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Lassemo E, Rodd HD, Skeie MS, Johnsen JAK, Nermo H, Sand K, Eftedal RK, Fagerhaug TN, Jasbi A, Marshman Z, Dahllöf G, Høiseth M. Dental professionals' views on motivational interviewing for the prevention of dental caries with adolescents in central Norway. BMC Oral Health 2023; 23:889. [PMID: 37986160 PMCID: PMC10662639 DOI: 10.1186/s12903-023-03649-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: 06/30/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Establishing positive oral health behaviours during adolescence should be a key priority to improve lifelong oral health. However, changing adolescent behaviours is known to be a challenge. Motivational interviewing (MI) is a method of working with patients to activate their motivation for change and has shown promising results within the dental setting. Yet, little is known about the actual experiences and perspectives of Norwegian dental health professionals in delivering motivational interviewing as part of routine care to their young patients. The overall aim of the present study was to explore the implementation of motivational interviewing by dentists and dental hygienists, employed by the Norwegian Public Dental Service, for their adolescent patients. METHODS As part of the larger #Care4YoungTeeth <3 project, a Norwegian Research Council funded four-year Collaborative Project to Meet Societal and Industry-related Challenges, an online survey was developed and administered to dental personnel (n = 168) in one region of Central Norway. Data were analysed by descriptive statistics and two-sample tests of proportions at the 95% confidence level. RESULTS A total of 98 dental personnel responded to the survey (response rate 58.3%), of which 37 were dental hygienists (response rate 72.5%) and 61 were dentists (response rate 52.1%). A greater proportion of hygienists reported implementing this intervention compared to dentists (78.4% versus 50.8%; p = 0.007). Similarly, a greater proportion of hygienists (83.8%) stated that they had received training in MI compared to dentists (65.6%; p = 0.051). About 80% of dentists and 90% of dental hygienists felt that they understood the principles of MI. However, only about 45% and 60%, respectively, felt confident in its use. Dental hygienists found MI more usable in their work (p = 0.052), to a greater extent want to use MI (p = 0.002) and found that using MI works well (p < 0.001), as compared to dentists. CONCLUSIONS A high proportion of dental professionals working within a Norwegian public dental service have received training in MI. However, barriers to implementation for adolescent patients and differences in practice between dentists and hygienists warrant further enquiry.
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Affiliation(s)
- Eva Lassemo
- Department of Health Research, SINTEF Digital, SINTEF, Trondheim, Norway.
| | - Helen D Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Marit Slåttelid Skeie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Jan-Are K Johnsen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Hege Nermo
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kari Sand
- Department of Health Research, SINTEF Digital, SINTEF, Trondheim, Norway
| | - Randi Krog Eftedal
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Tone Natland Fagerhaug
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Arefe Jasbi
- Department of Design, Faculty of Architecture and Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Göran Dahllöf
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Dental Medicine, Division of Orthodontics and Paediatric Dentistry, Karolinska Institutet, Stockholm, Sweden
| | - Marikken Høiseth
- Department of Health Research, SINTEF Digital, SINTEF, Trondheim, Norway
- Department of Design, Faculty of Architecture and Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Askelson N, Ryan G, McKernan S, Scherer A, Daly E, Avdic L. Engaging new partners in human papillomavirus (HPV) vaccine promotion: Considerations for training private practice dental professionals in HPV vaccine promotion. J Public Health Dent 2023. [PMID: 36891831 DOI: 10.1111/jphd.12566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/28/2022] [Accepted: 01/17/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVES With rates of the human papillomavirus (HPV) vaccination remaining low and rates of oropharyngeal cancer rising, engaging new partners to promote vaccination is necessary. We aimed to identify dental hygienists' and dentists' knowledge about HPV, the HPV vaccine, and preferences for continuing education. METHODS This mixed-methods study recruited dental hygienists and dentists working in private practice in Iowa to participate in a mailed cross-sectional survey (dental hygienists) and qualitative telephone interviews (dental hygienists and dentists). Survey and interview topics included existing knowledge about HPV vaccination, HPV vaccination promotion efforts, barriers to HPV vaccine promotion, and preferences for continuing education (CE). RESULTS We received 470 surveys from dental hygienists (response rate = 22.6%) and interviewed 19 dental hygienists and 20 dentists. Vaccine efficacy and safety, along with communication strategies, were key topics of interest for CE. Dental hygienists' most commonly identified barriers were lack of knowledge (67%) and low comfort levels (42%). CONCLUSIONS Knowledge was identified as a key barrier to providing a strong recommendation for HPV vaccination and convenience was the most important factor to consider for any future CE. Our team is in the process of designing a CE course based on this information to help dental professionals effectively engage in HPV vaccine promotion in their practices.
