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Fang P, Adkins-Hempel M, Lischka T, Basile S, Rindal DB, Carpenter MJ, Kopycka-Kedzierawski DT, Dahne J, Helseth SA, Levy DE, Truong A, Leo MC, Funkhouser K, Louis DR, Japuntich SJ. A National Dental Practice-Based Research Network phase II, cluster-randomized clinical trial assessing nicotine replacement therapy sampling in dental settings: study protocol for the Free Samples for Health (FreSH) study. BMC Oral Health 2024; 24:1007. [PMID: 39198824 PMCID: PMC11360338 DOI: 10.1186/s12903-024-04758-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 08/15/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Cigarette smoking has major detrimental effects on oral health. Tobacco interventions in dental settings are effective, but rarely delivered. The American Dental Hygienists Association recommends that oral health providers: Ask patients about tobacco use, Advise quitting tobacco use, and Refer to state quitlines (Ask-Advise-Refer; AAR). While AAR connects patients to counseling, it does not directly connect patients to medication. Nicotine replacement therapy sampling (NRTS) is an empirically supported intervention to provide starter packs of nicotine replacement therapy (NRT) to people who smoke. NRTS combined with AAR could be an effective tobacco treatment intervention for dental settings. METHODS This manuscript describes the study protocol for the Free Samples for Health (FreSH) study, a group randomized clinical trial testing the effectiveness of NRTS + AAR vs. AAR alone on long-term smoking abstinence. Fifty dental practices in the Midwest and Northeast nodes of the National Dental Practice-Based Research Network are randomly assigned to provide AAR and either a 2-week supply of 14-mg nicotine patches and 4-mg nicotine lozenges (NRTS condition) or an electric toothbrush (ET condition). Approximately 1,200 patients who currently smoke-regardless of interest in quitting- are recruited during dental visits. Participants complete a baseline survey in-person, then after visit, 1-, 3-, and 6-month follow-up surveys remotely. The primary outcome is carbon monoxide-confirmed 7-day point prevalence abstinence from combustible tobacco measured at 6 months post-enrollment. Secondary outcomes include: 24-h intentional quit attempts, change in cigarettes smoked per day, NRT utilization, attitudes toward NRT, intention to use NRT, and intention to quit smoking. A key informant process evaluation and cost effectiveness analysis will provide information for future implementation of NRTS. DISCUSSION This is the first clinical trial to assess the effectiveness of NRTS on promoting smoking cessation in dental settings. If effective, this treatment could be implemented to increase the provision of smoking cessation interventions in dental settings to provide an additional treatment access point for people who smoke. TRIAL REGISTRATION Registered at ClincalTrials.gov (NCT05627596) on 11/25/2022.
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Grants
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- UH3-DE-029973, U19-DE-028717 and U01-DE-028727 NIDCR NIH HHS
- National Institute of Dental and Craniofacial Research
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Affiliation(s)
- Pearl Fang
- Behavioral Health Equity Research Group, Hennepin Healthcare Research Institute, 701 Park Ave. S9.104, Minneapolis, MN, 55415, USA
| | - Melissa Adkins-Hempel
- Behavioral Health Equity Research Group, Hennepin Healthcare Research Institute, 701 Park Ave. S9.104, Minneapolis, MN, 55415, USA
| | - Tamara Lischka
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Sarah Basile
- HealthPartners Institute, 8170 33rd , Ave. S MS 21112R, Minneapolis, MN, 55440, USA
| | - D Brad Rindal
- HealthPartners Institute, 8170 33rd , Ave. S MS 21112R, Minneapolis, MN, 55440, USA
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Dorota T Kopycka-Kedzierawski
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave., Box 683, Rochester, NY, 14620, USA
| | - Jennifer Dahne
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Sarah A Helseth
- Department of Psychiatry and Behavioral Health, Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, 633 N. St. Clair St., Suite 2000, Chicago, IL, 60611, USA
| | - Douglas E Levy
- Mongan Institute Health Policy Research Center and Tobacco Research and Treatment Center, Massachusetts General Hospital, 100 Cambridge St, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Arthur Truong
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Michael C Leo
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Kimberly Funkhouser
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - David R Louis
- Health Partners Dental Group, 8455 Flying Cloud Dr., Eden Prairie, MN, 55344, USA
| | - Sandra J Japuntich
- Behavioral Health Equity Research Group, Hennepin Healthcare Research Institute, 701 Park Ave. S9.104, Minneapolis, MN, 55415, USA.
- Division of Clinical Pharmacology, Department of Medicine, & Department of Psychiatry, Hennepin Healthcare, 900 S. 8th St., G5, Minneapolis, MN, 55415, USA.
- Division of General Internal Medicine, Department of Medicine, University of Minnesota, 401 East River Parkway, Suite 131, Minneapolis, MN, 55455, USA.
- Department of Medicine, University of Minnesota Medical School, Minneapolis, USA.
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Warner FE, Sherriff A, Culshaw S, Holliday R, Ryan V, Conway DI. Trends and socioeconomic inequalities in the dental attendance of adult smokers in Scotland from 2009 to 2019, a repeated cross-sectional study. BMC Public Health 2024; 24:2156. [PMID: 39118032 PMCID: PMC11308390 DOI: 10.1186/s12889-024-19360-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/04/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Smoking continues to be the single largest cause of preventable disease and death and a major contributor to health inequalities. Dental professionals are well placed to offer behavioural support in combination with pharmacotherapy to increase smoking cessation rates across the population. We aimed to assess the trends and socioeconomic inequalities in the dental attendance of adult smokers in Scotland from 2009 to 2019 and examine the potential population reach of dental settings for smoking cessation interventions. METHODS A secondary analysis was conducted of combined Scottish Health Surveys (SHeS) from 2009/11, 2013/15 and 2017/19. 'Recent' dental attendance (within the past two years) was the focus and descriptive analysis examined attendance of self-reported smokers compared to non-smokers and stratified by the area-based Scottish Index of Multiple Deprivation (SIMD) and individual socioeconomic measures (income, education, and occupation). Generalised linear models were used to model recent attendance in non-smokers relative to smokers adjusted by the socioeconomic measures, for each of the survey cohorts separately. Absolute differences and risk ratios were calculated with 95% Confidence Intervals (CI). RESULTS Recent dental attendance was generally high and increased in both smokers (70-76%) and non-smokers (84-87%) from 2009/11 to 2017/19 and increased across all SIMD groups. After adjustment for sociodemographic variables, the adjusted Risk Difference (aRD) for recent attendance between non-smokers and smokers was 8.9% (95% CI 4.6%, 13.2%) by 2017/19. Within smokers, recent attendance was 7-9% lower in those living in the most deprived areas compared to those living in the least deprived areas over the three surveys. CONCLUSIONS SHeS data from 2009 to 2019 demonstrated that a high and increasing proportion of smokers in the population attend the dentist, albeit slightly less frequently than non-smokers. There were large inequalities in the dental attendance of smokers, to a lesser extent in non-smokers, and these persisted over time. Dental settings provide a good potential opportunity to deliver population-level smoking cessation interventions, but smokers in the most deprived groups and older age groups may be harder to reach. Consideration should be given to ensure that these groups are given appropriate proportionate support to take up preventive interventions.
