Electronic cigarette usage has become increasingly prevalent among all age groups, particularly over the past 10 years. While many of the effects of electronic cigarettes are still under investigation, systemic and oral impacts have begun to be elucidated. This article will discuss known systemic complications of electronic cigarette usage, known oral effects including pathological, microbiological, and anatomic factors, and considerations around smoking cessation efforts for electronic cigarette users. In reviewing these topics, this article will provide the dentist with considerations for evaluation and treatment of electronic cigarette users.