Passive Smoking and Dental Caries in Children Davies JAMA. 2003; 289: 2940 Tobacco use is the root of many oral health problems, including tooth-loss, jawbone loss and periodontal diseases. Half the cases of adult periodontitis are attributable to smoking. 1 Moreover, tobacco use impedes the effectiveness of periodontal therapy, dental implants, and wound healing. 1 Worst of all, smoking a pack of cigarettes a day or using smokeless tobacco quadruples the risk of developing oral cavity or oropharyngeal cancer, which kills 49% of its victims within 5 years of diagnosis. 2,3 The most significant risk factor in the development and progression of periodontal disease. Major risk factor for oral and pharyngeal cancer.
Treating Tobacco Use and Dependence p 63 Kattyapong, et al 2002
Leukoplakia is a precancerous lesion that develops on the tongue or the inside of the cheek as a response to chronic irritation. Leukoplakia is primarily a disorder of the mucous membranes of the mouth, caused by irritation. Lesions usually develop on the tongue, but they may also appear on the insides of the cheek. Irritation may result from smoking or other tobacco use (smoker's keratosis). Pipe smoking involves a high risk for development of leukoplakia, as does holding chewing tobacco or snuff in the mouth for a prolonged period of time. Like other mouth ulcers , leukoplakia may become a cancerous lesion. The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called &quot;gingivitis.&quot; In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place. When gingivitis is not treated, it can advance to &quot;periodontitis&quot; (which means &quot;inflammation around the tooth.&quot;) In periodontitis, gums pull away from the teeth and form &quot;pockets&quot; that are infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body's enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed. Black hairy tongue: An overgrowth of bacteria normally present in the mouth may cause discoloration of the tongue. These bacteria can accumulate on the hairlike projections (papillae) of the tongue. Some types of bacteria and yeast make red blood cell pigments (porphyrins), which give the tongue a black color. Also, the papillae may sometimes grow profusely, causing the tongue to look as though hair covers it. Smoker’s Palate Inflamed, highlighted ducts of Salivary Gland s Palatal submucosa rich in minor Salivary Gland s Diffuse white mucosal thickening on Hard Palate Pinpoint reddish Papule s on this white background Benign lesions, but predicts other Oral Tumor s
This figure helps to represent the target of this initiative and shows that without this new tool there is an expected decline in the number of dental hygienists who screen patients regarding tobacco use.
Helping Patients to Quit Using Tobacco Hill Air Force Base Dental Clinic August 11, 2005 Isa Kaluhikaua, CHES Davis County Health Department Bureau of Health Promotion 451-3398 [email_address]
Even brief advice to quit by a clinician results in greater
quit rates. Smokers cite a clinician's advice to quit as an
important motivator for attempting to stop smoking.
Advice should be:
Specific to the individual 's own situation (e.g. oral health
condition, family status, costs of tobacco).
ADVISE cont. “ I can’t see what tobacco is doing to your heart, lungs, brain and other organs, but I would like to show you some changes in your mouth .” Gingival recession Gingivitis Leukoplakia Oral Cancer Periodontitis, Stained teeth Nicotine Stomatitis “Smoker’s Palate” Black, hairy tongue
Have patient fill out the Utah Tobacco Quit Line Fax Referral Form.
1. Clinician writes name on item 1 of the form.
2. Patient fills out items 2-12.
3. The client must sign the form.
ASSIST cont. NO If the patient does not want to fill out the form, give the patient the Quit Line's toll free telephone number (1-888-567-TRUTH) or offer a Utah Tobacco Quit Line card so that the patient can contact the Quit Line when they are ready.