The effect of training on the use of tobacco-use cessation guidelines in dental settings

Abstract

Background An increase in the number of dentists conducting tobacco-use cessation treatment is needed. The authors assessed the effects of high-intensity training (HIT) or low-intensity training (LIT) and reimbursement on general dentists’ tobacco-use–related attitudes and treatment behaviors. Methods The authors randomly selected 265 dentists in three states and assigned them to one of five groups: HIT workshop groups with and without tobacco-use cessation counseling reimbursement, LIT mailed self-study groups with and without reimbursement or a control group. Outcomes at follow-up were dentists’ self-reported tobacco-use–related attitudes and behaviors and patients’ reports of dentists’ behaviors. Results Significantly more dentists in the intervention groups reported having positive attitudes and behaviors at follow-up than did dentists in the control group. Dentists in the HIT groups, however, reported assessing patients’ willingness to quit and assisting them with the quitting process significantly more often than did dentists in the LIT groups. Significantly more patients of dentists in the intervention groups who used tobacco reported receiving advice and assistance from their dentists than did patients of dentists in the control group. Adding reimbursement to HIT or LIT conditions did not provide additional intervention effect. Conclusion Dentists trained by means of a workshop or self-study program used components of a recommended guideline more frequently and felt more positive toward tobacco-use cessation counseling than did dentists in the control group. Clinical Implications Although the workshop training was more successful than the self-study training, the latter’s reach among dentists could have a more significant public health impact. The effect of reimbursement needs further study.

Profile of smokers and the role of dentists in tobacco use cessation: a cross-sectional study in southern Brazil

“…Although dentists have the opportunity to inform and motivate their patients to stop smoking, this is not a routine in dental care. The findings of this current study are consistent with the findings of previous works [25,26], showing that patients expect dentists to provide information and advice on smoking, but many people did not receive any information about the damage caused by tobacco use. Major barriers identified by dentists to smoking cessation in the dental setting are lack of reimbursement, time constraints, not knowing where to refer, lack of training and knowledge, and not feeling well prepared and confident for doing so [27,29].…”

Association of Strong Smoke-Free Laws With Dentists’ Advice to Quit Smoking, 2006–2007

“…1–8 Tobacco cessation interventions delivered by dentists during oral examination are associated with cessation. 9–12 Although dentists can effectively promote cessation, particularly when they receive training to do so, 13–17 such practices are not widespread. 18–22 The US Public Health Service clinical practice guidelines promote the 5A’s—ask about tobacco use, advise to quit, assess willingness to make a quit attempt, assist in the quit attempt, and arrange follow-up—as a standard tobacco use intervention.…”

Oral health and tobacco research in the Eastern Mediterranean Region in relation to the Framework Convention on Tobacco Control: a scoping review

“…Another study that assessed progress in implementing article 14 surveyed key stakeholders in 142 countries and showed better implementation in higher-income countries (23). Research suggests that tobacco cessation services by dentists may be as effective as those provided by other health professionals (24,25), and that tobacco control services provided by dentists can be improved with training and have a positive effect on patients who smoke even if they are not paid for this as a patient care service (26,27). Research on tobacco cessation in a dental context in countries of the Region would provide guidance on designing tobacco control interventions to be implemented by dental care personnel.…”