Prevalence and perceptions of e-cigarette use in orthodontic patients: A cross-sectional survey

Abstract

Objectives:

To assess the prevalence of e-cigarette use among orthodontic patients in a UK hospital setting, while investigating patterns of use and evaluating patients’ knowledge of the oral health effects of e-cigarettes, along with how it may impact orthodontic treatment outcomes.

Methods:

A cross-sectional survey was administered to patients aged 11 years and above attending routine appointments at the Orthodontic Department of St George’s University Hospitals NHS Foundation Trust over 3 months. The 34-item survey captured demographics, e-cigarette use and device type, initiation age, cessation attempts, knowledge of oral health effects, perceived treatment impact and patient–clinician communication. Descriptive statistics were used for data analysis.

Results:

A total of 140 participants completed the survey. A high prevalence of e-cigarette use was observed, with 25% of participants having tried them and 14.3% of all participants being regular users. The average age of initiation was 16 years, and 68% of users had no history of tobacco smoking. Reasons for use were primarily ‘curiosity’ (38%) and ‘social reasons’ (32%). A significant knowledge gap regarding oral health risks was identified, with only 11% of participants rating themselves as ‘very’ or ‘extremely’ knowledgeable. Despite this, 82% of participants believed e-cigarette use could affect their braces and 59% expressed some concern. A notable communication gap was found, as 92% of all participants had never spoken to their orthodontist about e-cigarette use. However, when advice was given, three out of four users reported a reduction or cessation of their habit.

Conclusion:

The prevalence of e-cigarette use in this cohort of orthodontic patients exceeds national averages and is largely driven by social factors. These patients have limited knowledge of the oral health risks and report a lack of clinical discussion, highlighting the need for routine screening, targeted education and cessation support from orthodontists.

Plain language summary

Vaping in patients with braces

Why was this study done? Vaping is becoming more common in young people. Many orthodontic patients are in this age group. We do not know how many of these patients vape. We also do not know what they understand about how vaping may harm their teeth and braces.

What did the researchers do? We asked patients at an orthodontic clinic to complete a short survey. The survey asked about vaping, reasons for use and knowledge of its effects on oral health and braces. In total, 140 patients aged 11 years and older took part.

What did the researchers find? About one in four patients had tried vaping. Around one in seven were current users. Most started in their mid-teens. Many had never smoked cigarettes. The main reasons for vaping were curiosity and social reasons. Most patients said they had little knowledge about the effects of vaping on oral health. However, many believed it could harm their teeth or braces. Very few had spoken to their orthodontist about vaping. When advice was given, some patients reduced or stopped vaping.

What do the findings mean? Vaping is common in orthodontic patients, but knowledge of the risks is low. Orthodontists are not often discussing vaping with patients. These conversations could help patients make better choices and may improve their treatment.