Clean and Protect My Mouth

Westdene Dental

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- Mandy Knowles, Personnel Manager, Brighton.
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Stop Smoking

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There are approximately 13 million adult smokers in the UK – 28 percent of the population. It is estimated that about 4million smokers a year attempt to quit the habit but of these only about five percent are successful.

The damaging and harmful effects of tobacco on oral health and the mouth tissues are now well documented. The main deleterious effects on the mouth are:
  • An increase in the number of patients with gum disease
  • The link between tobacco use of any kind with oral malignancy (cancer).

Smoking leads to the discolouration of teeth. It is likely to cause halitosis (bad breath) and may affect smell and taste. Wound healing takes longer for tobacco smokers. There is significant evidence that tobacco use contributes to the progression of periodontal (gum) disease. Treatment for periodontal disease often fails among smokers and it is difficult to halt the progression of the disease, which results in the destruction of the soft and hard tissues holding the teeth in place. For similar reasons dental implants fail twice as often in people who smoke compared with non-smokers.

Seventy-five percent of oral cancers are linked with tobacco smoking (ie cigarette, pipe or cigar smoking) especially when combined with heavy alcohol intake. The risk of developing oral and pharyngeal (throat) cancers is similar for cigarette and cigar smokers, with an overall risk seven to ten times greater than for people who have never smoked. When the frequency of daily tobacco use is taken into consideration there is a strong relationship between smoking rates and the risk of mouth cancer.

After giving up tobacco for a decade or so the risk of oral cancer of a past smoker drops significantly to levels almost comparable to people who have never smoked.

Dependence on tobacco shows many features of a chronic disease. People who regularly smoke are addicted to the habit because tobacco use results in true drug dependence. Only a small minority are able to stop smoking in one attempt and the majority will need some assistance to quit altogether. Many effective treatments are now available and dentists and their team members are becoming more actively involved in helping patients to stop smoking.

As with other chronic diseases, the most effective treatment of smoking requires several approaches in addition to the willpower of the smoker and the advice of a clinician. Many products available in high street chemists are proven to be effective and improve the success rates for people quitting smoking. Nicotine replacement therapy (NRT) is the first line of treatment. Several products are available; patches, gum, lozenges, inhalers and nasal sprays. All of these are currently available on prescription from a general medical practitioner or through pharmacists.

Other non-nicotine alternatives are also available to assist with smoking cessation. Both forms of treatment offer very significant success in the fight to quit smoking. In attempting to help a smoker who is willing to quit, a dentist will have the five ‘A’s’ in mind. He or she will:
  1. Ask about tobacco use
  2. Assess the patients desire to quit
  3. Advise those unwilling to quit that the topic will be revisited at their next dental appointment
  4. Assist in the attempt to stop – set a quit date, emphasise the importance of total abstinence, provide supplementary material, and recommend support from a doctor or tobacco counsellor (smoker’s clinic)
  5. Arrange a follow-up dental appointment to monitor the patients attempt to quit