Interventions for tobacco cessation delivered by dental professionals

Holliday, Richard; Hong, Bosun; McColl, Elaine; Livingstone‐Banks, Jonathan; Preshaw, Philip M.

doi:10.1002/14651858.cd005084.pub4

Cited by 43 publications

(30 citation statements)

References 107 publications

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“…Several studies have tested the delivery of brief behavioral interventions focused on tobacco cessation and found them to be effective [ 32 , 33 , 34 , 35 ]. A recent international Cochrane review of trials in dentistry (including 13 U.S. studies) found overall positive (but low-certainty) evidence that brief intervention from dental providers alone increases quit rates, although the level of evidence was more robust (moderate-certainty) when such brief intervention was paired with access to pharmacotherapy [ 36 ]. Research on SBIRT for alcohol and other substance use in dentistry is far more limited.…”

Section: Resultsmentioning

confidence: 99%

Leveraging Clinical Decision Support and Integrated Medical-Dental Electronic Health Records to Implementing Precision in Oral Cancer Risk Assessment and Preventive Intervention

Rindal

Mabry

2021

JPM

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Introduction: Precision medicine is focused on serving the unique needs of individuals. Oral and oropharyngeal cancer risk assessment identifies individual risk factors while providing support to reduce risk. The objective is to examine potential current and future strategies to broadly implement evidence-based oral and oropharyngeal cancer risk assessment and screening in dental practices throughout the United States. Methods: Feasible and effective oral cancer risk assessment and risk reduction strategies, ripe for implementation in dental practice, were identified in the published literature. Results: The Screening, Brief Intervention, Referral for Treatment (SBIRT) model is a feasible approach to assessing individual oral cancer risk and providing risk reducing interventions in the dental setting. HPV is a more recently identified risk factor that dentistry is well positioned to address. Evidence supporting the utilization of specific risk assessment tools and risk reduction strategies is summarized and future opportunities discussed. Discussion: Current knowledge of risk factors for oral and oropharyngeal cancers support the recommendation for dental providers to routinely assess all patients for risk factors, educate them about their personal level of cancer risk, and recommend actions to reduce relevant risk factors. Individuals ages 9–26 should be asked about their HPV vaccination status, educated about HPV and oropharyngeal cancer and receive a recommendation to get the HPV vaccination.

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Section: Resultsmentioning

confidence: 99%

Leveraging Clinical Decision Support and Integrated Medical-Dental Electronic Health Records to Implementing Precision in Oral Cancer Risk Assessment and Preventive Intervention

Rindal

Mabry

2021

JPM

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“…The multi-component tobacco cessation intervention that we created contains (1) a flip book to guide tobacco cessation based on appropriate BCTs, (2) a short video showing the harmful effects of tobacco to increase awareness, and (3) pharmacotherapy (NRT). Other tobacco cessation interventions delivered in dental settings have also used patient-facing flip books, leaflets and videos as intervention components and some studies used NRT [ 25 ]. Interventions including advice, assistance, and follow-up support, which are effective for the general population, are expected to be applicable for people with diabetes [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Dental professionals can use this opportunity to offer tobacco cessation advice [23], although this opportunity is rarely taken [24]. A systematic review by Holliday et al (2021) provided evidence with moderate-certainty that tobacco abstinence rates increase in cigarette smokers if dental professionals offer behavioural support in conjunction with the provision of nicotine replacement therapy (NRT) or e-cigarettes, when compared with no intervention, usual care, or brief, or very brief advice only (RR 2.76, 95% CI 1.58-4.82) [25]. Interventions in the dental setting usually included a multi-component tobacco cessation interventions in conjunction with an oral examination [26].…”

