They performed a cross-sectional analysis using the 2016 Behavioral Risk Factor Surveillance System data. Poor oral health was determined by the number of permanent teeth removed due to non-traumatic causes, and e-cigarette use determined by daily or intermittent use within 30 days prior to survey administration. Logistic regression analysis was performed to test associations between e-cigarette use and oral health with adjustment for factors associated with poor oral health, survey clustering, strata and weight.

Survey responses from 456,343 adults were included. Over half of respondents (51.5%) reported having at least one permanent tooth removed because of tooth decay or gum disease in their lifetime. Daily e-cigarette use was reported by 4957 (1.1%) of respondents. In multivariable analysis, daily e-cigarette use, was independently associated with a 78% higher odds of poor oral health (adjusted OR = 1.78, 95% CI: 1.39–2.30; P < 0.001).

The authors concluded that in a population-based health survey of US adults, self-reported health behavior and outcomes, daily use, but not intermittent use of e-cigarettes was independently associated with poor oral health. Care must be exercised in seeking "healthier" cigarette alternatives.