Can You Vape With Braces?

Vaping has become increasingly popular across the world, including in the UK. According to ASH (Action on Smoking and Health), some 5.5 million British adults use e-cigarette devices. Around half of these used to smoke cigarettes before and now don’t, so vaping is a common smoking cessation tool, which is some positive news. 

However, vaping isn’t only being used as a means to quit smoking. Concerningly, increasing numbers of young people are picking up the habit, either by following the trend or through being enticed by the colourful packaging and sweet flavours of today’s array of vaping tools. According to the BBC, there’s evidence that young adults (18-24 years), including those who never smoked, are increasingly vaping. Apparently, about 1 in 7 young adults who never regularly smoked now use e-cigarettes. 

This situation has naturally raised concerns around the health impacts of vaping – particularly in relation to lung and oral health. As orthodontists, we often get asked: “Is vaping bad for your teeth?” and “Can you vape with orthodontic devices like braces or Invisalign?”

In this blog, we’ll consider whether it’s safe to vape with braces. We’ll consider what the research tells us about vaping and orthodontics, and why your orthodontist would probably prefer you didn’t...

The Rise of Vaping in the UK

The numbers are pretty staggering when you look at UK vaping trends. Regular vaping among 11-17-year-olds increased from around 1.2% in 2021 to 3.7% in 2023, according to the 2023 ASH Smokefree GB Youth Survey and related NHS reports. A report by UCL in London showed that vaping among 18-24 year olds tripled from 9% (May 2021) to 29% (May 2023), with many never-smokers now vaping regularly. Much of this surge has been driven by disposable e-cigarettes, which has raised significant public health concerns about a new generation becoming hooked on nicotine.

While vaping might seem like a harmless alternative to traditional smoking, the reality is more complex – especially when you’ve got metal braces or clear aligners doing important work in your mouth.

Why Your Orthodontic Treatment Deserves Protection

Orthodontic treatment is a serious investment. We’re talking about time (often 18-24 months), money (thousands of pounds) and your personal commitment to achieving that healthy smile you’ve always wanted.

Braces work by applying gentle, consistent pressure to slowly move your teeth into their correct positions. This process requires your mouth to be in optimal health to ensure the best possible outcome. When you introduce vaping into the mix, you’re potentially compromising that investment in ways you might not expect.

How Vaping Impacts Your Oral Health – Especially with Braces

The Core Components of E-liquids and Their Oral Effects

Let’s look at what you’re actually inhaling when you vape. E-cigarettes heat up e-liquids to create an aerosol that contains several key ingredients:

• Propylene glycol (PG): This ingredient is hygroscopic, meaning it literally sucks moisture from your mouth, leading to dry mouth. It also breaks down into acids that can damage your tooth enamel and soft tissues.
• Vegetable glycerin (VG): While sweet on its own, when mixed with flavourings, it can increase microbial adhesion to your enamel by up to four times, creating the perfect environment for tooth decay.
• Nicotine: Restricts blood flow to your gums and compromises your immune system’s ability to fight off infections.
• Flavourings: Often contain chemicals that can irritate your mouth and contribute to bacterial growth.

Specific Oral Health Concerns Amplified by Braces

If you wear braces, you already know that keeping your teeth clean is more challenging than usual. Those brackets and wires create plenty of nooks and crannies where food particles and plaque love to hide. Vaping significantly amplifies these existing risks in several ways:

Dry Mouth (Xerostomia)

Saliva is your mouth’s natural defence system. It washes away food debris, neutralises harmful acids, and helps prevent tooth decay and gum disease. When propylene glycol in vape liquids reduces your saliva production, you’re left more vulnerable to all sorts of oral health problems.

Gum Irritation and Inflammation

The chemicals in e-cigarette vapour can irritate your gum tissue, causing redness, swelling, bleeding and sensitivity. This gum irritation can make your braces feel uncomfortable and make daily oral hygiene more painful. Research shows that vaping increases oral inflammation, which is the last thing you want when you’re trying to move teeth safely.

Increased Risk of Cavities and Infections

Those sweet flavourings in e-cigarettes aren’t just tasty, they’re also feeding acid-producing bacteria that attack your tooth enamel. Combined with dry mouth, this creates a perfect storm for cavity development.

The disruption to your mouth’s natural bacterial balance can also lead to infections like gingivitis. Since orthodontic patients are already at higher risk due to plaque accumulation around appliances, this is particularly concerning. Studies show that orthodontic patients face a 45.8% incidence of new cavities during treatment.

Teeth Staining and Discolouration

Nicotine and flavouring agents can cause yellowing or staining over time. With braces, this becomes particularly problematic because cleaning around brackets is more difficult, leading to uneven staining. You might end up with visible colour differences once your braces come off, like a map of where your brackets used to be.

Clear aligners like Invisalign and ceramic braces are also susceptible to discolouration, becoming less transparent and more noticeable over time.

The Direct Impact of Vaping on Your Orthodontic Treatment

Slowed Tooth Movement and Treatment Delays

Successful orthodontic tooth movement relies on healthy bone remodelling – essentially, your jawbone needs to break down and rebuild as your teeth shift into new positions. Nicotine restricts blood vessels and inhibits the healing necessary for this process, which can slow down tooth movement considerably.

Animal studies have shown that nicotine can actually increase the rate of orthodontic tooth movement, but not in a good way. It does this by increasing bone loss and root resorption, which can compromise the long-term health of your teeth.

