Introduction and objective:
Smoking is associated with periodontal disease, potentially malignant disorders and oral cancer. Recent increase in the electronic cigarette use creates new, yet undiscovered consequences for both general and oral health. Although the negative effects of nicotinism have been known for years, new information and correlations of the effects of tobacco smoking continue to emerge. The objective of this article is to provide an update on effects of both conventional smoking and electronic nicotine delivery systems on the oral health.

Review methods:
A review of the recent literature (from 01.2000 to 06.2022) was conducted using PubMed, Web of Since and Google Scholar databases.

Smoking alters immune function promoting inflammation and impairs tissue healing. Typical problems for smokers include poor oral hygiene, halitosis and periodontal disease. Nicotinism contributes also to the oral cancer. Modern heat-not-burn nicotine delivery systems, which operate with lower temperatures and do not exude typical cigarette smoke, are increasingly popular alternative to traditional cigarettes. It is likely that e-cigarettes have fewer carcinogenic effects, but they contain nicotine and other substances that negatively affect the oral cavity. Similarly, IQOS cigarettes generate harmful products, but generally at lower concentrations than traditional cigarettes.

Oral pathologies are predominantly associated with the use of traditional cigarettes as a result of the oral tissue and immune system exposure to composition of cigarette smoke. Although modern electric nicotine delivery systems seem to be less harmful, their long-term effects on oral health are still under-recognized. Medical professionals, especially dentists should identify the addicted patient and counsel on quitting nicotine addiction.

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