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| EDITORIAL |
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| Year : 2019 | Volume
: 11
| Issue : 2 | Page : 71-72 |
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Tobacco Cessation: Right for the Dental Office
Steven R Singer1, Mel Mupparapu DMD, MDS, Dipl ABOMR 2
1 Rutgers School of Dental Medicine, Newark, New Jersey, USA
2 Penn Dental Medicine, Philadelphia, Pennysylvania, USA
| Date of Submission | 13-Nov-2019 |
| Date of Acceptance | 20-Nov-2019 |
| Date of Web Publication | 29-Jan-2020 |
Correspondence Address:
Mel Mupparapu
Professor of Oral Medicine, Director of Adiology, Diplomate & Past-President, The American Board of Oral & Maxillofacial Radiology Robert Schattner Center, Suite # 214 240 S 40th Street, Philadelphia, PA 19104
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jofs.jofs_138_19
How to cite this article:
Singer SR, Mupparapu M. Tobacco Cessation: Right for the Dental Office. J Orofac Sci 2019;11:71-2 |
According to the Global Adult Tobacco Survey,[1] the prevalence of tobacco use in India is in the range of 25.0–34.9%. Perhaps of even greater concern is that it has been predicted that 13% of deaths in India in 2020 will be attributable to tobacco use, up from 1.5% in 1990.[2] Tobacco use among men is significantly higher than in women (48% or 197 million men versus 20% or 78 million women), but tobacco use in women is still of considerable concern. These numbers include an appalling 10% of 15 to 17 year olds who use tobacco products. It should be noted that many adult tobacco users started before they turned 18 years old. Most of these people use smokeless tobacco products, including pan masala, snuff, and gutkha.[3],[4] Other commonly used tobacco and tobacco-related products include cigarettes, bidis, betel quid, and cigars. In September 2019 India pre-emptively banned vaping products, also known as e-cigarettes.
Government efforts, including the e-cigarette ban, as well as tobacco cessation initiatives have made some progress in getting Indians to quit tobacco use. These include smoking bans in public areas, outlawing tobacco sales to those under 18 years of age, warnings placed on tobacco product packaging, limiting advertising, and the support of tobacco cessation clinics.However, much more needs to be done on other fronts.
Among patients who visited a healthcare provider, 46% of patients reported being asked about tobacco use and 53% were advised to quit.[1] In dental offices, this number could be 100%.
Periodontal disease, tooth loss, cardiovascular disease, submucous fibrosis, carcinoma of the hard palate, and other oropharyngeal malignancies are all known sequelae of tobacco use. Routine dental treatment is compromised from its onset by tobacco use. Periodontal treatments, implant placement, restorative care, and surgeries are more prone to early failure when the patient is a tobacco user.
Since many tobacco-related conditions can be observed and diagnosed during dental examination and treatment, oral healthcare professionals can be at the forefront of outpatient tobacco cessation services. Effective interventions exist, including supportive counseling and pharmacologic aids. All of these can easily be incorporated into dental office routine.[5] Patients are seen in dental offices on a regular basis and many patients are seen frequently.[6] Initial diagnosis of tobacco use is made by the dentist, followed by appropriate advice on quitting and possible prescription of nicotine replacement therapy, bupropion, and varenicline. These pharmacologic agents have been demonstrated to improve both the chances of quitting tobacco as well as remaining tobacco free over time.[7] Assistants and hygienists may provide the supportive counseling to help patients maintain a tobacco-free life. Although brief interventions have some measure of effectiveness, longer and more informative interactions may have a longer lasting effect.
Perhaps the best thing that can be done for patients is to prevent them from even starting to use tobacco. Dentistry has a long tradition of prevention, as seen with oral health home care instruction. A few minutes spent discussing the benefits of a tobacco-free life can be lifesaving in the long run.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | |
| 2. | Shimkhada R, Peabody JW. Tobacco control in India. Bull World Health Organ 2003;81:48-52.  |
| 3. | New Delhi: Ministry of Health and Family Welfare, Government of India; 2010. International Institute for Population Sciences (IIPS), Mumbai. Global adult tobacco survey India (GATS India), 2009-2010. |
| 4. | Chaly PE. Tobacco control in India. Indian J Dent Res. 2007;18:2-5. DOI:10.4103/0970-9290.30913 |
| 5. | Seidman DF, Covey LS. Helping the hard-core smoker: a clinician’s guide. Mahwah, NJ, Lawrence Ehrlbaum Associates, Inc., 2010 |
| 6. | Oberoi SS, Sharma G, Nagpal A, Oberoi A. Tobacco cessation in India: how can oral health professionals contribute? Asian Pac J Cancer Prev 2014;15:2383-91. DOI: 10. 7314 /apjcp.2014.15.5.2383 |
| 7. | Levy JM, Abramowicz S. Medications to assist in tobacco cessation for dental patients. Dent Clin North Am 2016;60:533-40. doi: 10.1016/j.cden.2015.11.010. Epub 2016 Jan 26 |
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