Can interventions delivered by dental professionals help tobacco users to quit

Carr A, Ebbert J

Published Online:

January 21, 2009

As well as the well-known harmful effects of smoking on respiratory and cardiovascular systems, tobacco use is associated with an increased risk for oral disease, including oral cancer and periodontal disease. Dental professionals are in a unique position to help tobacco users who present for dental care by providing cessation assistance. We identified and pooled six studies that showed a benefit of tobacco cessation counseling by dental professionals. The odds ratio was 1.44 (95% confidence interval 1.16 to 1.78) at 12 months, in favour of counseling, compared with usual care or no contact. The major implications of these findings are for smokeless tobacco users in the dental settings, as we found limited evidence for the effectiveness of similar interventions for cigarette smokers.

Abstract (click to read)

Background:

Tobacco use has significant adverse effects on oral health. Oral health professionals in the dental office or community setting have a unique opportunity to increase tobacco abstinence rates among tobacco users.

Objectives:

This review assesses the effectiveness of interventions for tobacco cessation offered to cigarette smokers and smokeless tobacco users in the dental office or community setting.

Search strategy:

We searched the Cochrane Tobacco Addiction group Specialized Register (CENTRAL), MEDLINE (1966-April 2006), EMBASE (1988-April 2006), CINAHL (1982-April 2006), Healthstar (1975-April 2006), ERIC (1967-April 2006), PsycINFO (1984-April 2006), National Technical Information Service database (NTIS, 1964-April 2006), Dissertation Abstracts Online (1861-April 2006), Database of Abstract of Reviews of Effectiveness (DARE, 1995-April April 2006), and Web of Science (1993-April 2006).

Selection criteria:

We included randomized and pseudo-randomized clinical trials assessing tobacco cessation interventions conducted by oral health professionals in the dental office or community setting with at least six months of follow up.

Data collection and analysis:

Two authors independently reviewed abstracts for potential inclusion and abstracted data from included trials. Disagreements were resolved by consensus.

Main results:

Six clinical trials met the criteria for inclusion in this review. Included studies assessed the efficacy of interventions in the dental office or a school community setting. All studies assessed the efficacy of interventions for smokeless tobacco users, one of which included cigarettes smokers. All studies employed behavioural interventions and only one offered pharmacotherapy as an interventional component. All studies included an oral examination component. Pooling of the studies suggested that interventions conducted by oral health professionals increase tobacco abstinence rates (odds ratio [OR] 1.44; 95% confidence interval [CI]: 1.16 to 1.78) at 12 months or longer. Heterogeneity was evident (I2 = 75%) and could not be adequately explained through subgroup or sensitivity analyses.

Authors' conclusions:

Available evidence suggests that behavioural interventions for tobacco use conducted by oral health professionals incorporating an oral examination component in the dental office and community setting may increase tobacco abstinence rates among smokeless tobacco users. Differences between the studies limit the ability to make conclusive recommendations regarding the intervention components that should be incorporated into clinical practice.

This record should be cited as:

Carr A, Ebbert J. Interventions for tobacco cessation in the dental setting. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD005084. DOI: 10.1002/14651858.CD005084.pub2

Assessed as up to date:

July 8, 2006

Find the research

Get full text at The Cochrane Library

Primary Review Group:

Tobacco Addiction Group

Health topics:

Lungs & airways > Smoking cessation > Interventions by specific providers

Tobacco, drugs, & alcohol dependence > Tobacco > Interventions by specific providers

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Can interventions delivered by dental professionals help tobacco users to quit

More like this

Copyright © 2012 - The Cochrane Collaboration