This article reviews the effects of smoked and smokeless tobacco on periodontal status, including the impact of smoking on periodontal therapy and potential mechanisms for the adverse effects of tobacco on the periodontium. Approximately half of periodontitis cases have been attributed to either current or former smoking. Both cigar and cigarette smokers have significantly greater loss of bone height than nonsmokers, and there is a trend for pipe smokers to have more bone loss than nonsmokers. Unlike smokers, who experience widespread periodontal destruction, the most prevalent effects of smokeless tobacco are localized to the site of placement, in the form of gingival recession and white mucosal lesions. Smoking has an adverse effect on all forms of periodontal therapy, and up to 90 percent of refractory periodontitis patients are smokers. The pathogenesis of smoking-related periodontal destruction has been attributed to alterations in the microflora and/or host response. Some data indicates that smoking may increase levels of certain periodontal pathogens, but there is more evidence that smoking has a negative effect on host response, such as neutrophil function and antibody production. An encouraging finding is that periodontal disease progression slows in patients who quit smoking and that these individuals have a similar response to periodontal therapy as nonsmokers. The facts presented in this paper will assist dental health professionals in treatment-planning decisions and provide them with important information to share with patients who use tobacco products.

Dental education can benefit from adopting new technologies and modern learning practices. Video-assisted clinical instruction in dentistry (VACID) uses video technology with the purpose of enhancing the teaching of technical skills and the acquisition of clinical knowledge, as well as fostering student-centered learning and critical self-appraisal. VACID is made possible through the capturing, recording, transmitting and viewing of high quality video images of live or pre-recorded clinical procedures. As such, the implementation of VACID represents an attractive teaching tool that can complement and strengthen current clinical and didactic teaching practices used in formal dental education. The primary objective of this paper is to provide an overview of VACID and discuses its various applications in dental education. A second objective of this paper is to provide a detailed description of the video camera set-up used at the University of Iowa for the implementation of VACID in the Department of Periodontics.

In order to facilitate effective tobacco cessation services within dental school clinics, it is necessary to understand the perceived barriers encountered by dental students while providing these services. The aim of this study was to identify which factors fourth‐year dental students perceive to be associated with barriers to providing tobacco intervention services. A written survey was developed and completed by incoming fourth‐year dental students (a convenience sample of seventy students) at the University of Iowa College of Dentistry in 2008. The survey assessed the perceived barriers to providing tobacco intervention services and related factors. Descriptive, bivariate, and linear regression analyses were conducted. The response rate was 97 percent. The most frequently reported barriers were patients’ resistance to tobacco intervention services (96 percent), inadequate time available for tobacco intervention services (96 percent), and forgetting to give tobacco intervention advice (91 percent). The following variables were significantly (p<0.05) related to greater perceived barriers in providing tobacco intervention services: lower “adequacy of tobacco intervention curriculum coverage of specific topics covered over the previous three years” and greater “perceived importance of incorporating objective structured clinical examination teaching method for learning tobacco intervention.” Students probably could benefit from additional didactic training, but most important may be enhanced clinical experiences and faculty reinforcement to facilitate effective practical student learning and adaptation for future delivery of intervention services in private practice settings.

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