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Implications of Electronic Cigarettes on the Safe Administration of Sedation and General Anesthesia in the Outpatient Dental Setting
Zachary A. HellerDO, DMD,
Edward C. Adlesic MSDMD, and
Jason E. Portnof DMDMD
Article Category: Research Article
Volume/Issue: Volume 69: Issue 2
Online Publication Date: Jul 18, 2022
DOI: 10.2344/anpr-69-02-16
Page Range: 41 – 52

Vaping devices, also known as electronic cigarettes (e-cigarettes) or electronic nicotine delivery systems, were first introduced to the US market in 2007 as aids for smoking cessation. Use of these devices rapidly grew in popularity as users perceived them as safe alternatives to conventional cigarettes and other smoked tobacco products. 1 When initially introduced, the effects that e-cigarettes had on one's health were unknown, and the number of users has continued to grow over time. Now there are many prospective and retrospective

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Figure 1.; Reusable electronic cigarette components. Reusable e-cigarettes are composed of a plastic or glass tank which allows the user to store a greater volume of e-liquid. The heating element is typically an atomizer which allows for greater generation of aerosols. Reusable e-cigarettes contain a larger battery compared with disposable ones. A larger power supply to the heating element allows for a greater volume of aerosol to be generated with each puff.
Zachary A. Heller,
Edward C. Adlesic MS, and
Jason E. Portnof DMD
Figure 1.
Figure 1.

Reusable electronic cigarette components. Reusable e-cigarettes are composed of a plastic or glass tank which allows the user to store a greater volume of e-liquid. The heating element is typically an atomizer which allows for greater generation of aerosols. Reusable e-cigarettes contain a larger battery compared with disposable ones. A larger power supply to the heating element allows for a greater volume of aerosol to be generated with each puff.

Figure 2.; Components of a disposable electronic cigarette. Disposable e-cigarettes do not contain a tank and instead store their e-liquid in a saturated piece of cotton. Aerosols are generated by a rudimentary wick and coil which is heated by a low voltage battery. The processor recognizes when the user is taking a puff and triggers the battery to supply power to the coil. The processor is set to a predetermined number of puffs. The device will stop generating aerosols once that number is reached or the battery runs out of power, whichever comes first.
Zachary A. Heller,
Edward C. Adlesic MS, and
Jason E. Portnof DMD
Figure 2.
Figure 2.

Components of a disposable electronic cigarette. Disposable e-cigarettes do not contain a tank and instead store their e-liquid in a saturated piece of cotton. Aerosols are generated by a rudimentary wick and coil which is heated by a low voltage battery. The processor recognizes when the user is taking a puff and triggers the battery to supply power to the coil. The processor is set to a predetermined number of puffs. The device will stop generating aerosols once that number is reached or the battery runs out of power, whichever comes first.

Figure 3.; Bronchiolitis obliterans or “popcorn lung.” Axial view of a CT chest in a patient who chronically used electronic cigarette devices, suffering from bronchiolitis obliterans. Image provided courtesy of Dr Jeremy S. Breit, MD.
Zachary A. Heller,
Edward C. Adlesic MS, and
Jason E. Portnof DMD
Figure 3.
Figure 3.

Bronchiolitis obliterans or “popcorn lung.” Axial view of a CT chest in a patient who chronically used electronic cigarette devices, suffering from bronchiolitis obliterans. Image provided courtesy of Dr Jeremy S. Breit, MD.

Ambulatory Anesthesia for a Case of Idiopathic Bronchiolitis Obliterans
Michelle WongDDS, MSc, EdD
Article Category: Case Report
Volume/Issue: Volume 68: Issue 2
Online Publication Date: Jun 29, 2021
DOI: 10.2344/anpr-68-01-05
Page Range: 98 – 106

. Known airway triggers included summer heat and humidity. Furthermore, she ingested cannabidiol 2 to 3 times weekly and vaped marijuana once per month for her other comorbidities. She occasionally used xylometazoline nasal sprays and saline rinses for allergic rhinitis and reported no known drug allergies. During her preanesthetic consultation and physical examination, she appeared well and not in distress. Assessment of her airway revealed full range of motion (cervical and temporomandibular joints), mouth opening and thyromental distance of 3 fingers' width