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Affiliation(s)
- Frances E Warner
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
| | - Andrea Sherriff
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Shauna Culshaw
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Richard Holliday
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Vicky Ryan
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - David I Conway
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
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Mdege ND, Shah S, Dogar O, Pool ER, Weatherburn P, Siddiqi K, Zyambo C, Livingstone-Banks J. Interventions for tobacco use cessation in people living with HIV. Cochrane Database Syst Rev 2024; 8:CD011120. [PMID: 39101506 PMCID: PMC11299227 DOI: 10.1002/14651858.cd011120.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
BACKGROUND The prevalence of tobacco use among people living with HIV (PLWH) is up to four times higher than in the general population. Unfortunately, tobacco use increases the risk of progression to AIDS and death. Individual- and group-level interventions, and system-change interventions that are effective in helping PLWH stop using tobacco can markedly improve the health and quality of life of this population. However, clear evidence to guide policy and practice is lacking, which hinders the integration of tobacco use cessation interventions into routine HIV care. This is an update of a review that was published in 2016. We include 11 new studies. OBJECTIVES To assess the benefits, harms and tolerability of interventions for tobacco use cessation among people living with HIV. To compare the benefits, harms and tolerability of interventions for tobacco use cessation that are tailored to the needs of people living with HIV with that of non-tailored cessation interventions. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group's Specialised Register, CENTRAL, MEDLINE, Embase, and PsycINFO in December 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) of individual-/group-level behavioural or pharmacological interventions, or both, for tobacco use cessation, delivered directly to PLWH aged 18 years and over, who use tobacco. We also included RCTs, quasi-RCTs, other non-randomised controlled studies (e.g. controlled before and after studies), and interrupted time series studies of system-change interventions for tobacco use cessation among PLWH. For system-change interventions, participants could be PLWH receiving care, or staff working in healthcare settings and providing care to PLWH; but studies where intervention delivery was by research personnel were excluded. For both individual-/group-level interventions, and system-change interventions, any comparator was eligible. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methods, and used GRADE to assess certainty of the evidence. The primary measure of benefit was tobacco use cessation at a minimum of six months. Primary measures for harm were adverse events (AEs) and serious adverse events (SAEs). We also measured quit attempts or quit episodes, the receipt of a tobacco use cessation intervention, quality of life, HIV viral load, CD4 count, and the incidence of opportunistic infections. MAIN RESULTS We identified 17 studies (16 RCTs and one non-randomised study) with a total of 9959 participants; 11 studies are new to this update. Nine studies contributed to meta-analyses (2741 participants). Fifteen studies evaluated individual-/group-level interventions, and two evaluated system-change interventions. Twelve studies were from the USA, two from Switzerland, and there were single studies for France, Russia and South Africa. All studies focused on cigarette smoking cessation. All studies received funding from independent national- or institutional-level funding. Three studies received study medication free of charge from a pharmaceutical company. Of the 16 RCTs, three were at low risk of bias overall, five were at high risk, and eight were at unclear risk. Behavioural support or system-change interventions versus no or less intensive behavioural support Low-certainty evidence (7 studies, 2314 participants) did not demonstrate a clear benefit for tobacco use cessation rates in PLWH randomised to receive behavioural support compared with brief advice or no intervention: risk ratio (RR) 1.11, 95% confidence interval (CI) 0.87 to 1.42, with no evidence of heterogeneity. Abstinence at six months or more was 10% (n = 108/1121) in the control group and 11% (n = 127/1193) in the intervention group. There was no evidence of an effect on tobacco use cessation on system-change interventions: calling the quitline and transferring the call to the patient whilst they are still in hospital ('warm handoff') versus fax referral (RR 3.18, 95% CI 0.76 to 13.99; 1 study, 25 participants; very low-certainty evidence). None of the studies in this comparison assessed SAE. Pharmacological interventions versus placebo, no intervention, or another pharmacotherapy Moderate-certainty evidence (2 studies, 427 participants) suggested that varenicline may help more PLWH to quit smoking than placebo (RR 1.95, 95% CI 1.05 to 3.62) with no evidence of heterogeneity. Abstinence at six months or more was 7% (n = 14/215) in the placebo control group and 13% (n = 27/212) in the varenicline group. There was no evidence of intervention effects from individual studies on behavioural support plus nicotine replacement therapy (NRT) versus brief advice (RR 8.00, 95% CI 0.51 to 126.67; 15 participants; very low-certainty evidence), behavioural support plus NRT versus behavioural support alone (RR 1.47, 95% CI 0.92 to 2.36; 560 participants; low-certainty evidence), varenicline versus NRT (RR 0.93, 95% CI 0.48 to 1.83; 200 participants; very low-certainty evidence), and cytisine versus NRT (RR 1.18, 95% CI 0.66 to 2.11; 200 participants; very low-certainty evidence). Low-certainty evidence (2 studies, 427 participants) did not detect a difference between varenicline and placebo in the proportion of participants experiencing SAEs (8% (n = 17/212) versus 7% (n = 15/215), respectively; RR 1.14, 95% CI 0.58 to 2.22) with no evidence of heterogeneity. Low-certainty evidence from one study indicated similar SAE rates between behavioural support plus NRT and behavioural support only (1.8% (n = 5/279) versus 1.4% (n = 4/281), respectively; RR 1.26, 95% CI 0.34 to 4.64). No studies assessed SAEs for the following: behavioural support plus NRT versus brief advice; varenicline versus NRT and cytisine versus NRT. AUTHORS' CONCLUSIONS There is no clear evidence to support or refute the use of behavioural support over brief advice, one type of behavioural support over another, behavioural support plus NRT over behavioural support alone or brief advice, varenicline over NRT, or cytisine over NRT for tobacco use cessation for six months or more among PLWH. Nor is there clear evidence to support or refute the use of system-change interventions such as warm handoff over fax referral, to increase tobacco use cessation or receipt of cessation interventions among PLWH who use tobacco. However, the results must be considered in the context of the small number of studies included. Varenicline likely helps PLWH to quit smoking for six months or more compared to control. We did not find evidence of difference in SAE rates between varenicline and placebo, although the certainty of the evidence is low.