Risk of Damage to Braces and Aligners

While vaping might not immediately break your brackets or wires, the residues from vapour can stick to metal components, making them harder to clean and encouraging bacterial build-up. The heat and moisture could also potentially weaken the bonding over time.

For clear aligner users, the risks are more immediate:

• Vaping can stain and discolour aligners, making them less hygienic and more visible.
• Heat from vapour can warp or damage aligners, disrupting your treatment plan.
• Propylene glycol can get trapped under aligners, sticking to enamel and contributing to decay.

Post-Treatment Relapse and Long-Term Stability

Perhaps most concerning is vaping’s potential impact on your long-term results. The damage to gum tissues reduces your teeth and gums’ ability to respond effectively to orthodontic treatment. This increases the risk of teeth relapsing into their original positions after treatment, as the support systems holding them in place are weakened.

Research on smoking (which shares similar chemical exposures with vaping) shows it can speed up tooth movement while slowing down bone regrowth, making teeth more susceptible to movement once treatment concludes.

What Orthodontists and Research Say

The Professional Consensus: Avoid Vaping

The message from orthodontists is pretty clear: don’t vape during orthodontic treatment. We’re trained to spot the signs of vaping – gum and tissue changes, dry mouth symptoms and excessive plaque build-up around appliances. 

Key Research Findings on Nicotine and Orthodontic Outcomes

While we’re still waiting for more comprehensive human studies, the research we have is concerning:

1. Animal studies show that nicotine can accelerate orthodontic tooth movement by increasing bone loss and root resorption.
2. University of Rochester research indicates that e-cigarettes and their flavourings trigger inflammatory responses in oral cells, contributing to increased inflammation and tissue destruction.
3. Systematic reviews highlight that while e-cigarettes may be less harmful than traditional smoking, they’re not risk-free, particularly for young people.
4. Clinical observations show the strongest evidence points to an increased risk of cavities.

Recognising the Signs of Vaping-Related Oral Issues

Visible and Symptomatic Indicators

Keep an eye out for these warning signs:

• Increased sensitivity, irritation, or pain around your braces.
• Allergic reactions like swelling, redness, or blisters on lips, gums, or tongue.
• Chronic bad breath (halitosis) intensified by dry mouth.
• Wobbly teeth or receding gum tissue.
• Gums that appear irritated, swollen, or bleed easily.

When to Consult Your Orthodontist

If you’re experiencing any persistent discomfort or notice these symptoms while vaping with braces, contact us straight away. We can assess your oral health, determine how vaping might be impacting your treatment, and provide guidance on necessary corrective measures. Regular dental check-ups are vital for early detection and intervention.

If You Vape: Mitigating Risks and Maintaining Oral Hygiene

Look, we get it – quitting anything isn’t easy, never mind addictive nicotine. If you’re not ready to stop vaping just yet, here’s how to minimise the damage:

Essential Oral Care Practices

1. Brush thoroughly for at least two minutes, twice daily, using a soft-bristle toothbrush.
2. Pay extra attention to areas around brackets and wires.
3. Floss daily with waxed floss or a floss threader, or consider using a water flosser.
4. Rinse immediately after vaping with water or fluoride rinse to wash away residues.
5. Use antibacterial mouthwash to help control harmful bacteria.

Choosing E-liquids Wisely

If you must vape, try to:

• Avoid e-liquids with dark colours, strong flavourings, or high acidity.
• Look for options low in acidity and sugar with natural flavourings.
• Steer clear of artificial sweeteners or colours.
• Remember that even nicotine-free e-liquids can pose oral health problems.

The Importance of Regular Professional Check-ups

Regular visits to your orthodontist and dentist are non-negotiable. We can monitor your oral health, detect vaping-related complications early, and provide tailored advice for maintaining your braces and oral health effectively.

Seeking Support for Quitting

The fact is, the most effective step you can take is to quit vaping altogether. If you’re finding it challenging, don’t hesitate to seek support from:

• Your GP or dentist
• Local stop-smoking services
• Your orthodontist 

Consider healthy alternatives for stress relief like physical activity, mindfulness, meditation, or journalling. Herbal teas, flavoured sparkling water, or sugar-free gum can help satisfy cravings without the oral health risks.

Empowering Healthy Choices for Your Future Smile

Understanding Peer Influence and Regulations

We know teenagers often face significant peer pressure around vaping. It’s important that they have open conversations with parents and trusted adults about these pressures. In the UK, you must be 18 to purchase e-cigarettes, and there are strict advertising regulations designed to deter young people from starting.

Prioritising Health Over Trends

Ultimately, the decision to vape during orthodontic treatment is yours. But making informed choices based on scientific evidence is crucial. Prioritising your oral health and protecting your orthodontic investment over fleeting trends will lead to a healthier, more vibrant smile that lasts.

Conclusion: Protect Your Smile Investment

So, can you technically vape with braces? Yes. But should you? Absolutely not, according to orthodontists and the available research.

The risks are significant: dry mouth, gum disease, staining, increased cavities, potential treatment delays and post-treatment relapse. For the best possible outcome and that truly beautiful, healthy smile you’re working towards, maintaining excellent oral hygiene and ideally quitting vaping are crucial steps.

Your orthodontic treatment is an investment in your future self. Don’t let vaping compromise those results.

Ready to discuss your treatment and how to protect your smile? Get in touch with us at Hampstead Orthodontic Practice. We’re here to support you every step of the way towards achieving that healthy smile you deserve.