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Affiliation(s)
- Natoshia Askelson
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Grace Ryan
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Susan McKernan
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Aaron Scherer
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Eliza Daly
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Lejla Avdic
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
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Alexandridi F, Tsantila S, Pepelassi E. Smoking cessation and response to periodontal treatment. Aust Dent J 2017; 63:140-149. [DOI: 10.1111/adj.12568] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2017] [Indexed: 01/10/2023]
Affiliation(s)
- F Alexandridi
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - S Tsantila
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - E Pepelassi
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
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Chaffee BW, Couch ET, Ryder MI. The tobacco-using periodontal patient: role of the dental practitioner in tobacco cessation and periodontal disease management. Periodontol 2000 2016; 71:52-64. [PMID: 27045430 PMCID: PMC4842013 DOI: 10.1111/prd.12120] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2015] [Indexed: 12/26/2022]
Abstract
Although the prevalence of tobacco use has declined in some parts of the world, tobacco use remains a persistent and, in some cases, growing problem that will continue to be a fundamental challenge facing dental practitioners in the decades ahead. Dental practitioners have a unique opportunity and professional obligation to be a positive influence in reducing the economic and social burden inflicted by tobacco use on dental and general health. In this article, the current noninvasive, evidence-based approaches are presented for dental practitioners to help patients avoid initiating tobacco use, to encourage and assist patients in ceasing tobacco use and to address tobacco-induced damage to periodontal supporting tissues.
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Svetanoff E, Romito LM, Ford PT, Palenik CJ, Davis JM. Tobacco Dependence Education in U.S. Dental Assisting Programs’ Curricula. J Dent Educ 2015. [DOI: 10.1002/j.0022-0337.2015.79.4.tb05894.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Laura M. Romito
- Department of Oral Biology; Indiana University School of Dentistry
| | - Pamela T. Ford
- Department of Periodontics and Allied Dental Programs; Indiana University School of Dentistry
| | - Charles J. Palenik
- Indiana University School of Dentistry and currently associated with GC Infection Prevention and Control; Indianapolis IN
| | - Joan M. Davis
- School of Allied Health; Southern Illinois University Carbondale
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Virtanen SE, Zeebari Z, Rohyo I, Galanti MR. Evaluation of a brief counseling for tobacco cessation in dental clinics among Swedish smokers and snus users. A cluster randomized controlled trial (the FRITT study). Prev Med 2015; 70:26-32. [PMID: 25445335 DOI: 10.1016/j.ypmed.2014.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 11/02/2014] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study is to assess the effectiveness of a very brief structured counseling for tobacco cessation in dentistry clinics. METHOD A cluster randomized trial was conducted in Sweden in 2012-2013. Twenty-seven dentistry clinics in two Swedish counties were randomized to provide either a structured brief advice based on the 5 A's model or usual care. Participants were 467 patients currently using tobacco daily (225 in the intervention group and 242 in usual care), of which 97% were retained at follow-up, six months after enrolment. Study outcomes were: 7-day abstinence (primary outcome); 3-month sustained abstinence; 50% reduction of the amount tobacco used; quit attempts lasting at least 24h. RESULTS Compared to usual care, brief counseling was not associated to statistically significant increase in the proportion abstinent from tobacco use after 6months. However, there was a statistically significant association with reduction of tobacco consumption (OR=2.07 95% CI 1.28-3.35). Changes in the expected direction for all outcomes were more frequent in the intervention than in the usual care group, and larger among exclusive snus users than among smokers. CONCLUSIONS Very brief and structured counseling in dentistry may achieve positive behavioral modifications among tobacco users, with significant reduction of tobacco consumption, particularly among smokeless tobacco users.