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Affiliation(s)
- Noreen D Mdege
- Department of Health Sciences, University of York, York, UK
- Centre for Research in Health and Development, York, UK
| | - Sarwat Shah
- Department of Health Sciences, University of York, York, UK
| | - Omara Dogar
- Department of Health Sciences, University of York, York, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Erica Rm Pool
- Institute for Global Health, University College London, London, UK
| | - Peter Weatherburn
- Sigma Research, Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, University of York, York, UK
| | - Cosmas Zyambo
- Department of Community and Family Medicine, School of Public Health, The University of Zambia, Lusaka, Zambia
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Japuntich SJ, Dunbar MS, Predmore Z, Bloom EL, Fang P, Basile S, Rindal DB, Waiwaiole LA, Carpenter MJ, Kopycka-Kedzierawski DT, Dahne J, Lischka TR, Richardson P. Dental staff and patient attitudes about nicotine replacement therapy samples in dental care: A National Dental Practice-Based Research Network study. Community Dent Oral Epidemiol 2024; 52:440-451. [PMID: 38095239 PMCID: PMC11176262 DOI: 10.1111/cdoe.12937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/26/2023] [Accepted: 11/29/2023] [Indexed: 05/24/2024]
Abstract
OBJECTIVES Cigarette smoking negatively affects oral health. Nicotine replacement therapies (NRT; e.g. nicotine patch or lozenge) and brief interventions (e.g. Ask-Advise-Refer; AAR) can improve cessation outcomes but are underutilized. NRT sampling (NRTS) increases NRT utilization by providing patients with samples of NRT as part of routine healthcare. Ask-Advise-Refer is a brief intervention where practitioners: ask patients about tobacco use, advise those using tobacco to quit and refer to the state quit line. The objective of this qualitative study was to explore dental care practitioners' and patients' attitudes and experiences regarding tobacco cessation treatment and perceptions of two brief intervention models, assessed separately: NRTS and AAR. METHODS Twenty-four dental care practitioners and nine patients, recruited through the National Dental Practice-Based Research Network, participated in semi-structured telephone interviews. Interviews assessed experiences with tobacco use intervention and attitudes towards NRTS and AAR. Thematic analysis identified emergent themes related to feasibility and acceptability of NRTS and AAR. RESULTS Practitioners varied on how they address tobacco use, from systematically to idiosyncratically. Some practitioners recommend NRT; few had prescribed it. Practitioners had favourable attitudes towards AAR and NRTS, with most believing that both interventions would be acceptable and feasible to implement. Concerns regarding AAR were time and patient resistance to discussing tobacco use. Concerns regarding NRTS were patient resistance to using NRT, side effects or medication interactions, and capacity to provide follow-up. Patients reported that oral health practitioners generally ask about tobacco use but do not provide interventions. Patients were open to discussing their tobacco use with practitioners and had favourable attitudes about NRTS. CONCLUSIONS This formative work suggests that NRTS and AAR may be feasible to implement in dental care settings. Future studies are needed to assess the effectiveness and implementation potential of NRTS in dental care settings.
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Affiliation(s)
- Sandra J Japuntich
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA
- Department of Psychiatry, Hennepin Healthcare, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Michael S Dunbar
- Health Care Division, RAND Corporation, Pittsburgh, Pennsylvania, USA
| | - Zachary Predmore
- Health Care Division, RAND Corporation, Boston, Massachusetts, USA
| | | | - Pearl Fang
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA
| | - Sarah Basile
- Health Partners Institute, Bloomington, Minnesota, USA
| | - D Brad Rindal
- Health Partners Institute, Bloomington, Minnesota, USA
| | - Lisa A Waiwaiole
- Kaiser Permanente Center for Health Research, Portland, Oregon, USA
| | - Matthew J Carpenter
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Dorota T Kopycka-Kedzierawski
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Jennifer Dahne
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Tamara R Lischka
- Kaiser Permanente Center for Health Research, Portland, Oregon, USA
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Alsoghier A, Alnutaifi A, Alotaibi O, Alotaibi A, Alharbi A, Almubarak N, Albassam S. Barriers and facilitators for oral health screening among tobacco users: a mixed-methods study. BMC Oral Health 2024; 24:306. [PMID: 38443882 PMCID: PMC10913556 DOI: 10.1186/s12903-024-04084-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/27/2024] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVES Tobacco consumption adversely affects general and oral health and is considered one of the significant public health burdens globally. The present study aims to assess the barriers and facilitators for attending oral and dental health screening among tobacco users who seek cessation advice. METHODOLOGY The present mixed-methods study used group concept mapping (GCM) to identify the facilitators/barriers to attending oral health screening among young adults attending face-to-face and virtual Tobacco Cessation Clinic at King Saud University (Riyadh, Saudi Arabia) between September 2022 and April 2023. Study investigators included healthcare social workers, dental interns, and oral and maxillofacial medicinists. Information about demographics, general health, oral/dental health and tobacco use were collected using self-completed questionnaires. The barriers and facilitators were assessed following GCM by brainstorming, sorting, rating, and interpretation activities. Descriptive, multidimensional scaling and hierarchical cluster analysis were used to describe the study participants and produce concept maps of the generated statements. RESULTS The study included 148 participants who generated 67 statements summarised into 28 statements as facilitators or barriers. Based on a 5-point importance scale, the participants indicated the importance of facilitators under health-related cluster [e.g. when I feel pain] as the highest, followed by personal [e.g. to maintain my mouth hygiene], social [e.g. the quality of treatment] and financial clusters [e.g. the reasonable cost]. Concerning barriers, financial factors [e.g. high cost] acted as the highest-rated barrier, followed by personal [e.g. lack of dental appointments] and health-related [e.g. worry that dental problems will worsen]. The social factors were the least considerable barrier [e.g. lack of time]. Clustering these facilitators/barriers on the concept map indicated their conceptual similarity by an average stress value of 0.23. CONCLUSION Pain was the most important facilitator to attending oral health screening by young adults seeking tobacco cessation advice. Notable barriers included the high cost of dental treatment and the lack of scheduled appointments. Thus, oral health care providers need to consider scheduling periodic and timely dental check-ups to prevent and reduce the burden of tobacco-associated and pain-causing oral diseases.
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Affiliation(s)
- Abdullah Alsoghier
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, 12372, Saudi Arabia.
| | - Abdulrahman Alnutaifi
- Dental Internship Training Programme, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Obaid Alotaibi
- Dental Internship Training Programme, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alotaibi
- Dental Internship Training Programme, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alharbi
- Smoking Cessation Clinic, Counselling and Guidance Center, Deanship of Student Affairs, King Saud University, Riyadh, Saudi Arabia
| | - Nada Almubarak
- College of Humanities and Social Sciences, Social Studies Department, King Saud University, Riyadh, Saudi Arabia
| | - Sara Albassam
- Department of Basic Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Linden J, Fletcher R. Clearing the smoke: are tobacco cessation interventions by the dental team successful? Evid Based Dent 2023; 24:190-191. [PMID: 37644194 DOI: 10.1038/s41432-023-00926-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023]
Abstract
AIMS This study aimed to assess the outcomes of tailored tobacco cessation interventions in a dental clinic setting over one year. DESIGN This interventional study recruited 1206 tobacco users who attended a smoking cessation clinic within an Oral Medicine Department in Bangalore, India. Baseline characteristics were recorded followed by a tailored smoking cessation intervention, delivered by trained faculty members and students. This followed the 3Es and 6As model - including a combination of personalised counselling, pharmacotherapy and one year follow up. CASE SELECTION 1206 participants were recruited. 95% were already receiving treatment within the dental hospital and 5% were walk-in patients, attempting to quit tobacco use. Participants who had been smoking or using smokeless tobacco more than twice daily for greater than 6 months were included in the study. Participants were excluded from the study if they were currently using nicotine replacement therapy (NRT) or non-NRT therapy for tobacco cessation, pregnant and lactating women, a recent history of myocardial infarction or a history of gastric ulcers. RESULTS Outcomes were categorised into the following four groups; Complete abstinence, Harm reduction (>50% reduction), No change and lost to follow up. Of the patients who completed the 12 month follow up, 18% quit tobacco use (n = 180), 34.2% reduced their tobacco usage by greater than 50% (n = 342), 41.5% exhibited no change (n = 415) and 6.2% relapsed (n = 62). Salivary nicotine levels were used to confirm self-reported abstinence. CONCLUSION This study shows that dental professional led tobacco cessation programmes can be successful in supporting patients to quit or reduce tobacco usage.
