Preventive dentistry: what do Australian patients endorse and recall of smoking cessation advice by their dentists?

Abstract

Objective To investigate patients' views regarding dentists' smoking cessation advice. Design Survey questionnaire. Setting One hundred and thirty five dental practices in Sydney Australia. Subjects Two thousand, four hundred and fifty one dental patients. Results One thousand, one hundred and sixty pre-consultation questionnaires were obtained (RR=80%), 302 (26%) were self-reported smokers. From these, 623 post-consultation questionnaires were returned (RR = 54%). Most patients expected dentists to be interested in their smoking status (n = 847/1160, 73%, 95% CI: 70% to 76%) and to discuss smoking with them (n = 713/1160, 61%, 95% CI: 59% to 64%), however, smokers were significantly less likely to respond as such compared with non-smokers (P < 0.001). Smokers and non-smokers equally would not change dentist even if asked about their smoking status opportunistically (59% versus 62%) (OR = 0.91, 95% CI: 0.67 to 1.22). Less than one third of all smokers would try to quit if their dentist suggested they do so (n = 90/302, 30%, 95% CI: 25% to 35%). Smokers' recall of quit advice from their recent consultation was low (n = 22/124, 18%). Conclusions Smoking cessation advice by dentists is not self-evidently effective. These findings behove interventional research to ascertain efficacy of smoking cessation advice delivered by dentists before admonishing changes in routine clinical practice.Results from studies examining whether dentists are effective in assisting their patients who smoke to quit are inconclusive. In one randomised controlled trial, advice by dentists in Indianapolis (n = 54) achieved sustained patient quit rates of 7.7% enhanced by their use of nicotine gum. 1 However, three other well-designed studies failed to demonstrate significant results. 2-4 Specifically, a randomised controlled trial in Finland of a comprehensive intervention comprising annual inquiries of adolescents about their smoking, photographs of the harmful

Patients' knowledge and views about the effects of smoking on their mouths and the involvement of their dentists in smoking cessation activities

“…There was little change in patient knowledge between the study of Rikard-Bell in 2003 5 and the present study, with the exception of an improvement from 74% to 85.5% in relation to oral cancer and from 49% to 59% in associating poor wound healing with smoking. The present study shows some contrasts to that of Al-Shammari in 2006, 8 with an increased awareness of the effect of smoking on oral cancer and wound healing in our study group.…”

“…[4][5][6][7][8] The questions concerned socio-demographic characteristics, smoking status, knowledge about the effects of smoking on general and oral health, and patients' attitudes about the involvement of their dentists in smoking cessation activities.…”

Patient demand for smoking cessation advice in dentist offices after introduction of graphic health warnings in Australia

“…However, of the dentists who indicated an interest in participating, 58 per cent responded, which was a response rate similar to Rikard-Bell's study. 17 Due to the methodology applied there is no way of gauging a response rate for the patients, but the size of the population (n = 800) was reasonable and their responses to major variables compared favourably to known major studies. Thus, the gender distribution in the population (more women than men) was typical for studies of dental patients.…”

Poor patient awareness of the relationship between smoking and periodontal diseases

“…One study 47 investigated patients' views regarding dentists' smoking cessation advice showed that most patients (61%) would not change dentists if questioned about their smoking status regularly. This could allay any fears dentists might have of alienating patients or interfering with the dentist-patient relationship.…”