Dentists’ Self-Perceived Role in Offering Tobacco Cessation Services: Results From a Nationally Representative Survey, United States, 2010–2011

Abstract

IntroductionDental visits represent an opportunity to identify and help patients quit smoking, yet dental settings remain an untapped venue for treatment of tobacco dependence. The purpose of this analysis was to assess factors that may influence patterns of tobacco-use–related practice among a national sample of dental providers.MethodsWe surveyed a representative sample of general dentists practicing in the United States (N = 1,802). Multivariable analysis was used to assess correlates of adherence to tobacco use treatment guidelines and to analyze factors that influence providers’ willingness to offer tobacco cessation assistance if reimbursed for this service.ResultsMore than 90% of dental providers reported that they routinely ask patients about tobacco use, 76% counsel patients, and 45% routinely offer cessation assistance, defined as referring patients for cessation counseling, providing a cessation prescription, or both. Results from multivariable analysis indicated that cessation assistance was associated with having a practice with 1 or more hygienists, having a chart system that includes a tobacco use question, having received training on treating tobacco dependence, and having positive attitudes toward treating tobacco use. Providers who did not offer assistance but who reported that they would change their practice patterns if sufficiently reimbursed were more likely to be in a group practice, treat patients insured through Medicaid, and have positive attitudes toward treating tobacco dependence.ConclusionFindings indicate the potential benefit of increasing training opportunities and promoting system changes to increase involvement of dental providers in conducting tobacco use treatment. Reimbursement models should be tested to assess the effect on dental provider practice patterns.

Dental Practitioners and Smoking Cessation in Ireland

“…This figure is even lower than that reported recently, which indicated that 11% of smokers receive cessation information from their dentists 11 . In the USA, where smoking cessation services in dental practices are much more established, the rate of referral to specialist services and/or offering cessation prescriptions can be as high as 35% 12 . Higher figures such as these indicate that implementing a smoking cessation referral system among the dental community in Ireland is a worthwhile and achievable goal.…”

Challenges to be overcome: Current situation involving smoking cessation in Dental setting

“…Tobacco use is associated with several oral diseases such as periodontal disease, tooth loss, an unsatisfactory response to implants, gingivitis and oral cancer. However, the potential of these professionals in tobacco use control during daily clinical practice remains an unexplored field [7,[17][18][19][20][21].…”

“…In this respect, the possibility of tobacco-dependence education will extend the quality and quantity of interventions and monitoring [7,[9][10][11][12][13]24,28,31,32,[38][39][40].…”

“…The minimum approach or intervention recommended by the WHO is based on the 5 A's intervention (ask, advise, assess, assist, and arrange). This method is indicated for all healthcare professionals and might be the starting up moment of contact with the patient, permitting the initial motivation on tobacco use cessation [5][6][7].…”

“…In the last years, several studies using questionnaires on tobacco cessation measures applied to dentists have been published [7,[9][10][11][12][13][14][15]. These studies have shown that, although dentists agree that smoking is an important risk factor for oral diseases including oral cancer, they are not prepared to treat patients because of lack of knowledge or desire to do so and approaches could therefore be more efficient [7,[9][10][11][12][13][14][15][16]. The arguments reported by dentists include the lack of training and time, the view that they would not be able to convince their patients to quit smoking, the fear of disturbing the patient who could be not interested on smoking cessation and the lack of reimbursement by the health system for more complex care.…”