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Affiliation(s)
- John Linden
- Public Dental Officer, Howden Dental Centre, Livingston, NHS Lothian, Scotland.
| | - Rosie Fletcher
- Post Dental Core Training Fellow in OMFS, St John's Hospital, Livingston, NHS Lothian, Scotland
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Amaral AL, da Costa Andrade PA, Lwaleed BA, Andrade SA. Impacts of smoking on oral health-what is the role of the dental team in smoking cessation? Evid Based Dent 2023; 24:186-187. [PMID: 37679450 DOI: 10.1038/s41432-023-00930-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023]
Abstract
DATA SOURCES Electronic searches were conducted on databases (PubMed, EMBASE, and Google Scholar). In addition, websites of national organisations (US Food and Drug Administration, National Cancer Institute, Centres for Disease Control and Prevention, American Dental Association, Office of Disease Prevention and Health Promotion, National Institute on Drug Abuse, Agency for Healthcare Research and Quality) were also searched. STUDY SELECTION To achieve the objectives of the study, systematic reviews, controlled clinical trials, and observational studies published between October 2021 and February 2022 were considered. DATA EXTRACTION AND SYNTHESIS This narrative review included articles which investigated the role of Dentistry professionals and their impact on smoking cessation and the effects resulting from tobacco use on oral health. RESULTS The review revealed that smokers have a significantly higher likelihood of developing oral cancer (95% CI: 3.19-6.77) compared to non-smokers. Passive smokers also have an increased risk (1.51 times) of developing oral cancer (95% CI: 1.20-1.91). Additionally, smokers have an 80% increased risk of periodontitis (RR = 1.82; 95% CI: 1.43-2.31), an 85% worsened periodontal condition (RR = 1.85; 95% CI: 1.5-2.2), and a 36.6% increase in caries prevalence (OR = 1.84; 95% CI: 1.64-2.07). Smoking is also associated with a higher potential for dental implant failure in a dose-dependent manner. Brief educational interventions by the dental team resulted in a smoking cessation rate of 74/1000 individuals versus 27/1000 individuals in the control group. When combined with pharmacological therapy, these interventions may lead to an additional 50 to 70% increase in long-term smoking abstinence. CONCLUSIONS Smoking is strongly linked to an increased risk of oral cancer, dental caries, implant failure, and periodontal disease. Dental teams play a vital role in identifying and addressing oral pathologies related to smoking and providing necessary care for smoking cessation. Brief educational interventions, either alone or in combination with pharmacotherapy, offer valuable approaches for the dental team to support smoking cessation. However, establishing a comprehensive training and continuing education program is crucial to integrate dental professionals into a multidisciplinary smoking cessation program.
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Affiliation(s)
- Ana Luisa Amaral
- Faculty of Dentistry, University of Itaúna (UIT), Itaúna, MG, Brazil
- Researcher, Research Center on Biological Chemistry (NQBio), Federal University of São João del-Rei (UFSJ), Divinópolis, MG, Brazil
| | - Patrícia Alves da Costa Andrade
- Researcher, Research Center on Biological Chemistry (NQBio), Federal University of São João del-Rei (UFSJ), Divinópolis, MG, Brazil
- Federal Center for Technological Education of Minas Gerais (CEFET-MG), Divinópolis, MG, Brazil
| | | | - Sérgio Araújo Andrade
- Researcher, Research Center on Biological Chemistry (NQBio), Federal University of São João del-Rei (UFSJ), Divinópolis, MG, Brazil.
- Professor, Faculty of Dentistry, University of Itaúna (UIT), Itaúna, MG, Brazil.
- Researcher, Optics and Photonics Research Center (CEPOF), Physics Institute of São Carlos of the University of São Paulo (IFSC-USP), São Carlos, SP, Brazil.
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8
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Holliday R. Electronic cigarettes and vape devices: a comprehensive guide for clinicians and health professionals. Evid Based Dent 2023; 24:149. [PMID: 37990101 DOI: 10.1038/s41432-023-00951-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 11/23/2023]
Affiliation(s)
- Richard Holliday
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
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9
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Chan HL, Chan AKY, Chu CH, Tsang YC. Smoking cessation in dental setting: a narrative review on dental professionals' attitude, preparedness, practices and barriers. FRONTIERS IN ORAL HEALTH 2023; 4:1266467. [PMID: 37808607 PMCID: PMC10552527 DOI: 10.3389/froh.2023.1266467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Integration of smoking cessation program into routine oral health care has been advocated by World Health Organization since it brings extensive benefits to oral health. By tobacco cessation, patients are less prone to progression of periodontal disease, have less future tooth loss, have reduced risks of oral mucosal lesions and head and neck cancers. Evidence indicates that dentists are in a favorable position to deliver effective smoking cessation advice to improve patients' oral health. This article aims to present the current situation of smoking cessation in dental setting, including dental management of smoking patients, perceptions of dentists and dental students towards smoking cessation, challenges dental professionals face when carrying out cessation interventions. Patients' perspectives are also evaluated to provide a clearer picture of smoking cessation practice in the dental field. Review of past surveys show most patients welcome smoking cessation advice from dental practitioners. Meanwhile dentists may have wrong assumption that patients would disapprove them if they advise patient to quit smoking. On top of that, main obstacles identified are lack of training, inadequate treatment time and insufficient knowledge towards smoking cessation guidelines and referral routes. With regard to the potential barriers, evidence demonstrates that more trainings on smoking cessation strategies are needed. Future research in this aspect is also indicated to further foster the practice of smoking cessation counselling in dental setting.
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Affiliation(s)
| | | | | | - Y. C. Tsang
- Faculty of Dentistry, The University of Hong Kong, The Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong SAR, China
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10
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Hashemipour M, Poyayi M, Roshani A. KNOWLEDGE AND ATTITUDE OF IRANIAN DENTAL STUDENTS ABOUT SMOKING CESSATION COUNSELING. Ann Ib Postgrad Med 2023; 21:62-69. [PMID: 38298340 PMCID: PMC10811706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/30/2023] [Indexed: 02/02/2024] Open
Abstract
Introduction and Aims Today, smoking is recognized as the biggest cause of preventable premature death. dentists can play a very important role in motivating and providing smoking cessation counseling and play this role of line requires gaining sufficient knowledge and education during the student period. Therefore, the purpose of this study is to determine the knowledge and attitude of dental students in Kerman in the field of smoking cessation counseling. Methods and materials This study was descriptive-analytical and crosssectional. The study population was fourth, fifth and sixth year dental students. A questionnaire was used to assess participants knowledge and attitude towards smoking cessation, using the 5 As of smoking cessation. Data were collected using a questionnaire and analyzed using SPSS 21, t-test and chi-square software. Results This study showed that the mean score of students' knowledge was 2.13 ± 14.12. There was a significant relationship between knowledge score, gender (women more than men) and the presence of a smoker in the family (P = 0.01, 0.001, respectively). Also, the mean attitude score was 36.25 41 5.41. There was a significant relationship between attitude score, gender (women more than men) and the presence of a smoker in the family (P = 0.01, respectively). Conclusion Results of this study showed that the students have good knowledge of the 5As (Ask, Advice, Assess, Assist, Arrange) but that they did not have much information about some parameters under Assess. Also, they have a positive attitude in this regard. Moreover, students believed that time limitations in dental visits and concerns on the effectiveness of smoking cessation consultations are the major obstacle in implementing a smoking cessation plan.
