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Oral
Health 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
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| Oral
Health 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
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to Top
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| 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
in a much better position to provide tobacco
cessation interventions than physicians.
- 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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to Top
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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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to Top
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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. The 5 A’s include:
|
| 1. |
ASK
patients if they use tobacco. This is most easily
accomplished by including tobacco use as part of
the medical history form. |
| 2. |
ADVISE
patients to quit in a manner that
is clear, strong, and personalized to the individual’s
situation. |
| 3. |
ASSESS
readiness to quit using tobacco by asking "Are
you willing to try to quit at this time?" |
| 4. |
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. |
| 5. |
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
Websites on Tobacco Cessation in Dental Settings |
| |
University
of Minnesota, Division of Periodontology, Tobacco
Use Cessation Program
http://www1.umn.edu/perio/tobacco/didactic.html
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| Tobacco-Related
Videos by the American Dental Association |
| |
Oral
Cancer Screening
http://www.oralcancerfoundation.org/multimedia/media/biopsy-dsl.wmv
Cigars
http://www.oralcancerfoundation.org/multimedia/media/cigars-dsl.wmv
Spit Tobacco Use In Baseball
http://www.oralcancerfoundation.org/multimedia/media/psa-ripk-dsl.wmv
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| Dental
News and Research about Tobacco |
| |
American
Academy of Periodontology: More Information on
Tobacco Use and Periodontal Disease
http://www.perio.org/consumer/smoking_info.htm
American Dental Association: Tobacco and Nicotine
http://www.ada.org/prof/resources/topics/tobacco/index.asp
American Dental Hygienists’ Association:
Ask. Advise. Refer.
http://www.askadviserefer.org/
Tobacco Cessation Intervention: How to Communicate
with Tobacco Using Patients. The Journal of Contemporary
Dental Practice
http://www.thejcdp.com/issue004/bakdash/01bak.htm
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to Healthcare Resources Main Page |
| References |
| 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/ |
