatic property. And the best part of this cream, there is no milk protein allergies. This product is called Remin Pro. That's R-E-M-I-N Pro. It's by Voco. And we do want to disclose Voco is the sponsor of this podcast. We appreciate their sponsorship and they sponsor a lot of educational activity on Viva Learning. Great company, very strong in R&D. And I know Shannon would never recommend a product that she doesn't use herself. And she's one of the most passionate people I know against vaping. And if there is a patient that has this remineralization, this demineralization occur, you certainly want to help the remineralization process. And that's why she's mentioning. this product called Remin Pro by Voco. I have to tell you, and I'm sorry to interrupt, but I'm so passionate about it. It's not only just for my vaping patients, but I've been using this product for my patients with dry mouth. You know, my passion is oral cancer. I speak on it globally and trying to help save one life, if we can save one life a day, because we have one person dying every hour of every day from oral cancer. And I have noticed that my patients with severe xerostomy, if they... this cream all over their teeth or help remineralizing, help from losing teeth just from oral cancer as well. And patient compliance is so good because they have great flavor choices, not just mint, but they have a melon and a strawberry. So if they're going to substitute something, especially for their vape liquids, they've got these wonderful flavors. So it's a great thing for kids. Insurance codes is a 9910. It can be used as an application for desensitizing medicament. So compliance should be good. operatory you know we have become our own little TSA agents the dental office If you see something to these patients, say something. Please don't let it go. And again, taking a photo with their cell phone. All kids have cell phones. And showing them what this looks like inside the oral cavity when they're going home. Days go later and they're going through their pictures and they see, oh, that's right. That dental hygienist told me to watch out for this. She was right. Maybe I won't vape tonight. That's a great idea. I never even thought about that. Using the phone of the patient, especially an adolescent, to accentuate what's actually going on in their mouth. And then you know they're going to flip through those pictures and see it. It's been working very well in my practice. That's a very great idea. Even oral lesions. I mean, if we see an oral lesion, I put a perioprobe right up next to the lesion, take a photo of it. So we can go back later on, six months later, to see if that lesion is still there. And if it's not gone seven to 10 days, that lesion should be looked at. But you know how sometimes you can lead the horse to the water, but they just may not drink. Yeah, well, thank you for your amazing insight. And thank you for all the hard work that you're doing, Shannon, for the cause of helping to reduce the mortality of oral cancer, especially. among young people. And vaping is certainly not the direction you want our young people to go in as they go through school and mature. You want to get them off these things as early as possible. So the least damage occurs. and they could keep their mouth healthy and avoid developing much more severe conditions like oral cancer. So we really thank you for that. And again, congratulations on the amazing webinar you did. For those of you who want to tap into that, visit us on VivaLearning.com. You can find the webinar by searching for Shannon Nanne, N-A-N-N-E. The name of the webinar is Real Talk, The Short and Long-Term Effects of Vaping. Thanks so much, Shannon, and we'll hopefully have you on the show again soon. Thanks for having me.