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Affiliation(s)
- M.A. Hashemipour
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - M. Poyayi
- Kerman Social Determinants on Oral Health Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - A. Roshani
- Kerman Social Determinants on Oral Health Research Center, Kerman University of Medical Sciences, Kerman, Iran
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11
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Yatabe N, Hanioka T, Suzuki N, Shimazu A, Naito M. Oral-malodor measurement and intention to quit smoking in men: A before-after study. Tob Induc Dis 2023; 21:95. [PMID: 37476486 PMCID: PMC10354836 DOI: 10.18332/tid/168365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/01/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION Few studies have examined the effect of feedback based on oral-malodor measurements on the motivation to quit smoking. Therefore, this study examined whether oral-malodor measurements were associated with the intention to quit smoking. METHODS This retrospective, uncontrolled before-after study invited smokers to a workplace health event in 2019 and 2020 to motivate them to quit smoking. They attended seminars on oral health and smoking cessation aids, and then underwent respiratory function and oral-malodor measurements using exhaled and oral cavity air, respectively. Intention to quit smoking was evaluated by answers to questions regarding the intention to quit in the next 1 or 6 months in questionnaires collected before and after the event. This study analyzed 241 men aged 20-54 years (mean: 33.2 ± 10.5) to examine factors associated with the intention to quit in multivariable logistic regression analyses for age, tobacco type (cigarettes and heated-tobacco products), and category of tobacco consumption. RESULTS Before the event, 8.7%, 17.0%, and 74.3% of smokers had intended to quit in the next month, the next six months, or had no intention to quit, respectively. After the event, the respective percentages were 17.8%, 26.6%, and 55.6%. A higher methyl mercaptan concentration, a volatile sulfide component of oral malodor, was significantly associated with the intention to quit in the next month (adjusted odds ratio, AOR=4.24; 95% CI: 1.52-11.8, p=0.006). The participants with higher daily tobacco consumption were less likely to acquire the intention to quit in the next six months (AOR=0.37; 95% CI: 0.15-0.92, p=0.032). Other variables, such as lung age deficit, exhaled CO concentration, and hydrogen sulfide concentration (another component of oral malodor), were not significantly associated. CONCLUSIONS Oral-malodor measurement feedback may help motivate men to quit smoking in the next 1 month rather than in the next six months.
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Affiliation(s)
- Naoko Yatabe
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Takashi Hanioka
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
- Department of Oral Health Sciences, Faculty of Health Care Sciences, Takarazuka University of Medical and Health Care, Takarazuka, Japan
| | - Nao Suzuki
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
- Oral Medicine Research Center, Fukuoka Dental College, Fukuoka, Japan
| | - Atsushi Shimazu
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Marie Naito
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
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12
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Sigal AR, Cardinali-Re BA, Campana L, Lopez-Santi P, Iomini P, Zanoni CA, Salcerini M, Pozzer L, Traghetti M, Pulido L, Piñeiro DJ, Rosende A, Garcia-Zamora S. [Self-perception of smoking cessation skills among Cardiology residents in Argentina]. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2023; 4:82-87. [PMID: 38046230 PMCID: PMC10688411 DOI: 10.47487/apcyccv.v4i3.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/23/2023] [Indexed: 12/05/2023]
Abstract
Objective To evaluate the self-perception of cardiology residents in Argentina regarding their abilities to help their patients stop smoking, as well as their opinions about their knowledge and skills in this area. Materials and methods A cross-sectional study was carried out using secondary data from a study carried out in five Latin American countries and Spain, focusing on the information provided by cardiology residents in Argentina. Discrete variables were expressed as median and interquartile range, and categorical variables were expressed as percentages, and were analyzed using the chi-square test or Fisher's exact test, depending on the relative frequency of the expected values. Results 447 residents participated; 87.5% routinely provided brief advice to quit smoking, and 11.6% used validated questionnaires to assess the degree of addiction. Furthermore, 32.1% stated that they prescribed pharmacological treatment, but 53.1% were only familiar with a single drug. When asked about their self-perception of getting their patients to stop smoking, the median response was 5 (scale from 1 to 10); only 13.7% responded with a score of 8 or more. Conclusions The present study suggests that cardiology residents in Argentina recognize the importance of carrying out smoking cessation interventions, but a high proportion of them do not feel qualified to do so.
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Affiliation(s)
- Alan R Sigal
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
| | - Braian Abel Cardinali-Re
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
| | - Lucas Campana
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
| | - Pilar Lopez-Santi
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
| | - Pablo Iomini
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
| | - Celeste A Zanoni
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
| | - Mariana Salcerini
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
| | - Leandro Pozzer
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
| | - Manuel Traghetti
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
| | - Laura Pulido
- Servicio de Neumonología, Hospital Italiano de Rosario, Rosario, Argentina. Servicio de Neumonología Hospital Italiano de Rosario Rosario Argentina
| | - Daniel José Piñeiro
- Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina. Universidad de Buenos Aires Facultad de Medicina Universidad de Buenos Aires (UBA) Buenos Aires Argentina
| | - Andrés Rosende
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
- Servicio de Neumonología, Hospital Italiano de Rosario, Rosario, Argentina. Servicio de Neumonología Hospital Italiano de Rosario Rosario Argentina
| | - Sebastián Garcia-Zamora
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina. Consejo Argentino de Residentes de Cardiología (CONAREC) Buenos Aires Argentina
- Servicio de Cardiología, Sanatorio Delta, Rosario, Argentina. Servicio de Cardiología Sanatorio Delta Rosario Argentina
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13
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Asfar T, Livingstone-Banks J, Ward KD, Eissenberg T, Oluwole O, Bursac Z, Ghaddar T, Maziak W. Interventions for waterpipe smoking cessation. Cochrane Database Syst Rev 2023; 6:CD005549. [PMID: 37286509 PMCID: PMC10245833 DOI: 10.1002/14651858.cd005549.pub4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND While cigarette smoking has declined globally, waterpipe smoking is rising, especially among youth. The impact of this rise is amplified by mounting evidence of its addictive and harmful nature. Waterpipe smoking is influenced by multiple factors, including appealing flavors, marketing, use in social settings, and misperceptions that waterpipe is less harmful or addictive than cigarettes. People who use waterpipes are interested in quitting, but are often unsuccessful at doing so on their own. Therefore, developing and testing waterpipe cessation interventions to help people quit was identified as a priority for global tobacco control efforts. OBJECTIVES: To evaluate the effectiveness of tobacco cessation interventions for people who smoke waterpipes. SEARCH METHODS We searched the Cochrane Tobacco Addiction Review Group Specialized Register from database inception to 29 July 2022, using variant terms and spellings ('waterpipe' or 'narghile' or 'arghile' or 'shisha' or 'goza' or 'narkeela' or 'hookah' or 'hubble bubble'). We searched for trials, published or unpublished, in any language. SELECTION CRITERIA We sought randomized controlled trials (RCTs), quasi-RCTs, or cluster-RCTs of any smoking cessation interventions for people who use waterpipes, of any age or gender. In order to be included, studies had to measure waterpipe abstinence at a three-month follow-up or longer. