Impact of electronic cigarette use on self-reported oral health over two years in adults in west of Iran

Background: Electronic nicotine delivery systems (ENDS) are increasingly used by individuals without prior tobacco exposure, yet their long-term oral health effects in non-smokers remain unclear. The present study aimed to evaluate the longitudinal effects of electronic cigarette use on oral health among non-smoking adults over two-years in the west of Iran. Methods: A prospective 24-month observational study was conducted among 66 non-smoking adults aged 16–75 years. Participants underwent periodic clinical oral examinations and completed standardized questionnaires. Demographic, socioeconomic, oral hygiene, and exposure-related variables were recorded. Results: Gingivitis (45%), xerostomia (40%), tooth sensitivity (35%), and dental caries (30%) were the most prevalent complications. Symptoms typically developed within 4–9 months after initiation of electronic cigarette use. No oral malignancies were observed. Conclusion: Electronic cigarette use was associated with clinically relevant oral health deterioration in non-smokers.