Aims: Both conventional cigarette use and e-cigarette/vape use appear to have detrimental effects on oral health by promoting the development of both dental caries and periodontal disease. This study aimed to compare the effects of the two with regards to dental caries risk level. Methods: A cross-sectional study on patient records was conducted. 1251 patients who attended the dental school clinics and met the inclusion criteria were included. The Kruskal-Wallis test and multivariable ordinal logistic regression were used to compare the e-cigarette/vaping only, conventional cigarette use only, and dual e-cigarette/vaping and conventional cigarette use groups in terms of caries risk. Results: A total of 1251 patient records met the inclusion criteria. There were 130 reported active users of e-cigarettes/vapes, 1094 active users of conventional cigarettes and 27 active users of both e-cigarettes/vapes and conventional cigarettes. The Kruskal-Wallis test showed no statistically significant difference between caries risk level among the 3 groups with 88.9% of the dual smokers (both conventional and e-cigarettes/vapes), 83.1% of the e-cigarette/vape only users, and 82.5% of the conventional cigarette only smokers being placed in the high/extreme caries risk category (P=.693). The comparison was also not significant (P=.719) when adjusting for age and gender. Conclusion: Though the percentage of patients in the high/extreme caries risk category was highest in the dual smokers group, followed by the vaping/e-cigarette use group and lastly the conventional cigarette group, there was no statistically significant evidence of a difference between these groups.