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcome was abstinence from waterpipe use at least three months after baseline. We also collected data on adverse events. Individual study effects and pooled effects were summarized as risk ratios (RR) and 95% confidence intervals (95% CI), using Mantel-Haenszel random-effects models to combine studies, where appropriate. We assessed statistical heterogeneity with the I2 statistic. We summarized secondary outcomes narratively. We used the five GRADE considerations (risk of bias, inconsistency of effect, imprecision, indirectness, and publication bias) to assess the certainty of the body of evidence for our primary outcome in four categories high, moderate, low, or very low. MAIN RESULTS This review included nine studies, involving 2841 participants. All studies were conducted in adults, and were carried out in Iran, Vietnam, Syria, Lebanon, Egypt, Pakistan, and the USA. Studies were conducted in several settings, including colleges/universities, community healthcare centers, tuberculosis hospitals, and cancer treatment centers, while two studies tested e-health interventions (online web-based educational intervention, text message intervention). Overall, we judged three studies to be at low risk of bias, and six studies at high risk of bias. We pooled data from five studies (1030 participants) that tested intensive face-to-face behavioral interventions compared with brief behavioral intervention (e.g. one behavioral counseling session), usual care (e.g. self-help materials), or no intervention. In our meta-analysis, we included people who used waterpipe exclusively, or with another form of tobacco. Overall, we found low-certainty evidence of a benefit of behavioral support for waterpipe abstinence (RR 3.19 95% CI 2.17 to 4.69; I2 = 41%; 5 studies, N = 1030). We downgraded the evidence because of imprecision and risk of bias. We pooled data from two studies (N = 662 participants) that tested varenicline combined with behavioral intervention compared with placebo combined with behavioral intervention. Although the point estimate favored varenicline, 95% CIs were imprecise, and incorporated the potential for no difference and lower quit rates in the varenicline groups, as well as a benefit as large as that found in cigarette smoking cessation (RR 1.24, 95% CI 0.69 to 2.24; I2 = 0%; 2 studies, N = 662; low-certainty evidence). We downgraded the evidence because of imprecision. We found no clear evidence of a difference in the number of participants experiencing adverse events (RR 0.98, 95% CI 0.67 to 1.44; I2 = 31%; 2 studies, N = 662). The studies did not report serious adverse events. One study tested the efficacy of seven weeks of bupropion therapy combined with behavioral intervention. There was no clear evidence of benefit for waterpipe cessation when compared with behavioral support alone (RR 0.77, 95% CI 0.42 to 1.41; 1 study, N = 121; very low-certainty evidence), or with self-help (RR 1.94, 95% CI 0.94 to 4.00; 1 study, N = 86; very low-certainty evidence). Two studies tested e-health interventions. One study reported higher waterpipe quit rates among participants randomized to either a tailored mobile phone or untailored mobile phone intervention compared with those randomized to no intervention (RR 1.48, 95% CI 1.07 to 2.05; 2 studies, N = 319; very low-certainty evidence). Another study reported higher waterpipe abstinence rates following an intensive online educational intervention compared with a brief online educational intervention (RR 1.86, 95% CI 1.08 to 3.21; 1 study, N = 70; very low-certainty evidence). AUTHORS' CONCLUSIONS: We found low-certainty evidence that behavioral waterpipe cessation interventions can increase waterpipe quit rates among waterpipe smokers. We found insufficient evidence to assess whether varenicline or bupropion increased waterpipe abstinence; available evidence is compatible with effect sizes similar to those seen for cigarette smoking cessation. Given e-health interventions' potential reach and effectiveness for waterpipe cessation, trials with large samples and long follow-up periods are needed. Future studies should use biochemical validation of abstinence to prevent the risk of detection bias. Finally, there has been limited attention given to high-risk groups for waterpipe smoking, such as youth, young adults, pregnant women, and dual or poly tobacco users. These groups would benefit from targeted studies.
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Affiliation(s)
- Taghrid Asfar
- Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
- School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Olusanya Oluwole
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Zoran Bursac
- Biostatistics, Florida International University, Miami, FL, USA
| | - Tarek Ghaddar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
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14
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Carra MC, Blanc-Sylvestre N, Courtet A, Bouchard P. Primordial and primary prevention of peri-implant diseases: A systematic review and meta-analysis. J Clin Periodontol 2023. [PMID: 36807599 DOI: 10.1111/jcpe.13790] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/21/2023]
Abstract
AIM This systematic review and meta-analysis aims to assess the efficacy of risk factor control to prevent the occurrence of peri-implant diseases (PIDs) in adult patients awaiting dental implant rehabilitation (primordial prevention) or in patients with dental implants surrounded by healthy peri-implant tissues (primary prevention). MATERIALS AND METHODS A literature search was performed without any time limit on different databases up to August 2022. Interventional and observational studies with at least 6 months of follow-up were considered. The occurrence of peri-implant mucositis and/or peri-implantitis was the primary outcome. Pooled data analyses were performed using random effect models according to the type of risk factor and outcome. RESULTS Overall, 48 studies were selected. None assessed the efficacy of primordial preventive interventions for PIDs. Indirect evidence on the primary prevention of PID indicated that diabetic patients with dental implants and good glycaemic control have a significantly lower risk of peri-implantitis (odds ratio [OR] = 0.16; 95% confidence interval [CI]: 0.03-0.96; I2 : 0%), and lower marginal bone level (MBL) changes (OR = -0.36 mm; 95% CI: -0.65 to -0.07; I2 : 95%) compared to diabetic patients with poor glycaemic control. Patients attending supportive periodontal/peri-implant care (SPC) regularly have a lower risk of overall PIDs (OR = 0.42; 95% CI: 0.24-0.75; I2 : 57%) and peri-implantitis compared to irregular attendees. The risk of dental implant failure (OR = 3.76; 95% CI: 1.50-9.45; I2 : 0%) appears to be greater under irregular or no SPC than regular SPC. Implants sites with augmented peri-implant keratinized mucosa (PIKM) show lower peri-implant inflammation (SMD = -1.18; 95% CI: -1.85 to -0.51; I2 : 69%) and lower MBL changes (MD = -0.25; 95% CI: -0.45 to -0.05; I2 : 62%) compared to dental implants with PIKM deficiency. Studies on smoking cessation and oral hygiene behaviors were inconclusive. CONCLUSIONS Within the limitations of available evidence, the present findings indicate that in patients with diabetes, glycaemic control should be promoted to avoid peri-implantitis development. The primary prevention of peri-implantitis should involve regular SPC. PIKM augmentation procedures, where a PIKM deficiency exists, may favour the control of peri-implant inflammation and the stability of MBL. Further studies are needed to assess the impact of smoking cessation and oral hygiene behaviours, as well as the implementation of standardized primordial and primary prevention protocols for PIDs.
