ArticlePloS one2018
Cariogenic potential of sweet flavors in electronic-cigarette liquids.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 115 citations in OpenAlex.
- The impact of e-cigarette use on periodontal health: a systematic review and meta-analysis.Evidence-based dentistry · 2025Pooled it
- The effects of electronic smoking on dental caries and proinflammatory markers: a systematic review and meta-analysis.Frontiers in oral health · 2025Pooled it
- Pulmonary effects of e-liquid flavors: a systematic review.Journal of toxicology and environmental health. Part B, Critical reviews · 2022Pooled it
- Electronic nicotine delivery system design and aerosol toxicants: A systematic review.PloS one · 2020Pooled it
- Inflammatory Biomarker Profiles in Gingival Crevicular Fluid of Electronic Cigarette Users: A Cross-Sectional Study.Dentistry journal · 2026Article
- To Vape or Not to Vape: Oral Health in the Age of Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems.International dental journal · 2026Review
- Sweeteners in E-Cigarettes: A Minireview of Flavoring and Biological Action.Journal of xenobiotics · 2025Review
- Halitosis among users of electronic nicotine delivery systems in a multi-center cross-sectional study.Scientific reports · 2025Article
- E-Cigarette effects on oral health: A molecular perspective.Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association · 2025Review
- Pathophysiological Responses of Oral Keratinocytes After Exposure to Flavored E-Cigarette Liquids.Dentistry journal · 2025Article
- Influence of electronic cigarette vapour on theBiomaterial investigations in dentistry · 2025Article
- The effect ofJournal of oral microbiology · 2025Article
- The Impact of Electronic and Conventional Cigarette Use towards Saliva Profile and Oral Microbiota in Adolescents.Asian Pacific journal of cancer prevention : APJCP · 2025Observational
- The Impact of E-Cigarettes on Oral Health-A Narrative Review.Dentistry journal · 2024Review
- The Effect of New Trend Electronic Cigarettes on Dental Caries in Relation to Glucosyltransferase B and Secretory Immunoglobulin A (A Case-control Study).Cell biochemistry and biophysics · 2024Article
- Effect of different types of smoking on oral health and on cellular changes in oral mucosa.The Saudi dental journal · 2024Article
- E-cigarette use, perceived risks, attitudes, opinions of e-cigarette policies, and associated factors among Thai university students.Tobacco induced diseases · 2024Article
- Review
- Review
- Oral microbiome of electronic cigarette users: A cross-sectional exploration.Oral diseases · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost electronic-cigarette liquids contain propylene glycol, glycerin, nicotine and a wide variety of flavors of which many are sweet. Sweet flavors are classified as saccharides, esters, acids or aldehydes. This study investigates changes in cariogenic potential when tooth surfaces are exposed to e-cigarette aerosols generated from well-characterized reference e-liquids with sweet flavors.
methodsReference e-liquids were prepared by combining 20/80 propylene glycol/glycerin (by volume fraction), 10 mg/mL nicotine, and flavors. Aerosols were generated by a Universal Electronic-Cigarette Testing Device (49.2 W, 0.2 Ω). Streptococcus mutans (UA159) were exposed to aerosols on tooth enamel and the biological and physiochemical parameters were measured.
resultsE-cigarette aerosols produced four-fold increase in microbial adhesion to enamel. Exposure to flavored aerosols led to two-fold increase in biofilm formation and up to a 27% decrease in enamel hardness compared to unflavored controls. Esters (ethyl butyrate, hexyl acetate, and triacetin) in e-liquids were associated with consistent bacteria-initiated enamel demineralization, whereas sugar alcohol (ethyl maltol) inhibited S. mutans growth and adhesion. The viscosity of the e-liquid allowed S. mutans to adhere to pits and fissures. Aerosols contained five metals (mean ± standard deviation): calcium (0.409 ± 0.002) mg/L, copper (0.011 ± 0.001) mg/L, iron (0.0051 ± 0.0003) mg/L, magnesium (0.017 ± 0.002) mg/L, and silicon (0.166 ± 0.005) mg/L.
conclusionsThis study systematically evaluated e-cigarette aerosols and found that the aerosols have similar physio-chemical properties as high-sucrose, gelatinous candies and acidic drinks. Our data suggest that the combination of the viscosity of e-liquids and some classes of chemicals in sweet flavors may increase the risk of cariogenic potential. Clinical investigation is warranted to confirm the data shown here.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.