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Tobacco Cessation in Dentistry

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Oral Problems Caused by Tobacco Use
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Advantages of Tobacco Cessation in Dental Offices
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ADA Position on Tobacco Cessation
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ADHA Position on Tobacco Cessation
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Patient Attitudes Toward Tobacco Cessation Advice
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Brief, Effective Tobacco Cessation Intervention
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Comprehensive Websites on Tobacco Cessation in Dental Settings
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Tobacco-Related Videos by the American Dental Association
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Dental News and Research about Tobacco


Oral Problems Caused by Tobacco Use

Tobacco use is the root of many oral health problems, including tooth-loss, jawbone loss and periodontal diseases. Half the cases of adult periodontitis are attributable to smoking. 1 Moreover, tobacco use impedes the effectiveness of periodontal therapy, dental implants, and wound healing. 1 Worst of all, smoking a pack of cigarettes a day or using smokeless tobacco quadruples the risk of developing oral cavity or oropharyngeal cancer, which kills 49% of its victims within 5 years of diagnosis. 2,3

Advantages of Tobacco Cessation in Dental Offices

Adults ages 20-44 rarely visit their physicians for preventive care unless such visits are mandated by their employer. 4 In contrast, more than half of adult smokers see a dentist each year for prevention-oriented care. 5 This puts dentists

The adverse effects of tobacco use are visible in the oral cavity even in relatively early stages of use. Personalizing advice by pointing out these effects can provide strong motivation to tobacco users to quit. 5

Randomized clinical trials have shown that even brief dental office-based interventions can be effective in motivating and assisting tobacco users to quit. 8

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ADA Position on Tobacco Cessation

The ADA has assigned a procedure code to tobacco cessation and maintains the policy that dentists should "become fully informed about tobacco cessation intervention techniques to effectively educate their patients to overcome their addiction to tobacco." 4,6

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ADHA Position on Tobacco Cessation

The ADHA has started a national smoking cessation initiative called "Ask. Advise. Refer" designed to encourage dental hygienists to perform smoking interventions with their patients. Since its launch, a national network of state SCI Liaisons has been established to disseminate the vast pool of resources made available to hygienists to refer their patients/clients who smoke for assistance in quitting. 9

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Patient Attitudes Toward Tobacco Cessation Advice

Dental professionals may withhold tobacco cessation advice because of concerns about offending their patients, but research has shown that most dental patients want their dentists to offer tobacco cessation advice and that tobacco users expect and are comfortable receiving such advice. 7 Dental patients request many treatments that counter the effects of tobacco use on their appearance, such as whitening agents, porcelain laminate overlays, crowns, and plastic composites. Patients welcome tobacco cessation advice as part of treatment for the cosmetic problems associated with tobacco use. 4

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Brief, Effective Tobacco Cessation Intervention

Tobacco cessation intervention does not need to be time-consuming. The Public Health Service has established an intervention, called the "5 A's", which has been proven to effectively reduce tobacco use rates while only requiring 3-5 minutes implementation time. Components of the intervention can be assigned to dental hygienists, dental assistants and support staff to further reduce strains on the dentist's time. 5

ASK patients if they use tobacco. This is most easily accomplished by including tobacco use as part of the medical history form.

ADVISE patients to quit in a manner that is clear, strong, and personalized to the individual's situation.

ASSESS readiness to quit using tobacco by asking "Are
you willing to try to quit at this time?"

ASSIST them to quit by offering brief suggestions about how to quit, referring them to free quitting programs such as Utah QuitNet or The Utah Tobacco Quit Line, and prescribing nicotine replacement therapy or bupropion.

ARRANGE follow-up to prevent relapse. An excellent way to do this is by faxing the Utah Tobacco Quit Line.

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Comprehensive Cessation Websites in Dental Settings

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Tobacco-Related Videos by the American Dental Association

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Dental News and Research about Tobacco


1.
American Dental Association
2.
American Dental Hygiene Association http://www.adha.org/
3.
American Cancer Society view web source
4.
Albert, D., Ward, A., Ahluwalia, K., and Sadowsky, D. Addressing tobacco in managed care: a survey of dentists' knowledge, attitudes, and behaviors. Am.J.Public Health 92(6), 997-1001. 6-2002.
5.
Tomar, S. L. Dentistry's role in tobacco control. J.Am.Dent.Assoc. 132 Suppl, 30S-35S. 11-2001.
6.
American Dental Association
7.
Campbell, H. S., Sletten, M., and Petty, T. Patient perceptions of tobacco cessation services in dental offices. J.Am.Dent.Assoc. 130(2), 219-226. 2-1999.
8.
Gordon, J. S. and Severson, H. H. Tobacco cessation through dental office settings. J.Dent.Educ. 65(4), 354-363. 4-2001.
9.
American Dental Hygienists’ Assocation http://www.askadviserefer.org/


 



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