Section: Introductionmentioning

confidence: 99%

Co-producing an intervention for tobacco cessation and improvement of oral health among diabetic patients in Bangladesh

et al. 2021

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Background Tobacco consumption is a major risk factor for many diseases including diabetes and has deleterious effects on oral health. Diabetic patients are vulnerable to developing certain oral conditions. So far, no studies have attempted to co-develop a tobacco cessation intervention to be delivered in dental clinics for people with diabetes in Bangladesh. Aim To co-produce a tobacco cessation intervention for people with diabetes for use in dental clinics in Bangladesh. Objectives To assess: (1) tobacco use (patterns) and perceptions about receiving tobacco cessation support from dentists among people with diabetes attending the dental department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) who smoke or use smokeless tobacco (ST) (2) current tobacco cessation support provision by the dentists of the dental department of BIRDEM (3) barriers and facilitators of delivering a tobacco cessation intervention at a dental clinic, and (4) to co-produce a tobacco cessation intervention with people with diabetes, and dentists to be used in the proposed context. Methods The study was undertaken in two stages in the dental department of BIRDEM, which is the largest diabetic hospital in Bangladesh. Stage 1 (July–August 2019) consisted of a cross-sectional survey among people with diabetes who use tobacco to address objective 1, and a survey and workshop with dentists working in BIRDEM, and consultations with patients to address objectives 2 and 3. Stage 2 (January 2020) consisted of consultations with patients attending BIRDEM, and a workshop with dentists to co-produce the intervention. Result All survey participants (n = 35) were interested in receiving tobacco cessation support from their dentist. We identified important barriers and facilitators to deliver tobacco cessation intervention within dental services. Barriers reported by dentists included lack of a structured support system and lack of training. As a facilitator, we identified that dentists were willing to provide support and it would be feasible to deliver tobacco cessation intervention if properly designed and embedded in the routine functioning of the dental department of BIRDEM. Through the workshops and consultations at stage 2, a tobacco cessation intervention was co-developed. The intervention included elements of brief cessation advice (using a flipbook and a short video on the harmful effects of tobacco) and pharmacotherapy. Conclusion Incorporation of tobacco cessation within dental care for people with diabetes was considered feasible and would provide a valuable opportunity to support this vulnerable group in quitting tobacco.

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“…Vladimirov and colleagues explored the effect of tobacco cessation on a cohort of patients with OLs who had undergone surgical excision, demonstrating that the patients who continued to smoke were significantly more likely to undergo an "unfavourable outcome" (i.e., recurrence of the OL or cancer development) (Vladimirov & Schiodt, 2009). It is feasible for dental offices to perform tobacco cessation (Holliday et al, 2021).…”

Section: Modification Of Known Risk Factorsmentioning

confidence: 99%

Management of oral potentially malignant disorders

Kerr

Lodi

2021

Oral Diseases

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Patients with oral potentially malignant disorders (OPMDs), including oral leukoplakia and erythroplakia, proliferative verrucous leukoplakia, oral submucous fibrosis, and oral lichen planus/lichenoid lesions, can be challenging to manage. A small proportion will undergo cancer development and determining a patient's cancer risk is key to making management decisions. Yet, our understanding of the natural history of OPMDs has not been fully elucidated, and a precision approach based on the integration of numerous predictive markers has not been validated by prospective studies. Evidence-based health promotion by clinicians and healthcare systems is not embraced universally. Medical and surgical interventions evaluated by rigorous research measuring important endpoints, such as cancer development, mortality, or survival, are difficult and expensive to run. Most of these studies employ non-ideal surrogate endpoints and have deep methodologic flaws. Diagnostic criteria for enrolling research subjects are not uniform, and patients with the highest risk for cancer development comprise small proportions of those enrolled. Few studies explore quality of life and patient preferences. It is time to rethink how we approach the management of these patients, across each OPMD, and considering the healthcare infrastructure and cost-effectiveness. Global networks with well-characterized patient populations with OPMDs and well-designed interventional trials using validated outcome measures are needed.

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Interventions for tobacco cessation delivered by dental professionals

Abstract: Analysis 4.1. Comparison 4: Behavioural support from dental professional at high school/college versus usual care/no intervention, Outcome

Cited by 43 publications

References 107 publications

Leveraging Clinical Decision Support and Integrated Medical-Dental Electronic Health Records to Implementing Precision in Oral Cancer Risk Assessment and Preventive Intervention

Leveraging Clinical Decision Support and Integrated Medical-Dental Electronic Health Records to Implementing Precision in Oral Cancer Risk Assessment and Preventive Intervention

Co-producing an intervention for tobacco cessation and improvement of oral health among diabetic patients in Bangladesh

Management of oral potentially malignant disorders

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