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Affiliation(s)
- Maria Clotilde Carra
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France.,Population-Based Epidemiologic Cohorts Unit, Inserm, UMS 11, Villejuif, France
| | - Nicolas Blanc-Sylvestre
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France.,URP 2496, Université Paris Cité, Paris, France
| | - Alexandre Courtet
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France
| | - Philippe Bouchard
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,URP 2496, Université Paris Cité, Paris, France
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15
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Aldossri M, Saarela O, Rosella L, Quiñonez C. Suboptimal oral health and the risk of cardiovascular disease in the presence of competing death: a data linkage analysis. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:125-137. [PMID: 36068436 PMCID: PMC9849623 DOI: 10.17269/s41997-022-00675-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/09/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The objective of this study is to simultaneously assess the associations between suboptimal oral health (SOH) and cardiovascular disease (CVD) and competing death (CD). METHODS Ontario residents aged 40 years and over who participated in the Canadian Community Health Survey 2003 and 2007-2008 were followed until December 31, 2016 for the incidence of CVD or CD. SOH was assessed based on self-rated oral health and inability to chew. Multivariable competing risk analysis was adjusted for socioeconomic characteristics, behavioural factors and intermediate health outcomes. RESULTS The study sample included 36,176 participants. Over a median follow-up of 9.61 years, there were 2077 CVD events and 3180 CD events. The fully adjusted models indicate 35% (HR = 1.35, 95% CI: 1.12-1.64) increase in the risk of CVD and 57% (HR = 1.57, 95% CI: 1.33-1.85) increase in the risk of CD among those who reported poor oral health as compared to those who reported excellent oral health. The fully adjusted models also indicate 11% (HR = 1.11, 95% CI: 0.97-1.27) increase in the hazard of CVD and 37% (HR = 1.37, 95% CI: 1.24-1.52) increase in the hazard of CD among those who reported inability to chew. CONCLUSION This study provides important information to contextualize CVD risk among those with SOH. The competing risk analysis indicates that those with SOH may benefit from additional interventions to prevent CVD and CD. Accordingly, managing the risk of CVD among those with SOH should fall under a more comprehensive approach that aims at improving their overall health and well-being.
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Affiliation(s)
- Musfer Aldossri
- Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON, M5G 1X3, Canada.
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Olli Saarela
- Division of Biostatistics, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Laura Rosella
- Division of Epidemiology, Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Populations & Public Health Research Program, ICES, Toronto, Ontario, Canada
- Research and Ethics Program, Public Health Ontario, Toronto, Ontario, Canada
| | - Carlos Quiñonez
- Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON, M5G 1X3, Canada
- Populations & Public Health Research Program, ICES, Toronto, Ontario, Canada
- Division of Clinical Public Health, Dalla Lana School of Public Health, Toronto, Ontario, Canada
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16
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Gajendra S, McIntosh S, Ghosh S. Effects of tobacco product use on oral health and the role of oral healthcare providers in cessation: A narrative review. Tob Induc Dis 2023; 21:12. [PMID: 36741542 PMCID: PMC9875717 DOI: 10.18332/tid/157203] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/11/2022] [Accepted: 12/06/2022] [Indexed: 01/26/2023] Open
Abstract
Tobacco use has detrimental effects on health, including oral health. The emergence and increasing popularity of newer tobacco and nicotine products make tobacco use one of the major public health problems in the world. Tobacco use increases the risk of oral diseases such as oral cancer, oral mucosal lesions, periodontal disease, and dental caries, among many other oral diseases and conditions. The dental office is an excellent venue for providing cessation intervention. However, there is a lack of knowledge and training in tobacco use prevention among dental professionals. More efforts are needed for smoking cessation interventions in the dental office. Smoking cessation interventions provided by oral healthcare providers include brief educational, behavioral, and pharmacological interventions. This review provides an overview of the ill effects of tobacco use on oral health and the role of oral healthcare providers in managing and preventing tobacco dependence.
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Affiliation(s)
- Sangeeta Gajendra
- Eastman Institute for Oral Health, University of Rochester, Rochester, United States
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester, Rochester, United States
| | - Sucharu Ghosh
- Eastman Institute for Oral Health, University of Rochester, Rochester, United States
- Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, United States
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17
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[Adaptation and validation of an instrument to evaluate the competence on a Brief Tobacco Intervention. BTI-Prof©]. Aten Primaria 2022; 54:102495. [PMID: 36347122 PMCID: PMC9618997 DOI: 10.1016/j.aprim.2022.102495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Adaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. DESIGN Cross-sectional study of adaptation and psychometric validation of a criterion-referenced test. SETTING Primary Health Care. PARTICIPANTS One hundred fifty-five general practitioners and nurses working at Primary Health Care. INTERVENTIONS Three clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. MAIN MEASURES Competence in brief tobacco intervention measured by the BTI-Prof©. RESULTS Results related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test-retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734-0.923), p<0.0001, for scenario 2 0.829 (95% CI 0.676-0.909), p<0.001, and for scenario 3 0.869 (95% CI 0.76-0.928), p<0.0001. CONCLUSIONS The BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.
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Barnes E, Bullock A, Chestnutt IG. 'It's their mouth at the end of the day': dental professionals' reactions to oral health education outcomes. Br Dent J 2022:10.1038/s41415-022-4978-z. [PMID: 36138097 PMCID: PMC9510212 DOI: 10.1038/s41415-022-4978-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/26/2022] [Indexed: 12/24/2022]
Abstract
Introduction Research has established varying levels of efficacy of oral health education (OHE) efforts. However, little is known regarding how outcomes impact dental professionals and their OHE practice. This study explores dental professionals' reactions to varying OHE outcomes and their motivations to persist with their efforts.Methods Qualitative, semi-structured interviews were conducted with dental team members working in mainly NHS general dental practices in South Wales, UK. Interviews were conducted face-to-face pre-COVID-19 and then by telephone, transcribed and analysed thematically.Results In total, 30 interviews were conducted (17 dentists, 6 dental therapists and 7 dental nurses). Pleasure was gained from improved patient oral health. Responses to non-adherence included disappointment, frustration and acceptance. Acceptance centred around a shared responsibility for oral care between clinician and patient and reassurance that they had 'done their job'. The unpredictability of patient adherence aided OHE motivation; efforts might eventually inspire patient action or might align with patient readiness to change.Conclusions This study reveals how OHE outcomes impact on dental professionals' perceptions of their role and personal motivations for continued educational efforts with patients. Greater emphasis on both preventative dentistry and self-care, coupled with understanding of the complex factors influencing oral health behaviour, would aid motivation for OHE.
