Tobacco cessation in dental settings: research findings and future directions

Abstract

The hazards associated with cigarette smoking and smokeless tobacco use have been well documented. In addition to its association with many cancers and coronary conditions, tobacco plays a role in the aetiology of a number of oral morbidities. Dental care practitioners are a largely untapped resource for providing advice and brief counselling to tobacco-using patients, and there are good reasons to believe that they can be effective. Data from seven randomised trials indicate there is ample evidence for the efficacy of dental office-based interventions, but adoption of these tobacco cessation activities into practice has been slow. The limited research on dissemination of tobacco interventions is promising, but there is a need to develop and evaluate new methods for encouraging adoption, implementation and maintenance of tobacco interventions into routine dental care. Several studies currently under way may help to increase the effectiveness and dissemination of office-based tobacco cessation programmes into routine dental care. If dental practitioners provided cessation assistance routinely to their patients and achieved even modest success rates, the public health impact would be enormous. Researchers and clinicians must continue to work together towards universal adoption of effective tobacco cessation interventions at each clinical encounter.

Curriculum survey on tobacco education in European dental schools

“…Furthermore, when multiplied by the number of attendees in dental practices, the public health impact of dentists' interventions could be enormous. 37 …”

What determines the provision of smoking cessation advice and counselling by dental care teams?

“…[1][2][3][4] Dentists and dental hygienists see their patients repeatedly over time as part of their provision of ongoing oral healthcare, 1,5 thus they have ample opportunity to give advice and counselling on how to stop smoking. Studies have shown that interventions to stop smoking in dental practices are effective, 3,6,7 with quit rates ranging from 16.9-18.8% compared to 4.6-7.1% in control groups. Therefore, dental guidelines recommend that dentists be involved in smoking cessation campaigns and training to involve the whole dental team.…”

“…Gordon shows that training and supportive materials such as pamphlets can help oral health professionals to address patients' tobacco use. 6 John 5 found that 88% of dentists believed they should encourage their patients to stop smoking as part of their role. Different kinds of barriers were identifi ed, eg lack of training and knowledge 2,4,6,7,[12][13][14][15][16] and lack of time.…”

What Factors Need to be Addressed to Support Dental Hygienists to Assist Their Patients to Quit Smoking?

“…Smoking negatively affects outcomes of dental treatment such as oral surgery, implants, and the treatment of gum disease (Johnson & Bain, 2000;SanchezPerez, Moya-Villaescusa, & Caffesse, 2007;Strietzel, et al, 2007), and has an aesthetic impact such as stained teeth. All of the above may offer a 'teachable moment' where patient receptiveness to quitting smoking is likely to be high (Gordon, Lichtenstein, Severson, & Andrews, 2006;Hébert, 2005;Stevens, Severson, Lichtenstein, Little, & Leben, 1995). As a consequence, there is increased attention on the dental setting as an opportunity to encourage smoking cessation (Edwards, Freeman, & Roche, 2006;Gordon, Andrews, Crews, Payne, & Severson, 2007).…”

“…There has been less research attention on dental hygienists. Dental hygienists have a stronger focus on prevention than dentists (Gordon, et al, 2006), have more time to spend with patients (Edwards, et al, 2006;Gordon, et al, 2006), and report fewer barriers to providing smoking interventions (Edwards, et al, 2006;Helgason, Lund, Adolfsson, & Axelsson, 2003).…”