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Affiliation(s)
- Suvi E Virtanen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Zangin Zeebari
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Sweden.
| | - Izla Rohyo
- Dentistry Clinic Solvändan, Sörmland Health Care Region, Mariefred, Sweden.
| | - Maria R Galanti
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Sweden.
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Ramseier CA, Burri M, Berres F, Davis JM. The implementation of a tobacco dependence education curriculum in a Swiss Dental Hygiene School - an 8-year review. Int J Dent Hyg 2012; 11:142-50. [PMID: 23057468 DOI: 10.1111/idh.12004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of our investigation was to review the implementation of a comprehensive tobacco dependence education (TDE) curriculum at the Medi School of Dental Hygiene (MSDH), Bern, Switzerland, 2001-2008. METHODS In 2001, new forms to record patients' tobacco use history and willingness to quit were created for all the MSDH patients. In 2002, a new theoretically based tobacco dependence treatment protocol was implemented into the MSDH curriculum. Students received instruction on how to provide brief tobacco use dependence interventions as well as maintain detailed records of patient tobacco use and cessation interventions for every smoker at all dental hygiene visits. RESULTS In 2002, 17 lecture hours were added to the following subjects: pathology, periodontology, preventive dentistry, pharmacology and psychology. During the same time period, 2213 patients (56.9% women) have visited the MSDH. Smoking status was recorded in 85.7% of all the patients (30.2% smokers). Brief tobacco use interventions were recorded in 36.8% of all smokers while 7.6% of these have reported to quit smoking. CONCLUSIONS Overall, the new TDE curriculum was successfully implemented and accepted by the MSDH faculty. Applications in the clinical practice, however, may still be improved to better identify smokers and increase initial and follow-up interventions potentially leading to higher quit rates.
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Affiliation(s)
- C A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
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Amemori M, Virtanen J, Korhonen T, Kinnunen TH, Murtomaa H. Impact of educational intervention on implementation of tobacco counselling among oral health professionals: a cluster-randomized community trial. Community Dent Oral Epidemiol 2012; 41:120-9. [PMID: 22934678 DOI: 10.1111/j.1600-0528.2012.00743.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 07/07/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Tobacco use adversely affects oral health. Clinical guidelines recommend that oral health professionals promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented successfully. This study aimed to evaluate two interventions to enhance tobacco use prevention and cessation (TUPAC) counselling among oral health professionals in Finland. METHODS We used a cluster-randomized community trial to test educational and fee-for-service interventions in enhancing TUPAC counselling among a sample of dentists (n=73) and dental hygienists (n=22) in Finland. Educational intervention consisted of 1 day of training, including lectures, interactive sessions, multimedia demonstrations and a role play session with standard patient cases. Fee-for-service intervention consisted of monetary compensation for providing tobacco use prevention or cessation counselling. TUPAC counselling procedures provided were reported and measured using an electronic dental records system. In data analysis, intent-to-treat principles were followed at both individual and cluster levels. Descriptive analysis included chi-square and t-tests. A general linear model for repeated measures was used to compare the outcome measures by intervention group. RESULTS Of 95 providers, 73 participated (76.8%). In preventive counselling, there was no statistically significant time effect or group-by-time interaction. In cessation counselling, statistically significant group-by-time interaction was found after a 6-month follow-up (F=2.31; P=0.007), indicating that counselling activity increased significantly in intervention groups. On average, dental hygienists showed greater activity in tobacco prevention (F=12.13; P=0.001) and cessation counselling (F=30.19; P<0.001) than did dentists. In addition, cessation counselling showed a statistically significant provider-by-group-by-time interaction (F=5.95; P<0.001), indicating that interventions to enhance cessation counselling were more effective among dental hygienists. CONCLUSIONS Educational intervention yielded positive short-term effects on cessation counselling, but not on preventive counselling. Adding a fee-for-service to education failed to significantly improve TUPAC counselling performance. Other approaches than monetary incentives may be needed to enhance the effectiveness of educational intervention. Further studies with focus on how to achieve long-term changes in TUPAC counselling activity among oral health professionals are needed.
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Affiliation(s)
- Masamitsu Amemori
- Department of Oral Public Health, Institute of Dentistry, University of Helsinki, Helsinki, Finland.
