It’s not known what the health effects are from using e-cigarettes. But one local dentist is raising concerns over a large number of young adult patients in her office with tooth decay, which she attributes to vaping.

In many low-income communities, especially in rural areas, charity clinics like this provide dental care for a population whose needs are not fully met by the existing safety net.

A recent report from the U.S. Department of Health and Human Services found that almost 80 percent of children on Medicaid were not receiving all required dental services and almost a third didn’t visit a dentist at all.