BACKGROUND: The aim of this study was to evaluate oral alterations among university students and explore possible associations with tobacco consumption in its various forms. METHODS: A cross-sectional study was conducted in 2 phases: the first phase involved administering an electronic questionnaire to participants determine the prevalence of tobacco use and the second phase involved a physical examination of the participants. The participants were grouped on the basis of their reported habits and compared using statistical analysis (P < .05). RESULTS: Of the 620 participants, 57.1% reported using tobacco in some form, with 47.4% reporting electronic cigarette (e-cigarette) use. In the clinical phase, comparing the presence of oral changes in tobacco users vs nonusers, e-cigarette users had a higher proportion of white-spot caries lesions (P = .041) and gingivitis (P = .012). When e-cigarette use was combined with other forms of tobacco use, additional oral changes were more prevalent, including coated tongue and nicotinic stomatitis (P < .05). CONCLUSIONS: The use of alternative forms of tobacco consumption is common among university students, with e-cigarette use being the most prevalent form, and may lead to detrimental effects on the oral cavity, such as caries and gingivitis, particularly when used in conjunction with other tobacco products. PRACTICAL IMPLICATIONS: The use of tobacco in alternative forms, such as e-cigarettes, can affect oral health directly or indirectly. Dentists should be familiar with the characteristics of this population and the potential oral repercussions associated with tobacco use to address the impact on health and raise awareness of the associated risks.
