Empowering Malaysian dentists to tobacco dependence treatment conduct

Abstract

As a signatory to the World Health Organisation 2003 Framework Convention on Tobacco Control, Malaysia has policies in place and funded 300 public Quit clinics. Unfortunately, government dentists are not included to run tobacco dependence treatment. A cross-sectional exploratory survey was carried out to seek Malaysian dentists' opinion on their knowledge, perception and willingness to conduct tobacco dependence treatment. Participation was voluntary from those who attended a specially designed one-day, four-module workshop on tobacco cessation intervention. Data were collected using the Audience-Response-System equipment which tracked immediate responses covering four domains namely: smoking as a public health problem, smoking as an addiction, the role of dentists in the programme and confidence in conducting smoking cessation in the clinic. Sample comprised more female dentists (73.5%), mean age 33.6 (SD 8.99) years and with more than 3 years working experience. Findings indicated that the majority agreed Malaysia has a rising problem in the prevalence of smoking (71.6%) and predicted that it will affect mostly the young (81.9%). Only half of the dentists surveyed (58.9%) routinely recorded their patients' smoking habits. The majority (71.6%) believed that dentists are effective in helping their patient to stop smoking and 76.3% agreed that dentists should discuss the smoking habit with their patients; however, 60% agreed that doing so is too time consuming. In addition, only 24.7% knew of more ways to treat a smoking habit. The majority felt comfortable giving advice to patients about changing their habits (76.5%) or discussing treatment options (60.5%): 75% would opt for a combined programme of counselling and use of medication if they have to do, 15% would choose to go on counselling only, while 8% did not want to treat. In conclusion, the findings suggest that dentists have a strong potential to contribute significantly to providing smoking cessation treatment if adequately trained.

Oral cancer screening in private dental practices in a developing country: opportunities and challenges

“…A similar situation was reported in the United States of America, where 60% of dentists do not routinely advise tobacco users to quit 34 . Training in accessing OC risk and smoking cessation has been included in the dental curriculum in one dental school from 2006 35 , and in 2013, the Malaysian Dental Council has designated the ability to provide smoking cessation advice as one of the minimum competency for undergraduates taking the dental curriculum. It remains to be seen whether this will increase participation of dentists in providing risk habit cessation advice.…”

Challenges to be overcome: Current situation involving smoking cessation in Dental setting

“…The demonstration of a cause-effect relationship between oral alterations and tobacco use and the benefits of dental treatment may encourage patients to quit smoking. Interventions performed by oral health professionals are effective and can improve the knowledge about the risks of smoking and increase tobacco abstinence rates [14,[22][23][24][25][26][27][28][29][30][31][32].…”

“…They include the lack of time, fear of the patient's reaction or resistance in accepting the approach, fear that the patient will lose trust in the professional, difficulty in addressing the topic, also being a smoker, lack of knowledge about the topic, lack of reimbursement, and fear of the reaction of colleagues [9,14,16,17,27,28,39,[41][42][43][46][47][48][49][50][51][52][53][54][55][56]. Once receiving training on tobacco cessation the graduation students and dental health professionals perceive significantly reduction on the pointed barriers [43].…”

“…In the last years, several studies using questionnaires on tobacco cessation measures applied to dentists have been published [7,[9][10][11][12][13][14][15]. These studies have shown that, although dentists agree that smoking is an important risk factor for oral diseases including oral cancer, they are not prepared to treat patients because of lack of knowledge or desire to do so and approaches could therefore be more efficient [7,[9][10][11][12][13][14][15][16]. The arguments reported by dentists include the lack of training and time, the view that they would not be able to convince their patients to quit smoking, the fear of disturbing the patient who could be not interested on smoking cessation and the lack of reimbursement by the health system for more complex care.…”

A Randomized Control Trial of Smoking Cessation Interventions Conducted by Dentists

“…Although in Malaysia, there were dentists trained either from their undergraduate institution (Yahya et al 2012) or on the job training (Amer Nordin et al 2014), to relate patients' tobacco-use with their oral health diseases and to advise them to quit, there is still limited data on the acceptability, feasibility and effectiveness of the smoking cessation intervention given. Therefore, the objective in this study was to assess the effectiveness of the 5A's smoking cessation intervention (5A's) to that of brief advice (BA) which dentists delivered in a dental setting.…”