Dentistry's role in tobacco control.

BACKGROUND

Cigarette smoking remains the nation's leading preventable cause of premature mortality. Tobacco use also is responsible for 75 percent of deaths resulting from oral and pharyngeal cancer, more than one-half of the cases of periodontitis and numerous other oral health effects.

METHODS

The author summarized the prevalence of tobacco use in the United States, evaluated recent literature on the status of tobacco control activities in dental schools and dental practice, and reviewed new guidelines on clinical and community-based interventions for tobacco use.

RESULTS

Nearly 25 percent of adults and 35 percent of high-school students smoke cigarettes, and many use other forms of tobacco. More than one-half of adult smokers and nearly three-fourths of adolescents see a dentist each year. However, more than 40 percent of dentists do not routinely ask about tobacco use, and 60 percent do not routinely advise tobacco users to quit. Meanwhile, less than one-half of dental schools and dental hygiene programs provide clinical tobacco intervention services.

CONCLUSIONS

At least 50 dental organizations have adopted policy statements about tobacco use, but much work needs to be done in translating those policy statements into action. Tobacco use remains prevalent in the United States, and dentistry has not yet maximized its efforts to reduce it.

PRACTICE IMPLICATIONS

The recently issued U.S. Public Health Service guidelines on treating tobacco use and dependence provides evidence-based, practical methods for dentists and other primary care providers to incorporate into their practice. Because dentists and dental hygienists can be effective in treating tobacco use and dependence, the identification, documentation and treatment of every tobacco user they see need to become a routine practice in every dental office and clinic.