Effetti del fumo di sigaretta tradizionale ed elettronica nel cavo orale dell'adolescente e del giovane adulto: una revisione della letteratura.

Introduction: Cigarette smoking, whether traditional or electronic, represents one of the most harmful and widespread habits among adolescents and young adults, with significant consequences for oral health. According to the most recent data published by the World Health Organization, it is estimated that, worldwide, 37 million adolescents aged 13 to 15 years (9.7%) use some form of tobacco. In the WHO European Region, about 4 million adolescents (10.8%) are tobacco users. The prevalence among boys aged 13–15 is 11.5%, while among girls it is 10.1%, corresponding to approximately 2 million each. The use of e-cigarettes is rapidly increasing across the WHO European Region, particularly among younger individuals, and in some countries it has clearly surpassed the prevalence of traditional cigarette smoking. In 2014, the first year in which the Italian National Institute of Statistics (ISTAT) began monitoring the use of these devices, approximately 800,000 individuals aged 14 years and older reported using them. Over time, especially since 2017, this number has steadily increased, reaching nearly 1.5 million people aged 14 years and older in 2021. This growth has involved both men and women, with prevalence more than doubling in both sexes over the course of nearly a decade. Several studies have shown that even at an early age, exposure to smoking leads to alterations affecting oral tissues, influencing the microbial flora, periodontal health, and bone remodeling processes. Understanding these mechanisms is essential in order to develop effective health education and preventive strategies, particularly targeting younger populations. Aim: The aim of this study is to analyze, through a review of the literature, the effects of traditional and electronic cigarette smoking on the oral health of adolescents and young adults. Particular attention is given to alterations in periodontal tissues, alveolar bone, and the oral microbiome, while evaluating similarities and differences between the two types of smoking. The objective is to provide data based on current knowledge to better understand how the early initiation of this habit can represent a significant risk factor for the future development of oral diseases. Materials and Methods: A literature search was conducted using the main biomedical database, PubMed. Fourteen recently published articles investigating the effects of traditional and electronic cigarette smoking on the oral cavity were selected, including only studies involving adolescent and young adult populations. Inclusion and exclusion criteria were applied to ensure the relevance and timeliness of the sources. Results: The reviewed studies showed that both traditional and electronic cigarette smoking are associated with significant modifications of the oral microbiome, an increase in inflammatory and oxidative markers, a reduction in alveolar bone height and density, and a greater susceptibility to periodontal diseases. Furthermore, it was observed that electronic cigarettes, although containing lower levels of toxic substances compared to traditional cigarettes, are not free from harmful effects. Conclusions: The evidence confirms that smoking initiation at a young age represents a major risk factor for the future development of oral diseases, as its harmful effects may appear early. This highlights the need to implement prevention and awareness programs targeting young populations. Further longitudinal investigations will be necessary to more precisely define the biological processes underlying the observed alterations and to better determine the specific consequences of traditional versus electronic cigarette smoking.