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Andersson P, Westergren A, Johannsen A. The invisible work with tobacco cessation - strategies among dental hygienists. Int J Dent Hyg 2011; 10:54-60. [PMID: 21974714 DOI: 10.1111/j.1601-5037.2011.00530.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study elucidates dental hygienists' experiences of work with tobacco cessation among patients who smoke or use snuff. METHODS Data were obtained and categorized by interviewing 12 dental hygienists, who worked actively with tobacco cessation interventions. Qualitative content analysis was used for analysis. RESULTS The latent content was formulated into the core category 'the invisible oral health promotion work'. The informants thought that they had a responsibility to work with tobacco cessation. They perceived the financial system in which they perform the activity as frustrating, because tobacco cessation has no treatment code in the dental care insurance. This was one of several reasons why they had to integrate it in other treatment procedures. The results identified three categories: 'balance in the meeting', 'possibilities and hindrance' and 'procedures'. In the narratives, both positive and negative aspects were displayed. CONCLUSIONS The financial conditions for tobacco cessation interventions need to be reformed and the activity has to be given a higher priority in the organization of dental care. Practical training in performing tobacco cessation interventions is important during the dental hygiene education; otherwise, tobacco cessation interventions will remain invisible in oral health promotion in the future.
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Affiliation(s)
- P Andersson
- Authors' affiliations: P Andersson, A Westergren, School of Health and Society, Kristianstad University, Kristianstad, Sweden.
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Garcia VG, Fernandes LA, Macarini VC, Almeida JM, Martins TM, Bosco AF, Nagata MJH, Cirelli JA, Theodoro LH. Treatment of experimental periodontal disease with antimicrobial photodynamic therapy in nicotine-modified rats. J Clin Periodontol 2011; 38:1106-14. [DOI: 10.1111/j.1600-051x.2011.01785.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2011] [Indexed: 10/17/2022]
Affiliation(s)
| | | | - Valmir Campos Macarini
- Group of Research and Study on Laser in Dentistry (GEPLO); Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University; Araçatuba; São Paulo; Brazil
| | - Juliano Milanezi Almeida
- Group of Research and Study on Laser in Dentistry (GEPLO); Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University; Araçatuba; São Paulo; Brazil
| | - Thiago Marchi Martins
- Group of Research and Study on Laser in Dentistry (GEPLO); Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University; Araçatuba; São Paulo; Brazil
| | - Alvaro Francisco Bosco
- Group of Research and Study on Laser in Dentistry (GEPLO); Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University; Araçatuba; São Paulo; Brazil
| | - Maria José Hitomi Nagata
- Group of Research and Study on Laser in Dentistry (GEPLO); Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University; Araçatuba; São Paulo; Brazil
| | - Joni Augusto Cirelli
- Department of Diagnosis and Surgery; Division of Periodontics; São Paulo State University; Araraquara; São Paulo; Brazil
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Carollo-Bittel B, Persson RE, Persson GR, Lang NP. Supportive periodontal therapy for high- and low-risk patients. ACTA ACUST UNITED AC 2011; 2:110-6. [DOI: 10.1111/j.2041-1626.2011.00050.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
PURPOSE OF REVIEW Tobacco use causes a significant amount of mortality and morbidity globally. The search for optimal cost-effective treatment interventions continues as current treatment modalities at best offer modest success in treatment outcome. This review evaluates current developments in behavioral interventions for tobacco cessation and their effectiveness. RECENT FINDINGS Most studies of behavioral interventions reported moderate success in quitting tobacco at 6 months. This finding is seen across different professionals providing interventions in diverse settings using various modalities. Behavioral interventions in adolescents and pregnancy seem presently more effective than pharmacotherapy. Technology-driven interventions have gained recent popularity. Combining interventions shows promising results compared with a single intervention. SUMMARY Most tobacco cessation intervention studies are from developed countries and for cigarette smoking. Long-term cessation still poses a challenge. Given the high global morbidity and mortality, there is a need to develop evidence-based, cost-effective intervention in developing countries for both smoking and smokeless tobacco use. Tobacco addiction produces neurobiological and behavioral change and optimal approaches involving behavioral methods and pharmacotherapy need to be developed.
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