People who use electronic cigarettes have unique microbial communities in their mouths that more closely resembled those of smokers than nonsmokers, which may signal an increased risk of gum disease for those individuals, according to findings from research funded in part by the National Institute of Health’s (NIH’s) National Institute of Dental and Craniofacial Research.

According to NIH, a team of researchers from New York University “examined 84 volunteers over a six-month period: 27 people who smoked conventional cigarettes, 28 who only used e-cigarettes, and 29 nonsmokers.” The team compared the types of bacteria found where the gums meet the teeth at the beginning and end of the study as well as markers of inflammation and immune cell activity, NIH said.

“It is apparent from this study that e-cigarette use promotes a unique periodontal microbiome, that contains distinctive features yet shares similarities with those of both conventional cigarette users and nonsmokers,” the researchers concluded. “The duration of e-cigarette use is a strong driver of subgingival microbiome composition over flavoring additions or nicotine concentration, indicating that basal e-cigarette components exert specific selection pressures on the subgingival plaque microbial community.”

The study used a machine-learning program that predicted an individual’s oral microbiome group with 74% accuracy, NIH said, but the program was “least accurate at picking out e-cigarette users, as the patterns of their oral microbes shared characteristics with both smokers and nonsmokers, with slightly more similarities to smokers.”

“Our data suggest that e-cigarette use promotes a stable periodontal microbiome that is between those of the conventional cigarette smoker and nonsmoker and has unique features that may impact host oral health in a manner different than conventional cigarette use,” the researchers said.

In its position statement on e-cigarettes and vaping, ONS said that the U.S. Food and Drug Administration should regulate e-cigarettes and vaping liquids to protect users from adverse health effects and potential nicotine addiction and collaborate with entities such as the Centers for Disease Control and Prevention and the U.S. Consumer Product Safety Commission to investigate and prevent the dangers of liquid nicotine. Nurses should advocate for e-cigarette regulation and inform patients about evidence-based tobacco cessation and the potential harm of e-cigarettes.