Current electronic cigarette use and untreated coronal caries in United States adults: a cross-sectional study

Introduction: Untreated coronal caries is common among adults in the United States, and electronic cigarette use has increased. Evidence on whether e-cigarette use is associated with untreated caries independently of combustible tobacco is limited. Methods: Cross-sectional analysis of pooled 2015-2016 and 2017-2018 National Health and Nutrition Examination Survey data from 9,042 dentate adults aged 20 years or older. Current e-cigarette use was defined as use in the past 30 days; untreated coronal caries was defined as at least one permanent tooth with untreated decay. Survey-weighted logistic regression with Taylor series linearization estimated odds ratios, adjusting for sociodemographic factors, combustible tobacco use and dental visits. Results: Weighted prevalence was 5.50% for current e-cigarette use and 19.20% for untreated coronal caries (30.20% among users and 18.50% among non-users). The odds ratio was 1.91 (95% CI 1.47-2.48) unadjusted and 1.64 (95% CI 1.23-2.19) after adjustment for age, sex and race/ethnicity. After full adjustment for education, income, cigarette smoking, cigar use and dental visits, the association was no longer evident (OR 0.98, 95% CI 0.76-1.27). Conclusions: The higher prevalence of untreated coronal caries among e-cigarette users was explained by combustible tobacco use and sociodemographic and dental-access factors; current e-cigarette use was not independently associated with untreated coronal caries in United States adults.