Dentists need to provide patients with counseling on tobacco use because of the desire of many smokers to quit. Counseling of smokers by the oral health team requires special attention and skills, because smokers' health behaviors and attitudes appear to be less favorable to oral health compared to nonsmokers.

The first nationwide survey of Finnish dentists' use of tobacco, their inquiring about and advising patients on tobacco use, and their attitudes toward anti-tobacco health education (ATHE) was carried out at the end of 1987. A questionnaire mailed to 540 dentists produced 435 answers (81%). One fourth of the male dentists and 6% of the female dentists currently were smokers, and 11% of men and 2% of women smoked daily. Information on smoking practices of patients was obtained always by 8%, often by 18%, and occasionally by 62% of the dentists. Four percent of the dentists advised always and 15% often their patients about smoking, and 62% did so occasionally. The majority of the dentists agreed that dentists should take part in ATHE and that dentists can encourage patients to stop using tobacco. The respondents supporting the involvement of dentists in ATHE reported having an active role in tobacco counseling (TC) significantly more frequently than those not sharing the idea of involvement. It was concluded that Finnish dentists could be a valuable resource in TC because of their positive attitudes.

The observations of Finnish periodontists and other dentists, and their concepts of the oral health consequences of tobacco use as well as their counseling on tobacco use, were surveyed from November 1987 to January 1988. A questionnaire was mailed to all 61 Finnish periodontists and to 535 other dentists; 37 periodontists (61%) and 432 of the other dentists (80%) responded. The periodontists enquired about and advised on smoking significantly more frequently than did the other dentists; 71% of the periodontists often or always enquired about, and 62% advised their patients on smoking. 31% of all dentists had patients who were users of smokeless tobacco, and 62% of those dentists had often or always advised the users to quit. Nearly all dentists had seen some tobacco-caused effects. Periodontists reported more frequently than the other dentists that they had observed more periodontitis, impaired healing of periodontitis and more changes in the oral mucosa in smokers compared with non-smokers. The majority of those who had seen users of smokeless tobacco had noticed changes in the oral mucosa and in the color of the gingiva. The majority of all dentists believed that heavy smoking may impair the host response in the periodontium, with periodontists believing in this more strongly than other dentists.

No abstract