Background: Tobacco smoking is a well-established risk factor for periodontal disease. In recent years, electronic cigarettes (e-cigarettes) have gained popularity as an alternative to conventional smoking; however, their effects on periodontal health remain inadequately understood. This study aimed to compare periodontal parameters among e-cigarette users, conventional smokers, and non-smokers.

Methods: A comparative cross-sectional study was conducted among 45 participants attending the Department of Periodontology, M.A. Rangoonwala College of Dental Sciences and Research Centre, Pune. Participants were equally divided into three groups: e-cigarette users (n=15), conventional smokers (n=15), and non-smokers (n=15). Clinical periodontal parameters assessed included Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), Bleeding on Probing (BOP), and Gingival Recession (GR). Data were analyzed using SPSS version 26.0. Intergroup comparisons were performed using one-way ANOVA with Tukey’s post hoc test and Chi-square test. Statistical significance was set at p<0.05.

Results: Conventional smokers demonstrated significantly higher plaque index (1.86 ± 0.28), gingival index (1.67 ± 0.31), and probing pocket depth (3.67 ± 0.41 mm) compared with e-cigarette users (1.18 ± 0.23, 0.98 ± 0.20, and 3.14 ± 0.32 mm, respectively) and non-smokers (1.10 ± 0.19, 0.87 ± 0.18, and 2.13 ± 0.28 mm, respectively) (p<0.001). Gingival recession was observed in 66.7% of e-cigarette users and 60.0% of smokers, whereas no cases were identified among non-smokers (p<0.001). Bleeding on probing was most prevalent among smokers (86.7%), followed by e-cigarette users (53.3%) and non-smokers (26.7%) (p<0.001). Oral hygiene practices were comparable among all groups and showed no statistically significant differences.

Conclusion: Both conventional smoking and e-cigarette use were associated with poorer periodontal health compared with non-smokers. Conventional smokers exhibited the greatest periodontal destruction and inflammation, while e-cigarette users demonstrated intermediate periodontal findings. These findings indicate that e-cigarette use is associated with adverse effects on periodontal tissues and should not be considered a safe alternative to conventional cigarette smoking. Further longitudinal studies with larger sample sizes are required to evaluate the long-term periodontal effects of e-cigarette use.