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Affiliation(s)
- Emma Barnes
- School of Social Sciences, Cardiff University, Cardiff, UK.
| | - Alison Bullock
- School of Social Sciences, Cardiff University, Cardiff, UK
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Caggiano M, Gasparro R, D’Ambrosio F, Pisano M, Di Palo MP, Contaldo M. Smoking Cessation on Periodontal and Peri-Implant Health Status: A Systematic Review. Dent J (Basel) 2022; 10:162. [PMID: 36135157 PMCID: PMC9497918 DOI: 10.3390/dj10090162] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/16/2022] [Accepted: 08/27/2022] [Indexed: 12/22/2022] Open
Abstract
Since smoking is considered among the main risk factors for the onset and progression of periodontitis and peri-implantitis, the present systematic review aimed to evaluate the effect of smoking cessation on clinical, radiographic, and gingival crevicular periodontal parameters around natural teeth and dental implants in ex-smokers compared to current and non-smokers. The study protocol was developed based on the PRISMA guidelines, the research question was formulated according to the PICO model, and the literature search was conducted through PubMed/MEDLINE, Cochrane library, and BioMed Central databases. From the 916 title/abstracts initially identified, seven articles were included in the present systematic review and assessed for quality through the ROBINS-I tool. Reported findings on clinical and crevicular periodontal parameters around natural teeth were contrasting when comparing ex-smokers to current and non-smokers; thus, individualized recommendations for previous smoker periodontal patients are currently lacking. No data on radiographic parameters were retrieved. Similarly, data on periodontal parameters around dental implants were not available, highlighting the need for focused investigations assessing the role of both smoking habit and cessation on peri-implant health status and responsiveness to treatment.
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Affiliation(s)
- Mario Caggiano
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Roberta Gasparro
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Francesco D’Ambrosio
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Massimo Pisano
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Maria Pia Di Palo
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialities, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Behaviour change intervention for smokeless tobacco (ST) cessation delivered through dentists within a dental setting: a feasibility study protocol. BDJ Open 2022; 8:12. [PMID: 35449103 PMCID: PMC9023496 DOI: 10.1038/s41405-022-00104-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/31/2022] [Accepted: 04/02/2022] [Indexed: 11/10/2022] Open
Abstract
Objectives/Aim To adapt a structured behavioural support intervention for smokeless tobacco (ST) cessation and to assess the feasibility and acceptability of delivering the intervention via dentists within dental settings in Pakistan. Material and methods The study will have 3 phases: (1) Adapt a previously developed intervention to make it suitable for delivery in a clinical/dental setting through qualitative interviews with dental patients and dentists; (2) A multi-centre, pilot randomised control trial in two teaching dental hospitals in Pakistan. Participants (dental patients) will be randomly assigned to intervention or control group in a 1:1 allocation ratio to receive either a structured behavioural support intervention involving face to face counselling or self-help material plus usual care. Each participant will be in the study for approximately 6 months and the overall study is expected to run for 12 months; (3) An embedded qualitative process evaluation. All trial participants will be followed up at 3 and 6 months to assess self-reported ST use. Outcome measures will include: rates of eligibility, recruitment and retention, randomisation group cross-over rates, the provision of data on ST use behaviour, fidelity to the intervention and qualitative assessment of acceptability and feasibility. Discussion Despite the high use of ST in Pakistan, users are offered negligible cessation support. The findings of this multi-centre, mixed-method feasibility study will inform the scope for a larger trial on ST cessation delivered through the existing dental health system.
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Livingstone-Banks J, Siddiqui F, Croucher R, Mehrotra R, Vidyasagaran A, Siddiqi K. Interventions for smokeless tobacco use cessation. Cochrane Database Syst Rev 2022; 2022. [PMCID: PMC8772273 DOI: 10.1002/14651858.cd015314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Affiliation(s)
| | - Faraz Siddiqui
- Department of Health Sciences and Hull York Medical School; York University; York UK
| | - Ray Croucher
- Department of Health Sciences and Hull York Medical School; York University; York UK
| | - Ravi Mehrotra
- Department of Health Sciences and Hull York Medical School; York University; York UK
- Centre for Health Policy and Innovation; New Delhi India
| | | | - Kamran Siddiqi
- Department of Health Sciences and Hull York Medical School; York University; York UK
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Smoking Cessation therapy is a cost-effective intervention to avoid tooth loss in Brazilian subjects with periodontitis: an economic evaluation. BMC Oral Health 2021; 21:616. [PMID: 34861866 PMCID: PMC8642876 DOI: 10.1186/s12903-021-01932-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Smokers present a higher prevalence and severity of periodontitis and, consequently, higher prevalence of tooth loss. Smoking cessation improves the response to periodontal treatment and reduces tooth loss. So, the aim of this study was to evaluate the efficiency in resources allocation when implementing smoking cessation therapy vs. its non-implementation in smokers with periodontitis. Methods We adopted the Brazilian public system perspective to determine the incremental cost-effectiveness (cost per tooth loss avoided) and cost-utility (cost per oral-related quality-adjusted life-year ([QALY] gained) of implementing smoking cessation therapy. Base-case was defined as a 48 years-old male subject and horizon of 30 years. Effects and costs were combined in a decision analytic modeling framework to permit a quantitative approach aiming to estimate the value of the consequences of smoking cessation therapy adjusted for their probability of occurrence. Markov models were carried over annual cycles. Sensitivity analysis tested methodological assumptions. Results Implementing the therapy saved approximately US$ 100 over the time horizon accompanied by a slightly better effect, both in CEA and CUA. Considering uncertainties, the therapy could be cost-effective in the most part of simulated cases, even being cheaper and more effective in 35% of cases in which the oral-health related outcome is used as effect. Considering a willingness-to-pay of US$100 per health effect, smoking cessation therapy was cost-effective, respectively, in 72% and 99% of cases in cost-utility and cost-effectiveness analyses. Conclusions Implementation of smoking cessation therapy may be cost-effective, considering the avoidance of tooth loss and oral health-related consequences to patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01932-2.
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Mishu MP, Elsey H, Choudhury AR, Dastagir S, Khan S, Tahsin T, Suma HM, Karmaker R, Dogar O. Co-producing an intervention for tobacco cessation and improvement of oral health among diabetic patients in Bangladesh. BMC Oral Health 2021; 21:516. [PMID: 34641838 PMCID: PMC8507134 DOI: 10.1186/s12903-021-01861-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022] Open
Abstract
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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Affiliation(s)
- Masuma Pervin Mishu
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
| | - Helen Elsey
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Arup Ratan Choudhury
- Department of Dentistry, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | - Shahana Dastagir
- Department of Dentistry, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | - Saeed Khan
- Department of Dentistry, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | - Tania Tahsin
- Department of Dentistry, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | - Hena Moni Suma
- Department of Dentistry, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | - Rajesh Karmaker
- Department of Dentistry, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | - Omara Dogar
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
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Leveraging Clinical Decision Support and Integrated Medical-Dental Electronic Health Records to Implementing Precision in Oral Cancer Risk Assessment and Preventive Intervention. J Pers Med 2021; 11:jpm11090832. [PMID: 34575609 PMCID: PMC8470765 DOI: 10.3390/jpm11090832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 11/17/2022] Open
Abstract
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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Lozano FR. World Oral Health Day 2021. Tob Prev Cessat 2021; 7:21. [PMID: 33768188 PMCID: PMC7970763 DOI: 10.18332/tpc/134441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/24/2022]
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