IQ healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Community Dent Oral Epidemiol. 2010 Oct;38(5):470-8. doi: 10.1111/j.1600-0528.2010.00553.x.
Smoking influences oral health in several ways (such as the occurrence of periodontitis, teeth discolouration and oral cancer); therefore, smoking behaviour should be addressed in dental care. Dentists can play a role in primary and secondary prevention of tobacco dependence. They see their patients repeatedly over time. This study investigates whether oral health complaints can be seized as an opportunity to start smoking cessation counselling.
A structured patient questionnaire in a sample of 1101 smokers (52.1% women, mean age 40.4 years) in a convenience sample of 87 primary care dental practices. The I-change model was used to describe factors influencing behavioural change. Dependent factors such as intention to quit smoking and related factors (attitude, social support and self-efficacy) were analysed in relation to independent factors such as oral health complaints (gingiva problems, gingiva inflammation, oral cancer and discoloured teeth) using a general linear model (univariate analysis), multinomial logistic regression analysis and multiple linear regression analysis.
A total of 56.3% had discoloured teeth, 27% of the smokers had a problem with their gums and 15.7% had gingiva inflammation. We found no direct relation between oral health complaints and the intention to quit smoking. However, teeth discolouration was positively related to attitudes towards smoking cessation [β, Confidential interval (95%); 1.92 (1.45-2.40 for advantages and -0.86(-1.18 to -0.53) for disadvantages] and negatively to self-efficacy regarding quitting [-2.69 (-3.49 to 1.88)].
We found no direct relation between oral health complaints and the intention to quit smoking, but oral health complaints and especially teeth discolouration were related to factors influencing the quit intention. Patients with discoloured teeth are more likely to have a positive attitude towards smoking cessation but are uncertain to persist smoking cessation. It is suggested that teeth discolouration can be a good entrance for addressing smoking cessation in daily dental practice.
吸烟通过多种方式影响口腔健康（例如牙周炎、牙齿变色和口腔癌的发生）；因此，应在口腔保健中解决吸烟行为。牙医可以在烟草依赖的初级和二级预防中发挥作用。他们随着时间的推移会反复看到自己的患者。本研究调查口腔健康问题是否可以作为开始戒烟咨询的机会。
在 87 家初级保健牙科诊所的便利样本中，对 1101 名吸烟者（52.1%为女性，平均年龄 40.4 岁）进行了一项结构化的患者问卷调查。使用 I-change 模型来描述影响行为改变的因素。使用一般线性模型（单变量分析）、多项逻辑回归分析和多元线性回归分析，分析依赖因素（如戒烟意愿）和相关因素（态度、社会支持和自我效能）与独立因素（如牙龈问题、牙龈炎症、口腔癌和牙齿变色）之间的关系。
共有 56.3%的人牙齿变色，27%的吸烟者有牙龈问题，15.7%的人有牙龈炎症。我们没有发现口腔健康问题与戒烟意愿之间存在直接关系。然而，牙齿变色与戒烟的态度呈正相关[β，置信区间（95%）; 1.92（1.45-2.40 为优势，-0.86（-1.18 至-0.53）为劣势]，与戒烟的自我效能呈负相关[-2.69（-3.49 至 1.88）]。
我们没有发现口腔健康问题与戒烟意愿之间存在直接关系，但口腔健康问题，特别是牙齿变色，与影响戒烟意愿的因素有关。牙齿变色的患者更有可能对戒烟持积极态度，但不确定是否能坚持戒烟。建议牙齿变色可以作为日常牙科实践中解决戒烟问题的一个切入点。
