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The dentist's role in smoking cessation management — a literature review and recommendations: part 1

From Volume 45, Issue 3, March 2018 | Pages 197-206

Authors

Ross M Keat

BDS, MFDS, PgCert

Birmingham Dental Hospital/School of Dentistry

Articles by Ross M Keat

Jean-Christophe Fricain

DDS, PhD

Université de Bordeaux

Articles by Jean-Christophe Fricain

Sylvain Catros

DDS, PhD

Université de Bordeaux, 33000 Bordeaux Cedex, France

Articles by Sylvain Catros

Luis Monteiro

DDS, MSc, PhD, Dip Oral Med

Instituto Universitário de Ciências da Saúde (IUCS)

Articles by Luis Monteiro

Luis Martins da Silva

DDS, PhD

Instituto Universitário de Ciências da Saúde (IUCS), 4585-116 Gandra PRD, Portugal

Articles by Luis Martins da Silva

Marcio Diniz Freitas

DDS, PhD

School of Medicine and Dentistry, University of Santiago de Compostela

Articles by Marcio Diniz Freitas

Angel Brandariz

DDS, PhD

School of Medicine and Dentistry, University of Santiago de Compostela, Spain

Articles by Angel Brandariz

Giovanni Lodi

DDS, PhD

Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche

Articles by Giovanni Lodi

Alberto Pispero

DDS

Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche, Milan 20142, Italy

Articles by Alberto Pispero

Saman Warnakulasuriya

OBE, BDS, PhD, FDS RCS, DSc

Department of Oral Medicine and Pathology, Guy's, King's and St Thomas’ School of Dentistry, WHO Collaborating Centre for Oral Cancer and Precancer, King's College London, Denmark Hill Campus, Caldecot Road, London SE5 9RW

Articles by Saman Warnakulasuriya

Zahid Khan

BDS, MFDS

Birmingham Dental Hospital/School of Dentistry

Articles by Zahid Khan

Rui Albuquerque

LMD, MS, DAS, PhD, PGCME, FHEA, FDS RCS(OM)

Birmingham Dental Hospital/School of Dentistry, University of Birmingham, 5 Pebble Mill Road, Birmingham B5 7EG, UK

Articles by Rui Albuquerque

Abstract

Abstract: In Europe, 29% of individuals identify as smokers, with tobacco use directly related to 650,000 mortalities each year across the continent; roughly 14% of all deaths. From a dental perspective, smoking is directly implicated in numerous chronic, and potentially life-threatening, sequelae which exclusively affect the oral cavity. By familiarizing the dental team with gold-standard cessation advice, it can be ensured that smokers are assisted at every available opportunity. Dentists should aim to give cessation advice to smokers based on how willing they are to change their smoking habit. The authors are developing an online resource to assist with smoking cessation advice. It is available at http://www.smokingcessationtraining.com/

CPD/Clinical Relevance: Dentists will see many smokers regularly, and advice should be given routinely to this cohort of patients. By improving understanding of potential oral sequelae and identifying individuals who may wish to quit, targeted advice can be offered to increase cessation success. Brief patient-centred advice ensures the highest chance of delivering successful smoking cessation, alongside safeguarding time for the dentist to examine and treat the individual.

Article

Dentists find themselves in a privileged position. They can access a part of the body actively affected by smoking, even when the individual is healthy. They should therefore be proactive in delivering smoking cessation advice to prevent the deterioration of oral and indeed general health in these individuals.

This article presents a review of current strategies regarding the need for, and provision of, adequate smoking cessation advice by the dental profession and is split into two parts. This part focuses on the oral implications of smoking, alongside the role of the dentist in eliciting a change toward cessation. This means that there must be a basic understanding of how to implement brief cessation advice. The dentist can then impart knowledge appropriately to the smoker of potential oral sequelae. For example, a smoker noticing that his/her teeth are becoming loose may be a crucial motivating factor in encouraging cessation.

Part 2 focuses on the ‘stages of change’ approach to encourage smoking cessation, continuing a ‘patient-centred’ approach. Knowledge of the ‘stages of change’ model ensures that the dentist offers advice that is appropriate based on the patient's willingness to quit, safeguarding the dentist-patient relationship. It is important that the dentist understands nicotine replacement therapies (NRT), pharmacotherapy and electronic cigarettes to answer any questions which may be fielded by the patient. We have therefore provided simple, yet thorough and appropriate, information within the second article.

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